A Clinical Report of Anesthetic Management on the Patient with Complete Left Bundle Branch Block / 대한마취과학회지

A 42-year-old woman who has had the past history of heart failure due to the congestive cardiomyopathy, was scheduled to he taken abdominal hysterectomy. Preoperative electrocardiography showed complete Left Bundle Branch Block(LBBB) without any subjective symptom. The anesthetic managements, pre- and post-operative, as well as intra-operative, were satisfactory.

Anesthetic Management for the Resection of Pheochromocytoma / 대한마취과학회지

Inhalation anesthetics, particularly the hydrocarbons and cyclopropane. lower the threshold to the arrhythmogenic activity of catecholamines. This interaction is of concern during the resection of a pheochromocytoma when the surgically-induced release of large amounts of norepinephrine and epinephrine from tumors sets the stage for ventricular arrhythmia by a direct effect on the myocardium together with an increase in blood pressure. In this communication, anesthesia was performed with N2,O-O2,-halothane. In addition patient was managed successfully, using d-tubocurarine, phentolamine (Regitine) and propranolol (Inderal). For the next same case, enflurane is recommended because of absence of flammability, arrhythmogenic activity and nephrotoxity. etc.

Trends of Anesthetic Managements in 20 Years / 대한마취과학회지

The anesthetic experience in 20 years was evaluated by statistically analyzing the total of 17,595 cases which were performed at S.N.U.H. from 1960 through 1979 according to age, sex, anesthetic agents and methods. To simplify the analysis, the authors selected the anesthetic cases of 1960, 1965, 1970, 1975, and 1978. The results were as follows: 1) General anesthesia has been used with increasing frequencies and local anesthesia with decreasing frequencies during the period. 2) More than half of the totaI cases were performed for the patients in their second or third decades. 3) General surgery cases were the majority of the total. 4) The usage of halothane has been increased ever since its introduction into clinical anesthesia in this hospital. 5) For intravenous induction, thiopental has been used as the main agent, and succinylcholine and pancuronium as the major muscle relaxants since 1975. 6) For anesthetic technique, semiclosed circle absorption system has been employed in almost all cases, and non-rebreathing system has been used recently with increasing frequencies in pediatric anesthesia.

An Experimental Study on the Effects of Operation Sites on Respiratory Functions in the Postoperative Period / 대한마취과학회지

The site of operation is one of the most significant factors affecting the degree of decreased respiratory function and arterial hypoxemia in the postoperative period. To elucidate the relationship between the site of operation and the postoperative hypoxemia, the authors have performed pre-and post-operative arterial blood gas analysises on the 1st POD through the 4th POD on 30 subjects. The experiment was performed on 3 groups, each of which consisted of 10 subjects; an upper abdominal surgery group, lower abdominal surgery group and extremity surgery group. We have selected only those who have had no preoperative cardiopulmonary problems and excluded those who have developed such complications. The results were as follows; 1) In the upper abdominal surgery group, all postoperative PaO2, values were found to be decreased significantly. 2) In the lower abdominal surgery group, only the 2nd POD PaO2 value was found to be significantly decreased. 3) No demonstrable postoperative change of PaO2, was noted in the extremity surgery group.

An Experimental Study on Changes of AaDO2 after Open-Heart Surgery / 대한마취과학회지

Changes of alveolar-arterial oxygen tension differences (AaDO2) after 35 cases of open heart surgery were evaluated with durations of extracorporeal circulation and prognosis. Following results were obtained. 1) AaDO2 values of pre-bypass in fatal open great cases were higher than in survival cases. 2) AaDO2 values of post-bypass were similar and noted no correlation to progonsis. 3) Luration of extracorporeal bypass time in fatal cases were longer than in survival cases. 4) Changes of AaDO2 values after extracorporeal circulation were much correlated to AaDO2 of pre-bypass than those of post-bypass.

An Experiment on Intraoperative Autotransgusion and Normovolemic Hemodilution with hartmann`s Solution and Rheomacrodex / 대한마취과학회지

We had recently 10 cases of intraoperative autotransfusion with arterial blood and concomitantly normovolemic hemodilution with Hartmanns solution and Rheomacrodex which amount 6 d to half the removal of arterial blood through a cannulated radial artery. We observed mean arterial pure, heart rate, central venous pressure, hematocrit and arteriovenous oxygen content difference compared to controls, just after removal of arterial blood with concomitant hemodilution and after autotransfusion. There were no changes of the above observations except for hematocrit values during the experiment. We recommend intraoperative autotransfusion with arterial blood and normovolemic hemodilution as a safe technique.

A Clinical Study on Haloperidol and Diazepam as Premedieants / 대한마취과학회지

One hundred patients, scheduled to receive operations under spinal anesthesia with tetracaine, were premedicated with haloperidol (Serenace, 0. 08mg/kg I.M.) or diasepam (0.3mg/hg LM.) and evaluated for effects of these premedicants in Seoul National University Hoapital. The results were as follows: 1) Haloperidol was superior to diaxepam in poetoperative antianxiety and analgesic effects. 2) Haloperidol and diasepam were equal in their antiemetic effects. 3) Both haloperidol (0. 04 mg/kg) and diaaepam (0. 1mg/kg) as an intravenous bolus were effective for sedation during operation. Patients given haIoperidol, however, were more cooperative to anesthesiologists and surgeons than were those given diazepam.

An Experimental Study on the Mechanism of Respiratory Stimulation by Remeflin® / 대한마취과학회지

To ten male volunteers, 25 to 35 years old and without any known disease, physiological saline solution (placebo) 1 ml, morphine 10mg, and Remeflin 16 mg were administered intramuscularly. Effects of tbese agents upon ventilation at rest and respiratory response to carbon dioxide rebreathing were studied. The results are as follows: 1) Morphine significantly decreased respiratory rate, minute volume, and Pao2 and increased Paco2 without significantly affecting either tidal volume or arterial pH. 2) In morphine-induced respiratory depression, Remeflin improved ventilation by significantly increasing tidal volume and minute volume with resultant increase in Pao2 and decrease in Paco2, Remeflin did not significantly alter respiratory rate and arterial pH 3) Morphine displaced respiratory response curve to carbon dioxide obtained with placebo 7 torr to the right and Remeflin 6 torr to the left. No changes in slope of the curves were observed. 4) It is concluded that Remeflin stimlulatea respiration by directly acting upon the respiratory center.

An Experimental Study on Cardiovascular Responses and Hepatie Functions by the Intravenous Anesthetic Agent-a Home Product Thiopental Sodium (Thiotal) / 대한마취과학회지

Blood pressures and heart rates were recorded with Twin-Viso (Sanborn, USA) for comparative estimations of cardiovascular responses by injection of intravenous anesthetic agents-2.5% solution of Pentothal Sodium (Abbott Laboratory, USA) and Thiotal (Samsung Pharmaceutical Co., ROK) mongrel dogs. Dogs were evaluated the hepatic function by biochemical studies of blood such as total protein, albumin, total bilirubin, direct bilirubin, thymol turbidity test, alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGOT). Liver biopsies were performed in dogs for identifications of hepatic darnages by injection of the above barbiturates, The following results were observed: 1) It was observed the remarkable negative inotropic effect in myocardium of the mongrel dogs intravenously injected with 20 mg/kg of the above barbiturates for three minutes (Table 7, Fig. 8) 2) It was noted slight negative inotropic effect in mongrel dogs intravenously injected with 10 mg/ kg of the above barbiturates for thirty seconds (Table 8, Fig. 8). 3) It was more shorter recovery time from negative inotropic effects in mongrel dogs injected with Thiotal than in the dogs injected with Pentothal Sodium. 4) It was noted no significant changes in pathological studies of Hematoxylin-Eosin stained liver specimen and liver function studies of the blood by biochemical analysis in mongrel dogs intravenously injected everyday with 10 mg/kg of the above barbiturates. 5) It was noted slight changes in mongrel dogs injected with 20 mg/kg of the above barbiturates on TTT, Alkaline Phosphatase, SGOT and SGPT as biochemical analysis in comparing with controI values. These values, however, were not concided with the pathological findings of HematoxyIin-Eosin stained liver biopsy specimen. The facts explain to be inquired into further investigations in the pathological and biochemical aspect.

Clinical and Laboratory Evaluation of Mechanical Ventilation in Acute Respiratory Insufficiency / 대한마취과학회지

Femoral arterial blood had been analyzed for pCO2 and pH by Astrup technique in 10 comatose patients with respiratory insufficiency due to acute drug intoxication, all of whom eventually recovered. It was found that blood gas analysis did not always surpass clinical judgement as to the efficiency of mechanical ventilation. The readers are reminded of the difference between in vitro and in vivo CO2 titration curves of human blood in acute respiratory acidosis.