Experience of Autotransfusion in Spinal Surgery / 대한마취과학회지

Autotransfusion has been used widely in surgical patients for the purpose of preventing complications associated with homologous transfusion. Recently it has been drawing much attention for the fear of transfusion-transmitted disease, especially AIDS. So we studied about the auto-transfusion applied to spinal surgical patients with various combinations of its methods in each patient. We measured perioperative changes of complete blood count associated with autotrans-fusion and the amount of blood salvaged by intra-and postoperative autotransfusion. And we scrutinized the occurrence of complications associated with transfusion. After presurgical blood deposit of 3 units (n=12), hemoglobin and hematocrit levels decreased to 12.0+/-1.2 gm% and 35.5+/-2.6% while the initial levels were 14.0+/-1.1 gm% and 40.6+/-2.8% respectively. The average salvaged blood volume during operation by Cell Saver (Haemonetics, USA) was 300+/-110 ml (n=14) and postoperatively salvaged blood volume using Orth-evac(TM) was 313+/-114 ml (n=14). Of those who received postoperative autotransfusion (n=l4), 2 patients revealed febrile reaction immediately after transfusion, but fever subsided thereafter without specific treatment. In conclusion, autotransfusion was carried out safely in operations when transfusion was expected, and so we recommend autotransfusion as a method of transfusion by which the complications of homologous transfusion can be averted.

Experience of Autotransfusion in Spinal Surgery / 대한마취과학회지

Autotransfusion has been used widely in surgical patients for the purpose of preventing complications associated with homologous transfusion. Recently it has been drawing much attention for the fear of transfusion-transmitted disease, especially AIDS. So we studied about the auto-transfusion applied to spinal surgical patients with various combinations of its methods in each patient. We measured perioperative changes of complete blood count associated with autotrans-fusion and the amount of blood salvaged by intra-and postoperative autotransfusion. And we scrutinized the occurrence of complications associated with transfusion. After presurgical blood deposit of 3 units (n=12), hemoglobin and hematocrit levels decreased to 12.0+/-1.2 gm% and 35.5+/-2.6% while the initial levels were 14.0+/-1.1 gm% and 40.6+/-2.8% respectively. The average salvaged blood volume during operation by Cell Saver (Haemonetics, USA) was 300+/-110 ml (n=14) and postoperatively salvaged blood volume using Orth-evac(TM) was 313+/-114 ml (n=14). Of those who received postoperative autotransfusion (n=l4), 2 patients revealed febrile reaction immediately after transfusion, but fever subsided thereafter without specific treatment. In conclusion, autotransfusion was carried out safely in operations when transfusion was expected, and so we recommend autotransfusion as a method of transfusion by which the complications of homologous transfusion can be averted.

A Case of Withdrawal Symptom after Injection of Nalbuphine in a Chronically Morphine-Dependent Patient / 대한마취과학회지

Nalbuphine, a mixed agonist-antagonist type opioid, can precipitate abstinence syndrome in opioid-dependent patients especially in large doses. We can prevent this syndrome by avoiding the injection of agonist-antagonist type opioid to the patient who already has used opioid for a long time, and the method of relatively small dose increments in its use. We experienced a case of opioid withdrawal symptom in chronically morphine-administered patient via epidural catheter after using intramuscular nalbuphine for analgesia. The symptom was promptly relieved by intravascular morphine injection without any problems.

The Clinical Study of the Method on the Stabilization of the Hemodynamic Response to Tripod Pin Fixation / 대한마취과학회지

We have observed that the tripod pin fixation for craniotomy is frequently accompanied by tachycardia and arterial hypertension, despite an apparently uate depth of general anesthesia beforehand. The method on the stabilization of the hemodynamic response to tripod pin fixation was studied in 73 adult normotensive patients. They were divided into four groups' 1) a control group (C group), 2) a group of bupivacaine loeal infiltration (B group), 3) a group receiving fentanyl 2 mg/kg intravenously (F group), and 4) a group receiving thiopental sodium 3 mg/kg intravenously (T group). Before the tripod pin fixation, we measured systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). After the tripod pin fixation we observed those parameters one minute interval till 7 minutes. B group and F group showed the significant stability of SBP, DBP and MAP in comparision to C group and T group. In the B group, all the parameters returned to pre-pin fixation level rapidly compared to F group. In conclusion, to prevent hemodynamic response to tripod pin fixation, bupivacaine local infilteration method is most effective in this study.