A Modification of Transaortic Celiac Plexus Neurolysis; One Needle, Periaortic Block: A case report / 대한마취과학회지

Celiac plexus neurolysis is performed to relieve intractable upper abdominal pain. Since Kappis had performed splanchnic nerve block in 1919, many methods and its modifications of celiac plexus block have been introduced. In 1983, Ischia and in 1990, Lieberman has introduced the transaortic technique of celiac plexus block. We employed a transaortic approach with some modification of the original method in 12 patients, in which a single needle was advanced from a left posterior paramedian approach through the aorta to deposit the drug directly onto the celiac plexus. After needle has punctured anterior wall of aorta, 50% alcohol 20ml was injected and after retracting the needle to the posterior wall of aorta, also 50% alcohol 20ml was injected. 11 patients experienced marked pain relief and no major complication was encountered. The authors think that our method has some theoretical benefits in effectiveness than the original transaortic method.

A Case of Anesthetic Management for Moderate Tetanus / 대한마취과학회지

Pulmonary edema is a recognized comphcation of acute airway obstruction. When pulmonary edema occurs, it usually follows relief of obstruction and is likely to be of noncardiogenic origin. We present a case of noncanhogenic pulmonary edema that occured in a ncy woman who was transfered to our hospital, because of endotracheal intubation failure and unrelieved bronchospasm, during general anesthesia for Cesarian section.

A Case Report of Tracheo-esophageal Fistula Discovered During General Anesthesia / 대한마취과학회지

A 69 years old, otherwise healthy male pt. was admitted and soheduled for subtotal gastrectomy under the Dx. of stornach Ca. The induction of anesthesia and beginning of Operation were smooth and unevntful. After peritoneal opening, the surgeon complained of distended stomach which was synch- ronous with ventilation. With repeating tracheogram and endoscopic examination, the authors fecund unsuspected tracheo-esophageal fistula on the low-middle esophagus. Durins convalescenee the pt, had not suffered any pulmonary complication.

Effect of Unilateral Lung Collapse and One-Lung Ventilation on Pulmonary Hemodynamics and Shunt Ratio in Dogs / 대한마취과학회지

One-lung ventilation (anesthesia) has been indicated for certain intrathoracic surgery. However the recommended oxygen concentrations and ventilatory patterns have been variously reported. To clarify this, the author has investigate the effect of left lung collapse and right lung ventilation with relatively large, constant tidal volume of 100% oxygen on pulmonary homodyamic and shunt ratio in 10 mongrel dogs with their left main bronchi ligated and cut following thoracotomy under Pentothal anesthesia. The results are as follows: 1) Heart rate, mean arterial pressure, central venous pressure, and pulmonary capillary wedge pressure did not change significantly. 2) Mean pulmonary artery pressure and pulmonary vascular resistance increased significantly during one-lung ventilation. 3) Cardiac output decreased slightly, and alveolar-arterial oxygen tension difference and pulmonary shunt ratio increased significantly. However arterial oxygen and carbon dioxide tensions remained in the normal range. It is concluded that to maintain noramil arterial oxygen and carbon dioxide tensions during one-lung ventilation, it is mandatory to ventilate with relatively large, constant tidal volume of 100% oxygen and all measures and precautions should be exercised to maintain normal cardiac output.

A Clinical Study Anesthesia for Renal Transplantation / 대한마취과학회지

This report is 5 anesthetic experiences of renal transplantation performed from October 1972 to May 1973 at Central Operating Theater, Seoul National University Hospital. The major considerations about renal transplantation are the states of anemia, uremia, acidosis, electrlytes imbalance with hyperpatassemia, hypertension and immunological problems. In anesthetic management, the following must be considered: 1) Operative method. 1. Concomitant transplantation with nephrectomy 2. Transplantation followed by nephrectomy 2) Duration of operation 3) Degree of hypertension 4) Degree of anemia 5) Degree of pulmonary function 6) Intraoperative arterial blood analysis.