Caudal analgesia reduces the sevoflurane requirement for LMA removal in anesthetized children / 대한마취과학회지

BACKGROUND: An anesthetic state can reduce adverse airway reaction during laryngeal mask airway (LMA) removal in children. However, the anesthetic state has risks of upper airway obstruction or delayed emergence; so possibly less anesthetic depth is advisable. Caudal analgesia reduces the requirement of anesthetic agents for sedation or anesthesia; it is expected to reduce the sevoflurane requirement for LMA removal. Therefore, we determined the EC(50) of sevoflurane for LMA removal with caudal analgesia and compared that to the EC(50) without caudal analgesia. METHODS: Forty-three unpremedicated children aged 1 to 6 yr were enrolled. They were allocated to receive or not to receive caudal block according to their parents' consent. General anesthesia were induced and maintained with sevoflurane and oxygen in air. EC(50) of sevoflurane for a smooth LMA removal with and without caudal analgesia were estimated by the Dixon up-and-down method. The LMA was removed when predetermined end-tidal sevoflurane concentration was achieved, and the sevoflurane concentration of a subsequent patient was determined by the success or failure of the previous patient with 0.2% as the step size; success was defined by the absence of an adverse airway reaction during and after LMA removal. EC(50) of sevoflurane with caudal block, and that without caudal block, were compared by a rank-sum test. RESULTS: The EC(50) of sevoflurane to achieve successful LMA removal in children with caudal block was 1.47%; 1.81% without caudal block. The EC(50) were significantly different between the two groups (P < 0.001). CONCLUSIONS: Caudal analgesia significantly reduced the sevoflurane concentration for a smooth LMA removal in anesthetized children.

Treatment Experience with Polymyalgia Rheumatica: A report of two cases / 대한통증학회지

Polymyalgia rheumatica is characterized by bilateral shoulder or pelvic girdle pain, morning stiffness of greater than 45 minutes' duration, constitutional symptoms, an elevated erythrocyte sedimentation rate and a rapid response to prednisolone (< or = 20 mg/day). Although it is not a rare disease, many cases might be neglected and treated inappropriately in pain clinics. We describe here two cases of polymyalgia rheumatica that was neglected and treated inappropriately.

Clinical Application of ThaIamonaI-Pentothal-N2O-O2 Anesthesia / 대한마취과학회지

The authors have introduced a method of Thalamonai dripping with concomitant use of small doses of Pentothal for rapid and smooth loss of consciousness and induction of anesthesia, and maintaining anesthesia with intermittent injections of Thalamonal and Pavulon as well as N2O inhnlation. From 21 cases, the following results were obtained: 1) Average dose of fentanyl as a premedicant was l. 143ug/kg (Thalamonal, 0. 023cc/kg). 2) Average dose of fentanyl during induction of anesthesia was 3. 48ug/kg (ThaJamonal, 0, 695 cc/10kg), and concomitant injection of Pentothal (average, l. 83mg/kg) achieved rapid and smooth induction of anesthesia. During induction, changes of blood pressure and pulse rate were insignificant. 3) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at every 30 minute interval, and average dose of fentanyl was 0.64ug/kg/30min. 4) Seventeen cases among 21 recovered promptly after discontinuation of N2O, and the recovery was delayed in the, remainder. Two patients had awareness without pain during operation, Delayed recovery of consciousness seemed related to overdosage of the droperidol component in Thalamonal, but not to total operating time.

An Experimental Study of the Effects of Muscle Relaxants on the Intraocular Pressure / 대한마취과학회지

Since succinyl choline was introduced, into clinical anesthesia, it has been used as main muscle relaxant because of its rare side effects and short duration of action. Our interest in the effects of this drug on extraocular muscles and intraocular pressure began in 1957 following reports of vitreous expulsion in patients who received succinylcholine during ocular surgery. The effects of muscle relaxants on the intraocular pressure were studied in 60 healthy human subjects. When succinylcholine was given alone, 20 human subjects had a mean increase in intraocular pressure of 10. 5 mmHg. When gallamine 2. 5 mg/kg or pancuronium 80 ug/kg was used, 20 subjects showed a mean decrease of 3. 1 mm Hg from control. Giving gallamine (20 mg) or dtubo curarine(3 mg) 2-3 minutes prior to the administration of succinylcholine, 20 human subjects had no significant change in intraocular pressure. This simple method prevents the increase in intraocular pressure associated with the use of succinylcholine.

Studies on the larval trematodes from brackish water fishes 3. Observation on Pseudexorchis major (Hasegawa, 1935) Yamaguti, 1938

The Parasitological investigation on the encysted metacercariae in brackish water fish, Tribolodon taczanowskii, in the downstream of Hyungsan river which is located in Kyungpook Province of Korea, were carried out serially and the following results were obtained. Metacercariae of Pseudexorchis major were found in six fishes(15.8 per cent ) out of 38 examined. Parasitic frequencies of the encysted metacercaria of Psedexorchis major in Tribolodon taczanowskii were 15.8 per cent (6 out of 38) in the scale, 10.5 per cent (4 out of 38) in the fin, 13.2 per cent (5 out of 38) in the gill, 10.5 per cent (4 out of 38) in the oral cavity and 7.9 per cent (3 out of 38) in the flesh. The worms were identified as Pseudexorchis major (Hasegawa, 1935) Yamaguti, 1938 by morphological studies on the metacercariae, excysted metacercariae, adults and eggs, and compared with prereported Pseudexorchis species.