ABSTRACT
BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Subject(s)
Adult , Child , Female , Humans , Infant , Infant, Newborn , Male , Anesthesia , Cleft Lip , Emergencies , Hernia , Hernia, Inguinal , Infant, Premature , Intussusception , Mortality , Palate , Pharmacology , Physiology , Postoperative Complications , Psychology , Retrospective Studies , Sepsis , Surgery, PlasticABSTRACT
BACKGROUND: Infants are very different from children and adults in the point of anatomy, physiology, pharmacology and psychology. The mortality rate of infant anesthesia is higher than that of child and adult. So that this study is to analyze the infant's operation and to recognize the tendency and problems of infant's anesthesia and also to improve the outcome. METHODS: A retrospective analysis was performed on 1436 infants who had operations from april 1987 to february 1995 according to age, sex, department, disease, operation time, postoperative complications, mortality rate and anesthetic method. RESULTS: Total number of operation tend to increase annually. The male to female ratio was 67.5% to 32.5%. The distribution of patients by department was 60.6% of general surgery, 21.0% of plastic surgery and small percentage of other department. The distribution of disease was the following : inguinal hernia - the most common; cleft lip and palate, intussusception and others. The postoperative complications developed in 98 of 1436. The most common complication was the respiratory problems, the others were sepsis, electrolyte unbalance, gastrointestinal and CNS problems. The total mortality rate was 3.6%. The emergency operation case was 17.9%. CONCLUSIONS: The most common distribution of age was neonate and the most commm department was general surgery and the most common disease was inguinal hernia. The most common postoperative complication was respiratory problems and the second was infection and sepsis. The mortality rate in preterm infant, neonate, emergency operation and long duration operation was higher than total motality rate.
Subject(s)
Adult , Child , Female , Humans , Infant , Infant, Newborn , Male , Anesthesia , Cleft Lip , Emergencies , Hernia , Hernia, Inguinal , Infant, Premature , Intussusception , Mortality , Palate , Pharmacology , Physiology , Postoperative Complications , Psychology , Retrospective Studies , Sepsis , Surgery, PlasticABSTRACT
This report is concerned with our clinical experience of 150 cases of anesthesia for open heart surgery at department of anesthesiology, In chon Gil hospital from Februry, 1990 to April, 1993. The results were as follows ; 1) Among 150 cases, 68 cases (45.3%) were congenital heart disease and 82 cases (54.7%) were acquired heart disease. 62 cases (41.3%) were males and 88 cases (58.7%) were females. 2) Glycopyrrolate, diazepam, morphine, were used as premedicants. 3) Fentanyl, ketamine, diazepam, thiopental sodium were used as induction agents and injected singly or in combination. 4) In congenital cyanotic heart diseases, ketamine was used as main anesthetic agent. In other heart diseases, fentanyl, isoflurane, diazepam were used. 5) Vecuronium was used for intubation and maintenance of muscle relaxation. 6) Overall mortality rate was 3.3% (5 cases) and the causes of death were low cardiac output, respiratory insufficiency, mediastinal infection.
Subject(s)
Female , Humans , Male , Anesthesia , Anesthesiology , Cardiac Output, Low , Cause of Death , Diazepam , Fentanyl , Glycopyrrolate , Heart Defects, Congenital , Heart Diseases , Heart , Intubation , Isoflurane , Ketamine , Morphine , Mortality , Muscle Relaxation , Respiratory Insufficiency , Thiopental , Thoracic Surgery , Vecuronium BromideABSTRACT
This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Subject(s)
Female , Humans , Pregnancy , Apgar Score , Blood Gas Analysis , Blood Pressure , Cesarean Section , Heart Rate , Intraoperative Awareness , Ketamine , Memory , Skin , ThiopentalABSTRACT
Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterized by hyperpyr-exia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. This case is presented of a 32 year old healthy male patient in whom a orthopedic operation was performed under O2-N2O-enflurane anesthesia with induction by pentothal sodium and succinylcholine. One hour after induction, tachycardia developed and was followed by unstable blood pressure, hyperpyrexia, arrhythmia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment was attempted. But the patient died about 4 hours after induction of anesthesia. The etiologic factors, clinical feature, treatment and prevention of malignant hyperthermia are discussed.
Subject(s)
Adult , Humans , Male , Anesthesia , Anesthesia, General , Anesthetics, Inhalation , Arrhythmias, Cardiac , Blood Pressure , Emergency Treatment , Malignant Hyperthermia , Muscle Rigidity , Muscle, Skeletal , Orthopedics , Sodium , Succinylcholine , Tachycardia , ThiopentalABSTRACT
Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterized by hyperpyr-exia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. This case is presented of a 32 year old healthy male patient in whom a orthopedic operation was performed under O2-N2O-enflurane anesthesia with induction by pentothal sodium and succinylcholine. One hour after induction, tachycardia developed and was followed by unstable blood pressure, hyperpyrexia, arrhythmia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment was attempted. But the patient died about 4 hours after induction of anesthesia. The etiologic factors, clinical feature, treatment and prevention of malignant hyperthermia are discussed.
Subject(s)
Adult , Humans , Male , Anesthesia , Anesthesia, General , Anesthetics, Inhalation , Arrhythmias, Cardiac , Blood Pressure , Emergency Treatment , Malignant Hyperthermia , Muscle Rigidity , Muscle, Skeletal , Orthopedics , Sodium , Succinylcholine , Tachycardia , ThiopentalABSTRACT
We studied the cardiovascular and intracranial pressure(ICP) effects of Vecuronium in cats with normal and artificially increased ICP. Under pentobarbital and nitrous oxide anesthesia, monitors for ICP, Mean Arterial Pressure(MAP), Heart Rate(HR), and Central Venous Pressure(CVP) were placed in the cats. The cats were then divided into two groups: one with normal ICP( N-ICP) (n=8) and the other with artificially increased ICP (AI-ICP) (n=8). In the AI-ICP group, a size 8F Foley catheter was placed in the epidural space through a 5 mm trephined hole on the right parietal area. In each group, ICP, MAP, HR, CVP, and Cerebral Perfusion Pressure(CPP) were measured after Vecuronium injection(80ug/kg)(CPP=MAP-ICP). Results showed no statistically significant changes in cats with N-ICP and AI-ICP.