Distance from Skin in the Lumbar Epidural Space in Korean Adult Male / 대한마취과학회지

The distance fmm skin to the lumber epidural space was measured in 60 male patients receiving epidural analgesia. The mean distance was found to be 4.45cm. The epidural depths were identified most frequently at 4.0 to 4.5cm deep and over 90% of total cases were less than 5.5cm deep. The epidural depths had correlations with weight and PI(P < 0.001), but not correlated with height.

Clinical Study of Ten Cases of Continuous Spinal Anesthesia for Total Hip Replacement / 대한마취과학회지

This study was primarily undertaken to assess the value of continuous spinal anesthesia for total hip replacements (Charnley's low friction arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. The results were as follows: 1. Preoperative diagnosis was in 4 cases hip joint tuberculosis,in 2 cases avascular necreosis, in 2 cases femur fracture, and in 2 cases osteoarthritis of the hip joint. 2. Average blood loss was 2, 800 ml for a one side operation and 5, 000 ml for a bilateral one. Overall average blood loss with continuous spinal anesthesia was 2, 600 ml and with general anesthesia was 1, 725 ml, and with amount of difference being 1. 175 ml more in the spinal anesthesia group (p<0. 025). 3. In 4 eases (40%) the hypotensive range was over 30% of the preoperative level, but recovery occurred soon after administration of Effortil. 4. Practically management of a patient with continuous spinal anesthesia is easier' thai with general anesthesia for total hip replacement, with fieeing of the anesthesio1ogist'a hands for better care of the patient during anesthesia.

A Clinical Study of Cardiac Arrhythmias during General Anesthesia in Patients with Preexisting ECG Abnormalities / 대한마취과학회지

The incidence of cardiac arrhythmias has been studied in 50 unselected surgical patients with preexisting ECG abnormailties preoperatively, by means of continuous monitoring, utilixingan eIectrocardioscope, Burdick CS-515 Monitor, and was recorded by EK-4S ECG, at the Kyung Hee University Hospital, Seoul, Korea. The results are as follows: 1) Among 50 patients, 32 cases (64%) developed a variety of arrhythmias during general anesthesia and operation. It also showed arrhythmias excluding sinus tachycardia in 14 cases. The 28 per cent incidence of arrhythmias was rather high compared with the patient groups without preexisting heart disease or arrhythmias, such as in our previous report in 1972 of 20%, Dodds 19, 9% and Vaniks 16. 3%. 2) The most common arrhythmia seen was sinus tachycardia (26 cases, 65% of the total arrhythmias) and the next one was premature ventrieular contraction. 3) Nine cases (22. 5%) were considered serious in nature, such as premature ventricular contractions. 4) There was an increased incidence of new arrhythmias in the patients in poor general condition. 5) The vast majority of arrhythmias seen during anesthesia, except for 3 cases did not require drug treatment. It is usual to eliminate the cause of the arrhythmia by lowering anesthetic depth, eliminating excess carbon dioxide by hyperventilation and proper oxygenation of the lungs. 6) Constant electrocardiographic monitoring of patients under anesthesia has proven to be valuable adjunct to the administration of clinical anesthesia.

Clinical Study for 20 Cases of Anesthesia for Total Replacement / 대한마취과학회지

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.