A Clinical Study on Anesthesia in Infants and Children with Congenital Heart Disease during Open Heart Surgery / 대한마취과학회지

To evaluate anesthetic experience during open heart surgery, 145 cases of patients under 15kg of body weight from January 1980 to June 1982 were analyzed according to age, sex, technique of anesthesia, anesthetica, premedicants, muscle relaxants, flow rates and mortality. The results were as follows: 1) Premedicants were mainly atropine, meperidine, hydroxyzine, triflupromazine and morphine. 2) Induction agents were thiopental in acyanotic group, but cyanotic group were mainly used ketamine. 3) The inhalation anesthetica that were halothane, methoxyflurane, N@O and enflurane were used in acyanotic group but cyanotic group did not used. 4) Early stage of open heart surgery, gallamine were mainly used but now, pancuronium were used. 5) During cardiopulmonary bypass, the lowest temperature were mean 27 degrees C and flow rate were 80~100ml/kg/m(2). 6) Overall mortality was 17.2%.

Severe Hypotension and Cardiac Arrest following Methylmethacylate Bone Cement during Total Hip Replacement / 대한마취과학회지

Introduction of acrylic cement during total hip replacement has become popular in the las 30 years. Sometimes it precipitates severe hypotension and cardiac arrest, and may be due to toxicity of methylmethacrylae monomer. Fat embolism, air embolism, or neurogenic reflex may be other possible causes of the hypotension. The anesthetist should keep in mind these risk factors, and to prevent these adverse effects, the central venous pressure line, esophageal sterthoscope or Doppler ultrasonic transducer, and adequate fluid volume maintenance are required. We have experienced two cases of complication following bone cement insertion: One case developed severe hypotension and the other case cardiac arrest. The former occured under epidural anesthesia and the latter under general anesthesia after prosthetic implantation in a total hip replacement.

Adult Respiratory Distress Syndrome Following Trauma - Case report / 대한마취과학회지

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.