A survey on informed consent process for epidural analgesia in labor pain in Korea / 대한마취과학회지

BACKGROUND: There is a legal obligation to explain the procedure and use of epidural analgesia in labor primarily due to the possibility of potential risks and associated complications. The present study details on the survey carried out to ascertain the current status of obtaining informed consent (IC) for explaining the epidural analgesia in labor. METHODS: The present study is based on a survey through a telephone questionnaire that covered all the hospitals in Korea where the anesthesiologists' belonged to and are registered with Korean Society of Anesthesiologists. The questionnaire included questions pertaining to administration of epidural analgesia to a parturient, information on different steps of obtaining an IC, whether patient status was evaluated, when the consent was obtained, and the reasons behind, if the consent had not being given. RESULTS: A total of 1,434 respondents took part in the survey, with a response rate of 97% (1,434/1,467). One hundred seventy-four hospitals had conducted epidural analgesia on the parturient. The overall rate of obtaining IC for epidural analgesia during labor was 85%, of which only 13% was conducted by anesthesiologists. The rate of evaluating preoperative patient status was 74%, of which 45% was conducted by anesthesiologists. Almost all of the consent was obtained prior to the procedure. CONCLUSIONS: The rate of obtaining IC for epidural analgesia in labor is relatively high (85%) in Korea. However, it is necessary to discuss the content of the consent and the procedure followed for obtaining IC during the rapid progress of labor.

Left Ventricular Rupture Immediately after Mitral Valve Replacement: A case report / 대한마취과학회지

Rupture of the left ventricle is a dreadful complication after mitral valve replacement.It is infrequent but potentially lethal. We have experienced a case of sudden hemorrhagic shock immediately after arriving at intensive care unit postoperatively and revealed left ventricle rupture on resternotomy.The possible mechanism and surgical maneuver are reviewed and the preventive measures in aspect of anesthetic management are discussed.

The Changes of Natural Frequency and Damping Coefficient of Disposable Pressure Transducer according to the Catheter Length and Time Assigned / 대한마취과학회지

BACKGOUND: The accuracy of a disposable blood pressure transducer (DBPT) is determined by its physical properties: natural frequency (NF) and damping coefficient (DC). We planned this study to investigate whether the NF and DC of a DBPT are altered by attaching extended catheters and evaluated changes of these physical properties over time. METHODS: Fifteen DBPT sets were connected to a monitor and recorder set. These sets were divided into three groups; five sets had catheters of normal length (Group 1), five sets had 50 cm extended catheters (Group 2), and five sets had 100 cm extended catheters (Group 3). The NF and DC of each system were measured using the fast flush (FF) test. After the DBPT sets were installed, the FF test was performed for each group at five time intervals: 4, 24, 48, 72, and 96 hours. RESULTS: The NF of Groups 2 and 3 decreased and their DC increased compared to those of Group 1. Whereas the NF of Group 3 increased over time, those of Groups 1 and 2 did not. The DC of Groups 2 and 3 decreased over time, but remained unchanged over time for Group 1. When the FF test was done at intervals longer than 24 hours, it was found that the NF, but not the DC, increased for all groups. CONCLUSIONS: Attention should be paid to interpret blood pressure using DBPTs measured by extended catheters and using DBPTs for long periods of time without FFs.