Control of Intraoeular Pressure by Intravenous Lidocaine Pretreatment / 대한마취과학회지

It is a known fact that the increase of intraocular pressure results from the action of succinylcholine, endotracheal stimulation to carina, bucking and coughing etc during the induction arid recovery periods. Efforts have been made by several inveatigators to prevent intraocular hypertension by giving trimetaphan, inderal or curare. However, their effects were not remarkable. In this study, lidocaine Img/tg was administered intravenously to selectee patients 2-3 minutes hefore induction ; followed by regular induction with pentothal, succinylcholine and incubation. Intraocular pressures were measured at the pre-induction and post-intutation time, and every 30 minutes until the early recovery period, thereafter. The result of this study showed that the post-intubational increase of intraocular pressure was prevented in 86.7% of the lidocaine pretreated cases. The increase of post-extuba-tional intraocular pressure was also reduced significantly in the lidocaine pretreated group-as well. We came to the conclusion that lidocaine pretreatment technic can be used effectively to prevent intraocular hyperteilsion caused by induction and extubation in clinical practice.

A Clinical Report on Oxygen Therapy Used Over a 14 Year Period / 대한마취과학회지

Since 1971, (for 14 years) we have run the oxygen therapy unit in the Department of Anesthesiology. During this time, unauthorized personnel have carried out the duties in the unit under the supervision of anesthesiologist. We came to realize the necessity of having educated personnel to do the work in the oxygen therapy unit. 1) Our data on oxygen therapy increases yearly because the use of respiratory care is gradually increasing. 2) The postoperative use of a respirator increases due to the increase of critical surgical patients such as those who have had open heart and cerebral aneurysm surgery. 3) Hyperbaric oxygen treatment has decreased yearly. 4) Oxygen therapy was most frequently used in patients in the first 10 years of life. 5) The cases which had oxygen treatment were: pneumonia, atelectsis, pulmonary edema, CVA, head trauma, Gullian-Barre syndrome, sepsis, asthma and tetanus in that order. 6) Seasonally, the cases were more frequent in the spiring and fall.

A Treatment for Intractable Pain / 대한마취과학회지

Recently, epidural tunnelling was introduced for the convenience of keeping a catheter inserted for a long period of time. We had 15 cases in which used epidural tunnelling for the tratment of intractable pain mainly in terminal cancer patients. Epidural puncture with cannulation was carried out in the same technique as used for epidural anesthesia. After the subcutaneous epidural tunnelling was done from the site of the epidural entry to the anterior chest, just under the skin using a tunnelling device, the catheter was threaded through the tunnelling needle at the sit of the outlet, was fixed and the tip of the catheter was connected to a filter. Five ml(2mg) of saline diluted morphine can be given at home as needed when intractable pain occurs. This long-term treatment of intractable pain by morphine injections through the epidural cannula place by subcutaneous tunnelling, is very convenient for the patient's daily routine and a better alternative in such a situation. Our technique, its advantages and problems were described in this paper.

Arytenoid Fracture and Vocal Cord Granuloma Resulting from Endotracheal Intubation - 2 cases report / 대한마취과학회지

Postoperative hoarsness is a rather common complication resulting from endotracheal intubation. However prolonged hoaraness without organic damage can hardly be seen as a post intubation complication. We have two cases with prolonged hoarsness Postoperatively. The first case, a 50-years old woman, was observed to have an arytenoid fracture and dislocation on the left side after a neck mass was removed under general anesthesia. The second case, a 28-years old woman, was found to have a right vocal cord granuloma in association with progressing hoarsness after a cesarean section was done under general anesthesia. We concluded that the prolonged hoarsness with arytenoid fracture and vocal cord granulom had resulted from the endotracheal intubation.

Etiologie Analyeis of Conjunctival Edema During General Anesthesia / 대한마취과학회지

Conjunctival edema in surgical patients is known to be a complication resulting from various causative factors. We have observed 30 cases during genral anesthesia in the last 5 months. They were analyzed in terms of distribution of age, sex, blood loss, transfusion and appearence of edema during general anesthesia. 1) Ether is known as an anesthetic to cause it. 2) Position of patient (Trendelenburg position). 3) Mechanical disturbance of venous return such as open heart surgery and neck surgery. 4) Continuous positive pressure ventilation. 5) Reduction of plasma oncotic pressure. (l.V. fluid) 6) Circulatory overloading. 7) Miscellaneous local factors. Therefore, conjunctival edema can be avoided by prevention of the above factors.

Analgesic Effect of Demerol Administered in Caudal Space in Anal Surgery / 대한마취과학회지

Epidural and intrathecal injection of narcotics for postoperative pain relief have been well reported. In an attempt to assess the postoperative analgesic effect of demerol in anal surgery, caudal block was carried out with 1.5% lidocaine mixed with demerol 5 mg(Group II) in 15 patients and demerol 1 0 mg(Group II) in 15 patients. As a control group(Group I), 16 patients were injected with 1.5% lidocaine alone in the epidural space for caudal anesthesia. The incidence of postoperative injection of demerol as needed by the patients for pain control were recorded and compared. As a result of this study, the 3rd group in which 10 mg of demerol were used, appeared to have a significantly prolonged analgesic effect and there were no serious complications observed in our experience such as nausea, vomiting or respiratory depression.

Changes of ALP , SGOT and SGPT Levels Following Halothane Anesthesia / 대한마취과학회지

In the present study, an effort was directed to assess the changes of hepatic ensymes according to the exposed in short and long surgical cases under halothane anesthesia. 60 surgical cases were studied in two different group. Halothane anesthesia was given for less than 2 hours in the first group of 30 cases and for more than 2 hours in the second group of 30 cases. The results were compared with the normal values and summarized as follows: In the first group, the changes after halothane exposure for less than 2 hours were negligible. In the second group, SGOT and SGPT were elevated significantly and the number of enzyme-elevated cases were 5~6 greater in group 1.

Cardiac Arrest during Epontol Intravenous Anesthesia / 대한마취과학회지

Epontol is well known as an ultra-short-acting intravenous anesthetic which can be used for minor surgery. This case report is to present the possibility of cardiac arrest while using Epontol in a patient with heart disease because its pharmacological action causes acute hypotension due to myocardial depression and histamine release. This 30 year old female who had a history of rheumatic fever with incomplete RBBB manifested by ECG, was admitted with vaginal bleeding and 500 mg of 5% Epontol was .administered for D % C. The patient appeared to have acute cyanosis immediately after Epontol administeration, followed by cardiac arrest. Despite cardiac resuscitation was performed adequately, the patient remained comatose for 1 year and 4 months and died of respiratory failure with sepsis.

Effect of Acute Alcohol Intoxication on the Hematocrit and Glutathione Levels in the Rat Blood / 대한마취과학회지

Ethyl alcohol is believed to inhibit the secretion of antidiuretic hormone (ADH) from the neurohypohysis, and an increase in urinary volume and reduction in the extracellular fluid volume may follow. In the case of acute alcohol intoxication, the red cells may be exposed. to the increasing level of the blood alcohol, and are in danger of being oxidized and/or hemolysed, for which the blood glutathione may exert a protective action. The aim of this study is to elucidate the acute effect of alcohol on the hematocrit, assuming that the decreased secretion of ADH will result in an increased value of the hematocrit, and also the change of oxidized glutathione (GSSG) and reduced glutatbione (GSH) of the blood following by the adminstration of alcohol. Albino rats were used throughout the experiment, and a rat was given 50% ethyl alcohol in the dose of l. 5 ml per 100 gm of body weight by the oral intubation. In all the alcohol administered cases, the rat immediately following the intubation became comatose and no voluntary effort to intake food or water was observed for at least twenty hours. The rat was sacrificed first by a strong blow on the head and the thorax was immediately opened. The blood sample for both hematocrit and glutathione was drawn from the thoracic cavity with the heart puncture if necessary after cutting the pulmonary and carotid arteries. The experiment was performed at 1,3,6,12 and 24 hours after the alcohol administration, and hematocrit was determined by the conventional hematocrit centrifuge and reader. The blood GSH was measured by the method of Ellman, and GSSG was measured by the method described by Dohan and Woodward. Controls were set which received the same amount of distilled water in place of alcohol.