Finger Necrosis Resulting from Percutaneous Radial Artery Cannulation / 대한마취과학회지

The technique of radial artery cannulation and its complications are well documented. However, serious complications are rare. This is a report of one case of finger necrosis developed from the arterial cannulation in a patient who had open heart surgery. This 33 year old female underwent mitral valve replacement surgery with Carpentier Edward porcine prosthesis during a cardiopulmonary bypass. Right radial artery cannulation was carried out percutaneously using an 18 gauge angiocath after the Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. Cardiac arrest occured and the patient was resusciated 3 hours postoperatively. After that her blood pressure was maintained around 60/40 by dopamin drips. On the second postoperative day, her right hand became cold and dusky purple so that the catheter was removed, and a right stellate ganglion blcok was carried our. However, necrotic change on right thumb, index finger and little finger became worse and the whole palm became blue and edematous. She died of cardiac arrest on the 4th postoperative day.

Jackson Rees Technique for Pediatric Anesthesia (1235 Cases) / 대한마취과학회지

The Jackson Rees technique has become increasingly popular in pediatric anesthesia. This article presents an original Jackson Rees technique that we have used on 1235 cases for the past 7 years, and which is known as Pentothal-Curare-Hyperventilation technique or the Liverpool technique because of its origin and agents used. Technique 1) Atropine and demerol generally are given as premedication but atropine is only given in the newborn baby. 2) Patients are given pentothal 4mg/kg to sleep. 3) A dose of curare 0.6mg/kg is administered to paralyse and the patient is intubated with an appropriate size tube. 4) The patient is hyperventilated with three times the minute volume of N2O/O2 in a 1:2 ratio using a Jackson Rees modification unit. 5) At the end of surgery N2O is discontinued and curare is reversed with prostigmine 0.1mg/kg and atropine 0.03mg/kg. As a result of our experience this technique has been considered to be a very satisfactory technique in all fields of pediatric andsthesia. The advantages and controverses are discussed.