Sedation with Dexmedetomidine during Tracheostomy in Severe Tracheal Stenotic Patients / 대한구급학회지

In patients with severely compromised airways, a tracheostomy is usually performed under local anesthesia. Dexmedetomidine can be a better choice of sedative for such patients because it causes minimal respiratory depression. We report two cases of patients with severe stenosis of the airways who underwent sedation with dexmedetomidine during tracheostomy under local anesthesia. In the first case, recurrent laryngeal cancer caused laryngeal stenosis, and the narrowest laryngeal width was less than 3 mm. In the second case, the tracheostomy opening site was narrowed to a diameter of 3.4 mm in a patient with a history of total laryngectomy. For both patients, sedation was induced by dexmedetomidine infusion and the tracheostomy was performed successfully under local anesthesia without any events. Dexmedetomidine seems to be an effective and safe sedative for tracheostomies in patients with critical airways. The management and implications of sedation with dexmedetomidine in the patients with severe stenotic airways are discussed.

A Study on Working Environment and Health Status of Workers in Some Dyeing Factories / 대한산업의학회지

This study was carried out to evaluated the actual conditions of working environment and health status of workers and search more effective health management method of workers in some dyeing factories. This study was conducted from April 1 to October 30, 1992, for 426 workers in two dyeing factories and an electric wire making factories. Among 324 workers in two dyeing factories, 57.5% were male and 42.5% were female. Most of the engaged workers had less than 2 years of working carrier and aged 30 years or below. The used chemical substances exceeding 1 ton per a month were sodium hydroxide(NaOH), hydrogen peroxide(H2O2), sodium chlorite(NaClO2), sodium sulfate(Ma2SO4), sodium carbonate(Na2CO3), and sodium hydrosulfite(Na2S2O4). The used chemical dyes exceeding 100kg per a month were suncion blue H-ERD, levafix brilliant red E-4BA, suncion yellow E-3G, and remazol black B. As the allowable exposure time by governmental threshold limit valuses to industrial noise levels in 90 dBA for 8 hours. Average noise levels of the individual plants were ranged from 75 to 95 dB (A). The TLV for total cotton dust in 2.0mg/m3. Average cotton-dust concentration in these working environmental air were ranging from 0.2-1.3mg/m3. The TLV chlorine, acetic acid and formic acid are 1 ppm, 10 ppm & 5ppm, respectively. The range of chlorine, and acetic and formic acid concentration in these working environmental air were detected 0.2-1.6 ppm and at trace level. The accident by chemical substances and dyes was not found on these working environment. From the physical examination and Todai Health Index scores results, there was no significant correlation between the used chemical substances and the diseases, such as bronchial asthma, other hyperreactive respiratory diseases and contact dermatitis. It was suggested that long term survey should be performed to detect the occupational health problem on these working environment.