A Case Report of Anesthetic Management in a Patient with Complete Left Bundle Braneh Block / 대한마취과학회지

Among the intraventricluar block, bundle branch block is the most common type and left bundle branch block(LBBB) may progress to a more serious condition of complete heart block. Anesthetic methods such as nitrous oxide-oxygen-relaxant sequence, neuroleptanesthesia, and nitrous oxide-oxygen-minimal halothane(or penthrane) are generally accepted by the patient with heart disease. In the U.S., opioid anesthesia is also applied frequently. The authors successfully twice performed of operations with balanced anesthesia and spinal anesthesia respectively in a 39-year-old male patient who showed complete left bundle branch block pattern in a preoperative electrocardiographic tracing without any subjective symptoms.

Respiratory Arrest following Intrathecal Administration of Morphine / 대한마취과학회지

Epidural and subarachnoid narcotics have raised new possibilities for selective blockade of pain transmission at the spinal cord level. However, it must still be regarded as an experimental technique until detailed pharmacological and physiological data are available, since many reports have treated the development of respiratory arrest which may be related to the dynamics fo CSF flow. We experienced 2 cases of respiratory arrest after intrathecal injection of 2mg morphine. One patient developed respiratory arrest at approximately 5 1/2 hours after intrathecal morphine and the other at approximately 12 1/2 hours. Those respiratory arrests were completely reversed with naloxone hydrochloride without interfering with the analgesic effect of the drug.

Cinical Studies of Anesthesia for the Hyprteneive Patient / 대한마취과학회지

Until several years ago it was generally agreed that anihypertensive medication should be stopped a few weeks before anesthesia and surgery in order to regain the compensatory function of cardiovascular system during anesthesia and surgical stress. However the present concept is that the better the hypertension is controled the more the patient's chances of surving anesthesia and it is recommended that antihypertensive medication should be continued to the time of anesthesia. The authors have experienced cases of hypertensive patients undergoing various kinds of operation and have-analyzed these cases according to the degree of hypertension, sex, department, anesthetic agent and technique, previous anesthetic medication, abnormal ECG finding and arterial blood pressure changes after anesthesia, at Jeonbug National University Hospital from January 1977 to June 1979. The results were as follows: 1) The number of hypertensive cases was 326 (12. 3%) out of 2664 total patient who received various surgical operations. 2) Only a few patients(16cases, 0. 5%) received antihypertensive medication before surgery. 3) The degree of hypertension was mostly class 1 or 2(274 patients, 78%) according to the severity index of Elwood 4) Most of the patients (253 cases, 74%) revealed elevated blood pressure after induction of anesthesia.