Continuous Postopdrative Bleeding after Primary Palatorrhaphy: A case Report

Myoglobinuria Following General Anesthesia / 대한마취과학회지

The authors experienced a case of myoglobinuria accompanied by generalized myalgia and mild fever that developed 3 hours 30 minutes after general anesthesia. Tracheal intubation was done smoothly 5 minutes after injection of thiopental sodium(275 mg) and pancuronium bromide(6 mg), and anesthesia was maintained with ethrane/N2O/O2(1.5-2%/21/21/min). There was no specific event except tachycardia and fluctuation of blood pressure throughout operation. In this case, we assume that the myoglobinuria is a presentation of the sign of an abortive type of malignant hyperthermia. However, it was not confirmed. We had good patient outeome with the supportive measures of hydration and diuresis. The patient was discharged twenty three days after operation without any complication.

A Clinical Study of Geriatric Anesthesia / 대한마취과학회지

In contrast to younger patients, geriatric patients are generally considered to be a poor risk for anesthesia and surgery and greater care should be taken in anesthetic management, because many have chronic systemic diseases in addition to a decrease in physiologic function. To evaluate geriatric anesthetic experiences, we received clinical records of 1,062 patients aged over 65 out of 21,656 surgical cases performed at Korea University Hye-Wha Hospital from January 1980 to December 1986. The cases were analysed according to age, sex, department, preoperative physical status, anesthetic techniques and agents, duration of anesthesia, operation site, length of hospital stay, laboratory data(Chest X-ray, EKG), associated diseases, postoperative complications and mortality. The results are as follows: 1) Of the 1,062 geriatric surgical patients, 516 cases(48.6%) were 65~69 years of age. 2) The number of geriatric surgical cases was 1,062 of which 672(63.3%) were male and 390(36.7%) were female. 3) Most surgical cases were general surgery(401 cases, 37.8%). 4) The rate of elective and emergency surgery was 78.0%(829 cases) and 22.0%(233 cases), respectively. The ratio of insurance patients (737 cases, 69.4%) versus noninsurance patients(325 cases, 30.6%) was approximately 2:1. 5) The number of general anesthesia cases was 777 (73.2%), spinal anesthesia 244( 23.0%), epidural anesthesia, 21(.20%), and brachial plexus block, 5( 0.5%). The anesthetics were thalamonal and meperidine hydrochloride(238 cases, 22.4%), halothane(204 cases, 19.2%) and tetracaine(244 cases, 23.0%). 6) The duraion of anesthesia was within 1hour in 88 cases( 8.3%), 1~2 hours in 421 cases(39.6%), and 2~3 hours in 291 cases(27.4%). 7) The number of lower abdominal surgery cases was 497 (46.8%) and the number of upper abdominal surgery cases was 188(17.7%). 8) Preoperative laboratory findings were as follows: The findings of preoperative chest X-rays revealed that 219 cases(21.4%) were within normal mits. 182 cases(17.8%) had hypertensive heart, and 208 cases(20.4%) had atherosclerosis. The EKG, which was done on 90.8% of the patients, revealed that 333 cases (34.5%) were within normal limits, 77 cases(8.0%) showed left ventricular hypertrophy, 65 cases(6.7%) showed sinus bradycardia, and 27 cases(2.8%) showed myocardial ischemia. 9) Hypertension(88cases, 49.4%) was the most commonly associated disease. 10) The total number of postoperative complication cases was 73(6.9%). Seventeen cases showed wound infection and delayed skin closure, 19 cases showed pneumonia, and 7 cases showed atelectasis. 11) The total number of postoperative deaths was 18 cases(1.7%).

The Effect of Vecuronium on the Intraocular Pressure / 대한마취과학회지

In ocular surgery, many studies have been carried but in order to evaluate intraocular pressure chance during induction and maintenance of anesthesia. In this study, Vecuronium (Norcuron), new monoquaternary analogue of pancuronium, has been used in a group of patient undergoing elective sugery in order to evaluate its influe-nce on intraocular pressure. 40 patients without a history of eye digease, in age from 20 to 60 years, were evaluated. Their condition fell into ASA class l. On arrival, initial measurement of intraocular pressure(as control value) was taken with Shiotg tonometer after instilling a 0.5% pontocaine into conjuntival sac. Subsequent measurements were taken after thiopental injeotion as soon at the lid reflex was lost, then 2 minutes after Vecuronium injection, 1,3,5,10 and 20 minutes after endot-racheal intuhation. Blood pressure and pulse rate were measured together. The results were as follows, 1. At 2 minutes after intubation, intraocular pleasure was decreased as compared with the control value. 2. At 1 minute after intutation, intraocular pressure was more increased than the value of 2 minutes after vecuronium injection. but was not significantly changed as compared with control valule. 3. All values measured followed 3 minutes after intubation were significantly derceased. 4. Mean arterial pressure and pulse rate were increased at 1 minute after intubation but all the other values were not significantly changed as compared with control value.

Anesthesia for Transurethral Resection in 97 Cases / 대한마취과학회지

Consecutive anesthesia records of transurethral resection. (TUR) on 97 patients have been reviewed. The patients' anesthetic management and complications were discussed. Operations in this series were classified as follows: 65 cases of TUR of the benign prostate hypertrophy(BPH), 8 cases of TUR of prostate ca, 24 cases of TUR of the bladder tumor. Of all the 97 cases of TUR, 62 cases had some systemic disease. Circulatory diseases, such as hypertension, abnormal EKG and ischemic heart disease were encountered most frequently, namely in 24 cases(26%). The patients who underwent TUR of the BPH had the highest mean age(70 years old). Spinal anesthesia was given 79.4%, and general anesthesia in 18. 6%. Complications did not occur during or after TUR. There was no death associated with anesthesia and operation in this study.