Comparison between the continuous Infusion and the Intermittent Administration of Vecuronium / 대한마취과학회지

The neuromuacular blocking effects of the repeated bolus injection and continuous injection of vecuronium have been compared in 20 patients by means of evoked twitch tension. Group I received a loading dose (0.08 mg/kg) of vecuronium and followed by maintenance doae (0.02 mg/kg) when twitch tension had recovered to 25% of control. Group II received a loading doses (0. 08mg/kg) of vecuronium plus a continuous infusion delivering 0.06 mg/kg/hr. Anesthesia was maintained with nitrous oxide, oxygen and 1.5% enflurane. The neuromuscular blocking effect were reversed by the neostigmine 1.0 mg and robinul 0.2 mg when twitch tension had recovered 25% control in both groups near the end of operation. With repeated injection of vecuronium (group I), the duration of blockade of 25% recovery was 21.6+/-4.2 minutes and the recovery times from 25% to 75% was 6.8+/-1.9 minutes The continuous infusion of vecuronium (group II) produced consistent neuromuscular blockade at the average level of 90% twitch depression. The times from the end of infusion to 25% and fr,om 25% to 75% are averaged 16.0+/-2.5 and 4.2+/-0.7 minutes respectively. The reeovery index was more rapid in infusion group than maintenance group (P<0.05).

Clinical Evaluation of Intravenous Regional Aneetheeia using Bupivacaine / 대한마취과학회지

We prospectively studied the clinical effect of intravenous bupivacaine for regional anes-thesia in the lower & upper extremities in sixty consecutive patient from September, 1985 to truly 1986. 0.2% bupivacaine was used and dosage was varied between 1.0mg/kg and 2.5mg/kg. according to the 7ype of surgery, site, body weight and the size of the limb. The amount of bupivaeaine required was rather depend upon the size of the limb thats the patient's body weight. The effect of the anesthesia for a variety of extremity procedures was rated as exoellent, good or fair in 98.3% of the patient.

Clinical Application of the Mapleson B System for Controlled Ventilation in Pediatric Patients / 대한마취과학회지

This study was undertaken to observe whether an adult ventilator with a preset volume could be used as a controlled ventrolled ventilator far pediatric anesthesia. 35 Patients ranging in age from 3months to 7 years were divided into two groups based on body weight(Group 1: 5~10kg, 14 cases, Group 2: 11~15kg, 21 cases) and anesthetized with halothane-N2O/O2 - pancuronium using the Mapleson B system. Immediately after induction, the reservoir bay of the Mapleson B system was replaced by the reservoir tube of the adult ventilator (MCM 801). Arterial blood gas studies 30 and 60 minutes after induction were performed, and the data from group 1 was compared with that of group 2. The magnitude of PCO2 increase 30 minutes after induction was not significantly different from that at 60 minutes(p>0.05), and alterations of PCO2 in group 1 were not stati-stically significant with group 2 (P>0.05). In conclusion, it is suggested that the Mapleson B system attached to adult ventilator is an useful and convenient device for controlled ventilation in pediatric patients.

Postoperative Changes of Arterial Blood Gas Tension and Ventilatory Function / 대한마취과학회지

Pulmonary comp1ications following surgery continue to be a major cruse of postoperative mobidity. The purpose of this study was to measure the effects of various surgical procedures upon arterial blood gas tension and ventilatory function in the early postoperative period. 30 patients with no history of cardiopulmonary disease before surgery were selectively chosen and divided into 4 categories depending on the location of the operative incision and the type of anesthesia. Group l was composed of upper abdominal incision cases, Group ll lower abdominal incision cases, and Groups lll and lV had nonabdominal surgery. Groups, l, ll and lll received general anesthesia, while lV was liven spinal anesthesia. Lung volumes were measured and blood samples were taken preoperatively and 70 minutes after surgery. Patients were maintained in semisitting position before and after surgery. Vital capacities were significantly reduced in the postoperative period in the general ane- sthesia groups, and tidal volumes were significantly reduced in the upper and lower abdominal incision groups. The mean PaO2 value after anesthesia decreased significantly in the upper and lower abdominal incision groups, but there were no significant differencea in the PaCO2 value. It seems that supplemental oxygen and encouragement of deep inspirations are essential and beneficial in the early postoperative period, especially for the patients with abdominal surgery.