Clinical Evaluation of the Anesthetie Methods for the Surgery of the Upper Extremity / 대한마취과학회지

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.

Anesthetic Management for Cesarean Section in Six Patients with Kyphoacoliosis / 대한마취과학회지

The disorders of cardiac and pulmonary function as complications due to scoliosis have been described by numerous investigators since Hippocrates. The abnormalities of respiratory and cardiovascular function in scoliosis include reduced lung volume and compliance of the total respiratory system, arterial hypoxemia, which may be associated with hypercarbia, imparied chemical regulation of ventilation and increased pulmonary vascular resistance. We recently had six severs scoliotic patients who underwent Cesarean section under balanced anesthesia in Chonbuk National University Hospital. The following conclusions were obtained through our experiences in regards to the anesthetic management. 1) Arterial blood gas must be checked serially. 2) Anesthesiologists must know the degree of abnormality of the spine and the cardiopulmonary dysfunction. 3) During anesthesia intermittent positeve pressure breathing(IPPB) or positive end expiratory pressure(PEEP) is nedded ofr good oxygenation. 4) Length and location of endotracheal tube is very important. 5) For treatment of postoperative complication, digitalizations, hronchodilators and mechanical ventilation may be needed.