A Comparison of Epidural 0.2% Ropivacaine Alone and in Combination with 4 microgram/ml Fentanyl for Postoperative Analgesia after Total Abdominal Hysterectomy / 대한마취과학회지

BACKGROUND: Epidural infusions usually comprise a local anesthetic, an opioid, or more commonly, a combination of the two, to minimize individual doses and to reduce unwanted side effects. The aim of this study was to compare analgesic and side effects of epidural infusion with 0.2% ropivacaine alone and in combination with 4 microgram/ml fentanyl after total abdominal hysterectomy. METHODS: Forty healthy total abdominal hysterectomy patients under general anesthesia with postoperative analgesia by continuous epidural infusion were randomly allocated into Group I; 0.2% ropivacaine alone (n = 20) or Group II; 0.2% ropivacaine and 4 microgram/ml fentanyl (n = 20). We assessed the visual analogue scale (VAS, 0 = no pain, 10 = worst pain), frequency of supplemental analgesics, side effects and patients' satisfaction of the result. RESULTS: The VAS and the frequency of supplemental analgesics were significantly lower and fewer in Group II compared to Group I. The incidence and severity of side effects were no differences between two groups. The satisfactions of patients were significantly higher in Group II. CONCLUSIONS: For postoperative analgesia, the epidural infusion of 0.2% ropivacaine with 4 microgram/ml fentanyl provided better analgesia than 0.2% ropivacaine alone.

Changes of Blood Glucose Levels by infusion of 5% Dextrose in Water and Hartmann`s Solution during Halothane Anesthesia / 대한마취과학회지

This study was attempted to cumpare the effects on blood glucoge of 5% Dextrose in Water (D5W) and Hartmann's solution infused during halothane anesthesia.20 female patients in the state of A.S.A. classification 1 were chosen and divided into 2 groups, i.e. first group D5W. the second group Hartmann's solution. Blood samples were collected on the operating table prior to starting I.V. infusion, after 1/2 hour, 1 hour and 11/2hour from the time 1.V. infusion started. Intravenous fluid was administered at 10 ml/kg/hr. Changes of blood glucose levels were as follows. In the group of D5W, the values of bleed glucose were 83.4+/-13.5 mg% at N.P.O., 198.4+/-33.6 mg% at 1/2 hour, 245.5+/-55.6mg% at 1 hour, and 259.5+/-40.1 mg% at 11/2 hours. In the group of Hartmann's solution, the values of blood glucose were 64.9+/-9,5 mg% at N. P.O., 93.3+/-21.9mg% at 1/2 hour. 99.0+/-15.6mg% at 1 hour, and 105.6+/-24.2mg% at 1 1/2hours.

Intrathecsl Injection of Small Amount of Morphine for Obstetric Analgesia / 대한마취과학회지

Intrathecal injection of a small amount of morphine was used to provide obstetric analgesia in 20 primiparous women in labor. When the cervix was 3~4cm dilated approximately, 0.25mg or 0.5mg of morphine was injected intrathecally in each patient. In all parturients, labor pains were completery relieved after 10~60 min and analgesia lasted 8 to 15 hours. The vital signs of all parturients after intrathecal morphine injection were stable. The analgesia was well achieved but there was no alteration of motor power or pinprick sensation. The maternal side effects such as itching, nausea, vomiting, somnolence and urinary retention occured in a high proportion of parturients, but severity of these side effects were mild in most cases. Urinary retention was most severe side effect in our cases. All newborns were scored as having 8~10 on Apgar scores at 1 min after birth.