The Effect of Crystalduringloid Administration on Blood Pressure and Heart Rate Change during Epidural Anesthesia in Cesarean Section / 대한마취과학회지

BACKGROUND: Recently, epidural anesthesia for elective and emergency cesarean section is increasing in popularity and graudally replacing general anesthesia. However, the complications from the epidural anesthesia such as hypotension, dyspnea, nausea and vomiting have often been reported. This study was designed to estimate the efficacy of crystalloid administration on blood pressure and heart rate change during epidural anesthesia in cesarean section. METHODS: Forty ASAI and II patients scheduled for cesarean section under epidural anesthesia were randomly allocated to receive either only maintained fluid administration(group I) or 15 ml/kg crystalloid solution over 15 minutes(group II). Epidural anesthesia was performed in a lateral decubitus position. According to the patient's height, 20~23 ml of 2% lidocaine was injected through epidural catheter at the L3~4 interspace. RESULTS: Cardiovascular responses and complications after induction of epidural anesthesia were compared and results were as follows. The incidence of hypotension was 14/20 (70%) in the groupI and 4/20(25%) in the group II(p<0.05). Systolic blood pressure after induction of epidural anesthesia in the group I significantly decreased from 6 min to 12 min as compared to the group II. The mean heart rate after induction of epidural anesthesia in the both group was no significant difference to baseline heart rate. CONCLUSIONS: Considering above results, we conclude that a prophylactic crystalloid solution infusion is effective for minimizing and managing hypotension associated with epidural anesthesia in cesarean section.

Development of Urine CRM for the quality Control of Heavy Matal Determinations / 대한산업의학회지

Urine certified reference material (CRM) has been developed to help clinical labolatories control analytical accuracy. Two levels of freeze-dried urine were prepared. The low level CRM was made from normal urine and the abnormal level CRM was prepared by spiking the normal urine with As, Cd, Cr, Cu, Hg, Ni and Pb. Urine reference materials were analyzed by graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma mass spectrometry (ICP-MS) . Analyte elements were separated from matrix elements by using ion exchange resin and hydride generation. Isotope dilution method was employed to enhance analytical accuracy. Round robin test results are also presented which were carried out with 5 clinical laboratories.

A Long - term Effect of Pentobarbital on the Atrial Natriuretic Peptide System in Rats / 대한마취과학회지

A long-term effect of pentobarbital on the atrial natriuretic peptide (ANP) system was investigated. The experimental group of rats (Sprague-Dawley, male) was one week previously treated with pentobarbital (50 mg/kg, intraperitoneal), and the control was an age-matched group of rats which had never been anesthetized. ANP reaponse to volume-expansion (VE) induced by intravenous infusion of iso-oncotic saline over 30 min (total volume infused amounted up to 5% body weight) was examined under thiopental anesthesia (50 mg/kg, intraperitoneal). Basal plasma ANP level did not significantly differ between the experimental and control groups. Following VE, while the plasma ANP five-fold increased in the control, it rather decreased in the experimental group. Despite the different ANP responses, the magnitude of urinary responses (volume and sodium excretion) to VE did not differ between the two groups. Right and left atrial tissue contents of ANP were significantly lower in the experimental group than in the controL In another series of experiments, the two-kidney, one clip rats were made under either pentobarbital or ether anesthesia and the blood pressure and ANP responses were compared. While the magnitude of blood pressure increases did not differ, the plasma ANP level measured on Day 12 after the clipping was lower in the pentobarbital group than in the ether group. These results suggest that pentobarbital has a long-term inhibitory effect on the ANP system. Its physiological significance in blood pressure and body fluid homeostasis remains to be determined.

Comparative Study of Time - dependent Changes of Arterial Oxygen Saturation between upper Extremity and Lower Extremity in Spinal Anesthetic Patients / 대한마취과학회지

To study the effect of one part of hemodynamic changes following spinal aneethesia on the time-dependent change of aterial oxygen saturation (SaO2) from the upper extremities and lower extremities, we analyzed the ASA class I, 30 patients (Group I, Tetracaine only (n =15), 40+/-6 years, 58+/-7kg, 162+/-6cm, Group II, Tetracaine+/-Epinephrine (n=15), 41+/-6 years, 59+/-6kg, 161+/-7cm) scheduled for urologic surgery under lower spinal anesthesia. The results were as follows: 1) There was no significant difference of preanesthetic SaO2 between upper and lower extremities in two groups (p>0.05). 2) There was no significant diference of time-dependent changes of postanesthetic SaO, in the upper extremities as compared with preanesthetic value (p=0.05). 3) There was significant ifference of time-dependent changes of postanesthetic SaO2, at 5 min, 10 min and 15 min in the lower extremities of Group I, on the other hand, at 10 min and 15 min in Group II as compared with control value (p<0.05). 4) There was significant difference of postanesthetic SaO at 10 min and 15 min in the lower extremities between two groups (p<0.05). 5) It took more longer to reach the maximum level of SaO2, after inal anesthesia in Group II as compared with Group I (p<0.05).