An Evaluation of Depth of Double Lumen Endobronchial Tube with Fiberoptic Bronchoscope / 대한마취과학회지

In Korea, the study about the normal depth of insertion of dauble lumen tubes bas not been reported yet. So we studied 50 adult patients(30 males and 20 females) undergoing thoracic surgery under one lung ventilation. Endotracheal intubation was done with the disposable polyvinylchloride Robertshaw-type double lumen endobronchial tube. The exact position of a left-sided double lumen endobronchial tube was confirmed by passing a fiberoptic bronchoscope through the tracheal lumen of the double lumen, The depth was measured when we had a view of a clear straight-ahead view of the tracheal carina, the right lumen going off to the right, and the upper surface of the blue left endobronchial balloon just below the tracheal carina, The resullts were as follows; 1) In the male patients, the average depth of the tube was 30.7+/-1.4cm and this measure- ments were related with height but not the weight and age. 2) In the female patients the average depth of the tube was 28,3+/-l.2cm and this measurements were unrelated with height, age and weight. 3) Among the male and female patients the average depth of the tube was 30.0+/-1.8cm and this measurements were related with a height but not with weight and age.

Does the " Curare Cleft " on the Capnogram always mean that the Patient is in Need of Relaxant ? / 대한마취과학회지

A fifty-eight years old male patient was given general anesthesia for the clipping of aneurysm on the posterior communicating artery. The respiration of the patient was controlled with Ohmeda 7000 anesthesia ventilator. During the surgery there appeared curare cleft on the capnogram which did not disappear after the administration of neuromuscular blocker, but disappeared after the change of the anesthesia ventilator with another one. After that another curare cleft was made by the transient obstruction of the outlet of the excess patient circuit gas of the new anesthesia ventilator. It may be said that inappropriately functioning pop-off valve of the anesthesia ventilator can be one of the causes of curare cleft on the capnogram.

A Statistical Survey of Foreign Body Removal under General Anesthesia / 대한마취과학회지

Foreign body accidents in the air and food passages are common problem encountered in the ENT field. Especially the foreign body accidents in the air passage in the children are serious and urgent. They are influenced by mode of living, customs, habits and environment1). We have clinico-statistically analysed 83 cases removal of foreign bodies in air and food passages under general anesthesia from January 1979 to March 1991 in Korea Univer- sity Hospital. The results are as follows: 1) Of the total 83 cases,64 cases(77.1%) were in food passage and 19 cases(22.9%) were in air passage. 2) Peanuts and beans were the most common intruders of air passage(79%). In the food passage coins enjoyed the greatest popularity(31.3%) and bones, Badook stones, and meats follow in order of frequency. 3) In the age distribution, 42.1% of foreign bodies in food passage and 78.9% of foreign bodies in air passage were under 5 years. 4) Of the total numbers of foreign body cases, 61.4% of the patients were male and 38.6 % were female. 5) In duration of lodgement, 44 cases(68.8) of foreign bodies in food passage and 6 cases(31.6%) in air passage were removed within 24 hours. 6) In food passage, 56 cases(87.5%) of all were diagnosed initially by chest P-A but 9 cases(47%) were diagnosed initially in air passage.

Continuous Epidural Infusion of Fentanyl / Bupivacaine Mixtures for Analgesia after Thoracotomy / 대한마취과학회지

Post-thoracotomy pain is so severe that may lead to postoperative complications, such as sputum retention, atelectasis, pneumonia and respiratory failure. These complications are associated with shallow breathing and inability to cough due to pain. To reduce postoperative pulmonary complications and improve respiratory mechanics, effective pain relief is essential. Among the many methods, epidural administrations of narcotics or local anesthetics have been shown to provide profound relief of postoperative pain. Forty-five patients undergoing thoracotomy were randomized into three groups based on a postoperative pain regimen as indi-cated: Group I; intermittent intramusculal injections of nalbuphine 0.2mg/kg for pain control(n= 15) Group II; intermittent epidural injections of mixtures of 0.2% bupivacaine and fentanyl 3 ug/ ml (n=15) Group III: continuous epidural infusion of mixtures of 0.2% bupivacaine and fentanyl 3 ug/ml at a rate of 4-5 ml/hr with supplementation on pain complaint. We evaluated postoperative pain score at 30 minutes, 8 hours, 16 hours, 24 hours, 32 hours, 40 hours, and 48 hours after thoracotomy. And we observed the duration of analgesia and the incidence of systemic side effects of three methods. The results were as follows; 1) The pain score was significantly decreased in group III compared to group I and II<0. 05). 2) The mean duration of analgesia was significantly longer in group III compared to group I and II(p<0.05). 3) the number of case of systemie side effects in group I was one case of nausea and vomiting, in group II, two cases of mild hypotension, and one case of nausea and vomiting, pruritus, headache, and urinary retention each respectively and in group III, one case of ruinary retention.

A Case Report of Acute Hepatitis after General Anesthesia with Halothane / 대한마취과학회지

A 25 year old male was admitted for the reduction of right side mandible fracture. The patient was injured during a fight with someone under the influence of liquor. Nine days after the halothane anesthesia, the patient began to suffer from acute hepatitis with symptoms of fever, diarrhea, nausea, vomiting, and jaundice. The patient was cared for at the department of internal medicine and discharged after 49 day's hospitalization. The exact causes of the acute hepatitis were still unknown.