Reappraisal of the predictive factors for postoperative pulmonary complications after general anesthesia / 대한내과학회지

BACKGROUND: As our population in Korea ages, more postoperative pulmonary complications (PPCs) have recently developed. There have been several studies about the predictive factors for PPC, but any consensus has not been established. In this study, we reappraised the predictive factors for PPC after general anesthesia in a population from Gyeong-ju, which was composed of elderly people. METHODS: We retrospectively investigated the incidence and predictive factors for PPC in 84 patients who underwent general anesthesia. We investigated gender, age, height, weight, BMI, smoking, underlying disease, underlying respiratory disease, malignancy, the laboratory findings (hemoglobin, albumin, arterial O2 saturation) and the pulmonary function tests of the patients. RESULTS: 84 patients were initially enrolled into the study, and PPC developed in 31 (36%) patients. The mean age of the enrolled patients was 66.515.1 years-old, so it shows the trend of an aging society. Three predictive factors were revealed that are independently associated with the PPC: site of operation (OR, 8.3), underlying disease (OR, 9.9) and serum albumin (OR, 4.0). CONCLUSIONS: Among the statistically meaningful predictive factors, underlying disease and operation site are well known from previous studies, but the albumin level<3.5 g/dL is also meaningful, which is higher than the previous reference level. It implies that the patient with a albumin level 3.0~3.5 g/dL can be classified into the high risk group. Therefore, we should recognize that it is necessary to apply more strict reference levels in an aging population to reduce the incidence of PPC.

A Case Report of Asthmatic Attack in the Postoperative Recovery Room / 대한마취과학회지

Anesthetic managment of bronchial asthmatic patient requires understanding of the patho- physiology of the disease and the drug interaction with anesthetics and the drugs related to the treatment. A 53-year old male patient with hemorrhagic pancreatitis had been operated for exploratory laparotomy. He had history of the bronchial asthma. After the operation was completed, patient was transfered to recovery room after extubation. Sudden airway obstruction signs and patients agitation were noted 5 minutes after arrival in the recovery room. Asthmatic attack was relieved with salbutamol, corticosteroid, aminophylline, and isoproterenol intravenously. We have experienced one case of severe asthmatic attack in the postoperative recovery room. We report this case and review the anesthetic managements and drug interactions.