A Clinical Study on Arterial Oxygen Saturation in the Early Period of Anesthetic Recovery from General Endotracheal Anesthesia / 대한마취과학회지

To investigate the incidence of hypoxemia which was defined as arterial blood oxygen saturation (SaO2) of 90% or less following general endotracheal anesthesia, 112 adult patients were randomly allocated to one of 8 groups aceording to oxygen administration or not. SaO2 was continually measured during postanesthetic period using a pulse oximeter (Nellcor, N-100 C, USA). The incidence of hypoxemia was lower in oxygen administration groups (5%) than in no administration groups (14%) in the recovery room. The mean discharge time of oxygen administration groups in the recovery room (37.9 min) was significantly shorter than that of no administration groups (45.6 min) (P=0.003). There were two cases of hypoxemia during transfer of patients from the operating room to the recovery room. The incidence of hypoxemia in oxygen administration groups (9%) was lower than no oxygen administration groups (71%) during 5 minutes after endotracheal extubation. It was coneluded that the incidence of hypoxemia can be reduced by administrating oxygen during postanesthetic period. Therefore, it is recommended that oxygen should be administered to all postoperative patients for prevention of hypoxemia following general endotracheal anesthesia.

The Effects of Epidural Clonidine with Morphine or Bupivacaine after Upper Abdominal Surgery / 대한마취과학회지

Epidural narcotics has been most widely used for the control of postoperative pain. However, patients have been treated insufficiently because of the fear of respiratory depression. Urinary retension, nausea and vomiting, pruritus are other complications of epidural narcotics. Epidural local anesthetics may be an alternative to epidural narcotics. But the duration of action is usually too short, although epinephrine can prolong the analgesic effect. Clonidine, an a2-adrenergic agonist has its own analgesic effect and can prolong the effects of epidurally administered drugs. Therefore epidural clonidine may be expected to lessen the requirement of epidural narcotics and hence reduce the complications of narcotics. 75 ug or 150ug of clonidine was added to 0.125% bupivacaine or 2 mg of morphine. 6ml of mixed solution was administered epidurally during and after operation for the control of pain following upper abdominal surgery. Clonidine caused increase in the analgesic duration of epidural bupivacaine and morphine. Clonidine also cause decrease in systolic pressure in dose-dependent manner, especially during anesthesia without significant alterations in heart rate. Clonidine may be an useful adjunct to epidural narcotics, provided the dosage is carefully titrated in the range of modest hemodynamic change.