Effects of Preoperative Oral Fruit Juices on Gastric olume and pH in Children / 대한마취과학회지

Backgrounds: The purpose of fasting before surgery is to minimize the volume of gastric contents. A short fast after solid food increases gastric volume, but a small drink of clear fluid 2 to 3 hours preoperatively decreases gastric volume. This investigation examined the effects of a small drink of clear fruit juice 2 to 3 hours prior to anesthesia on gastric volume, gastric pH, thirst and hunger. METHODS: Two hundred eighty children whose ages were five to ten years, scheduled for elective surgery were randomly assigned to one of 7 groups. Group 1 continued to fast but in the other 6 groups the children drank 2 ml/kg, 3 ml/kg, or 4 ml/kg of clear fruit juice (orange or grape) 2 to 3 hours preoperatively. The degree of thirsty and hunger was checked. The volume of gastric contents was measured by syringe and the pH by pH meter. RESULTS: The children who drank fruit juice preoperatively had decreased gastric volume. The gastric pH was not significantly different with that of the control group. The degree of thirst and hunger was not significantly different with that of the control group. CONCLUSIONS: We conclude that a small drink of fruit juice 2 to 3 hours preoperatively is more preferable than 8 hours fasting.

Appropriate Sizes of Uncuffed Endotracheal Tubes and Distance from Upper Incisor to Carina in Korean Children under Eight Years Old / 대한마취과학회지

BACKGROUNDS: Various methods have been devised for choosing the correct internal diameter (ID) of endotracheal tubes and the proper lengths for oral endotracheal tubes at different ages in children. This study was performed to evaluate the appropriate sizes of uncuffed endotracheal tubes and distance from upper incisor to carina in Korean children under 8 years old. METHODS: Five hundred thirty five children under 8 years in ASA class 1 and 2 were evaluated for the study by age groups: 0~3 months, 4~11 months and every each year until 8 years. Appropriate sizes were to permit a gas leak at 15~25 cmH2O with positive pressure ventilation. Distances from incisor to carina were at the point which bilateral lung sounds were noticed during slow extubation from endobroncheal intubation. RESULTS: Appropriate tube sizes were 3.0 mm to 3.5 mm for infants under 3 months, 3.5 mm to 4.0 mm for 4 to 11 months and ""4.15+0.28xage (yr) (mm)"" (R2=0.77, p<0.05) for children between 1 and 8 years old. Distances from upper incisor to carina were 12.0 cm for infants under 3 months, 13.7 cm for 4 to 11 months and ""14.5+0.6xage (yr) (cm)"" (R2=0.62, p<0.05) for children between 1 and 8 years old. CONCLUSIONS: We conclude that the endotracheal tube ID for the Korean children are a little greater than those of previous reports in foreign countries and airway lengths for the Korean children are similar to those of foreigners.

Comparisons of the Oxygen Saturation Between Right Atrial and Pulmonary Arterial Blood Immediately After Emergence from Cardiopulmonary Bypass During Open Heart Surgery in Pediatric Patients / 대한마취과학회지

BACKGROUND: Mixed venous oxygen saturation (SO2) monitoring turned out to be invaluable in following up systemic cardiovascular status. But balloon-tipped flow-directed thermodilution catheter (Swan-Ganz catheter) insertion carries additional inherent risks other than those of central venous catheterization, and it costs much more expense than simple venous catheter. There has been a lot of papers which argue that central venous catheterization may substitute for the Swan-Ganz catheterization. In addition, it may be very difficult or impossible to insert the Swan-Ganz catheter in pediatric patients. This study was performed to determine whether Swan-Ganz catheterization might be replaced by the central venous catheterization in regards to SO2. METHODS: In 17 pediatric open heart surgery (OHS) patients, from the central venous catheter, the tip of which had been located in the center of right atrium (RA) and pulmonary artery, blood samples were drawn for gas analysis simultaneously, which was done immediately after emergence from cardiopulmonary bypass. RESULTS: There were no significant differences between RA blood and mixed venous blood gas analyses except oxygen saturation. The oxygen saturations of both were linearly correlated with each other. The relation was SO2=17 0.8 SRAO2 (R=0.77, p<0.05) CONCLUSIONS: It may be concluded that RA blood may be used for blood gas analysis in place of mixed venous blood immediately after pediatric open heart surgery.