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1.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2485-2487,2488, 2015.
Article in Chinese | WPRIM | ID: wpr-602292

ABSTRACT

Objective To observe the safety and efficacy of rocuronium rapid sequence induction in patient undergoing laparoscopic cholecystectomy(LC).Methods 100 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups(n =50):control group(group C)and rocuronium rapid sequence induction group (group R).Conventional induction of anesthesia was used in group C,rocuronium rapid sequence induction was used in group R and assisted ventilation was not implemented in the induction process.Oxygen saturation(SpO2 ),partial pressure of oxygen(PaO2 ),carbon dioxide partial pressure(PaO2 ),pH were recored at the condition of breathing air (T0 ),breathing pure oxygen 5 minutes(T1 ),after intubation(T2 )and mechanical ventilation five minutes(T3 ).The grade of the exposure in operation field,the operative time,indwelling of gastric suction tube,the time of no ventilation in group R were recorded,too.Results Compared to T1 time point,PaO2 and pH in group R decreased,but PaCO2 was significantly higher at T2 time point(P 0.05),but SpO2 and PaO2 were higher than preoperative at every time point(P <0.05).The incidence of Indwelling gastric suction tube is higher in group C than in group R,the grade of exposure in the operation field were better in group R than in group C(P <0.05).Conclusion Application of rocuronium rapid sequence induction technique in laparoscopic cholecystectomy can improve the operative conditions and field,it can be safely used in clinical anesthesia.

2.
Chinese Journal of Medical Aesthetics and Cosmetology ; (6): 15-17, 2013.
Article in Chinese | WPRIM | ID: wpr-431436

ABSTRACT

Objective To study the application of suture and ligature and swelling technique in the removal of giant skin benign tumor in none-extremity position.Methods The swelling technique was merely used in those whose lesions were located on face and neck before operation.If the lesions were located on scalp or truck,suture and ligature and swelling technique would be combined in the treatment.Firstly,the lesion was sutured and ligated one or two circles all around.Then swelling fluid was injected under lesion,and incision was done inside or between sutures.Results The area of lesion once excised was 154.00-2394.75 cm2,and the quantity of swelling fluid was 150 1950 ml.The longest time to suture and to ligate the lesion was one hour,and operative bleeding was obviously decreased.Conclusions Suture,ligature and swelling technique might be helpful to decrease operative bleeding during excision of giant skin benign tumor in none-extremity position,and therefore increase operative safety.

3.
Rev. méd. Minas Gerais ; 19(4,supl.1): S21-S62, out.-dez. 2009. tab
Article in Portuguese | LILACS | ID: lil-563439

ABSTRACT

Gestantes com doença cardíaca habitualmente possuem prognóstico favorável tanto materno quanto fetal. Com exceção das pacientes com a síndrome de Eisenmenger, hipertensão pulmonar primária e síndrome de Marfan com aortopatia, morte materna durante a gravidez em pacientes cardiopatas é rara. A gravidez por si só impõe modificações hemodinâmicas significativas, colocando à prova o sistema cardiovascular. Doença cardíaca reumática é a mais frequente nas gestantes, e o edema agudo pulmonar, a complicação mais comum. Defeito do septo atrial é a cardiopatia congênita acianótica mais prevalente na população adulta, enquanto que a Tetralogia de Fallot é a mais frequente das cardiopatias congênitas cianóticas. Gravidez e cardiopatia são uma associação de grandes desafios para o anestesiologista. Para evitar complicações decorrentes da morbidade ou mortalidade materno-fetal, o anestesiologista deve conhecer a evolução da doença durante a gravidez. Aqui são discutidas a fisiopatologia, apresentação clínica e a condução anestésica das doenças cardíacas valvulares adquiridas, das doenças cardíacas congênitas, da doença isquêmica do miocárdio e das miocardiopatias na gravidez.


Pregnancy in most women with heart disease has a favorable maternal and fetal outcome. With the exception of patients with Eisenmenger syndrome, pulmonary hypertension primary, and Marfan syndrome with aortopathy, maternal death during pregnancy in women with heart disease is rare. Pregnancy per se imposes significant hemodynamic changes placing a major burden on the cardiovascular system. Rheumatic heart disease remains the most frequent heart disease in the pregnant population and the pulmonary edema is the most frequent complication. Atrial septal defect is the most frequent congenital acianotic heart disease in the adult population, whereas tetralogy of Fallot is the most common cyanotic congenital heart disease. Pregnancy and heart disease present a unique challenge to the anesthesiologist. To avoid untoward complications resulting in significant maternal and/or fetal morbidity or mortality, the anesthesiologist must be familiar about the progression of heart disease during pregnancy. In this article, we review the pathophysiology, clinical presentation, and anesthetic management of valvular, congenital, vascular and ischemic heart disease, and cardiomyopathy in pregnancy.


Subject(s)
Humans , Female , Pregnancy , Anesthesia, Obstetrical , Heart Defects, Congenital , Pregnancy Complications, Cardiovascular/physiopathology , Risk Factors , Antibiotic Prophylaxis , Arrhythmias, Cardiac/prevention & control , Cardiomyopathy, Hypertrophic/prevention & control , Aortic Coarctation/prevention & control , Eisenmenger Complex/prevention & control , Heart Septal Defects, Atrial/prevention & control , Heart Valve Diseases/prevention & control , Aortic Valve Stenosis/prevention & control , Mitral Valve Stenosis/prevention & control , Marfan Syndrome/prevention & control , Tetralogy of Fallot/prevention & control
4.
Korean Journal of Anesthesiology ; : 938-943, 1999.
Article in Korean | WPRIM | ID: wpr-138243

ABSTRACT

BACKGROUND: This prospective study of 40 patients who underwent diagnostic laparoscopy at outpaient surgery center was performed to assess the use of ketamine as a analgesic adjuvant during intravenous anesthesia with propofol compared with the combination of propofol-fentanyl. METHOD: Anesthesia was induced with propofol (2 mg/kg) and either fentanyl (1 microgram/kg) or ketamine (0.2 mg/kg). Anesthesia was maintained with propofol 200 microgramkg-1min-1 during the first 5 min, followed by 180 microgram/kg 1min 1 for 5 min and then 160 microgram/kg-1min-1 after 10 min. The patient's lungs were mask ventilated with 50% N2O-O2. Increments of propofol were given during anesthesia if analgesia was judged to be inadequate. RESULT: Stable arterial pressure and heart rate were seen in the patients of both groups, except for a temporary increase of heart rate after induction of anesthesia in ketamine group. There were no significant differences between ketamine and fentanyl groups in total dose of propofol, response time, recovery time or VAS at 30 min after operation. Patients who received propofol-ketamine demonstrated a longer discharge time than the patients received propofol-fentanyl. There were higher incidences of dizziness and 1 patient showed emergence delirium in patients given propofol-ketamine, other side effects were similar. CONCLUSION: We concluded that low-dose ketamine with propofol can replace propofol-fentanyl for intravenous outpatient anesthesia.


Subject(s)
Humans , Analgesia , Anesthesia , Anesthesia, Intravenous , Arterial Pressure , Delirium , Dizziness , Fentanyl , Heart Rate , Incidence , Ketamine , Laparoscopy , Lung , Masks , Outpatients , Propofol , Prospective Studies , Reaction Time
5.
Korean Journal of Anesthesiology ; : 938-943, 1999.
Article in Korean | WPRIM | ID: wpr-138242

ABSTRACT

BACKGROUND: This prospective study of 40 patients who underwent diagnostic laparoscopy at outpaient surgery center was performed to assess the use of ketamine as a analgesic adjuvant during intravenous anesthesia with propofol compared with the combination of propofol-fentanyl. METHOD: Anesthesia was induced with propofol (2 mg/kg) and either fentanyl (1 microgram/kg) or ketamine (0.2 mg/kg). Anesthesia was maintained with propofol 200 microgramkg-1min-1 during the first 5 min, followed by 180 microgram/kg 1min 1 for 5 min and then 160 microgram/kg-1min-1 after 10 min. The patient's lungs were mask ventilated with 50% N2O-O2. Increments of propofol were given during anesthesia if analgesia was judged to be inadequate. RESULT: Stable arterial pressure and heart rate were seen in the patients of both groups, except for a temporary increase of heart rate after induction of anesthesia in ketamine group. There were no significant differences between ketamine and fentanyl groups in total dose of propofol, response time, recovery time or VAS at 30 min after operation. Patients who received propofol-ketamine demonstrated a longer discharge time than the patients received propofol-fentanyl. There were higher incidences of dizziness and 1 patient showed emergence delirium in patients given propofol-ketamine, other side effects were similar. CONCLUSION: We concluded that low-dose ketamine with propofol can replace propofol-fentanyl for intravenous outpatient anesthesia.


Subject(s)
Humans , Analgesia , Anesthesia , Anesthesia, Intravenous , Arterial Pressure , Delirium , Dizziness , Fentanyl , Heart Rate , Incidence , Ketamine , Laparoscopy , Lung , Masks , Outpatients , Propofol , Prospective Studies , Reaction Time
6.
Korean Journal of Anesthesiology ; : 571-576, 1999.
Article in Korean | WPRIM | ID: wpr-195433

ABSTRACT

BACKGROUND: The anesthesia machine PhysioFlex was especially constructed to deliver anesthetics in a closed circuit system. In this anesthesia machine the concentrations of the respiratory gases and the gas volume in the circle system are automatically controlled by a feedback mechanism. The aim of this study is to introduce 1,132 patients who have received general anesthesia in a closed circuit system using PhysioFlex, and to calculate the real consumed amount of oxygen and nitrous oxide, and to describe the advantages and disadvantages of PhysioFlex for clinical uses. METHOD: The author used a PhysioFlex in cases of 1,132 various surgical interventions. After induction with thiopentone and suxamethonium, general anesthesia was maintained with nitrous oxide in 50% oxygen and enflurane (or isoflurane, halothane) and supplemented with nalbuphine and pancuronium. These cases were analyzed by their sex, age, height, weight, method of airway maintenance during general anesthesia, operation position, anesthesia time, and arterial blood gases by review of anesthesia records. Average minute-consumed amount of oxygen and nitrous oxide was calculated by recording every 30 seconds throughout the anesthesia procedures except preoxygenation and flush periods. The advantages and disadvantages of PhysioFlex were described on the base of the author's clinical experience. RESULTS: The anesthetic technique of the closed circuit system by PhysioFlex could be used adequately for any surgical procedures. In this system consumed amounts of oxygen and nitrous oxide were 179.72+/-2.48 ml/min and 88.49+/-2.78 ml/min respectively. The author found out several advantages and few disadvantages of PhysioFlex for its clinical uses. CONCLUSIONS: Closed circuit system of PhysioFlex anesthesia machine offer numerous advantages such as reduction of gas consumption, low cost, less pollution in both the operating theater and the environment, increase in inspired gas humidity, easy handling of machine, and excellent respiratory alarm systems.


Subject(s)
Humans , Anesthesia , Anesthesia, General , Anesthetics , Enflurane , Gases , Humidity , Isoflurane , Nalbuphine , Nitrous Oxide , Oxygen , Pancuronium , Succinylcholine , Thiopental
7.
Korean Journal of Anesthesiology ; : 782-786, 1997.
Article in Korean | WPRIM | ID: wpr-18488

ABSTRACT

BACKGROUND: Brachial plexus is invested by a fascial envelope, which forms a perineural and perivascular space that extends all the way from the cervical intervertebral foramen to the distal axilla. Therefore a single injection of a local anesthetic into any sites of this space can provide anesthesia of the entire brachial plexus. Nowadays many methods of brachial plexus block have been developed but there are some severe complications and they can't prevent tourniquet pain completely. METHODS: We have performed parascalene technique for brachial plexus block in 206 cases from Jan., 1992 to Dec.,1994. We studied the cases retrospectively by reviewing patients' anesthesia records. The technique for parascalene block is the injection of local anesthetic solution into the lower part of the posterior triangle of the neck at the point 1.5~2.0 cm above the clavicle at the lateral border of the anterior scalene muscle. RESULTS: We could provide the proper anesthesia for the upper extremity and shoulder operation without any remarkable complications except Honor's syndrome of 3 cases. And there were no tourniquet pain in all 96 cases who had used tourniquet. CONCLUSIONS: The parascalene approach is the useful, safe and reliable method for brachial plexus block.


Subject(s)
Anesthesia , Anesthetics , Axilla , Brachial Plexus , Bupivacaine , Clavicle , Lidocaine , Neck , Retrospective Studies , Shoulder , Tourniquets , Upper Extremity
8.
Korean Journal of Anesthesiology ; : 352-358, 1996.
Article in Korean | WPRIM | ID: wpr-63914

ABSTRACT

BACKGROUND: We evaluated the possibility of tracheal intubation and intubating conditions following anesthetic induction with propofol 2.5 mg/kg, with or without fentanyl, lidocaine as pretreatment and without neuromuscular blocking agents. METHODS: Thirty six patients, ASA I or II, under various surgical procedures were randomly assigned into three groups according to anesthetic pretreatment: group 1 received only propofol : group 2, propofol and fentanyl 4 mcg/kg and group 3, propofol, fentanyl 4 mcg/kg and lidocaine 1 mg/kg. Two minutes after administration of lidocaine, we administered the fentanyl over 20 seconds, and then one minutes after fentanyl, administered propofol over 40 seconds. After loss of consciousness, intubation of the trachea was performed and intubating conditions were assessed as acceptable or unacceptable on the basis of a scoring system depending on the easiness of laryngoscopy, vocal cord position and coughing when tracheal tube was inserted. RESULTS: The overall assessment of intubating conditions were acceptable in 58 %, 75 % and 83 % of patients in groups 1-3, respectively. Supplementing fentanyl with lidocaine improved intubating conditions and was less coughing among three groups (p<0.01). CONCLUSIONS: The use of propofol without neuromuscular blocking agent was not adequate for intubation since laryngotracheal reflexes were not suppressed. Pretreatment with or without fentanyl and lidocaine did not improve the responses sufficiently enough to perform intubation safely.


Subject(s)
Humans , Anesthesia , Anesthetics , Cough , Fentanyl , Intubation , Intubation, Intratracheal , Laryngoscopy , Lidocaine , Neuromuscular Blockade , Neuromuscular Blocking Agents , Propofol , Reflex , Trachea , Unconsciousness , Vocal Cords
9.
Korean Journal of Anesthesiology ; : 345-350, 1988.
Article in Korean | WPRIM | ID: wpr-104910

ABSTRACT

Total 1950 cases of general, spinal and epidural anesthesia for cesarean section were performed in Department of Anesthesiology, Yonsei University, Wonju College of Medicine from June 1982 to May 1987. The followings are results of the observations on 1950 cases. 1) The incidence of cesarean section was 21.76 percent of total deliveries and the tendency is increasing. 2) Types of anesthesia are General anesthesia(1004 cases), Spinal anesthesia(557 cases), Epidural anesthesia(389 cases). 3) One minute Apgar score in spinal, epidural anesthesia are better than in general anesthesia. 4) Perinatal mortality of total deliveries is 1.007%. 5) Painless delivery: 50 cases. 6) Postoperative pain control: Spinal anesthesia: 48 cases. Epidural catheter: 335 cases(Ketamine:50 cases)


Subject(s)
Female , Pregnancy , Anesthesia , Anesthesia, Epidural , Anesthesia, General , Anesthesia, Obstetrical , Anesthesia, Spinal , Anesthesiology , Apgar Score , Catheters , Cesarean Section , Incidence , Pain, Postoperative , Perinatal Mortality
10.
Korean Journal of Anesthesiology ; : 509-512, 1988.
Article in Korean | WPRIM | ID: wpr-209603

ABSTRACT

Thyrold storm, when related to surgery, usually develops within 6~18 hours postoperatively, with symptoms and signs of pyrexia, marked tachycardia, susceptability to severe hypotension, and restlessness. There are a few case reports of thyroid storm related to thyroid surgery or the surgery related to non thyroid surgery with the patient of the hyperthyroidism. We have experienced anesthetic management and postoperative thyroid storm management. The patient have had brain tumor and Grave's disease which was treated with antlthyroid agents and beta-blocking agents to mate the patient euthyroid state for two weeks by the internist. The patient tolerated the two hours of general anesthesia well, but on the first postoperative day, thyroid storm was developed with symptoms and signs of dyspnea, restlessness, nausea, vomiting, diarrhea and tachycardia. After thirty minutes to start the treatment with antithyroid agents, betablocking agents, sedatives and electrolyte balance, the thyroid storm was treated and the patient was discharged on the twenty first postoperative days with healthy state.


Subject(s)
Humans , Anesthesia, General , Antithyroid Agents , Brain Neoplasms , Diarrhea , Dyspnea , Fever , Hyperthyroidism , Hypnotics and Sedatives , Hypotension , Nausea , Psychomotor Agitation , Tachycardia , Thyroid Crisis , Thyroid Gland , Vomiting , Water-Electrolyte Balance
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