Clinical Study of Intubating Dose of Pancuronium in Divied doses for Endotracheal Intubation / 대한마취과학회지

Many technics have geen tried to avoid the adverse effects of succinylcholine administered for endotracheal intubation especially with the complications of hyperkalemia, aspiration pneumonis, increased intraocular pressure and postoperative muscle pain. One of these is that the prior administration of a small subparalizing dose of nondepolarizing muscle relaxant would shorten the onset time of an intubating dose of muscle relaxant. However, the priming dose, the intubating dose, and the time interval between these doses requires better definition. This study was undertaken to determine the intubating dose of a nondepolarizing agent, pancuronium bromide under the condition of fixed priming dose and administration interval time. Fifty five patients were divided randomly into three groups, administered intubating dose of 60(group l), 80(group ll) and 100(group lll) ug/kg including 20, 20 and 15 cases, respectively. The results are as follows: 1) Nine patients complained of blurred vision or diplopia after the administration of priming dose. 2) There was no difference of intubation condition between one and another group. 3) In the low grading of intubation condition, female patients were more distrbuted and better facilitated endotrscheal intubation than male patients(p<0.05). 4) There was no difference of interval time between the administration of intubating dose and the maximum depression of TOF in each group. The interval revealed 7.0+/-3.3, 6.2+/-3.3 and 5.4+/-2.4min. in l, ll and lll group, respectively. 5) The interval time between the administration of intubating dose and reappeared first twitch of TOF revealed 36.6+/-18.3, 45.7+/-17.6 and 65.4+/-22.2 min. in l, ll and lll group, respectively. The interval in group lll was significantly longer than that in group l and ll(p<0.05). In conclusion, the priming and intubating doses may not be required in the divided doses of pancuronium more than 15 and 100ug/kg, respectively.

Anesthesia for Aorto-coronary Bypass Graft / 대한마취과학회지

Fourty one cases with coronary occlusive disease were anesthetised for aortocoronary bypass graft from May 1977 to December 1983 st Severance Hospital, Yonsei University Medical Center. The main anesthetic agents were diazepam-morphine-pancuronium-O2-N2O in most cases, and supplemented with halothane, enflurane of methoxyflurane in some cases. Nitroglycerin, nitroprusside, triflupromasine, and dopamine were used for keeping the hemodynamic stability before, during and after anesthesia depending on the needs. Two operative death occured in our early years. The mortality rate was 4.87% and no late deaths. The overall anesthetic management for aortocoronary bypass graft surgery is disscussed.