The Effect of Posture on the Induction of Epidural Anesthesia / 대한마취과학회지

BACKGROUND: A study was done to determine if there is any difference in the quality of anesthesia and time to reach maximum anesthesia between the induction of lumbar epidural anesthesia in the sitting and supine position in young male patients undergoing appendectomy. METHODS: We randomly divided 30 patients to 2 groups. An epidural catheter was inserted at L2~3 interspace. In group 1, with the patient sitting, 3 ml of 1% lidocaine with 5mcg/ml epinephrine was injected as a test dose via the epidural catheter, and then 3 minutes later, 0.5% bupivacaine 30 ml was given through the same catheter. After maintaining sitting position for 5 minutes, the patient changed to a supine position and the quality of anesthesia was assessed at 3-minute intervals for 30 minutes. In group 2, after the epidural catheter was inserted at the sitting position, the patient changed to a supine position immediately. Remaining procedures were the same. RESULTS: The two groups showed no difference in maximum cephalad spread of anesthesia and motor block. CONCLUSIONS: The position of the patient during induction of epidural anesthesia has no effect on the cephalad sensory and motor block.

A Case of high-Frequency Oscillatory Ventilation / 대한마취과학회지

Neonates with severe respiratory distress syndrome who require high levels of assisted ventilation have a high mortality and morbidity rate. Morbidity is mainly composed of bronchopulmonary dysplasia which is a result of air leak syndrome(ALS), oxygen toxicity. Even with unsolved controversy, there is a possibility that high-frequency oscillatory ventilation would decrease the development or progression of ALS in infants with severe respiratory distress syndrome. ALS is defined as pulmonary interstitial emphysema or gross air leak such as pneumothorax. We experienced HFOV to be effective in the treatment of newborn infant with pneumothorax.

Intraoperative Contralateral Epidural Hematoma Following Removal of Cerebral Arteriovenous Malformation / 대한마취과학회지

A 46 years old woman developed a sudden transcalvarial brain herniation 1 hour after removal of a huge right frontal arteriovenous malformation intraoperatively. In spite of all possible anes- thesiologic resuscitative treatments, the brain swelling was not subsided. Resuscitative resection of the frontal lobe was done. The brain CT taken immediately postoperatively showed a large unsuspected epidural hematoma over the contralateral left temporal and occipital areas. This rare complication should be remembered during brain surgery if unexpected brain swelling occurs without apparent reasons after resection of arteriovenous malformation.