Validity on Postoperative Routine Supplemental Oxygen Using Pules Oximetry-Determining factor on the Postoperative Arterial Hypoxemia / 대한마취과학회지

Routine use of supplemental oxygen(O2) in the recovery room traditionslly has been used to minimize the incidence of hypoxemia. However with the advent of continuous noninvasive monitoring by pulse oximetry is routine administration of O2 necessary? We hypothesized that administration O2 as needed based on pulse oximetry dats, would effect without compromieing patient care. And factors that might influence the incidence of post-operative hypoxemia were analyzed. On hundred thirty eight adult (> or = 18yrs) patients were enrolled in the study. During recovery room care, when O2 saturation(SpO2) was continuously more than 94%, no supplemental O2 was given. When SpO2 was less than 94%, supplemental O2 was given by face mask(O2 51/min). SpO2 and Aldrete score(AS) were measured at preoperatively, at the end of anesthesia, on arrival in the recovery room, at 10 min, 20 min and 30 min after arrival in the RR and at discharge. The results are as follows: 1) Supplemental O2 was unneeessary in the 55.8% of patient for the duration of the recovery room stay. 2) A significant multiple correlation was found between low SaO2 level, while breathing room air on arrivsl in the recovery room and preoperative SpO2, weight and Aldrete score on arrival in the recovery room. With the above results the authors concluded that in as much as pulse oximetry monitoring is now standard in the recovery room, administration O2 as need based on the pulse oximetry data would effect without compromising patient care, and that preoperative oxygen saturation and weight are the main factors influencing early postopertative hypoxemia in this study.

Effect of Methylpredisolone to the Changes of Blood Sugar Levels , Blood Pressure and Heart Rate During General Anesthesia / 대한마취과학회지

Maintenance of optimum blood sugar level is a basic factor in energy metabolism and maintenance of cell function. Insulin and glucagon are the important factors in blood sugar control. The surgical stress increases the secretion of catecholamine, glucocorticoid and induces hyperglycemia. These hormones inhibit glucose-induced insulin secretion. Inhalation anesthesia affect the carbohydrate metabolism by reducing glucose-induced insulinogenic response and inhibiting the insulin secretion from the pancreas. Diazepam and muscle relaxant used in balanced anesthesia do not significantly affect blood glucose level. Methylprednisolone has an important role in maintenance of homesostasis of body function and is often used in surgical anesthesia. When large dose of methylprednisolone is administered to a normal person, fasting blood increases and glucose tolerance decreases. These factors may aggravate the symptoms of diabetic patients. We measured blood sugar level, systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate after administration of methylprednisolone. The results were as follows: 1) Blood sugar leve increased significantly in all groups after induction of anesthesia, and the increase was greater in methylpredinsolone group and halothane anesthesia group. 2) Systolic blood pressure increased significantly and more in methylprednisolone group in balanced anesthesia. In halothane anesthesia group, systolic blood pressure decreased, but recovered in methylprednisolone group, 2 hours after anesthesia. 3) The changes in mean and diastolic blood pressure were similar to the changes in systolic blood pressure in all groups. 4) The changes in heart rate in methylprednisolone group was less than other groups.