Recovery State of Hemorrhagic Stroke Patients: Exploratory Comparison of Recovery State between Spontaneous Intracerebral Hemorrhage(s-ICH) and Spontaneous Subarachnoid Hemorrhage(s-SAH) / 성인간호학회지

PURPOSE: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. METHODS: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. RESULTS: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. CONCLUSION: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.

The Effect of Fentanyl and Remifentanil on the Side Effects after Sevoflurane Anesthesia in Children Undergoing Herniorrhaphy / 대한마취과학회지

BACKGROUND: Emergence agitation is one of the major problems in pediatric anesthesia. The aim of this study was to compare the effect of remifentanil and fentanyl on the incidence of emergence agitation, postoperative pain and postoperative vomiting after administering anesthesia with sevoflurane. METHODS: Thirty ASA physical status 1-2 children, aged 12-60 months undergoing a unilateral inguinal herniorrhaphy were randomized to receive either remifentanil (group R, bolus 0.5microgram/kg; infusion 0.2microgram/kg/min) or fentanyl (group F, 1microgram/kg) after thiopental sodium induction. All patients received sevoflurane for maintenance of anesthesia. Heart rate and blood pressure were measured at baseline (T0), preintubation (T1), postintubation (T2) and 5 minutes after intubation (T3). The agitation score, pain score and incidence of postoperative vomiting were assessed upon arrival at the recovery room (P0), 30 minutes thereafter (P1) and 3 hours after discharge from the recovery room (P2). RESULTS: The agitation score were higher in group R at P0 (P < 0.05). The pain score was higher in group R at P0, P1 and P2 (P < 0.05). Postoperative vomiting was present only in one patient in group F. CONCLUSIONS: Adjuvant use of fentanyl during sevoflurane anesthesia revealed advantages over the use of remifentanil concerning the incidence of postoperative agitation and pain without any prolongation of recovery time.

The Effect of Lidocaine or Fentanyl on Withdrawal Movement during Rocuronium Injection / 대한마취과학회지

BACKGROUND: This study compared the efficacy of intravenous fentanyl with lidocaine as a pretreatment for the prevention of a withdrawal response after a rocuronium injection. METHODS: Eighty patients were divided into four groups according to the drugs used for pretreatment as follows: group I: normal saline, group II: lidocaine 0.5 mg/kg, group III: lidocaine 1.0 mg/kg, group IV: fentanyl 1microgram/kg. Twenty seconds after inducing anesthesia, each pretreatment drug was injected. After twenty seconds, rocuronium was injected. The incidence and severity of the withdrawal responses was assessed. The BIS value and heart rate was recorded at each point (T0: baseline, T1: pretreatment drug injection, T2: 10 seconds after pretreatment drug injection, T3: rocuronium injection, T4: 10 seconds after rocuronium injection, T5: 20 seconds after rocuronium injection). RESULTS: The incidence of withdrawal movement was significantly lower in groups II and III than in groups I and IV (P = 0.002). The BIS was significantly lower in group IV than in groups I, II and III at T2 and group I at T3 (P < 0.05). The heart rate at T4 was significantly lower in group IV than in group II (P < 0.05). An assessment of BIS at the withdrawal movements showed a significantly higher value in the severe group than in the none and mild groups at T5 (P < 0.05). CONCLUSIONS: A pretreatment with 0.5 mg/kg or 1.0 mg/kg of lidocaine effectively reduced the incidence of a withdrawal response by the rocuronium injection. However, 1.0 mg/kg of lidocaine most effectively prevented the withdrawal response without causing any significant changes in heart rate.