The Effect of Pancuronium and d-Tubocurarine on the Intraocular Pressure in man during Balanced Anesthesia / 대한마취과학회지

The purpose of this study was to evaluated the effect of muscle relaxants on the intraocular pressure during balanced anesthesia for intraocular surgery. Forty one patients without history of eye disease in physical status 1 and 2 (adopted by American Society of Anesthesiologist). aged from 17 to 66 years were studied during anesthesia for elective surgery. All were premedicated with 50 mg of meperidine hydrochloride and 0.5mg of atropine sulfate. Before induction of anesthesia intraocular pressure was measured and defined it as control value. Anesthesia was induced with 50mg of meperidine hydrochloride. 5mg/kg of thiopental sodium, and 0.11mg/kg of pancuronium bromide or 0.4mg/kg of d-tubocurarine. Anesthesia was maintained by meperidine hydrochloride, nitrous oxide-oxygen. Subsequent measurements were performed at 5, 10, and 20 minutes, after administration of pancuronium bromide and d-tubocurarine respectively. The results were as follows: 1) There was significant decrease in intraocular pressure after intubation with the administration of pancuronium bromide and d-tubocurarine chloride. 2) Significant decrease in intraocular pressure was observed druing balanced anesthesia with pancuronium bromid or d-tubocurarine.

Changes of Blood Sugar and Electrolytes According to Maintenance Fluids in General Anesthesia / 대한마취과학회지

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.

Anesthetic Experience with a Case of Cushing's Syndrome / 대한마취과학회지

We have experienced the anesthetic management of bilateral adrenalectomy in a 17 years old male, who was diagnosed as Cushing's syndrome. Anesthetic problems in Cushing`s Syndrome are hypertension, tachrcardia, hyperglycemia, hypokalemia and acute adrenal insufficiency. Therefore anesthetic management of this disease should focus on the through understanding of pathophysiology and adequate control of preoperative condition. Careful monitoring of the patient and frequent measurement of electrolytes and acid base balance status during the operation are also needed. We report the case of anesthetic experience of Cushing`s Syndrome and review anesthetic choice and management for better outcome of the patient.

Anesthetic Experience of Low Hemoglobin Level Patients due to Refusal of Blood Transfusion / 대한마취과학회지

Jehovah's Witness patients who require an operation represent a challenge to the physician because of the patients' refusal to accept a blood transfusion. We report 5 years experience with a consecutive series of 12 Jehovah's Witness patients in the Obstetric & Gynecological department who underwent operation. In 12 cases, death ensued in one patient who underwent subtotal hysterectomy for ectopic pregnancy. The cause of death was severe anemia & complicated respiratory problems. We discussed the problem of elective & emergency operations on Jehovah's Witness patients. Anesthesiologists must understand legal aspects, as well as and ethical, if they are to conduct their practice as an art as well as science.

Pheochromocytoma found during Transurethral Resection for Bladder Tumor - A case report / 대한마취과학회지

Unsuspected pheochromocytoma in a surgical patients may lead to serial complications. These include extreme hypertension, taehycardia and cardiac arrythmias which lead to cardiac arrest, cerebrovascular accident and renal failure in the postoperative period. Pheochromocytoma arising in the urinary bladder is a rare tumor. We recently experienced a case of pheochromocytoma which was found during transurethral resection for biopsy of bladder tumor under spinal anesthesia. The blood pressure suddenly rose during resection. of the tumor. It was difficult to arrive at a correct diagnosis in this case because of the predominant bladder symptams without hypertenaive attack. Therefore, final diagnosis was made as the pheochromocytoms after histological examination. The resection of the tumor was performed under general anesthesia after careful studies. The patient was not treated during the preoperative period as she had no particular symptoms, but Regitine was glven during surgery. Regitine was used twice to control the transient hypertension during manipulation of the tumor. After removal of the tumor, the blood pressure was well regulated without vasopressor drugs. We report a case of pheochromocytoma of urinary bladder with successful anesthesia management and the use of neuroleptanesthetics.

Anesthesia for Transurethral Resection in 97 Cases / 대한마취과학회지

Consecutive anesthesia records of transurethral resection. (TUR) on 97 patients have been reviewed. The patients' anesthetic management and complications were discussed. Operations in this series were classified as follows: 65 cases of TUR of the benign prostate hypertrophy(BPH), 8 cases of TUR of prostate ca, 24 cases of TUR of the bladder tumor. Of all the 97 cases of TUR, 62 cases had some systemic disease. Circulatory diseases, such as hypertension, abnormal EKG and ischemic heart disease were encountered most frequently, namely in 24 cases(26%). The patients who underwent TUR of the BPH had the highest mean age(70 years old). Spinal anesthesia was given 79.4%, and general anesthesia in 18. 6%. Complications did not occur during or after TUR. There was no death associated with anesthesia and operation in this study.