The Effect of Salbutamol on Succinylcholine - induced Hyperkalemia / 대한마취과학회지

In the present study, patients were traumatized with muscle-crushing injuries, or they were non-traumstized. The plasma concentration of potassium and sodium were measured before the induction of anesthesia and at selected intervals after the administration of succinylcholine(SCC) in some patients were inhaled the beta2-agonist, salbutamol (about 800 ug) via an endotracheal tube and in the others were not given it. There was no significant difference in the base lines of potassium and sodium between the traumatized and nontraumatized patients. Salbutamol diminished the rise of potassium(-0.30 to 0.09 mEq/L) but did not affect the plasma sodium level. There was no significant side-effect of this agent, but sinus tachycardia was the only thing noted. These results are consistent with the proposed mechanism that the decrease in serum potassium due to salbutamol is most likely a shift of potassium ions from the extracellular space to the intracellular space. Inhalation of salbutamol may be a useful method for the prevention of SCC induced hyperkalemia without any serious side-effect in patients with preexisting hyperkalemia properties who have gone through traums.

Clinical Evaluation of Ambulatory Surgical Patients / 대한마취과학회지

Ambulstory surgery in a hospital-based setting has been practiced at Yongdong Severance Hospital since August 1983. Several factors favor ambulatory surgery over the inpatient approach, first, hospital costs are decreased, second, it is less disruptive to the patient's personal life and the risk of hospital-acquired infection can be significantly decreased. The charts of 1913 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to obtain better guidance for anesthetic management in ambulatory surgical patients. The results are as follows: 1) The number of patients has been increasing since 1983. 2) A total of 1913 patients were evaluated, including 660 males and 1253 females, ranging in age from 5 months to 80 years and averaging 26 years. 3) The operations performed were grouped into: gynecologic(33.9% of the cases), otolaryngologic(33.7%), orthopaedic(10.4%), etc. The most frequent procedures were diagnostic dilation and curettage(23.7%) and excision(17.6%). 4) General anesthesia was performed for 852 patients(44.5%) and the anesthetic agents administered were intravenous narcotics in 360 cases, halothane-N2O-O2 in 289 cases, enflurane-N2O-O2 in 67 cases, etc. Nongeneral anesthesia was included regional nerve block in 76 cases(4.0%) and local infiltration in 985 cases(51.5%). 5) Anesthesia lasted less than one hour in 79.2% of the cases. Recovery time lasted less than one hour in 88.0% of the cases. 6) Only one patient was admitted for an anesthetic reason which was aspiration pneumonia. Seventeen patients were admitted for surgical reasons such as fever, bleeding, etc. From the above results, we believe that anesthetic care for ambulatory surgical patients can be provided safely and cost saving. Safety is an attitude, and when good practice is followed in selection of patients with careful preanesthetic evaluation and careful anesthetic technique, there is no reason to expect more complication than under the circumstance of hospitalization.