The Experiences of Airway Management for Anesthesia of Patients with Involved Cervical Spine Ankylosing Spondylitis / 대한마취과학회지

Ankylosing spondylitis is a chronic and systemic disease involving the axial skeleton. In patients with involved cervical spine ankylosing spondylitis, endotracheal intubation by direct laryngoscope may be difficult because they have a limitation of cervical movement and anatomical anomalies. We experienced the evaluation of thirteen patients with involved cervical spine ankylosing spondylitis by the Mallampati classification, Cormack and Lehane grade, thyromental distance and orolaryngeal angle. By Mallampati class and Cormack and Lehane grade, patients were almost class 3 or 4. Thyromental distance was 5.3 +/- 0.4 cm, and orolaryngeal angle was 90.4 +/- 8.0o.

Analysis of 1968 Cases of Preoperative Laboratory Screening Test Results / 대한마취과학회지

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.

Analysis of 1968 Cases of Preoperative Laboratory Screening Test Results / 대한마취과학회지

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.

The Predictors of Difficult Tracheal Intubation can Predict Difficult Mask Ventilation / 대한마취과학회지

BACKGROUND: Unexpected failed mask ventilation can result in brain damage or death. The purpose of this study was to demonstrate that the tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation in Koreans. METHODS: One hundred ninety one patients were assessed before operation using the modified Mallampati test and by measuring the atlanto-occipital angle (AOA), thyromental distance (TM), hyomental distance (HM), sternomental distance (SM), and horizontal length of mandible (HLM). The mask ventilation grades and the laryngeal grades were determined. The sensitivities, specificities and positive predictive values of tests were calculated. RESULTS: Eleven patients (5.7%) had difficulty in mask ventilation and 8 patients (4.1%) had difficulty in intubation. AOA grade had the highest sensitivity and every tests had relatively high specificities for predicting difficult mask ventilation. CONCLUSIONS: The tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation.