Anesthetic Experience of Cerebral Infarction Following Operation / 대한마취과학회지

A 68 year old, ASA physical status 11, hypertensive male patient underwent open reduction, angulated blade plate fixation, and bone graft of femur intertrochanteric fracture due to non-union. Anesthesia was induced with thiopental and succinylcholine and maintained with vecuronium- Halothane-nitrous oxide-oxygen. Three uints whole blood was transfused and any significnat change in vital signs and EKG were not found during 4 hours operation. Soon after the patient was recovered. But he was found to be hemiplegia and sensory disturbance on the next day. Brain CT revealed infarction of middle cerebral artery territory. He expired 7 days following the surgery despite strenuous supportive measure.

The Effect of pH Adjustment of Bupivacaine on Caudal Anesthesia / 대한마취과학회지

Increasing the pH of local anesthetic solution with sodium bicarbonate has been known to hasten its onset of action. This study was designed to verify the effect of pH adjustment of bupivacaine on caudal anesthesia. Forty adult male patients having caudal block for perianal surgery were randomly assigned to four groups(n=l0) as follows. Group 1: control, 0.5% bupivacaine 20ml+0.6ml saline Group 2: 0.5% bupivacaine 20 ml+0.1% epinephrine 0.1 ml+0.5ml saline Group 3: 0.5 bupivacaine 20ml+5% sodium bicarbonate 0.5ml+0.1 ml saline Group 4: 0.5% bupivacaine 20 ml+5% sodium bicarbonate 0.5ml+0.1% epinephrine 0.1 ml The pH of prepared solution of each group is 6.23+/-0.032, 5.95+/-0.028, 7.35+/-0.054, 6.92+/-0.067 respectively. The time of onset of anesthesia (time between the completion of anesthetic injection and loss of temperature sensation at S4, S5 dermatome) was significantly rapid in group 3 followed by group 4. The time of onset of surgical anesthesia (time between the completion of anesthetic injection and loss of pain sensation by pin-prick test at S4, S5 dermatome) was significantly rapid in group 3.