Anesthesia for Laryngeal Microsurgery: A Comparison of Propofol and Thiopenthal-Enflurane / 대한마취과학회지

Propofol, a new intravenous anesthetic agent,is now used for brief operation and day case surgery for its characteristics on recovery and controllability. We evaluated fourteen and fifteen patients undergoing laryngeal microsurgery with N2O-O2-propofol and N2O-O2 enflurane anesthesia respectively. In propofol group, induction dose of 1.5-2.0 mg/kg according to age was followed by continuous infusion of 10mg/kg/h with infusion pump. In enflurane group thiopenthal 3-5mg /kg and N2O-O2-enflurane were administrated for induction and maintenance of anesthesia. We checked systolic blood pressure, diastolic blood pressure and heart rate. There were no significant differnce between propofol and enflurane group in systolic and diastolic blood pressure. But hesrt rate of propofol group was significantly lower than enflurane group. Propofol group showed significantly higher incidence of pain during injection. We checked recovery time from anesthesia. Propofol group showed significantly shorter recovery time than enflurane group. Postoperative emesis and vomiting were occurred 1 patient in each group. According to arterial blood gas analysis, ventilatory function in time of eye opening recovered to normal ranges in propofol group, but not in enflurane group. We conclude that propofol is a safe and effective anesthetic agent for laryngeal microsurgery.

Changes of Whole Body Oxygen Consumption According to Changes of Systemic Vascular Resistance During Hypothermic Extracorporeal Circulation / 대한마취과학회지

Changes in whole body oxygen consumption associated with decreasea in systemic vascular resistance produced by Nipride (ssodium nitroprusside) infusion were measured in 15 patients during hypothermic extracorporeal circulation. When the body temperature was 29.3+/-2.16degrees C, mixed venous and arterial blood were sample simultaneously for the calculation of whole body oxygen consumption. Blood sample were withdrawn simultaneouely from the arterial outlet line and venous inlet line of the oxygenator for blood gas analysis. In each patient, whole body oxygen consumption at 29.3+/-2.16degrees C was determined as control. After then Nipride was infused until 10% decreasing of systemic vascular resistance was achieved and whole body oxygen consumption waa calculated. Body temperature, pump flow and hematocrit were maintained within a narrow range in each patients during studies. Arterial and mixed venous blood gases were analyzed at 37degrees C, uncorrected for body temperature(alpha-stat acid-base management). The result was that the whole body oxygen consumption changed from 43.3+/-12.12mL/min/m to 68.9+/-19. 16mL/min/m by Nipride infusion during hypothermic extracorporeal circulation. The 10% de- creasing of systemic vascular resistance by Nipride during hypothermic extracorporeal circulation lead to the 58+/-6.2% increasing of whole body oxygen consumption. We found that significant increase in whole body oxygen consumption hsd occured following Nipride infusion.