Comparision of Ketamine Versus Propofol for Intravenous Anesthesia Undergoing Dilatation and Currettage in the Gynecological Patients / 대한마취과학회지

Intravenous anesthesia of propofol was compared with ketamine on 20 gynecological patients undergoing dilatation and currettage. The patients were randomly assigned to study in two treatment groups so that l0 patients was administered ketamine anesthesia and 10 patients was administered propofol anesthesia. The hemodynamic responses and recovery characteristics of the two group were compared with control group. Arterial blood pressure(systolie, .mean, diastolic) and heart rate after induction were significantly increased in ketamine group, but showed significantly decrease in propofol group(table 5). Time to full recovery(mean+/-SD) was significantly less in the propofol group(14.3+/-2.9 min vs 40.2+/-4.l min, p<0.01)(table 4). The authors conclude that intravenos anesthesia of propofol is a pratical alternative technique for gynecological patients undergoing dilatation and currettage and may be preferable to ketamine because of the significantly shorter recovery time.

Anesthetic Management of Open Heart Surgery of the Patient with a Permanent Pacemaker / 대한마취과학회지

A 49-year-old man was admitted to Baptist Hospital on September 1, 1990. For mitral valve replacement due to mitral regurgitation. He has been treated by implantation of artificial pacemaker due to complete heart block for 1 year ago. We have experienced anesthetic management above patient who was scheduled of MVR. The patient with a cardiac pacemaker (VVI type) could give anesthesiologist many associated problems during the operation and anesthesia. During anesthesia an anesthesiologist should be able to manage the problems which might occur because of a cardiac pacemaker by various origins. Authors report this case with evaluation of references.

A Case Report of Asthmatic Attack in the Postoperative Recovery Room / 대한마취과학회지

Anesthetic managment of bronchial asthmatic patient requires understanding of the patho- physiology of the disease and the drug interaction with anesthetics and the drugs related to the treatment. A 53-year old male patient with hemorrhagic pancreatitis had been operated for exploratory laparotomy. He had history of the bronchial asthma. After the operation was completed, patient was transfered to recovery room after extubation. Sudden airway obstruction signs and patients agitation were noted 5 minutes after arrival in the recovery room. Asthmatic attack was relieved with salbutamol, corticosteroid, aminophylline, and isoproterenol intravenously. We have experienced one case of severe asthmatic attack in the postoperative recovery room. We report this case and review the anesthetic managements and drug interactions.

Anesthetic Management for Repair of Congenital Diaphragmatic Hernia / 대한마취과학회지

A 2600 gm term female baby was born through Caesarean section at Baptist Hospital to 29-year-old, primigravda woman who had pregnancy induced hypertension(PIH), HBsAg carrier, and chronic glomerulonephritis. Apgar scores were 5 at one minute and 7 at five minutes. There was extreme respiratory distress in the nursery and she was diagnosed as congenital diaphramatic hernia. At operation, there was a left sided foramen of Bochdalek hernia with hypoplasia of left lung. The diaphragmatic hernia was reduced and cardiac evaluation revealed no evidence of congenital heart disease (CHD) by clinical examination. There also noted no right to left shunt via patent ductus arteriosus. After operation, endotracheal tube was left in place and the patient returned to the nursery where she received respiratory care with infant ventilator. The major determinants of outcome in patients with CHD are the extent of pulmonary hypoplasia and the degree of pulmonary hypertension. So pre- and postoperative management of the pulmonary hypertension is as important as surgical correction of the CHD. The patient tolerated anesthesia and surgery well, and was discharged one month later.

A Case Report of Hypoglycemic Shock Immediately after Induction of General Anesthesia / 대한마취과학회지

Diabetes mellitus is a chronic systemic disease due to a relative or absolute lack of insulin. Hypoglycemia is the clinical occurence most feared when dealing with diabetic patients. The actual level below which blood glucose concentrations are insufficient level at which symptomatic hypoglyeemia occurs is variable. We experienced a case of hypoglycemic shock immediately after induction of general anesthesia on a patient with diabetes mellitus and hypertension. This is the case report and a review of the literature on diabetes mellitus.

Postoperative Thyroid Storm / 대한마취과학회지

Thyrold storm, when related to surgery, usually develops within 6~18 hours postoperatively, with symptoms and signs of pyrexia, marked tachycardia, susceptability to severe hypotension, and restlessness. There are a few case reports of thyroid storm related to thyroid surgery or the surgery related to non thyroid surgery with the patient of the hyperthyroidism. We have experienced anesthetic management and postoperative thyroid storm management. The patient have had brain tumor and Grave's disease which was treated with antlthyroid agents and beta-blocking agents to mate the patient euthyroid state for two weeks by the internist. The patient tolerated the two hours of general anesthesia well, but on the first postoperative day, thyroid storm was developed with symptoms and signs of dyspnea, restlessness, nausea, vomiting, diarrhea and tachycardia. After thirty minutes to start the treatment with antithyroid agents, betablocking agents, sedatives and electrolyte balance, the thyroid storm was treated and the patient was discharged on the twenty first postoperative days with healthy state.

Mechanisms and Evaluation of Hepapotoxicity / 대한마취과학회지

No abstract available.

Hepatitis Developing after Halothane Anesthesia : A Case Report / 대한마취과학회지

Anesthetists use halothane as a popular anesthetic agent, but after halothane anesthesia, hepatitis developed intermittently. However, it is not easy to prove halothane as a causative agent, because there are many factors causing hepatitis. We had a case of acute hepatitis developing after halothane anesthesia. Case: A 29-year-old male had an operation for split thickness skin graft on the right antetibial area under halothane anesthesia. Prior to operation, he was medicated Cefoxitin 1.0gm tid IV to control infection. On the postoperative 11th day, he developed high fever of 40.5 degrees C. Thereafter, skin rashes and jaundice followed. Liver function tests showed marked elevation of SGPT, SGOT, alkaline phosphatase, and eosinophillia. HBsAG(-), HBcAb(-), and HBeAg(-) were reported. There also was negative finding in HVA-IgM. He recovered gradually from the hepatitis and went home in good health on the 34th postoperative day. A possible cause or causes of the hepatitis in this case were considered to be the Cefoxitin adn/or the halothane.

The Eligibility Study of Anesthesia and Surgery for HBs Antigen Positive Patients / 대한마취과학회지

There are many article about hepatitis B antigen vaccination and protection against the hepatitis B viruses for medical people, however there are no article about surgical patients who had hepatitis B surface antigen. This study was performed to evaluate the eligibility for anesthesia and surgery of hepatitis B surface antigen positive patients by comparing pre-and post-operative liver function tests. Thirty hepatitis B surface antigen positive patients who were scheduled for surgery were selected for this study and another thirty hepatitis B surface antigen negative patients who were also scheduled for surgery were selected for the control group. AS result were concluded that the hepatitis B surface antigen positive patient who doesn't have active hepatitis is eligible for anesthesia and surgery.

Cardiovascular Effect of Caudal Anesthesia with Lidocaine / 대한마취과학회지

Since Sicard, Cathlin and Tuffier performed the first sacral extradural anesthetic technique in 1901, surprisingly increased interest in this technique and basic investigation has been done concerning the anatomy, the physiology, and the fate of the local anesthetic in the body, after in jection in the epidural space. Recently, a decreasing interest in peridural anesthesia and nerve block thechniques have resulted from the availability of more efficacious and more safe volatile anesthetics. However in case of contraindication of both general and spinal anesthesia, this caudal anesthesia should be available and very usefull. Authers have undertaken to evaluate the circulatory effect of caudal anesthesia with the injection of lidocain into the epidural space through the sacral hiatus. Ten cases were selected and observed the change of the cardiovascular system before and after caudal anesthesia. The changes of the heart rate and systolic blood pressure between pre-and post anesthesia were insignificant statistically.

The Effect of Intravenous Anesthesia with Ketamine on Respitatory System / 대한마취과학회지

An increasing interest in intravenous anesthetic techniques has resulted from the availability of more efficacious intravenous agents, possible discomfor of the patient on endotracheal intubation and the concern over anesthetic pollution in the operating room. This study was done to investigate the effect of intravenous anesthesia with ketamine on the respiratory system by comparing arterial blood gas analysis before and after the procedure. Analysis of arterial blood for PCO2, PO2, pH, and excess were carried out. Heart rate and blood pressure were monitored on 15 patients in ASA class l for diagnostic or short procedures. Each patient was premedicated with atropine 0.01mg/kg and valium 0.2mg/kg intramuscularly 30 minutes before the procedure. ketamine was administered intravenously 1.0~1.5 mg/kg or intramuscularly 3~5mg/kg for induction of anesthesia. The anesthesia was maintained with ketamine 0.5~1.0mg/kg and valium 0.1mg/kg ever 5 to 10 minutes. The results of this study showed that ketmine anesthesia seemed not to cause any untoward effect on respiratory function. In other words, ketamine seems to be a safe and good intravenous anesthetic agent for diagnostic or short surgical procedures.