A Case of Pulmonary Thromboembolism during Ceaserian Section of Placenta Previa Totalis: A case report / 대한마취과학회지

The pulmonary thromboembolism (PTE) developes occasionally in trauma, surgery and pregnancy. It presents dyspnea, tachycardia, syncope, hypotension and may be fatal by right heart failure. Severe intraoperative PTE is rare. But an intraoperative PTE occurs, it is difficult to diagnose with classic diagnostic measures such as ventilation-perfusion scan, pulmonary angiography, so appropriate management may be delayed. We experienced a case of severe PTE during Ceaserian section of placenta previa totalis. The patient survived and showed complete resolution after 1-year follw-up.

Comparison of Therapeutic Effect of C2 ganglion Block for Cervicogenic Headache, Tension-type Headache, and Migraine without Aura / 대한마취과학회지

BACKGROUND: A paracervical C2 ganglion blockade was carried out for therapeutic and diagnostic reasons of cervicogenic headache only. METHODS: This study was designed to investigate the therapeutic effect of C2 ganglion blockade in patients with cervicogenic headache(CEH), migraine without aura, and tension-type headache(TTH). From March 1995 to June 1995, we treated 24 cases of chronic headache(CEH:12, TTH:9, migraine:3) using C2 ganglion blockade with methylprednisolone and mepivacaine. The diagnoses of CEH in this study was established according to the recent diagnostic criteria(Sjaastad et al. 1990). The diagnoses of migraine and TTH were based on the IHS criteria. RESULTS: In the cases of cervicogenic headache, 11 patients out of 12(91.67%) improved after C2 ganglion blockade. In the cases of tension-type headache, 7 patients out of 9 improved(77.78%). In the cases of migraine, 1 patient out of 3(33.33%) improved. CONCLUSION: No significant differences of the therapeutic value were found in patients with three groups of headache(Fishers exact test).

Neurolytic Blockade of the Ganglion Impar for Relief of Cancer-Related Perianal Pain: A case report / 대한마취과학회지

The perineum refers to the anatomical area immediately below the pelvis, and is comprised of diverse anatomic and somatic innervation. Although various interventions have been proposed for the management of intractable cancer-related perineal pain, their efficacy are limited because the target of nerve blocks has focused on somatic rather than sympathetic components. Recently, blockade of the ganglion impar has been introduced as an alternative means of managing intractable neoplastic perineal pain of sympathetic origin. We successfully treated a patient who had suffered from cancer-related intractable perineal pain with ganglion impar block.

A Case Report of Hypothermia during the Operation / 대한마취과학회지

Perioperative hypothermia can occur rather frequently with in varying degree and lead to the various complications. Because infants, small children, elderly patient, cachetic patient and multiple trauma patients are prone to develop hypothermia during the operation and anesthesia. An anesthesiologist should be aware of deveolpment of hypothermia and take appropriate measures to prevent it. Authors experienced a case of hypothermia with body temperature dropped 32.4degrees C during the reconstruction of retrognathism and temporo-mandibular joint release in 6-year-old female child. Appropriate measures were taken for hypothermia, and the patient was discharged without any complication.

Orthotopic Liver Transplantation in Dogs by Veno - venous bypass using Centrifugal Pump / 대한마취과학회지

The Orthotopic liver transplantation for the terminal liver diseases has been performed frequently since the introduction of new immuno-suppressive agent (cyclosporin A), technical advances in surgical skill, uae of biopump during anhephatic stage, rapid infusion system for transfusion and thromboelastography for coagulopathies were used. In Korea, only one case of orthotopic liver transplantation succeeded in 1988, but the animal experiments have been going on for many years in many institutes. Orthotopic liver transplantation in dogs using centrifugal pump (Bio-pump) were experienced and the results were analysed; 1) There were no differences in hemodynamic parameters during anhepatic stage with assistance of Biopump compared with preanhephatic stage. 2) The mean flow rate of Biopump during anhepatic stage was 0.75+/-0.09L/min, and maximun and minimum flow rate were 1.5L/min. and 0.4L/min, respectively. 3) Mean artery pressure, cardiac output and systemic vascular resistance after reperfusion of transplanted liver were significantly reduced compared with the values of before reperfusion; meanwhile, mean pulmonary artery pressure, pulmonary capillary wedge pressure and pulmonary vascular resistance were not significantly different. 4) After reperfusion of transplanted liver serum potassium level was significantly increased to 6. 07+/-1.8 mEq/L and the amount of base was significantly decrease to-12.9+/-5.9 mEq/L. By using Bio-pump the degree of hemodynamic changes could be reduced during the clamping of inferior vena cava and hepatic vein.