The Hope, Burden, and Family Function in Mothers of Children with Cancer / 아동간호학회지

The purpose of the descriptive correlation study was to examine relations among the hope, the burden and the family function in mothers caring for children with cancer. 145 mothers completed the three questionaires of the study divided into tree sections: a) The Hope Scale, b) The Burden Scale, c) FACES-lll. The collected data was analysed with t-test, ANOVA, Scheffe test and Pearson correlation coefficients. The results were as follows: 1) The average age of mothers of children with cancer was 35.6 years old and the ages between 30 to 39 were the most abundant. 57.3% of the mothers had an education level of below high school education and 66.0% had religion. The average age of the children was 8.6 years old. Ages between 1 to 7 were the most and 60.8% were diagnosed as leukemia. 2) Regarding the section of degree of burden, mothers of children with cancer marked 2.6 out of 5, and the degree of hope 3.2 out of 4. The result for family function came out to be 3.5 out of 5, an average of family cohesion of 3.9 and family adaptation of 3.1. 3) There were significantly less burden to the mothers who were living together with a spouse compared to the mothers who were not. Also mothers who replied that they preserved good health came out to be exposed to less burden compared to the mothers who did not. In analysing hope according to the general characteristics of mothers of children with cancer, mothers who were employed marked high in the degree of hope compared to unemployed mothers. Furthermore, the degree of family cohesion marked higher with mothers who had higher education of college graduate, mothers with religion and mothers with a monthly family income of over W3,000,000, compared to the group of mothers with lower education of high school graduate, non-religious or with a monthly family income of less than W1,000,000. 4) Excluding the fact that the group sorted with children diagnosed as leukemia marked a perceivably high score regarding family cohesion, compared to groups with other cancers, the degree of burden, hope and family cohesion did not show any noticeable difference according to characteristics of children with different cancers. 5) In the correlation of the hope, the burden and the family function regarding the mothers of children with cancer, the burden did not have any manifest relationship with hope or family function. However, the degree of hope and family function cohesion had a direct proportional relationship, as family cohesion marked higher when the degree of hope were high.

The Inhibitory Effects of Midazolam and Diazepam on Smooth Muscle Tension in Rat Trachea / 대한마취과학회지

BACKGROUND: It has been demonstrated that a group of minor tranquilizers, benzodiazepines, are able to relax airway smooth muscle, but the mechanism by which these agents produce muscle relaxation are not fully understood. This study was undertaken to determine the effects and mechanism of diazepam and midazolam on Ca2+ and K+ channel in isolated rat trachea muscles by measuring isometric tension. METHODS: Our experiment was performed to evaluate the effects of midazolam and diazepam by cumulative administration from 10(-6)M to 3 x 10(-5)M to tracheal smooth muscle contraction which was induced by contractile agonists such as ACh 10(-5)M, carbachol 3 x 10(-7)M, and KCl 40 mM. The effects of midazolam and diazepam were evaluated on Ca2+ and K+ channels by inhibition of contraction using a nonspecfic K+ channel blocker such as tetraethyl ammonium (TEA) elicited by a 2 mM Ca2+ space addition to Ca2+ free on high K+ depolarizing rat tracheal muscle. Also, to elucidate any mechanism involved, the effects of flumazenil (a specific central antagonist of benzodiazepines), propranolol (a beta adrenergic antagonist), and atropine (a muscarinic antagonist) and tracheal epithelium removal were examined. RESULTS: In a concentration-dependent way, both midazolam and diazepam relaxed airway smooth muscle directly and had inhibitory effects on voltage-dependent Ca2+ (VDCC) and K+ channels. CONCLUSIONS: These results suggest that benzodiazepines relax airway smooth muscle, not via a neural pathway or benzodiazepine receptor but through a direct action on Ca2+ and K+channels. Benzodiazepine enhanced K+ conductance, leading to a decrease in VDCC opening, thus reducing Ca2+ through the voltage-dependent Ca2+ channel, in addition to inhibiting of intracellular Ca2+ release.

Paraplegia Caused by Caudal Analgesia / 대한마취과학회지

Caudal analgesia is a widely accepted technique for providing pain relief. However, both permanent and transient neurologic complications, including paraplegia, have been reported. We report on a patient who developed paraplegia following a caudal block for an epidural mass. The cause of the paraplegia was unknown, but possibly spinal angioma may have taken part in the onset and progression of the paralysis. A mechanism is proposed by which the caudal injection may have caused a change in blood flow through the spinal angioma resulting in cord ischemia.

The Comparison of Epidural Morphine and Epidural Morphine-Ketamine for Postoperative Pain Relief after Subtotal Gastrectomy / 대한마취과학회지

BACKGROUND: Epidural narcotics are now widely used for postoperative pain relief, but their side effects are problematic. Thus, this study was undertaken to evaluate the analgesic effects and to minimize the side effects of the combination of epidural morphine and ketamine versus epidural morphine alone in pateints with postoperative pain. METHODS: The value of using a combined infusion of morphine with a variable dose of ketamine for postoperative analgesia following subtotal gastrectomy was assessed in a double-blind randomised study of 30 patients. Three groups of 10 patients received an infusion of morphine at 2 mg/day, either alone, or combined with ketamine at a rate of 0.4 or 0.6 mg/kg/day. RESULTS: Postoperative anlagesia, sedation, and side effects were not statistically significantly different between groups I and II. Postoperative sedation, and side effects were not statistically significantly different between groups I and III. VAS of group III at 1-2 h was lower than in group I. CONCLUSION: The addition of ketamine to a continuous infusion of morphine dose not significantly improve postoperative analgesia. In addition, increasing the dose of ketamine does not significantly improve postoperative analgesia, Nor does it increase sedation, or side effects.

The Effects of Etomidate on Isolated Tracheal Smooth Muscle in Rat / 대한마취과학회지

BACKGROUND: Etomidate is an intravenous anesthetic which has properties of hemodynamic stability, minimal respiratory depression, and cerebral protection. Also, it is a useful induction agent for patients compromised by asthma and other reactive airway diseases. The aim of this study was to investigate the effect and action mechanism of etomidate on isolated tracheal smooth muscle in rats. METHODS: The rat's trachea was dissected free, cut into rings (2 mm) and mounted for isometric tension in Tris Tyrode solution. Cumulative dose-response curves for etomidate (3 X 10(-7) 3 X 10 (-4) M) were obtained from the tension measurements of acetylcholine (10 (-5)M)-contracted rings. The effects of propranolol, L-NAME and indomethacin on the etomidate induced tracheal response were investigated. Also, the effect of etomidate on the extracellular Ca2+ influx and Ca2+ release from internal stores was investigated. RESULTS: Etomidate produced relaxation of acetylcholine-precontracted trachea in a dose-dependent fashion. Pretreatment with propranolol, L-NAME had no effects on concentration-response curves to acetylcholine. Pretreatment with indomethacin had an effect on the concentration-response curve to acetylcholine. Pretreatment with etomidate inhibited acetylcholine-induced contractions in the absence of extracelluar Ca2+ and the presence of extracellular Ca2+ . CONCLUSIONS: The tracheal smooth muscle relaxation by etomidate is not related with beta-adrenergic activation and NO synthesis but related with prostaglandin production. The relaxation effect of etomidate is induced by a decrease in concentration of intracellular Ca2+ through the blockade of extracellular Ca2+ influx and the simultaneous release of Ca2+ from internal stores.

The Effect of Midazolam, Fentanyl and a Small Dose of Etomidate for Prevention of Myoclonus during Induction of Anesthesia with Etomidate / 대한마취과학회지

BACKGROUND: The hypothesis that subcortical disinhibition is the reason for etomidate-induced myoclonus suggest that drugs acting on the subcortical area may reduce myoclonus. To verify the hypothesis, premedication with placebo, etomidate of a small dosage, midazolam and fentanyl were compared. METHODS: Sixty ASA physical status I or II patients undergoing elective surgery were allocated into four groups. All groups were induced with etomidate 0.3 mg/kg and vercuronium 0.1 mg/kg and maintained with 50% N2O and 1.5-2% enflurane. Group I (n = 15) received normal saline 3 ml 5 minutes before the etomidate 0.3 mg/kg administration, group II (n = 15) received 0.05 mg/kg etomidate 50 seconds before the etomidate 0.3 mg/kg administration, group III received midazolam 0.05 mg/kg 5 minutes before the etomidate 0.3 mg/kg and group IV received 2 microgram/kg fentanyl 5 minutes before the etomidate 0.3 mg/kg. In all patients, the grade, starting time, maintenance time of myoclonus and vital signs were checked and compared between the four groups. RESULTS: In group IV, myoclonus did not develope except in one patient and there were no differences in the incidence of myoclonus between the others. All premedicating drugs do not affect vital signs. CONCLUSIONS: We find that fentanyl reduces the incidence of etomidate-induced myoclonus but midazolam and a small dose of etomidate are not effective.

Effects of Vecuronium and Pancuronium on the Tension of the Smooth Muscle in the Rat Trachea / 대한마취과학회지

BACKGROUND: Vecuronium and Pancuronium have been proven to be associated with nicotinic receptor of skeletal muscle. Generally, nondepolarizing muscle relaxant is associated with contraction of smooth tracheal muscle, but there have been few studies about effects of nondepolarizing muscle relaxant on the smooth tracheal muscle. METHODS: We studied the acetylcholine dose response curve of the tracheal smooth muscle contraction and effects of propranolol, L-NAME after pretreating with vecuronium and pancuronium. RESULTS: Vecuronium shifted the acetylcholine dose-response curve of the tracheal contraction to the left, and pancuronium shifted the curve to the right. Vecuronium and Pancuronium reduced the contraction of smooth tracheal muscle with the use carbachol. Propranolol and L-NAME had no effect on the contraction of smooth tracheal muscle after pretreating with vecuronium and pancuronium. CONCLUSION: We suggest that vecuronium has an anticholinergic effect, while pancuronium has some effect on the muscarinic receptor in addition to its anticholinergic effect.

The Effects of Vecuronium and Pancuronium on the Tension of the Isolated Rat Tracheal Smooth Muscle / 대한마취과학회지

BACKGROUND: Non-depolarizing muscle relaxants have their muscle relaxing effect by competing with acetylcholine (ACh) at the nicotinic receptor level. What are the effects of such muscle relaxants on the tracheal smooth muscle? This present study was set up to address the question as to how vecuronium and pancuronium influence the tracheal smooth muscle. METHODS: Sixty male Sprague-Dawley rat tracheal smooth muscles were isolated at optimal length for isometric force. The preparations were set up in an organ bath containing Tyrode's solution. And isometric force displacement transducer and physiograph were used to record the change in force. After the equilibration period the preparations were contracted with ACh 10(-5) M and carbachol 3x10(-7)M seperately. The preparations were washed with fresh tyrode's solution and allowed to return passively to resting tone. Then the cumulartive effect of ACh (from 3 10(-7) M through 10(-5) M) and carbachol (CCh, from 10(-8) M through 3 10(-6) M) were produced before and after pretreating the preparation with vecuronium (10(-5) M and 10(-6) M) and pancuronium (10(-5) M and 10(-6) M) respectively. Also, we studied the changes of contraction produced by neostigmine before and after pretreatment with vecuronium (10(-5) M and 3 10(-5) M) and pancuronium (3 10(-6) M and 3 10(-5) M). RESULTS: Vecuronium shifted the ACh dose-response curve of the tracheal contraction to the left (p0.05). CONCLUSIONS: Vecuronium inhibits the ACh hydrolyzing enzyme, especially acetylcholinesterase. Therefore it potentiates ACh contraction in the tracheal smooth muscle, but not the CCh contraction, while pancuronium has a different effect in comparison with vecuronium. That is, at a low concentration it reveals an antagonistic effect on the muscarinic M2 receptor and at a higher concentration it has an antagonistic effect on the muscarinic M3 receptor in the tracheal smooth muscle.

Acute Pulmonary Edema Occurred in a Patient with Hypothyroidism during Emergence from General Anesthesia: A case report / 대한마취과학회지

Anesthesia and surgery in patients with untreated or inadequately treated hypothyroidism carries the risk of potential complications such as prolonged unconsciousness, hypotension, hypoventilation, hyponatremia, precipitation of congestive heart failure, cardiopulmonary arrest and myxedema coma. In addition, these patients have an impaired ability to excrete free water. Therefore, careful attention must be devoted to fluid and electrolyte management to prevent fluid retention and edema. We experienced a case of acute pulmonary edema during emergence from anesthesia in a patient with cured hypothyroidism. The pulmonary edema was completely resolved with ICU care on the 5th postoperative day. We conclude that surgery in the patient with hypothyroidism require thyroid hormone replacement therapy, careful monitoring and management for the cardiovascular status.

Repeated Ventricular Fibrillation during Emergence of General Anesthesia Caused by Variant Angina: A case report / 대한마취과학회지

Variant angina is characterized by recurrent attacks of chest pain occurring at rest and associated with ST segment elevation on EKG and its cause is now established to be spasm of a major coronary artery. In patient with variant angina coronary artery spasm can be provoked by a number of physiologic maneuver, hyperventilation and pharmacologic agents such as ergonovine, histamine, epinephrine, methacholine, and dopamine. This may be associated with acute myocardial infarction and severe cardiac arrhythmia including ventricular tachycardia and fibrillation as well as sudden death. We present a case of repeated ventricular fibrillation that occured in a 60 years old male patient at the emergence from anesthesia. The cause of venticullar fibrillation was strongly suspected of variant angina on the basis of EKG findings. The patient was successfully resucitated by intensive treatment and nitroglycerine infusion. The patient recovered uneventfully and diagnosed variant angina by ergonovine test performed after recovery.

Comparison of Intubation Following Propofol-Fentanyl with Intubation Following Succinylcholine-Thiopental Sodium / 대한마취과학회지

BACKGROUND: This study was performed to determine the effect of a endotracheal intubation & induction of anesthesia using propofol 2.0 mg/kg or 2.5 mg/kg and fentanyl 2 g/kg without succinylcholine chloride. Also we have compared this method with technique using succinylcholine 1.5 mg/kg and thiopental sodium 5 mg/kg. METHODS: They were divided into 3 groups as follows: group 1, succinylcholine 1~1.5 mg/kg and thiopental sodium 5 mg/kg; group 2, propofol 2 mg/kg and fentanyl 2 microgram/kg; group 3, propofol 2.5 mg/kg and fentanyl 2 microgram/kg. Systolic arterial pressure (SAP) and diastolic arterial pressure (DAP), and heart rate (HR) were measured before induction, after induction, after tracheal intubation immediately, at 1, 2, 3, and 5min. after tracheal intubation in all patients. The incidence of adverse effects and the quality of condition for intubation were measured in all patients. RESULTS: There were significant increases in SAP, DAP, HR after intubation in group 1 but significant decreases in SAP, DAP after induction and at 5min. after intubation in group 2 and group 3. The incidence of adverse effects, and the quality of condition for intubation were no significant difference between group 1 and group 3. CONCLUSIONS: From the above result, use of propofol 2.5 mg/kg and fentanyl 2microgram/kg provided a satisfactory alternative to succinylcholine and thiopental sodium for rapid sequence induction of anesthesia.

Effects of Lidocaine and Airway Epithelium on Tension in the Rat Tracheal Smooth Muscle / 대한마취과학회지

BACKGROUND: Lidocaine is often administered intravenously to suppress airway reflexes associated with tracheal intubation or tracheal suction. In addition, lidocaine is known to have airway relaxant effects through a direct relaxant mechanism on the smooth muscle. The presence of airway epithelium has been reported to reduce the sensitivity and maximum contractile response to histamine or acetylcholine(ACh). The purpose of this study was to determine whether the cumulative application of lidocaine may cause a concentration-dependent relaxation of the rat tracheal smooth muscle strips with intact or rubbed epithelium. METHODS: Using the rat tracheal smooth muscle strips, the effects of 10 6~3 10 3M of lidocaine pretreatment on isometric tension induced by 40 mM of K+ or 10 5M of ACh in presence or absence of adherent epithelium, and the influences of 10 6M of propranolol, 10 4M of L-NAME and 10 6M of atropine on relaxing response of lidocaine were studied. RESULTS: The tracheal smooth muscle concentration induced by K+ and ACh was similar magnitude both in presence or absence of adherent epithelium. The removal of epithelium did not affect the relaxant effect of lidocaine on the K+ and ACh-induced tracheal smooth muscle contraction. Lidocaine pretreatment reduced Ca2+-dependent contraction of the rat tracheal smooth muscle. Following pretreatment of the tracheal smooth muscle preparations respectively with propranolol, L-NAME and atropine the relaxing responses to lidocaine of tracheal smooth muscle were not depressed. CONCLUSIONS: These results suggest that the effect of the epithelium on lidocaine-induced relaxation of the tracheal smooth muscle is not significant and lidocaine may directly relax tracheal smooth muscle by the influences on the Ca2+ mobilization.

Vasodilative Effects of Propofol on Isolated Pulmonary Artery in Rats / 대한마취과학회지

BACKGROUND: Propofol, 2,6-diisopropyl phenol, is a short-acting, potent intravenous anesthetics agent. In both general anesthetic care and the anesthetic care of patients undergoing cardiovascular surgery, the unique characteristics of propofol might make it a logical part of the anesthetic plan for patients such as pulmonary hypertension. But there are limited experimental and clinical data on the effects of propofol on pulmonary vascular resistance, and they are somewhat contradictory. the purpose of this study was to investigated.the effect and mechanism of vasodilation induced by propofol using isolated rat pulmonary artery rings. METHODS: Cumulative dose-response curves for propofol(10(-6)~10(-3)M) were obtained from tension measurements of rings that contracted with phenylephrine(10(-6)M) and KCI(40 mM) in the presence and absence of endothelium, and in the pretreatment of L-NAME(3x10(-4)M) and substance P(3x10(-4)M). Thereafter the effect of propofol(10(-4)M) on vascular smooth muscle contration in response to Ca++ mobilization in vscular rings were investigated. RESULTS: Propofol(10(-6)~10(-3)M) produced dose-dependent relaxation and had no signficant effect from endothelium. Pretreatment of L-NAME and substance P failed to have influence on cumulative dose-respose curves. Therefore vasodilator effect of propofol was not endothelium-dependent. And 10(-4)M propofol attenuated a contraction in response to CaCl2 in vascular rings depolarized by KCI, and vasoconstraction in response to calcium entry in the presence of phenylephine was attenuated by 10(-4)M propofol. Ryanodine preteament had not influence on contractile response. CONCLUSIONS: These results suggest that vasodilation produced by propofol is not endothelium-dependent but is probably due to nonspecific intracellular Ca++ influx blockade through voltage-operated calcium channels and receptor-operated channels.

Effects of Orally Administered Baclofen in the Animal Model for Neuropathic Pain / 대한마취과학회지

The aim of this study was to compare with the effects of baclofen using an animal model of neuropathic pain. The sciatic nerve of rats was ligated unilaterally about dorsal half-portion in the tight according to the method of Seltzer and his colleague. After surgical operation, the rats showed painful symptoms of the ipsilateral hind paw, suggesting the possibility of spontaneous pain. And then, the paw withdrawal latency to the local heating on the paw through the glass plate and the frequency of paw withdrawal response to innocuous mechanical stimulation with modified von Frey filaments were determined to compare with the effects of pre-and post-medication of baclofen, respectively, at postoperative 3, 7, and 10 days. The results obtained were as follows: 1) The thermal hyperalgesia and mechanical allodynia produced by partially tight ligation of sciatic nerve appeared continously postoperative 3 days later. 2) In the hyperesthetic rats, the thermal hyperalgesia was inhibited from the 3rd posroperative day with orally administered baclofen 0.2mg and 1.0mg. 3) In the hyperesthetic rats, the mechanical allodynia was inhibited with baclofen 0.2mg, but not with baclofen 1.0mg, These results suggest that baclofen have more specific effects on thermal hyperalgesia than mechanical allodynia.

The Addition of Subarachnoid Fentanyl to Hyperbaric Bupivacaine with Morphine for Cesarean Section / 대한마취과학회지

To investigate the effect of intrathecal fentanyl,36 ASA physieal status 1 or 2 parturients who underwent cesarean section with apinal anesthesis using 0.25% bupivacaine in 5.0% dextroae with 0.25mg morphine were studied. Patients were randomly allocated to receive either saline 0.2ml (group 1, n=17) or fentanyl 10ug(group 2, n=19) in 3.525ml volume mixed with the bupivacaine with morphine. Spinal anesthesia was performed in sitting position using a 25 guage spinal needle. At the completion of injection, patients immediately turned supine with left uterine diaplacement. There was no statistically significant difference in the incidence of the hypotension between groups. The progress of sensory and motor blocks was similar in the two groups. The times from drug injection ta the onset to maximal sensory blockade and complete motor blockade, complete recovery of sensation and motor power were not different between groups. post delivery,the incidence of visceral pain were significantly less in group 2, as 2 of 19 patients(10%) in group 2 compared to 8 of 17 patients(47%) in group 1(p< 0.05). The effective analgesia time was no significant different: 31.7+/-2.5 hour in group 1 compared to 28.6+/-5.6 hour in Group 2. The ineidence of patients not requiring narcotics until discharge was similar in two groups. No patient showed any evidence of respiratory depression. The incidence of other side effects,such as nausea,vomiting and pruritus was not different between groups. No neonate had an Apgar score below 7.

The Addition of Subarachnoid Fentanyl to Hyperbaric Bupivacaine with Morphine for Cesarean Section / 대한마취과학회지

To investigate the effect of intrathecal fentanyl,36 ASA physieal status 1 or 2 parturients who underwent cesarean section with apinal anesthesis using 0.25% bupivacaine in 5.0% dextroae with 0.25mg morphine were studied. Patients were randomly allocated to receive either saline 0.2ml (group 1, n=17) or fentanyl 10ug(group 2, n=19) in 3.525ml volume mixed with the bupivacaine with morphine. Spinal anesthesia was performed in sitting position using a 25 guage spinal needle. At the completion of injection, patients immediately turned supine with left uterine diaplacement. There was no statistically significant difference in the incidence of the hypotension between groups. The progress of sensory and motor blocks was similar in the two groups. The times from drug injection ta the onset to maximal sensory blockade and complete motor blockade, complete recovery of sensation and motor power were not different between groups. post delivery,the incidence of visceral pain were significantly less in group 2, as 2 of 19 patients(10%) in group 2 compared to 8 of 17 patients(47%) in group 1(p< 0.05). The effective analgesia time was no significant different: 31.7+/-2.5 hour in group 1 compared to 28.6+/-5.6 hour in Group 2. The ineidence of patients not requiring narcotics until discharge was similar in two groups. No patient showed any evidence of respiratory depression. The incidence of other side effects,such as nausea,vomiting and pruritus was not different between groups. No neonate had an Apgar score below 7.

Effects of Fentanyl, Midazolam, and Fentanyl-Midazolam on the Cardiovascular System and Blood Glucose during General anesthetic Induction / 대한마취과학회지

In this study, we evaluated the effects of fentanyl, midazolam, and fentanyl-midazolam on cardiovascular system and blood glucose during endotracheal intubation in forty normotensive patients scheduled for elective surgery under general anesthesia. The patients were randomly classified into four groups; Group I (control) received tracheal intubation with thiopental 5 mg/kg (n=10), group II received tracheal intubation with fentanyl 6 ug/kg followed by thiopental 2 mg/ kg (n=10), group III received tracheal intubation with midazolam 0.3 mg/kg (n=10), group IV received tracheal intubation with fentanyl 4 ug/kg followed by midazolam 1 mg/kg (n=10). The changes of systolic blood pressure, diastolic blood pressure, mean arterial blood pressurie, heart rate, and blood glucose were compared in each group. The results were as follows; 1) In group I, endotracheal intubation caused a significant rise in SBP, HR and blood glucose. 2) In group II, endotracheal intubation caused little changes in SBP, DBP,MAP and blood glucose but HR was rised. 3) In group III, endotracheal intubation caused little changes in SBP, DBP, MAP, HR and blood glucose. 4) In group IV, endotracheal intubation caused little changes in SBP, DBP, MAP, HR and blood glucose.

Epidural Analgesia in a Parturient following Splenorenal Shunt Operation for Liver Cirrhosis / 대한마취과학회지

Pregnancy with liver cirrhosis and/or portal hypertension is uncommon. Additionally, pregnancy in young women who previously underwent splenorenal shunt operation for portal hypertension due to liver cirrhosis is extremely rare. Esophageal variceal rupture, fatal hemorrhage and epidural hematoma must be considered during the management of such patients. This is a case of epidural analgesia for labor in a patient who previously underwent splenorenal shunt operation for portal hypertension due to liver cirrhosis.

The Effects of epidural Anesthesia to the Serum Glucose, Lidocaine Concentration and Cardiovascular System / 대한마취과학회지

In the lower abdominal surgery, it is well known that epidural anethesia inhibit endocrine response to surgical stress. We used lidocaine and morphine for epidural anesthesia and investigated the changes of serum lidocane and glucose concentration compared to general anesthesia. Also we estimated the duration of postoperative pain relief. Patients in group I received general anesthesia and patients in group II received 2% lidocaine 20 cc, patients in group III received 2% lidocaine 20 cc with morphine 4 mg. The results were as follows. 1) Blood pressure and pulse rate were increased significantly in group I but were less changed in group II and group III. 2) Blood glucose concentration increased significantly in group I but there was no significant changes in group II, group IIL 3) The duration that plasma lidocaine concentration was reached peak level was prolonged in group III but no significancy was found. 4) In group III that we adminstrated 4 mg morphine epidurally. postoperaive pain relief was sustained for about 15 hours. We conclucled that Epidural anesthesia with Morphine is more convenient during perioperative and postoperative period.

The in Vivo Effects of Ethrane Anesthesia and Single Intravenous Injection of Hydrocortisone 250 mg on T-cell Subsets / 대한마취과학회지

The in vivo effects of ethrane and single intravenous injection of hydrocortisone 250 mg on T-cell subsets (T3, T4 and T8), s-cortisol, s-Na+ and K+, polymorphonuclear leukocytes, lymphocytes and HSR (T-helpers to T-suppressors ratio) has been studied. Six healthy volunteers and 16 patients was selected and observed. Sixteen patients has been done surgery under ethrane anesthesia, and single dose of hydrocortisone 250 mg was injected intravenously to eight patients among them. The result is as follows; 1) Serum cortisol level was increased after surgery under ethrane anesthesia and was decreased bellow control value at 24 hours after injection of hydrocortisone 250 mg. 2) After surgery under ethrane anesthesia, PMN's counts and monocyte counts in peripheral blood were increased, but absolute number of lymphocytes and T-cell subsets were decreased. 3) After surgery under ethrane anesthesia with hydrocortisone 250 mg, there was the most elevation of PMN's counts and the most redution of absolute number of T-cell subsets at 5 hours and was somewhat tended to return to control values, but remained changed at 24 hours, and monocyte counts was unchanged. 4) Adding hydrocortisone 250 mg compared with ethrane anesthesia alone, the increasing rate of PMN's counts and the decreasing rate of lymphocytes and absolute number of T-cell subsets were higher at 5 hours, and were lower at 24 hours. 5) Relative percentage of T-cell subsete and HSR were unchanged after surgery under ethrane anesthesia alone and adding hydrocortisone 250 mg.