Postanesthetic Unusual Excitement due to Atropine Overdose / 대한마취과학회지

Postanesthetic unusual excitement and prolonged postauesthetic recovery time were experienced after general anesthesia. The cause was discovered later due to accidentally administered atropine overdoses. Atropine vials supplied by the hospital pharmacy were labeled no containing quantity. After survey, the content of atropine was notified as 5 mg/ml instead of 0.5 mg/ml. It was ten times stronger content of the usual dose. General anesthesia were performed under halothane-N2O or methoxyflurane-N2O with semi- closed circle absorber system. Pentothal sodium or epontol intravenously was used as induction agent. For premedication, valium and atropine or valium, demerol and atropine was given intramuscularly. Additional atropine was given before reversing the muscle relaxation with neostigmine. 20 cases of acute atropine toxicity after general anesthesia were analysed for incidence of excitement, prolonged recovery time, total doses of atropine, change of the pulse rate, scarlet and tremor. The results were as follows; 1. Postanesthetic unusual excitement was observed but there were no mortality. 2. Doses of accidentally administered atropine were 9.53+/-4.75 mg (Mean+/-S.D.) 3 Postanesthetic recovery time was unusually prolonged, Mean recovery time was 146.1+/-24.4 minutes. 4. Among the patients, the following rate of complications were found; unusual excitement was 75%, scarlet was 50% and tremor was 10%, respectively 5. Law of the pharmacist should be strictly observed to prevent the accidental overdoses.

Body Temperature Change during Surgery and General Anesthesia / 대한마취과학회지

It is known that changes in body temperature occur during surgical operations with the patient under general anesthesia. Body temperature who has had elective surgery on St. Mary's Hospital at spring time (February to April) was measured by rectal thermometer. Body temperature was checked at before surgery and immediate postoperatively. Measured body temperature was analysed for sex, comparison of abdorninal surgery, skin graft or cranial surgery (who had exposed room temperature (20~23 degrees C) as almost naked), duration of operation, types of anesthetic system and operating room temperature. Results were as follows; 1. In abdominal surgery, body temperature change in man was decreased 0.64 degrees C postoperatively, in woman decreased 0.35 degrees C pastoperatively. But no statistical significance was obtained(p>0.05). 2. In abdominal surgery, body temperature change was decreased 0.25 degrees C postoperatively but room temperature was increased 0.51 degrees C significantly(p<0.01) postoperatively. Correlation coefficient between body temperature and room temperature was not observed (gamma=0.37, 0.04). 3. In skin graft and cranial surgery, body temperature was decreased 1.3 degrees C postoperatively and room temperature was increased 0.4 degrees C, respectively. But no statistical significance and no correlation coefficient were observed. 4. In duration of surgery (in abdominal surgery), body temperature was decreased 0.75 degrees C within 2 hours and over 3 hours duration, each. 5. In duration of surgery (in skin graft and cranial surgery), body temperature was significantly decreased 0.51 degrees C within 2 hours and significantly decreased 1.17degrees C over 3 hours duration(p<0.001). 6. In vaporizer inside the circuit (Air-Med anesthetic machine), body temperature was increased 0.3 degrees C postoperatively and was significant(p<0.001). Room temperature change was significantly increased 1.17 degrees C postoperatively and was significant(p<0.001).