Epilural Morphine in Treatment of Caneer Pain / 대한마취과학회지

Epidural injection of 2.0 mg morphine with distilled water or 0.9 % normal saline 10 ml were given to a bladder cancer patient with severe chronic intraetable pain which radiated from low abdomen to gluteal and low leg region. The patient had absolute pain relief which began 2~3 minutes to onset, with 3~5 minutes of peak of action and was effective for 20~25 hours (mean 24 hours) without complications or continuous care as an ambulatory patient. It is suggested that the morphine reached the subarachinoid space through the membrane and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior horn of the spinal cord.

Blood Pressure and Pulse Rate Responses to Extubation with and without Topical Tracheal Anesthesia / 대한마취과학회지

Usually, blood pressure and pulse rate are increased in the light planes of anesthesia at the end of operation especially just prior to extubation. The increasing of heart rate and blood pressure produce an elevation in cardiac work and oxygen demand and can lead to mycardial ischemia in patients with coronary artery disease. Tracheal anesthesia with 2 or 4% lidocaine (jelly and liquid) was done as a method which permits patients to be extubated during light planes of anesthesia. The results were as follows: 1) Each groups had similar blood pressure and pulse rate five or ten miriutes before extubation. 2) Lidocaine group did not have a significant elevation in systolic or diastolic blood pressure and pulse rate at or after extubation or in the recovery room. 3) The control group had significantly increases in both pressure and pulse rate(p<0.01). The data suggest that maneuver should be of advantage to patients with coronary artery disease who may not be able to tolerate the increased cardiac dynamics during extubation period.