An In-vitro Evaluation of Intratracheal Pulmonary Ventilation Physics / 대한마취과학회지

No abstract available.

The Effects of Patterns of AMBU bag Ventilation on the Inspiratory Oxygen Concentration / 대한마취과학회지

The AMBU bag is a useful equipment at the cardiopulmonary resuscitation (CPR) or the respiratory therapy. The AMBU bag eonsists simply of a self-reflating bag, a patient valve and a inlet valve. The patient valve is a non-rebreathing valve and the self-inflating bag is a recoiled rubber bag. The inlet valve on the posterior site of self-inflstion bag is closed during the bag is squeezed, and opened during the bag is released. During reflation of bag, fresh room air through the one-way valve and fresh oxygen through the orifice for oxygen supply will mix. Therefore the inspiratory oxygen concentration is decided by a speed of re- flation of the self-reflating bag. We measured inspiratory oxygen concentration during AMBU bag ventilation under different inspiration : expiration (I:E) ratio, frequency of venti- lation, ventilatory volume and flow rate of oxygen. The results were that factors increase a inspirstory oxygen concentration are 1) decrease of I:E ratio, 2) decrease of frequency of ventilation, 3) decrease of ventilatory volume, 4) inerease of flow rate. We found that haste of physician makes frequent squeezing of AMBU bag and the haste results a decrease of inspiratory oxygen concentration.

Effect of Needle Bevel Direction on the Postspinal Headache in Young Males of the Third Age Decade / 대한마취과학회지

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, needle size, needle configuration, pregnancy, direction of needle bevel, number of dural puncture. This study was done to see the effect of various gauge Quincke needles(22, 23, 24, 25, 26gauge) and needle bevel direction on the incidence, severity, onset and location of postspinal headache in the 200 male patients of the third age decade undergoing spinal anesthesia. There were one group consisting of 100 patients who underwent parallel insertion to longitudinal dural fibers and the other group consisting of 100 patients who underwent vertical. Each group consisting of 100 patients had five subgroups with 20 patients in related to each needle gauge. A system of criteria for registering postspinal headache and its severity is proposed. The following results were observed: 1) The incidence of postspinal headache was 10% in one group who underwent parallel insertion to longitudinal dural fibers but 27% in the other group who underwent vertical. 2) The severity of headache was mild level in all the 10 cases with postspinal headache of parallel insertion group but above moderate level in 14 cases of all the 27 cases with postspinal headache of vertical insertion group. 3) The small size of needle had a trend with lower incidence of postspinal headache than the large size . 4) The onset of postspinal headache was within 3 day after spinal anesthesia in the almost patients(92.5%) with postspinal headache. 6) The sites of postspinal headache were 59.5% in frontal, 18.9% in occipital, 16.2% in generalized, 5.4% in parietal region. In conclusion, the method of insertion parallel to longitudinal dural fibers is significantly lower incidence of postspinal headache than that of insertion vertical to longitudinal dural fibers in young males of the third age decade.

What`s the optimal timing of pretreatment with pancuronium before succinylcholine to prevent muscle fasciculation? / 대한마취과학회지

Succinylcholine(SCh)-induced muscle fasciculations may be prevented by pretreatment with small doses of nondepolarizing muscle relaxants. The optimal timing of pretreatment to abolish fasciculation varies according to the drug used and dose. In this study, we determined the optimal timing of pretreatment of pancuronium to prevent muscular fasciculation in 100 patients. Each group (n=20) was received pancuronium 0.015 mg/kg at 1, 2, 3, 4, 5 minutes before SCh 3 mg/kg administration, respectively. The degree of fasciculations after SCh administration was observed and classified into one of 4 grade. There were significant differences between each groups (Ridit scores=10.078, p<0.01) To compare observed fasciculations of one grpup with those of the others, the degree of fasciculations was summed according to an arbitrary scale. The summation of grade in 4 minute group was lowest in this scale. It was concluded that the optimal timing of pretreatment, pancuronium 0.015 mg/kg, was 4 minutes before SCh 3 mg/kg injection.

The Dosage of Sodium Nitroprusside and its Effects on the Cardiovascular System for Deliberate Hypotension in Halothane Anesthesia / 대한마취과학회지

The effects of deliberate hypotension by sodium nitroprusside (SNP) on the cardiovascular system and dosage of SNP were studied in 10 patients undergone Cotrel-Dubousset instrumentation for the operative treatment of scoliosis, spinal stenosis or herniated intervertebral disc. Mean arterial pressure decreased significantly (p0.05), r= -0.2 (p>0.05), and r= - 0.25 (p>0.05) respectively. The amount of whole blood transfused during the operation was 5. 3+/-1 .7 units. Hemoglobin and hematocrit decreased significantly (p<0.05) from 11.3+/-1.3g/dl and 33.7+/-4.1% to 10.1+/-1.5g/dl and 30+/-4.1% during operation.

An Evaluation of Therapeutic Intervention Scoring System ( TISS ) in Critically Ill Pediatric Patients / 대한마취과학회지

There are few reports analyzing the results of intensive care for children in Korea. A total of 40 critically ill pediatric patients were evaluated in terms of Therapeutic Intervention Scoring System (TISS), The group was composed of patients from 4 services: cardiothoracic surgery, pediatric surgery, pediatrics and other surgeries. We evaluated duration of stay and cost in pediatric intensive care unit (PICU), Seoul National University Hospital, and TISS related to departments. The patients with higher TISS showed longer duration of stay and higher cost in PICU than those with lower TISS. The duration of stay of the patients with high TISS more than 50 was 5.0 days, but it was 2.8 days in 40-49, 2.4 days in 30-39, 2.1 days in 20-29 and 1.9 days in 10-19 of TISS's, respectively. The postoperative first day cost of intensive care was approximately 2,210,000 Won in the patients with high TISS more than 50, but it was 1,060,000 Won in 40-49, 220,000 Won in 30-39, 460,000 Won in 20-29, 120,000 Won in 10-19 of TISS's, respectively. The patients in cardiothoracic surgery showed higher values in maximum, minimum and discharge TISS than other services. Maximum, minimum and discharge TISS of the patients in cardiothoracic surgery were 41, 28 and 23, respectively. TISS's of patients in pediatric surgery and neurosurgery were similar, but durations of stay in PICU were 3.5 days in pediatric surgery and 1.2 days in neurosurgery. In this study, we conclude that duration of stay in PICU and cost of intensive care might be proportional to TISS.