The Effect of Oral Premedication Using Bethanechol on Bladder Dysfunction Following Spinal Anesthesia / 대한마취과학회지

BACKGROUND: Urinary retention is one of the most common complications after spinal anesthesia, and its inadequate management can result in serious outcomes. Overdistended bladder due to urinary retention should be catheterized. This study determined whether the prophylactic medication of oral bethanechol, a parasympathomimetic drug, results in reduction in the frequency of catheterization due to urinary retention. METHODS: Twenty-seven healthy male patients undergoing lower extremity operation under spinal anesthesia were subjected and randomly allocated into three groups according to the drug which was given. Group I (n = 9) had no medication, Group II (n = 9) and Group III (n = 9) were given bethanechol 50 mg or bethanechol 100 mg orally, respectively, before anesthesia. We measured the number of catheterized patients, the frequency of catheterization per catheterized patient, and perioperative cardiovascular complications in each group after their operations. RESULTS: The number of catheterized patients was nine (100%) in Group I, three (33%) in Group II, and two (22%) in Group III (P < 0.002). There was a significant statistical difference among the groups (P < 0.002). As the dosage of bethanechol increased, its effect increased relatively (P < 0.001). CONCLUSIONS: Prophylactic oral medication of 50 100 mg bethanechol reduces the frequency of catheterization in urinary retention after spinal anesthesia.

The Effect of Oral Premedication Using Bethanechol on Bladder Dysfunction Following Spinal Anesthesia / 대한마취과학회지

BACKGROUND: Urinary retention is one of the most common complications after spinal anesthesia, and its inadequate management can result in serious outcomes. Overdistended bladder due to urinary retention should be catheterized. This study determined whether the prophylactic medication of oral bethanechol, a parasympathomimetic drug, results in reduction in the frequency of catheterization due to urinary retention. METHODS: Twenty-seven healthy male patients undergoing lower extremity operation under spinal anesthesia were subjected and randomly allocated into three groups according to the drug which was given. Group I (n = 9) had no medication, Group II (n = 9) and Group III (n = 9) were given bethanechol 50 mg or bethanechol 100 mg orally, respectively, before anesthesia. We measured the number of catheterized patients, the frequency of catheterization per catheterized patient, and perioperative cardiovascular complications in each group after their operations. RESULTS: The number of catheterized patients was nine (100%) in Group I, three (33%) in Group II, and two (22%) in Group III (P < 0.002). There was a significant statistical difference among the groups (P < 0.002). As the dosage of bethanechol increased, its effect increased relatively (P < 0.001). CONCLUSIONS: Prophylactic oral medication of 50 100 mg bethanechol reduces the frequency of catheterization in urinary retention after spinal anesthesia.

Circulatory Arrest, Profound Hypothermia and Barbiturate for Giant Cerebral Aneurysm Surgery Case report / 대한마취과학회지

The surgical and anesthetic management for giant cerebral aneurysm is difficult because of their great size or lack of an anatomic neck. Recently, total circulatory arrest, profound hypothermia using cardiopulmonary bypass and the cerebral protection of barbiturate are able to manage the difficult cerebral aneurysm operation due to the ease of the surgical approach and the decreased post operative neurological injury. These techniques were successfully utilized in the patient of the diamerer-3 cm sized giant cerebral aneurysm located at the bifurcation between the right internal carotid artery and the anterior cerebral artery, and the surgical and anesthetic considerations are reviewed.