The Last Fifty Years of Western Medicine in Korea: Korean Soceity of Anesthesiologists

No abstract available.

The Pulmanary Toxicity after Treatment with Bleomycin in Combination with Hyperoxia / 대한마취과학회지

The bleomycin is a chemotherapeutic agent useful in the treatment of selected neoplasms, including non-seminomatous testicular carcinoma. An increased incidence of respiratory failure postoperatively in patients previously treated with bleomycin has been reported. And an increase in the toxicity of high concentration of oxygen in oxygen therapy has been demonstrated in rodents after administration of bleomycin. However, the use of an enriched inspired oxygen concentration 41% was reported not hazardous in a testicular cancer population who were exposed to significant doses of bleomycin. The pulmonary toxicity of bleomycin therapy in combination with high oxygen exposure is still controversial. The aim of this study is to analyze the effect of exposure to 50% oxygen in the mice pretreated with bleomycin. Bleomycin were administered intraperitoneally to the mice, 4 mg/ kg twice a week for 5 weeks. After administeration of bleomycin to the mice, the half of the miee, the experimental group, were exposed to 50% oxygen for 24 hours. And the other control group were exposed to room air. Morphometric analysis with light microscopy was performed to the following parameters; number of total pulmonary cell count, percentage of consolidation of lung parenchyma and degree of intensity of fibrosis of lung parenchyma. The area of diseased lung was increased in mice given with bleomycin and hyperoxia compared with that of those treated with bleomycin only. The results were as follows, l) In the control group given 4 mg/kg bleomycin and room air, the number of total pulmo- nary cell count were 36.21+/-6.53/10(-8) m(2) and the percentage of consolidation was 1.2+/-0.4%. 2) In the experimental group given with 4 mg/kg bleomycin and 50% oxygen for 24 hrs, the number of total pulmonary cell count were 59.67+/-9.13/10(-8) m(2) and the percentage of area of consolidation of lung parenchyma was 5.8+/-2.3%, 3) Fibrosis of the lung parenchyma was seen only in the experimental group to which oxygen was given after administration of bleomycin. In conclusion, this study demonstrated that hyperoxia potentiated the pulmonary damage by bleomycin in the mice.

Change of Hemodynamic Parameters and Plasma Catecholamine Level during Laparoscopic Cholecystectomy / 대한마취과학회지

In the last decade, advances in laparoscopic equipment have allowed the development of laparosopic surgical treatment for gynecologic affection. Intraabdominal endoscopy can be extended safely for cholecystectomy. Patients undergoing laparoscopy under general anesthesia exhibit various hemodynamic and blood gas change. To analyze the physiologic mechanisms of these hemodynamic effect of laparoscopic surgery during general anesthesia, the change of mean arterial blood pressure, heart rate, end tidal carbon dioxide and plasma catecholamine were studied. Ten patients undergoing cholecystectomy by means of laparoscopy were selected randomly. Measurements of the above parameters were made about 10 minutes after tracheal intubation when the conditon of the patients stabilized(control), shortly after completion of insufflation of peritoneal cavity with carbon dioxide, 30 minutes after insufflation of carbon dioxide and after deflation of carbon dioxide. There were significantly increased mean arterial pressure, end tidal carbon dioxide, plasma epinephrine, norepinephrine during CO2 insufflation into peritoneaf cavity and increased there after with deflation of CO from the peritoneal cavity in laparoscopic cholecystectomy. In conclusion, these hemodynamic parameter changes seem to be correlated to the increased catecholamine release which was caused by sympathetic stimulation during the laparoscopic cholecystectomy.

Changes in Plasma Concentration of Catechloamine during Sodium Nitroprusside-induced Hypotension / 대한마취과학회지

Sodium nitroprusside is used to induce hypotension to decrease bleeding in operation site, Sodium nitroprusside decrease vascular resistance by directly relax arteriolar and venous smooth muscle, to a lesser extent. Hypotension stimulate baroreceptors and increase sympatho-adrenal activity. The function of sympatho-adrenal mdullary system may be monitored by the changes of plasma cancentrations of epinephrine and norepinephrine. To study the relationship between induced hypotension and the catecholamine release, the plasma epinephrine and norepinephrine concentration were measured before, during and after infusion of aodium nitropruaside to rabbits The results were as follows: 1) The mean arterial blood pressure decreased significantly after SNP infusion (5.0 ug/kg/minute) from the control value of 98.1+/-11.9 mmHg to 66.3+/-16.2, 57.9+/-17.9 mmHg in 10 and 20 minutes after SNP infusion (P<0.01) and 78.8+/-12.5 mmHg after discontinuation of SNP infusion. 2) The heart rate increased significantly after SNP infusion from the control value of 149.8+/-12.8 beat/minute to 166.5+/-10.8, 190.4+/-17.6 beats/minute in 10 and 20 minutes after SNP infusion (P<0.05, P<0.01) and the heart rate increased after discontinuation of SNP infusion. 3) The plasma epinephrine concentration increased significantly after SNP infusion from the control value of 181.2+/-91.9 pg/ml to 547.5+/-163.2, 837.5+/-253.6 pg/ml in 10 and 20 minutes after SNP infusion and continued to increase of epinephrine after discontinuation of SNP infusion. 4) The plasma norepinephrine concentration increased significantly after SNP infusion from the control value of 566.2+/-92.6 pg/ml to 1131.3+/-424.7, 1432.5+/-479.2 pg/ml 10 and 20 minutes after SNP infusion and continued to increase after discontinuation of SNP infusion. There was a highly significant correlation between decrease in mean arterial pressure and increase in plasma epinephrine and norepinephrine concentrations.

The Changes of Metabolic and Acid - base Status and Respiratory Gases Elicited by Pneumatic Tourniquet for Lower Extremity Surgery / 대한마취과학회지

For extremity surgery, tourniquet is placed routinely. With deflation of the tourniquet, the metabolic product is flushed into the systemic circulation and theoretically poses a potential for toxic reactions. In actual fact, these are rare events with this technique. Vigilant monitoring will detect cardiovascular depression at this time. By the tourniquet application, lactic acidemia, abnormal coagulopathy, hypotention, hyperkalemia, increased PaCO2, and production of noxious oxygen free radicals were reported following the release of the tourniquet. But the serial changes of metabolic derangement, degree of lactic acidemia following the use of the tourniquet were not exactly known. To confirm the safety of the pneumatic tourniquet use for two hours, the serial changes of lactic acid levels, acid-base status, potassium concentration, concentration of respiratory gaaes (arterial and end-tidal CO2,) and also hypotension, dysrhythmias and respiratory pattern following release of the tourniquet were studied. Patients were anesthetized with 1% halothane, 50% nitrous oxide and 50% oxygen. Ventilation was maintained by the ventilator to keep the end-tidal CO2, to 4.0% just before the release, and then respiratory parameters (respiratory rate, tidal volume) were constantly maintained through the study. The data were measured from arterial samples or monitors with the following interval; just before tourniquet apply (BTA), before tourniquet release (BTR), at 1, 3, 5, 15 and 30 minutes after the tourniquet release (ATR 1 m, 3m, 5 m, 15 m 30 m). Data measured before the tourniquet apply were used as control values. All data were analyzed by the paired t-test with control. Changes of mean values of each time in one parameter were analyzed by one-way ANOVA. Correlationships between the parameters and duration of ischemia induced by the tourniquet were analyzed by simple regression. The results of this study were as follows; 1) The arterial concentration of lactic acid was maximally increased at 3 minutes after tourniquet release and not returned to control value until 30 minutes after tourniquet release. 2) End-tidal CO, was reached to maximal values of 5.3% at 5 minutes after release of tourniquet. Accompanying theses changes, spontaneous respiration was recovered from the controlled ventilation in 11 patients out of 13 and fought with mechanical ventilator due to asynchronism of respiratory cycles. 3) Mild metabolic acidosis showing the decreased arterial pH and increased PaCO2, in arterial blood gas analysis was maintained in 30 minutes following the release of tourniquet. 4) There were no significant changes of concentrations of potassium. 5) Three episodes of mild hypotension were observed out of 13 patients, but dysrhythmias and other significant clinical changes not observed through the study. The above results showed the possibility of lactic acidemia and changes of respiratory pattern by increased PaCO2, after release of the tourniquet may occur. More intent monitoring is needed to the patients who have had the metabolic derangement in acid-base balance and increased intracranial pressure in application of tourniquet on limbs.

Folinic Acid Protection Against Hematopoietic Cell Depression Induced by Nitrous Oxide in Rats / 대한마취과학회지

The degree of hematopoietic depression and spontaneous recovery of depressed cells with 50% nitrous oxide inhalation for 6 or 12 hours were studied in 120 Sprague-Dawley rats. Immediately after, 1 day, 3 days and 1 week after nitrous oxide inhalation, precursor cells of granulocyte-monocyte and T lymphocyte in bone marrow and blood were sampled and cultured. After one week of culture period, the numbers of colony forming unit-granulocyte monocyte (CFU-GM) and colony forming unit-T lymphocyte (CFU-TL) were counted. There was no change in the number of colony immediately after inhalation of nitrous oxide, but was significant decrease in number of colony 1 day and 3 days after inhalation of nitrous oxide (p<0.001). One week after cessation of nitrous oxide inhalation, spontaneous recovery of number of colony developed without any treatment. To evaluate the protective effect of folinic acid (Rescuvolin) against hematopoietic depression, Rescuvolin 0.1 mg/0.3 ml were injected intraperitoneally at 12 hours and 1 hour before, 1 hour before and immediately after nitrous oxide inhalation, respectively. The data of each group were compared with that of the animals which have inhaled nitrous oxide for 6 hours without folinic acid. Folinic acid injected groups showed significant increase in numbers of colony (p<0.001) especially in 12 and 1 hour before nitrous oxide inhalation. In conclusion, the longer the duration of nitrous oxide inhalation, the faster and severer hematopoietic depression developed. The pretreatment of folinic acid may prevent the bone marrow depression by a long-term and repeated use of nitrous oxide. In clinical anesthesia, it is recommended to avoid to use nitrous oxide for the patients with bone marrow depressed disease such as leukemia and aplastic anemia.

Effects of Inhalation Anesthetics on Lymphocyte Transformation / 대한마취과학회지

Anesthesia and operation may impair the immune system so that bacterial growth and tumor cells spread can occur more rapidly and host response to transplanted tissue may be altered. In order to evaluate the influence of inhalation anesthetics on immune function, mitogen induced lymphocyte transformation and colony formation of T lymphoctye of peripheral blood in rats were studied. The experimental animals were divided into 4 groups according to inhaled anesthetics such as control, 0.8% halothane, 1.65% enflurane and 1.05% isoflurane 6 hours inhaled group. One day after inhalation of anesthetics, 5 ml of blood was sampled from inferior vena cava and the lymphocytes were isolated and cultured. Spontaneous and phytohemagglutinin (PHA) or pokeweed mitogen (PWM) induced lymphocte transformation were measured by the titration of H-thymidine uptake and the number of colony forming unit-T lymphocyte (CFU-TL) were counted. The results were as follows: Spontaneous lymphocyte transformation was increased by halothane and decreased by enflurane significantly but not differed by isoflurane compared with the control group. Lymphocyte transformation were decreased significantly before and after PHA stimulation in all of the anesthetic groups respectively compared with the control group. 3) Lymphocyte transformation by PWM stimulation also decreased in all of the anesthetic groups. 4) The numbers of CFU-TL cluster and colony decreased in all of the anesthetic groups compared with the control group. In conclusion, inhalation anesthetics such as halothane, enflurane and isoflurane decreased immune competence and that halothane was the most, isoflurane was the least immunosuppressive among these three inhalation anesthetics.

Correlation between Artsrial and End Tidal Carbon Dioxide Pressure during General Anesthesia / 대한마취과학회지

To determine how closely end- tidal PCO2 measured by capnometer(Datex, Finland), a kind of infrared gas analyzer, reflects arterial PCO2(measured by Corning 175: U.S.A.) during general anesthegia, peak- tidal PCO2 and arterial were measured simultaneously. Thirty patients ranging between the age of 18 and 49, having no apparent abnomalities and having physical status class I by American Society of Anesthesiologist's classification-were seleted for the study. The anesthesia was induced with 2.5% pentothal sodium 4~5 mg/kg, succinylcholine 1mg/kg and incubated. The anesthesia was maintained with each 2 L/min gas flow of nitrous oxide, oxygenand 1 halothne. The patients were ventilated br anesthetic ventilator with tidal volume 8~10 ml/kg and ramie of 15 Per minute. The measurement of CO2 gas tension was performed 20 minutes after the induction when the patient's anesthetic conditions were stabilized. The CO2 gas ganlples were taken from mouth piece inserted between endotracheal adapter and circle breathing circuit, The arterial blood tramples were taken from the radial artery. There was a significant correlation between the end-tidol PCO2 and the arterial PCO2 in this series. The mean arterial PCO2 was 37.57+/-4.59 mmHg and the mean end tidal PCO2 was 23.73+/-5.78 mmHg. The mean difference between the arterial and the end tidal PCO2 was 6.53+/-2.23 mmHg. The correlation index between the two measurement was 0.8. In conclusion, the measurement of the end-tidal PCO2 by Datex Capnometer reflected the blood PCO2 and is convenient method of clinical use for its non invasiveness and continuous measurement of ventilatory status of patients under general anesthesia.

Anesthetic Management of Bone Marrow Donors / 대한마취과학회지

Thirty-six adult patients who received caudal anesthesia for perianal surgery were rando-mly agsigned to two grgups. Of these, 15 patients ingroup 1 were given 1.5 and 2% plain lidocaine in 18 and 7 ml doses, repectively. Twenty-one patients in group 2 were given lidooaine carbonated with 5% NaHCO3 0.1 ml per 1 ml-lidocaine in the same volume and concentration as in group 1. The time of onset of analgesia for the pin prick and scratch tests was significantly more rapid in group 2(2.04+/-0.63 and 4,69+/-1.12 min for the pin prick and scratch tests, respecti-vely-) than those in group 1(5.00+/-1.70 and 9.48+/-5.40 min for the pin prick and scratch test, respectively). However, the duration of anesthesia in both groups was not significantly different (111.80 +/-40.24 and 105.95+/-45.04 min in group 1 and 2, respectively). The mean pH of the 1.5 and 2% agents used in group 1 was 5.289+/-0.206 and 5.257+/-0.193, respectively, while the mean PH of the 1.5 and 2% carbonated lidocaine used in group 2 was 7.004+/-0.079 and 7.023+/-0.288, reapectively. The results iridicate that pH-adjusted lidocaine for caudal anesthesia has a more rapid onset than plain lidocaine hut that there is no difference in the length of duration of its effect.

Useful Life of Soda Lime in the Circle Absorber / 대한마취과학회지

During general anesthesia, removal of exhaled carbon dioxide by rebreathing appliances is provided by chemical absorption and this carbon dioxide absorption during anesthesia would at first glance seem to be a simple problem. The problem, however, is far more complicated and much attention must be given to details of rebreathing appliances. Incomplete removal of carbon dioxide in circle absorber systems, which are commonly used today must be carefully monitored to prevent hypercapnea caused by accumulation of carbon dioxide in the breathing circuits. Although circle absorbers have been developed through clinical trials anesthesiologists have no reliable indication of the end point of useful life of the absorbent. This study was undertaken to investigate the useful life of the soda lime used in two type of canisters (type A: canister of anesthesia machine. Quantiflex, USA. 12.9cmX16.6cm, tbye B: canister of anesthesia machine, International 2. U.K., 13.1cmX16.9cm). the effect of flow rate on this useful life and the relations between indicator change and the endpoint of useful life of the soda lime. The control group used a as total flow rate of fresh gases at 2.0 liters per minute and the experimental group used a total flow rate of 4.0 liters per minute. The carbon dioxide concentration of 0.1% at the canister exit was employed as the end point of useful life of the absorbent and the exit carbon dioxide concentration were monitored continuously by intra-red carbon dioxide monitor apparatus(Datex Normocap CD-102, Pinland). Also the carbon dioxide concentration in the respiratory circuit of exhaling side was examined. The results were as follows: 1) In type A, the average useful life of soda lime was 1,885 minutes in the control group and 2,514 minutes in the experimental group. In type B, the average useful life of soda lime was 1,587 minutes in the control group and 1,980 minutes in the experimental group. 2) At the end point of useful life of the absorbent the level of the color change of the indicator of the absorbent in all types was above the three-fourth height of two chambered canister. 3) At the end point, end tidal CO2 concentration was 3.5 vol% in the control group 2.88 vol% in the experimental group. The data obtained from this observation indicated that the increase of total flow rate of gas and the type A canister prolonged the useful life of soda lime and that the double chambered canister could be used safely until the color change of the indicator reached the level of three fourth the height of the canister.

Therapeutic Effect of Traeheal Suction on Pulmonary A spiration of HCI in Rabbits / 대한마취과학회지

Aspiration of gastric content is always a threat in emergency operations. The consequences of pulmonary aspiration are connected with both the volume and the character of the material inhaled, but perhaps the most serious consequences result from the relative acidity of gastric secretions. Inhalation of materiaI with a pH less than 2.5 causes an immediate iatense bronchoconstriction, epithelial degeneration of the bronchi, pulmonary edema and hemorrhage. Once the aspiration of material from the stomach is thought to have occurred, the airway should be cleared as soon as possible and any aspirated material remaining in the oropharynx should be cleared by means of suction. This experimental study was carried out to assess the therapeutic effect of suction on pulmonary aspiration of hydrochloric acid and the changes in chest X-ray findings caused by aspiration of the acid. The condition of oxygenation of the animals were studied by blood gas analysis. In this experiment,24 rabbits weighing 1.8-2.2 kg were used and divided into 4 groups each group consisting of 6 rabbits. Group I: No suction after aspiration Group II: Immediate suction after aspiration Group III: Suction 5 seconds after aspiration Group IV: Suction 10 secoads after aspiration Each of the four groups in the state prior to aspiration served as a control. All experimental animals were anesthetized by intravenous injection of ketamine 75 mg/kg and HC1 (pH: l.0, 2 ml/kg) was instilled into the trachea through a tracheostomy tube while the animals were fixed in a head-up position. Suction was made 5 times vigorously through a tracheostomy tube using an electric suction apparatus in the suction groups. Spontaneous respiration was maintained in room air throughout the experiment. To see cehange in the findings of the lung, chest X-ray was taken 24 hours after the aspiration of HCL. The sample of arterial blood was taken from the femoral artery and analyzed for blood gas 5 minutes, 10 minutes, 30 minutes, 1 hour and 2 hours after the aspiration of HCl. The results were as follows:1) In all rabbits except one in group II, the findings of radioopacity was visible in the lungs 24 hours after the aspiration of HCL. 2) In the chest X-ray findings, group I revealed radioopacity in the area of 74.76+/-8.93% of the whole lung field, group II in the area of 9.13+/-5.84%, group III in the area of 40.67+/-15.89% and group IV in the area of 58.96+/-6.65%. 3) In blood gas analysis, PaO2 decreased to 52.2% of control at 5 minutes in all aspiration groups (P<0.01) and 2 hours later, the recovery of PaO2 values observed were 73.2% of the control in group I, 88.7% in group II, 82.7% in group II and 77.1% in group IV, The value of the PaCO2, was significantly decreased at 10 minutes, 30 minutes, 1 hour and 2 hours in group II(P<0.01) after aspiration but in the other groups, the changes were insignificant. The value of pH shown insignificant decrease in group I and group IV, and insignificant increase in group II and group III. From the above findings, the pulmonary changes after the aspiration of hydrochloric acid seemed not to be lessened by suction treatment after 10 seconds following aspiration of the acid.

Anesthesia for Thymectomy in Myasthenis Gravis - A case report / 대한마취과학회지

Anestheiologists are called upon to undertake, or to assist in the management of severe respiratory and circulatory emergencies that may occur in myasthenics or to administer anesthesia for thymectomy or other surgical procedures to be performed on myasthenic subjects. Consequently the well-trained anesthesiologists must be sufficinetly familiar with the diagnosis and treatment of myasthenia gravis to carry on the therapy. A case of anesthesia for thymectomy in myasthenia gravis was experience. During operation, 0.1% succinylcholine in dripp method was given for adequate muscle relaxation and no respiratory probelms were encountered postoperatively.

Glossopharyngeal Neuralgia - A case report / 대한마취과학회지

Glossopharyngeal neuralgia, first discribed by Labat in 1928, is a very rare disease of unknown cause. This neuralgia is associated with a characteristic sharp pain of the posterior pharynx, tonsils and larynx, and especially triggered by swallowing action. It is said that this pain is more severe than that of trigerminal neuralgia and the pain may last several up to 30 minutes and the attack repeats intermittently. Diagnosis of glosspharyngeal neuralgia is made by the symptoms and by the elongation of the right side of the styloid process in this case. The glossopharyngeal nerve block by the deposition of local anesthetic solution is useful in the accurate diagnosis of the douleureux or neuralgia in which this nerve is involved and in providing anesthesia for operative intervention upon the posterior third of the tongue. This is a report of a case of glossopharyngeal neuralgia, which did not respond to Tegretol and other analgesic drugs and treated by glossopharyngeal nerve block with 0.5% bupivacaine l.5-2.0 ml. The block was performed every day for 15 days and the neuralgia disappeared without complication.

A Study of the Prevention of Pollution of Operating Rooms with Halothane / 대한마취과학회지

Attention has been drawn to the possible deliterious effects on operating theatre personnel of breathing in an atmosphere polluted with anaesthetic vapour, in particular, halothane. Whether or not the relation of these effects of anaesthetic vapours has been adequately proved, there is unlikely to be any disagreement that pollution of theatre air with anaesthetic is undesirable. Comparable atmospheric pollution with halothane in the same theatre was studied with and without use of halothane absorber "Aldasorber". The theatre had no device for reducing air pollution. Anaesthetic exhaust fases were drained to the ground. An anaesthetic machine in a semiclosed circle with carbon dioxide absorber was used throughout the anaesthesia. Anaesthesia was maintained with halothane l.0% and 50% oxygen in nitrous oxide, free gas flow rate were oxygen l.5 liter/min and nitrous oxide 1.5 liter/min, Halothane concentrations at various sites of the operating theatre were studied using the method of gas chromatography. 1) Halothane concentrations in the atmosphere of the operating theatre were 0.11 +/-0.07 ppm without halothane absorber and 0.13 +/-0.14 ppm with halothane absorber at the level of 115cm above the operating theatre floor before anaesthesia. 2) Halothane concentrations in the atmosphere of the operating theatre were 7.50 +/-1.32ppm without halothane absorber and 2.82 +/-0.93 ppm with halothsne absorber at the level of 115cm above the operating theatre floor after 3 hours of anesthesia. 3) Comparing this data it was concluded that the concentration of halothane vapour in the operating theatre air after 3 hours of anesthesis could be reduced by 65% W1th halothane absorber Aldasorber.

Acute Pulmonary Edema Caused by Direct Current Shock during Cardiac Surgery - A case report / 대한마취과학회지

There are various etilogic factors concerned in the formation of pulmonary edema but it is rare that pulmonary edema is elicited as a consequence of direct current shock. The cause of this complication is unknown. The mechanism of pulmonary edema is suspected that acute alteration or disparities in atrial or ventricular mechanical function of the heart consequent to the application of electrical discharge precipitate pulmonary congestion. A case of acute pulmonary edema following the use of direct current shock during anesthesia for mitral commissurotomy was experienced. The patient was treated with oxygen, diuretics, steroid, continuous positive pressure ventilation and partial cardiopulmonary bypass. The patient recovered without further event.

A Clinical Survey of 1, 441 Anesthesia Cases over 60 Years of Age / 대한마취과학회지

To evaluate geriatric anesthetic experience, 1,441 cases of patients aged over 60 years. Out of 29,692 surgical cases admitted to St. Mary's Hospital from January 1971 to December 1980 were analyzed according to age, sex, surgery, preoperative condition, technique of anesthesia, duration of anesthesia, anesthetics, and mortality. The results were as follows: 1) The percentage of geriatric cases were 4.9% in average which ranged between 3.9% and 6.0% and showed steady numbers in this period. The distribution of the number of patient according to the age were 1,150 cases(79.8%) in the group of 60~69 years, 262 cases (18.2%) in 70~79 years, and 29 cases(2.0%) over 80 years. 2) There were 833 male(57.8%) and 608 female(42.2%) cases. 3) 833 cases(57.8%) were in general surgery: the most prevalent diagnosis were empyema of gallbladder and cholelithiasis which amounted to 195 cases(13.6%) 4) The rates of elective to emergency surgery were 75.4% (1086 cases) to 24.6%(355 cases). 5) Premedicants were mainly atropine with sedatives(785 cases, 61.2%) and atropine with analgesics(220 cases, 17.1%). 6) Preoperative hemoglobin level ranged between 10.1 and 12.0gm/dl in 40.1% of the patients. 7) The techniques of anesthesia were (1,234 cases, 85.6%) general anesthesia, (75 cases, 5.2%) intravenous anesthesia and spinal anesthesia(60 cases, 4.2%). 8) The duration of anesthesia (500 cases, 34.7%) were 1~2 hours in average. 9) The inhalation anesthetics were Halothane(1,110 cases, 90.0%) , Methoxyflurane(112 cases, 9.1%), N2O (6 cases, 0.5%), and Ether(6 cases, 0.5%). 10) The preoperative chest X-ray and clinical signs showed that 963 cases (54.3%) were normal. 159 cases(10.6%) had emphysems, 152 cases(10.1%) had pulmonary tuberculosis and 41 cases (2.7%) had bronchitis. 11) The preoperative EKG and clinical symptom revealed that 952 cases(62.1%) were normal in cardiovascular aspect, 23 cases (15.1%) showed hypertension, 124 cases(8.1%) had arrhythmis, and 79 cases(5.2%) had myocardial ischemia. 12) During the surgical procedure cardiac arrest were experienced in 5 cases(0.3%) and sudden hypotensive pisods in 18 cases, which were successfully resuscitated. There were no operative mortalities within 48 hours. In summary, the patients over the 69 to 80 age group had a poor surgical risk, but they were able to withstand this risk when properly managed with modern anesthesia.

Hemoglobinuria due to the Use of Frozen Red Blood Cells during Anesthesia / 대한마취과학회지

Because of the significant reduction in complications from transfusion owing to the development in the technique of preservation of blood, the tendency of hemoglobinuria during anesthesia and surgery has decreased. it seems that there are many causes of hemoglobinuria, and its prognosis is varied. The incidence of Rb negative blood in Korea is no more than 0.2%. Therefore, such a rare blood type may be presserved by freesing for longterm storage. But this freesing and thawing of blood leads to partial hemolysis of the red cells. A case of hemoglobinuria occured during transfusion of Rh negative type B frozen blood.

The Experiences of Lumbar Epidural Anesthesia for Cesarean Section / 대한마취과학회지

From Sept. 1980 to Jan. 1981 twenty three cases of epidural anesthesia for cesarean section were performed at St. Mary's Hospital, Catholic Medical College, Seoul, Korea. The choice of anesthesia for cesaren section is still controversial. But the popularity of epidural anesthesia for elective cesarean section continues to grow even though the thechnique offers no advantage in terms of the biochemical condition of the mother and child. Marcaine which is a new stable, long-acting local anesthetics, was recently introduced to our department. A comparative study between marcaine and lidocaine application to the lumbar epidural anesthesia was performed. The results were as follows: 1) All of the 0.25% marcaine group revealed inadequate anesthesia for cesarean section. 2) Muscle relaxing effect of the 0.5% Marcaine group was revealted to be inferior to that of 2% lidocaine group. 3) Average time of onset of anesthesia was 24 min with marcaine and 18 min with lidocaine respectively. 4) Duration of single epidural injection of marcaine was 27.9+/-47 min and that of lidocatine was 122+/-31 min which revealed the duration of epidural anesthesia with marcaine was longer than that of lidocaine-about one hour. 5) The post operative pain was controlled successfully by means of continuous epidural technique with either 1.0% lidocaine or 0.25% Marcaine.

Anesthesia for Removal of Traeheobronchial Foreign Eodies in Children - Report of 54 Cases / 대한마취과학회지

Trachobronchial aspiration of foreign bodies is one cause of fatal acciderts in children. Serious complications and death of these children is avoided by early diagnocsis and early removal of foreign bodies. The purpose of this report is to analyze the alteration of anesthetic method for removal of tracheobronchial foreign bodies in 54 children(62 anesthesia) experienced in St. Mary's hospital, Catholic Medical College, seoul, Korea, From Jan. 1, 1963 to Sep. 30, 1980. The removal of tracheobronchail foreign bodies for all cases was done under general anesthesia. Results were as follows: 1) Most tracheobronchial foreign bodies appeared in the 1~3 year old group (24 cases among 54 children). 2) The kinds of foreign bodies were foods and metals. Most were peanuts and beans, which were not visible on chest X-ray films. These foreign bodies can cause atelectasis and emphysema in 24 hours, which was evidenced by chest X-ray. 3) During bronchoscopy, the chest was compressed manually after mask ventilation. Recently 1005 oxygen was inhaled through a thin plastic catheter lodged side the bronchescope. intravenous ketamine with 100% oxygen through thin catheter allowed safe anesthesia for bronchoscopic procedure. 4) Anesthetic time required for bronchoscopic procedure was 31~60 minutes on the average. 5) Pulse rate was increased in 39 cases during bronchoscopic procedure.

The Second Japanese-Korean Anesthesia Joint Symposium Subject : RESPIRATORY INSUFFICIENCY / 대한마취과학회지

>No abstract available.