A Study on the Middle Ear Pressure Variation during General Anesthesia / 대한마취과학회지

This study was carried out to observe and evaluate the middle ear pressure(MEP) change by nitrous oxide(N2O) and end tidal PCO2 during general anesthesia with halothane or enflurane. MEP was measured during general anesthesia by impedance audiometer(GSI 28 Auto tymp model) in 50 patients who were relatively healthy without upper respiratory tract infection and otologic problems from August 1987 at Chonbuk National University Hospital. The results were as follows: 1) During general anesthesia with 100% O2 and halothane or enflurane, MEP was decreased progressively under the preinduction level with time. 2) The decrease in MEP during general anesthesia with 100% O2 and halothane or enflurane was reversed by relative hypoventilation, but MEP showed negative values in all patients. 3) End tidal PCO2 was increased progressively by relative hypoventilation and returned gradually to pre-hypoventilation level by normoventilation. 4) MEP was increased during general anesthesia using N2O, which is propotional to the concentration of N2O by 20 minutes. Thereafter, MEP remained increased until termination of N2O administration. From the above results, it is concluded that MEP is increased during anesthesia using N2O. MEP can also be affected by end tidal PCO2 even though physiologic range. Therefore, it is prudent to avoid N2O especially when hyperventilation is not adequately permitted during general anesthesia for middle ear surgery and patient with middle ear disease.

A Case of Hyperkalemia discovered immediately after the Induction of General Anesthesia / 대한마취과학회지

Acute hyperkalemia may result from many causes, i.e. excessive load, transcellular shift, decreased renal excretion, and so on, and may be associated with irreversible and fatal cardiac manifestations, muscle weakness, ventilatory and adrenal insufficiency, etc. We experienced a case of acute hyperkalemia probably due to red cell lysis which was evident immediately after the induction of general anesthesia with thiopental sodium and succinylcholin in 1 33 year-old female patient with common bile duct obstructive jaundice. In spite of active management during anesthesia and posoperative period, eventually she died of cardiac arrest. For the successful management of the acute hyperkalemia, the anesthesiologist should be aware of its etiologies, pathophysiology, diagnosis & treatment.

Pneumothorax and Subcutaneous Emphysema in the Recovery Room after Surgery / 대한마취과학회지

A postoperative recovery room serves to care for patients until they are sufficiently recovered from the physiologic derangements produced by surgery and general anesthesia. Upon emergence from general anesthesia, airway obstructuion, hypoxemia, pneumothorax, hypotension, hypertension, aspiration or excitement may occur. A Case of presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema in the recovery room. This complication was the result of an accidental sealing of the tracheal tube with plaster by an aid nurse. The patients was discharged with no problems. We report this case along with a review of the literature.

Pneumothorax and Subcutaneous Emphysema in the Recovery Room after Surgery / 대한마취과학회지

A postoperative recovery room serves to care for patients until they are sufficiently recovered from the physiologic derangements produced by surgery and general anesthesia. Upon emergence from general anesthesia, airway obstructuion, hypoxemia, pneumothorax, hypotension, hypertension, aspiration or excitement may occur. A Case of presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema in the recovery room. This complication was the result of an accidental sealing of the tracheal tube with plaster by an aid nurse. The patients was discharged with no problems. We report this case along with a review of the literature.