The Effect of CO2 on Body Temperatures during Cooling and Rewarming of Cardiopulmonary Bypass / 대한마취과학회지

Background: It is well known that the addition of CO2 gas during cardiopulmonary bypass (CPB) can increase cerebral blood flow (CBF). In this study, we tried to find whether the increase of CBF by CO2 gas could be expressed on the measurement of body temperatures. Methods: This study included 22 adult patients who underwent CPB with moderate hypothermia and were assigned randomly to two groups by adding CO2 gas (CO2 group and Air group). We measured each tympanic (TM), nasopharyngeal (NP), oral, forehead, finger, rectal and CPB arterial line temperatures of CPB circuit for 20 times during cooling in every one minute for 20 minutes and during rewarming every two minutes for 40 minutes. Results: During cooling and rewarming, the TM, NP and oral temperatures changed more rapidly than the rectal and finger temperatures. In TM temperature, as time changed, the percent changes of temperature varied more prominently in the CO2 gas group than in the Air group. The statistical differences were significant especially during 13 minutes to 20 minutes in cooling and 8 minutes to 20 minutes during rewarming. Conclusion: From this data, we can postulate the effect of CO2 gas on CBF indirectly by measuring several sites of body temperatures.

The Effect of Anesthesia with Propofol-N2O on Neonate and Maternal Awareness during Cesarean Section / 대한마취과학회지

BACKGROUND: In anesthesia for cesarean section, there is an increased incidence of maternal awareness because a light plane of general anesthesia is chosen for fetal safety and rapid recovery. Propofol may be the choice if smooth induction and rapid maternal recovery are desired. Authors tried to know that propofol has properties which suggest that it might be useful alternative to thiopental and enflurane. METHODS: Forty patients in ASA class I or II scheduled for cesarean section were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. Anesthesia was induced with propofol 2 mg/kg IV and maintained by continuous infusion of propofol 8 mg/kg/hr in P group and was induced with thiopental 4 mg/kg IV and maintained by inhalation of 1 vol% enflurane in T-E group. All patients received vecuronium 0.1 mg/kg and 50% N2O-O2. Blood pressure, heart rate, Apgar score, umbilical arterial blood gas analysis and the incidence of maternal awareness using the isolated forearm technique (IFT) were evaluated. RESULTS: Diastolic pressure was decreased in P group than T-E group at 10 min after delivery. Heart rate was increased in P group than T-E group at immediate after extubation (p<0.05). For apgar score, umbilical artery gas analysis and maternal awareness there were not significant differences between two groups. CONCLUSIONS: In comparison with thiopental-enflurane, propofol infusion (8 mg/kg/hr) coupled with N2O was proved to be clinically satisfactory anesthesia for cesarean section with no adverse effects on both mother and neonate.