This patient who was a 42-year-old female had suffered from bearing down sensation and pain on anal region due to metastatic rectal cancer. She was done intrathecal block with 15% phenol in glycerine. The result was exellent to bearing down sensation and pain on anal area. Because lower back pain, pain on lower extremity and generalized painful sensation was not improved, we has done pharmacologic assistance. Urination difficulty became slightly aggrevated but was improved at post-block day 4th. This pain clinic report that intrathecal block with 15% phenol in glycerine was effective to treatment of cancer pain without major complications.
Adult ; Female ; Glycerol* ; Humans ; Low Back Pain ; Lower Extremity ; Pain Clinics ; Phenol* ; Rectal Neoplasms* ; Sensation ; Urination

A case of lateral neck mass caused by thrombosis of the right external jugular vein is presented. Macroscopic examination of the excised thrombosed vein showed a pin-point opening of the jugular vein connecting to the hemorrhagic mass and microscopic examination revealed the vein to have an organized thrombus with somewhat degenerated vessel walls. Venipuncture would seem the most likely cause of thrombosis of the venous aneurysm in this 6 year old female patient.
Aneurysm* ; Child ; Female ; Humans ; Jugular Veins* ; Neck ; Phlebotomy ; Thrombosis ; Veins

A electrical safety in the operating room is one of important responsibility for the anesthesiologists and surgeons. When the patient is included in an electric circuit with poor ground during operation under the general anesthesia electrical accident might be occurred, such as sustained muscular contration with asphixia, impairment of CNS function, ventricular fibrillation, and more commonly, burn and other physiological injuries. Authors report an electrical burn on the right calf area (3X5 cm) and both heels by ground plate of electrosurgical unit which is probably poor contacts with the patient and review about its prevention and safety of electric practice.
Anesthesia, General ; Burns* ; Heel ; Humans ; Operating Rooms ; Ventricular Function

A clinical study was performed of the respiratory care of 1309 critically ill patients who had been admitted to respiratory intensive care units (RICU) in 1986 and 1987. 1) The number of patients who needed respiratory care was 691 and the mortality in RICU was 1.45% (10 case) in 1986, and 618 and 2.59% (16 cases) in 1987, respectively. 2) The average duration of ventilatory support was 2.1 days in 1986, and 1.9 days in 1987. The patients of thoracic surgery needed respiratory support for 2.6 days in 1986, and 2.3 days in 1987. 3) The mortalities according to department were:1.42% (6 of 424 cases) in thoracic surgery, 1.89% (2 of 107 cases) in general surgery, 20% (1 of 5 cases) in pediatry surgery, and 7.14% (1 of 14 cases) in gynecology in 1986. In 1987, 2.56% (8 of 312 cases) in thoracic surgery, 4.0% (6 of 150 cases) in neurosurgery, 0.96% (1 of 104 cases) in general surgery, and 7.69% (1 of 13 cases) in urology. 4) The most frequently used ventilator was Bear II, followed by Benett MA-I. 5) The major causes of death in RICU were low cardiac output syndrome, sepsis, respiratory failure, and brain damage.
Brain ; Cardiac Output, Low ; Cause of Death ; Critical Illness* ; Gynecology ; Humans ; Intensive Care Units ; Critical Care* ; Mortality ; Neurosurgery ; Respiratory Insufficiency ; Sepsis ; Thoracic Surgery ; Urology ; Ventilators, Mechanical

The usually stable body temperature of homeothermic animals can be affected by innumerable biolagical and physical agents. Neurotransmitters, neuromodulators, synthetic drugs will cause an elevation or depression in body temperature depending on the dose, species and route of administration. The effects of clonidine (0.15 mg/kg), hydralazine (1 mg/kg), nifedipine (1 mg/kg) and verapamil (5 mg/kg) on rectal temperature in Sprague-Dawley rats were assessed 15, 30 and 45 min. After intraperitoneal injection of drugs. The results were as follows; 1) Rectal temperature of rats was significantly increased in clonidine group compared with hydralazine group. However, there were no significant changes in other groups. 2) In hydralazine group, there was highly significant decrease in rectal temperature of rats compared with control, clonidine and nifedipine group. 3) Rectal temperature of rats was significantly increase in nifedipine group compared with hydralazine group. However, there were no significant differences in changes of rectal temperature between nifedipine and other groups. 4) Rectal temperature of rats no significantly changes in verapamil group compared with other groups.
Animals ; Antihypertensive Agents* ; Body Temperature* ; Clonidine ; Depression ; Hydralazine ; Injections, Intraperitoneal ; Neurotransmitter Agents ; Nifedipine ; Rats* ; Rats, Sprague-Dawley ; Verapamil

Dialysis and transplantation are the only therapies available for patients with the end stage of renal diseases. Transplantation offers several distinct advantages; the trans-plantation patient has an opportunity of regaining normal kidney functions, he can avoid the recurrent and enervating need for twice weekly dialysis, dieary and fluid restrictions can be removed, anemia, bone disease and neuropathy may be rapidly reversed, growth may occur in children and the long term costs of treatment are substantially reduced. Since the initial report on anesthesia for renal transplantation from the peter Bent Brigham Hospital in 1962, anesthesia for kidney transplantation has been reviewed and discussed by many authors. This report is concerned with our clinical experience of 55 cases of anesthesia for living donor renal transplantations at Dong San Medical Center during the period between November 1982 and December 1987. The results are summarized as follow: 1) The age incidence of recipients was prevalent in the 3rd to 4th decade and the ratio of males to females was 37:18. 2) The age incidence of donors was prevalent in the 3rd to 4th decade and the ratio of males to females was 22:33. Of 55 cases, 30 cases involved a parent to child donor relationship, younger brother, elder and younger sister were donors in 18 cases and 6 cases were non-related. 3) The overall one and two year transplantation survivals were 91.9% and graft survivals were 87.2% and 75.9% respectively. 4) Succinylcholine and vecuronium were used for intubation and maintenance of muscle relaxation. 5) Lower concentrations of halothane and nitrous oxide were used as inhalation anesthetics in most, except in HBs Ag(+) patients. In hepatitis patients, enflurane were used.
Anemia ; Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Bone Diseases ; Child ; Dialysis ; Enflurane ; Female ; Graft Survival ; Halothane ; Hepatitis ; Humans ; Incidence ; Intubation ; Kidney ; Kidney Transplantation* ; Living Donors ; Male ; Muscle Relaxation ; Nitrous Oxide ; Parents ; Siblings ; Succinylcholine ; Tissue Donors ; Transplantation ; Vecuronium Bromide

This report is of 81 anesthetic experiences of renal homotransplantation performed under general anesthesia from December 1984 to April 1988 at Kosin Medical Center. Our anesthetic procedures in the recipients were as follows: 1) Preanesthetic preparation with dialysis. 2) Premedication with Robinul and Demerol. 3) Thiopental and succinylcholine for anesthetic induetion. 4) N2O-O2-relaxant (pancuronium and/or norcuron) with halothane or enflurane for maintenance. 5) Antagonism against the relaxant with neostigmine or pyridostigmine. 6) Transfusion and fluid infusion with which CVP was maintained around 10 cm H2O. These patients had several common problems of significance to anesthesiologists, including anemia, coagulopathies, electrolyte imblance, acidosis, hytertension with associated therapy, previous therapy with steroids and immunosuppressants, and dialysis etc. As well as the problems listed above, we experienced a case of protrusion of a grafted kidney due to inadequate relaxation, several cases of bradycardia which did not respond to intravenous atropine during anesthesia, and 5 cases of delayed recovery of respiration.
Acidosis ; Anemia ; Anesthesia ; Anesthesia, General ; Atropine ; Bradycardia ; Dialysis ; Enflurane ; Halothane ; Humans ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation* ; Meperidine ; Neostigmine ; Premedication ; Pyridostigmine Bromide ; Relaxation ; Respiration ; Steroids ; Succinylcholine ; Thiopental ; Transplants

In relief of postoperative pain, the value of epidural or subdural injection of opioids including morphine, methadone, petidine and fentanyl is now well established. The advantages of epidural or subdural over parenteral opioids is prolonged duration of analgesia, which last from several hours to several days, without sympathetic and motor blockade. But undesirable side effects include pruritus, urinary retention, delayed onset of somnolence, and cardiovascular and respiratory depression. To reduce postoperative pain, we evaluated the effects of caudal pentazocine 0.2-0.4 mg/kg with lidocaine 1.5% 400 mg for perianal surgery in 36 cases. The results were as follows: 1) There was no difference in analgesic onset between the Control Group (used lidocaine only) and Group A and B (mixed use of lidocaine and pentazocine: Group A, 0.2 mg/kg pentazocine; Group B, 0.4 mg/kg) 2) Mean duration of analgesia following caudal pentazocine and lidocaine injection was over 12 hours, but was less than 5 hours in the used lidocaine only. 3) Urinary retention was observed in all groups; 3 case in the Control group, and 4 cases in Group A and B. 4) In Group A and B, 6 cases had not used analgesics within 24 hours after caudal anesthesia. 5) No specific clinical changes were noted in the vital signs in all groups.
Analgesia ; Analgesics ; Analgesics, Opioid ; Anesthesia, Caudal ; Fentanyl ; Lidocaine ; Methadone ; Morphine ; Pain, Postoperative ; Pentazocine* ; Pruritus ; Respiratory Insufficiency ; Urinary Retention ; Vital Signs

Anesthesia, General*

In order to evaluate causes and the effective treatment of postoperative bleeding after open heart surgery, we measured platelet count and plasma fibrinogen levels before, during a 30 and 60-minute, and after a 30, 60 and 90-minute extracorporeal circulation in 5 patients perfused by a bubble and membrane oxygenator, respectively. The results were as follows: 1) The platelet count was reduced significantly by 57.2+/-3.04% during a 30-minute extracorporeal circulation using the bubble oxygenator and by 43.8+/-0.84% using the membrane oxygenator, and these levels were maintained throughout the extracorporeal circulation. 2) The platelet count after a 90-minute extracorporeal circulation increased significantly compared with after a 30-minute extracorporeal circulation (p<0.05) and these effects were more prominent using the bubble oxygenator (p<0.025). 3) The plasma fibrinogen level was reduced by 28.6+/-7.50% during a 30-minute extracorporeal circulation using the bubble oxygenator and by 33.6+/-5.77% using the membrane oxygenator, and these levels were maintained throughout the extracorporeal circulation. 4) The plasma fibrinogen level after a 90-minute extracorporeal circulation increased significantly compared with after a 30-minute extracorporeal circulation (p<0.05).
Blood Platelets* ; Extracorporeal Circulation* ; Fibrinogen* ; Hemorrhage ; Humans ; Oxygen ; Oxygenators ; Oxygenators, Membrane ; Plasma* ; Platelet Count* ; Thoracic Surgery