Maternal and fetal effects of anesthesia for 423 cesarian section, performed during the past three and quarter years period in this hospital, have been evaluated. It is emphasized that the selection of anesthetic agent and method should depend upon the physical status of the patients and the ability of both obstetrician and anesthesiologists. Author results were as follows: 1. The incidence of c-section was 13.9% of total deliveries. 2. More than about three fourths of total cases were emergency cases. 3. Almost all cases were operated under general anesthesia. 4. The good physical states of patients resulted in better Apgar score of infants. 5. The shorter the interval from induction of anesthesia to delivery, the better was the Apgar score of infants.
Anesthesia ; Anesthesia, General ; Apgar Score ; Emergencies ; Humans ; Incidence ; Infant ; Methods

BACKGROUND: This study undertook to compare the effect-site concentration of remifentanil for prevention of hemodynamic responses to endotracheal intubation, employing the single-lumen tracheal tube and the double-lumen bronchial tube during total intravenous anesthesia. METHODS: Based on the nature of the surgery, 38 patients undergoing general anesthesia were assigned either to the single-lumen tube group or the double-lumen tube group. Anesthesia was induced by a target controlled infusion of propofol, with an effect-site concentration of 4 µg/ml. Remifentanil was then administered to the first patient in each group, with an effect-site concentration of 3.5 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to intubation, based on the up-and-down method. RESULTS: The effect-site concentrations of remifentanil for prevention of hemodynamic responses to endotracheal intubation in 50% of patients (EC₅₀) were 2.8 ng/ml (95% CI, 2.0–3.7 ng/ml) in the single-lumen tube group, and 2.9 ng/ml (95% CI, 2.5–3.2 ng/ml) in the double-lumen tube group. No significant difference was observed between the two groups. CONCLUSIONS: The effect-site concentration of remifentanil for prevention of hemodynamic responses to endotracheal intubation did not differ during total intravenous anesthesia, using either the single-lumen tracheal tube or the double-lumen bronchial tube.
Anesthesia ; Anesthesia, Endotracheal ; Anesthesia, General ; Anesthesia, Intravenous ; Hemodynamics* ; Humans ; Intubation* ; Intubation, Intratracheal ; Methods ; Propofol

Adult ; Anesthesia, General ; methods ; Anesthesia, Intravenous ; methods ; Cesarean Section ; methods ; Female ; Humans ; Muscular Atrophy, Spinal ; Pregnancy

To evaluate historical trends, anesthetic experiences of 14, 337 in the total performed at the Korea University Hospital from Jan. 1966 through Dec. 1977 were analyzed statistically according to age, sex, department, methods, physical status, duration of anesthesia, induction agents, main agents and anesthetic techniques. The results were as follows: 1) General anesthesia has been used as almost the main method of anesthesia. 2) Patients were about half in the 21~40 group of age. 3) Male patients were 2. 2 times more than females. 4) The most largest department for surgery was of patients in general surgery. 5) According to the ASA, classification of physical status, patients in class 1 were 43. 5%, and elective surgery to emergency ratio was 1. 3 to 1. 6) Patients in the 1~ 2 hour duration group were 41. 7%. 7) Thiopentone has mainly been used for intravenous induction. 8) Ether had mainly been used for a main anesthetic agent until 1970, but balanced anesthesia has been used with increasing favor since that time. 9) In almost all cases, a semiclosed circle absorption system has been employed and non- rebreathing system has recently been used with increasing favor for pediatric anesthesia.
Absorption ; Anesthesia* ; Anesthesia, General ; Balanced Anesthesia ; Classification ; Emergencies ; Ether ; Female ; Humans ; Korea ; Male ; Methods ; Thiopental

Regional anesthesia is mostly used in operations on the lower abdomen or lower extremities in elderly patients. It shows nearly no difference in long-term outcomes compared to general anesthesia, but it is used more often because of the several advantages. However, during the regional anesthetic procedures, the patient must cooperate and has to be lateral decubitus position without physical movement. Therefore, in the case of the patients who are not cooperated, it may be not easy to perform regional anesthesia. In this study, we present 3 case reports that regional anesthesia after sedation is performed in un-cooperated patients. Regional anesthesia after sedation may be a good method to improve outcomes in un-cooperated elderly patients.
Abdomen ; Aged* ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Consciousness Monitors ; Humans ; Lower Extremity ; Methods

PURPOSE: To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. MATERIALS AND METHODS: One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. RESULTS: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9+/-3.2 days vs. 11.5+/-6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). CONCLUSIONS: Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General* ; Fever ; Humans ; Kidney Calculi ; Length of Stay ; Methods ; Nephrostomy, Percutaneous* ; Retrospective Studies

The authors have been experienced a case of laryngeal granuloma following endotracheal anesthesia which is rare in children and have used two different method of general anesthesia for resection of granuloma. These two methods are; 1) using endotracheal tube insertion for general anesthesia. 2) applying general anesthesia via under mask. Comparing with two different methods of general anesthesia, we come to the conclusion that the former is more reliable for clinical anesthesia because of supplying continuous positive pressure with oxygen and anesthetics in spite of poor operation field.
Anesthesia ; Anesthesia, Endotracheal ; Anesthesia, General* ; Anesthetics ; Child ; Granuloma* ; Granuloma, Laryngeal* ; Humans ; Masks ; Methods ; Oxygen

BACKGROUND AND OBJECTIVES: Since rhinoplasty techniques require meticulous and delicate manipulation, proper anesthesia is essential. The aim of the current study is to compare patient satisfaction and complication of rhinoplasty performed under local anesthesia against general anesthesia. SUBJECTS AND METHOD: Patients who underwent rhinoplasty by a single surgeon between March 2014 and January 2017 were enrolled in this study. Midazolam was utilized to sedate the patient during local anesthesia. Pain and memory of surgery under local anesthesia, satisfaction of anesthesia, and willingness to undergo the surgery with the same anesthesia method again were evaluated. Cardiopulmonary events, nausea, and vomiting were assessed as complications. Aesthetic satisfaction of patients and the doctor was evaluated 6 month after the surgery. The parameters were compared between local and general anesthesia. RESULTS: A total 120 patients were included in this study. The degree of pain was low during surgery under local anesthesia. Although most of patients remembered the process of surgery during local anesthesia, satisfaction of local anesthesia was high. The satisfaction of anesthesia and willingness to undergo surgery with same anesthesia were not signifcantly different between local and general anesthesia. No serious complications developed during local anesthesia and there were no signifcant differences of aesthetic satisfaction between local and general anesthesia. CONCLUSION: Patient satisfaction and aesthetic results of rhinoplasty performed under local anesthesia were comparable to general anesthesia, indicating that surgeons do not need to be afraid of applying local anesthesia in rhinoplasty.
Anesthesia ; Anesthesia, General* ; Anesthesia, Local ; Humans ; Memory ; Methods ; Midazolam ; Nausea ; Patient Satisfaction* ; Rhinoplasty* ; Surgeons ; Vomiting

A foreign body was found in left bronchi of a 8-month infant. A fish bone of 26 mm long was pulled out with bronchoscopy under general anesthesia. This kind of surgery done in infant is more challenging than that done in child.
Anesthesia, General ; Bronchi ; Bronchoscopy ; methods ; Foreign Bodies ; surgery ; Humans ; Infant

BACKGROUNDThe laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA).

METHODSWe collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups.

RESULTSDuring the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups.

CONCLUSIONSOur results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies.

Anesthesia, General ; methods ; Cesarean Section ; methods ; Female ; Humans ; Intubation, Intratracheal ; methods ; Laryngeal Masks ; Pregnancy ; Retrospective Studies