To build a clinical data base for the patient is one of the important works in the department of anesthesiology. Many of the works can be accomplished by presonal computer, of which include registration of patient data, searching for articles, and analysis of clinical data etc. We would like to introduce a computer programs for the management of various data of anesthesia department and patients. We expect that more advanced and beneficial programs appear to the management of data for anesthesia department and patients.
Anesthesia Department, Hospital* ; Anesthesia* ; Anesthesiology ; Humans ; Microcomputers*

BACKGROUND: Resilience engineering is a paradigm for safety management that focuses on coping with complexity to achieve success, even considering several conflicting goals. Modern sociotechnical systems have to be resilient to comply with the variability of everyday activities, the tight-coupled and underspecified nature of work, and the nonlinear interactions among agents. At organizational level, resilience can be described as a combination of four cornerstones: monitoring, responding, learning, and anticipating. METHODS: Starting from these four categories, this article aims at defining a semiquantitative analytic framework to measure organizational resilience in complex sociotechnical systems, combining the resilience analysis gridand the analytic hierarchy process. RESULTS: This article presents an approach for defining resilience abilities of an organization, creating a structured domain-dependent framework to define a resilience profile at different levels of abstraction, and identifying weaknesses and strengths of the systemand potential actions to increase system's adaptive capacity. An illustrative example in an anesthesia department clarifies the outcomes of the approach. CONCLUSION: The outcome of the resilience analysis grid, i.e., a weighed set of probing questions, can be used in different domains, as a support tool in a wider Safety-II oriented managerial action to bring safety management into the core business of the organization.
Anesthesia Department, Hospital ; Commerce ; Learning ; Safety Management

Fuwai Hospital was established in 1956 and the Anesthesia Department of Fuwai Hospital was one of the earliest anesthesia departments then in China. Under the leadership of several department directors and with the concerted efforts of all generations of colleagues, the Anesthesia Department of Fuwai Hospital has dramatically transformed, upgraded and modernized. For more than six decades, the Anesthesia Department has been providing high-quality peri-operative anesthesia care for cardiovascular surgeries, conducting innovative experimental and clinical researches, and offering comprehensive training on cardiovascular anesthesiology for professionals across China. Currently, Fuwai Hospital is the National Center for Cardiovascular Diseases of China and one of the largest cardiovascular centers in the world. The present review introduces the Anesthesia Department of Fuwai Hospital, summarizes its current practice of anesthesia management, the outcomes of cardiovascular surgeries at Fuwai Hospital, accumulates relevant evidence, and provides prospects for future development of cardiovascular anesthesiology.
Anesthesia ; Anesthesia Department, Hospital ; Anesthesiology ; Cardiovascular Diseases ; Hospitals ; Humans

BACKGROUND: Obstetrics departments are unique and medical accidents in obstetric anesthesia may show differences from non-obstetric anesthesia accidents.So we compared both groups in several aspects for the understanding their characters and decreasing their incidence. METHODS: Obstetric anesthesia accidents (n = 30) and non-obstetric anesthesia accidents (n = 106) were compared in 6 categories (patient age, anesthesia method, damaging event, anesthetic care, severity of injury, payment). RESULTS: The most common complications in obstetric anesthesia accidents were maternal death (40%), maternal brain damage (13%), and maternal nerve injury (13%).In contrast, the most common complications in non-obstetric anesthesia accidents were patient death (62%), and patient brain damage (27%). The severity of injury score of obstetric anesthesia adverse outcomes was analogous to that of non-obstetric anesthesia adverse outcomes, but the payment for obstetric accidents was significantly greater than that for non-obstetric accidents. CONCLUSIONS: Obstetric anesthesia accidents revealed distinct medical risk profiles, such as patient age, damaging event, severity of injury, and payment.Special care should be used when anesthetizing younger women and caring for a newborn in obstetric anesthesia.More studies and analyses are necessary to prevent obstetric anesthesia accidents.
Anesthesia ; Anesthesia, Obstetrical ; Brain ; Female ; Humans ; Infant, Newborn ; Maternal Death ; Obstetrics and Gynecology Department, Hospital

BACKGROUND: Obtaining and utilizing the feed-backs from residents who have finished four year of anesthesia residency could well contribute to improvement in training program. Therefore authors have designed a self questionnaire to analyze the degrees or measures of satisfaction from such training program and data were evaluated to provide,in future,the guideline which would improve the quality of the training program. METHODS: The self-questionnaires were sent to residents(n=148),who have been through the entire four year of residency training courses under anesthesia department. The assessment was conducted to measure the degree of satisfaction based on several variables such as motivation, selection of anesthesiology as a first choice, type of training hospital, and sex. To evaluate the current problems of anesthesia residency program, we made 30 open-ended and close-ended questions. Data analysis was made using Fishers exaet test. RESULTS: There were no statistically significant difference between the degree of satisfaction and their motivation for choosing anesthesia, anesthesia as a major, selection of anesthesiology as a first choice, and types of hospitals. As for the difference in satisfaction of training, male residents showed significantly higher satisfaction rate( n=92, 36.2%) than female residents(n=47, 17%). CONCLUSIONS: These results suggest that degrees of satisfaction was more likely related to the program of each training hospital and sex compared to other variables studied.
Anesthesia Department, Hospital ; Anesthesia* ; Anesthesiology ; Education ; Female ; Humans ; Internship and Residency* ; Male ; Motivation ; Surveys and Questionnaires ; Statistics as Topic

Based on the testing results of samples, this article represents the safety status of anesthetic units used in Shanghai medical institutions. In order to guarantee the safety and efficacy of the anesthetic devices, the medical institutions should set up some effective management systems, the related government departments should immediately perfect their administration system and bring in the market-operated professional maintenance organizations.
Anesthesia ; Anesthesia Department, Hospital ; organization & administration ; China ; Equipment Safety ; Quality Control ; Surgical Equipment

OBJECTIVES: Nurses' turnover has a negative influence on the nursing staff, as well as on the hospital organization as a whole. In an effort to reduce the turnover of nurses, the conditions causing turnover intentions can be identified and managed. The research is conducted to identify the association among verbal abuse, social support, and turnover intentions for special unit nurses. METHODS: A survey was conducted in 105 registered nurses who worked in the following areas at Kyonggi province hospital: operating room, intensive care unit, and anesthesia department. The questionnaires included questions in the following areas: verbal abuse by doctors, supervisors, and colleagues social supports by supervisors and colleagues and turnover intention. The survey was distributed and analyzed based on nurses' responses. RESULTS: Operating room nurses had the highest turn over intentions. The verbal abuse by doctors and supervisors were highest in the operating room. Verbal abuse by supervisors had a significantly positive association with turnover intentions. Verbal abuse by doctors and by colleagues was not associated with the intention to leave. Finally, the social support by supervisors had a significant negative association with turnover intentions. Social supports by colleagues did not affect turnover intentions. CONCLUSIONS: For nurses working at special units, verbal abuse and social support by supervisors had a significant association with turnover intentions. It is important for supervisors to make an effort to reduce nurses' turnover intentions by reducing verbal abuse and by increasing social support.
Anesthesia Department, Hospital ; Humans ; Intensive Care Units ; Intention ; Nursing Staff ; Operating Rooms ; Questionnaires

Ever since Mixter and Barr demonstrated the relationship between disk protrusion and radicular pain nearly 50 years ago, there has been a swing toward mechanical explanations for all problems of this type. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that the causal irritant is likely to be a chemical product of disk degeneration. That administration of steroids reduces the inflammatory process is well known. The present study was undertaken to acess our experience in using epidural steroid injection ofr patients suffering from diskogenic low back pain. Ten patients with the clinical diagnosis of sciatica and with post larninectomy sequelae were referred to the anesthesia department of Maryknoll hospital. Our routine epidural injection of the lumbar spine(L3-4) consists of 2ml of 2% xylocaine and 120mg of methylprednisolone(Depo medrol). Following the injection of Depo Medrol patients were encouraged to ambulate actively and were asked to evaluate their subsequent pain relief. Of the 10 patients studied, all patients experience pain relief within 10 minutes of the epidural injection. A follow up study of these patients was done between 5 and 10 months after injection. The results were as follows: 1) 3 patients: Complete relief. 2) 3 patients: moderate relief. 3) 3 patients: no relief. 4) 1 patient: technical failure.
Anesthesia Department, Hospital ; Back Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Injections, Epidural ; Intervertebral Disc Degeneration ; Lidocaine ; Low Back Pain ; Methylprednisolone ; Sciatica ; Steroids*

BACKGROUND: Malignant hyperthermia (MH) is a hypermetabolic disorder of skeletal muscle that manifests after exposure to triggering episodes such as halothane or succinylcholine. The first case was reported in Australia on 1960 by Denborough. In Korea the first case report was made by Lim on 1971. The authors retrospectively analysed the reported cases of MH and/or masseter muscle rigidity in Korea for the establishment of appropriate diagnostic criteria and rapid treatment. METHODS: Twenty-one cases of MH and 2 cases of masseter muscle rigidity were analysed retrospectively form 1971 to 1995. These cases were reported in Journal of Korea Society of Anesthesiology and Journal of Research Institute of Medical Science of Korea. The analyzed items were age, department, anesthesia, symptoms and signs, drugs for treatment, history of patient and family and prognosis of MH. RESULTS: The incidence of MH was higher in male patients below the 4th decade of life. The rate was 0.6 per year from 1971 to 1995. In nineteen patients, inhalation anesthetics with succinylcholine were suspected as triggering agents and 4 patients' conditions were related to spinal anesthesia by tetracaine. Only one case of MH occured within 10 min. after induction, but 22 cases occured during operations or the recovery period, and one case in the ward. The most common initial signs were muscle rigidity, high fever with arrhythmia and increased blood pressure. Related laboratory findings were acidosis, elevated end tidal CO2, and hyperkalemia. Six cases had family histories or past histories related to MH. CONCLUSIONS: The incidence of MH is progressively increasing in Korea. But MH will be prevented and treated effctively. So we should prepare a monitoring system for early detection and a supply of dantrolene for treatment. These precautions will spread nationwide and will need the support of the anesthesiology society and the goverment.
Academies and Institutes ; Acidosis ; Anesthesia Department, Hospital ; Anesthesia, Spinal ; Anesthesiology ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Australia ; Blood Pressure ; Dantrolene ; Fever ; Halothane ; Humans ; Hyperkalemia ; Incidence ; Korea* ; Male ; Malignant Hyperthermia* ; Masseter Muscle ; Muscle Rigidity ; Muscle, Skeletal ; Prognosis ; Retrospective Studies ; Succinylcholine ; Tetracaine

Central venous pressure is an extremely useful parameter in the effective monitoring of patients who are seriously ill. Since the subclavian venepuncture for central venous pressure was introduced by Ashbough in 1963, it has become extremely useful for prolonged intravenous administration of fluids, for a reliable intravenous route in cases of peripheral vascular collapse, and for hyperalimentation. Since then several different techniques for large vein puncture i.e., subclavian vein and internal jugular vein, have been developed. Since 1974, 265 cases of catheterizations have been recorded by the anesthesia department in the Dong San Medical Center. These were performed mostly by the supraclavicular approach. We have observed the following advantages of this approach over the infraclavicular approach. 1) More definitive skin landmark. 2) The distance between the skin and the vein is shorter. 3) The direction of the needle is easily controlled. 4) There is less tissue trauma because the pectoralis major muscle is not penetrated. 5) There is less incidence of pneumothorax or hydrothorax. 6) The procedure can be performed during surgery by an anesthesiologist. 7) The failure rate is lower. The subclavian vein is located within the costo-clavicular-scalene triangle and is approximately 3 to 4 cm long and 1 to 2cm in diameter in adults. The patient is placed in a supine and Trendelenberg position to allow the subclavian vein to distend and to help prevent air embolization when the vessel is cannulated. Following preparation of the supraclavicular fossa, a 16 gauge needle with a 10cc syringe attached is inserted and advanced in the direction of the innominate vein, approximately 1 cm from the- junction of the clavicle and the lateral border of the sternocleidomastoid muscle (clavister- nomastoid angle, fig. I) It is important to maintain a negative pressure while advancing the needle until a free- flow of blood is observed in the svrinre. When blood is observed a catheter is inserted and. threaded through the needle then the needle is removed. The catheter is connected to a 3 way stopcock which is connected to the intravenaus solution line. It is also important at the time that the needle is removed to put the patient in a semi- Fowlers position to decrease hematoma formation and allow the walls of the vein to contract around the inserted catheter. The complications of subclavian venepuncture and catheterization include pneumothorax hydrothorax, hemothorax, air embolism, hematoma, catheter embolism, thrombosis and sepsis etc. Fewer complications from a supraclavicular approach in comparison to a infraclavicular approach have been reported in various journals. In the supraclavicular subclavian vein catheterization, the above complications have not been major problems when attemptedunder careful supervision in our institution.
Administration, Intravenous ; Adult ; Anesthesia Department, Hospital ; Brachiocephalic Veins ; Catheterization* ; Catheters* ; Central Venous Pressure ; Clavicle ; Embolism ; Embolism, Air ; Hematoma ; Hemothorax ; Humans ; Hydrothorax ; Incidence ; Jugular Veins ; Needles ; Organization and Administration ; Pneumothorax ; Punctures ; Sepsis ; Skin ; Subclavian Vein* ; Syringes ; Thrombosis ; Veins