Anesthesiologists have a particular interest in myasthenia gravis, since they may need to provide anesthesia for thymectomy or other surgery, or they may have to be involved in the treatment of respiratory failure which mar complicate this disease. We report a case of balanced anesthesia, using thalamonal-N2O-O2 for thymectomy in myasthenia gravis, which posed no postoperative respiratory problem.
Anesthesia ; Balanced Anesthesia* ; Myasthenia Gravis* ; Respiratory Insufficiency ; Thymectomy*

The reason for undertaking a special study of pediatric anesthesia is that children and especially infants differ sharply from adult patients. We know the important factors are psychogenic, anatomic, pharmacologic, physiologic and pathologic differences. Although the most apparent contrast in the neonate is his size, immature enzymatic activity probably could prove a greater problem to an uninformed anesthetist. So it seems worthwhile for us to analyze our past pediatric anesthetic experiences(8,600 cases) from 1970 to 1979. The following was obtained from this clinical analysis. 1) Total number of pediatric anesthesias given has been increasing year by year, especially under the age of one year. 2) General inhalation anesthesia has shown increasing numbers, but spinal anesthesia has been decreasing in numbers. 3) Flammable agents such as cyclopropane and ether was disappeared completely from our operating theater in spite of their excellent qualities. However, balanced anesthesia with Innovar has been increase. 4) Pediatric cardiac patients among 8,600 cases have sharply increased from 0.5% in 1970 to 4.7% in 1975 and 11.6% in 1979.
Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Spinal ; Balanced Anesthesia ; Child ; Ether ; Humans ; Infant ; Infant, Newborn ; Mortuary Practice

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

Among the intraventricluar block, bundle branch block is the most common type and left bundle branch block(LBBB) may progress to a more serious condition of complete heart block. Anesthetic methods such as nitrous oxide-oxygen-relaxant sequence, neuroleptanesthesia, and nitrous oxide-oxygen-minimal halothane(or penthrane) are generally accepted by the patient with heart disease. In the U.S., opioid anesthesia is also applied frequently. The authors successfully twice performed of operations with balanced anesthesia and spinal anesthesia respectively in a 39-year-old male patient who showed complete left bundle branch block pattern in a preoperative electrocardiographic tracing without any subjective symptoms.
Adult ; Anesthesia ; Anesthesia, Spinal ; Balanced Anesthesia ; Bundle-Branch Block ; Electrocardiography ; Heart Block ; Heart Diseases ; Humans ; Male

Somatosensory evoked potential (SSEP) monitoring has been used to minimize neurologic morbidity during spine surgery. SSEP monitoring may be affected by technical factor including operation, physiological factor associated with patient and anesthetics used to induce and maintain general anesthesia. Several clinical studies have shown that inhaled anesthetics more decrease the amplitude of SSEP than a narcotic based general anesthesia. We have experienced 15 patients who received spine surgery under balanced anesthesia with propofol, remifentanil and 50% N2O, which is supposed to be another useful anesthesia technique for spine surgery under SSEP monitoring.
Anesthesia ; Anesthesia, General ; Anesthetics ; Balanced Anesthesia ; Evoked Potentials ; Evoked Potentials, Somatosensory ; Humans ; Piperidines ; Propofol ; Spine

The changes of the serum potaseum, chloride and CO2 concentration during ether, halothane, enflurane and balanced anesthesia were compared before anesthesia and during anesthesia 78 surgical patients. Anesthesia induced by thiopenthal sodium and maintained by ether, halothane, enflurane and niteous oxide produces little change in the serum sodium, potassium,, and chioride concentrations. But the serum potassium concentration falls during balanced anesthesia after 60minutes. Except in either anesthesia, ther is a significant decrease in the serum carbon dioxide concentration during halothane, and balanced anesthesis.
Anesthesia ; Anesthetics, General* ; Balanced Anesthesia ; Carbon Dioxide ; Electrolytes* ; Enflurane ; Ether ; Halothane ; Humans ; Potassium ; Sodium

We report a case of an erroneously elevated bispectral index (BIS) during robot assisted thyroidectomy using an electromyographic endotracheal tube (EMG tube), which is safe and useful for laryngeal electromyographic monitoring. Ten minutes after start of the operation, a sudden increase of BIS value up to 98 was noticed. The BIS values were not decreased to < 65 with supplemental anesthetics. The anesthetic method was changed from total intravenous anesthesia to balanced anesthesia. The BIS sensor and monitor were changed and other models were used. These interventions did not alter BIS values. BIS levels remained between 60 and 70 throughout the main procedure and intermittently increased to the mid-90s without any trace of poor signal quality. At the end of the surgery, the BIS values returned to normal range. The patient did not complain of intraoperative recall. Knowledge of potential interference from the use of an EMG tube must be considered when interpreting BIS.
Anesthesia, Intravenous ; Anesthetics ; Balanced Anesthesia ; Humans ; Organothiophosphorus Compounds ; Reference Values ; Thyroidectomy

In 30 ASA class I patients aged 15-30 undergoing peripheral operations, PaO2 and SaO2 were determined while the mixture of nitrous oxide and oxygen was administered at the inspired oxygen concentration of 21%. Anesthesia was maintained with 75% or so nitrous oxide and small dose fentanyl, and ventilation was adjusted to maintain normoventilation with tidal volume increased to 15 ml/kg. PaO2 and SaO2 during anesthesia were increased significantly when compared to those which were measured immediately prior to anesthetic induction, that is to say, no one developed hypoxemia despite administration of the same inspired oxygen concentration as that of room air. These results indicate that, in case rapid emergence from anesthesia is required, balanced anesthesia with high concentration nitrous oxide and small dose fentanyl should be very useful and safe so long as we make good selections of patients and deliver large tidal volumes to them during artificial ventilation.
Anesthesia* ; Anoxia ; Balanced Anesthesia ; Fentanyl ; Humans ; Nitrous Oxide* ; Oxygen* ; Tidal Volume ; Ventilation

Balanced anesthesia is being equilibrated with the maintenance of light planes of anesthesia and the relatively free utilization of muscle relaxants to prevent untoward movement of the patient in response to surgical stimuli. However, muscle relaxants per se do not contributes to the state of hypnosis or analgesia. Therfore, awareness during modern anesthesia must be seriously taken. We have given anesthesia in 175 cases for cesarean section in order to investigate intraoperative awareness. Among the 175 anesthetic cases, 13 cases had awareness of pain and 19 cases had auditor awareness. Accordingly the total incidence of awareness in our investigation was 16% which was significantly high and should be considered in clinical anesthesia practice.
Analgesia ; Anesthesia* ; Balanced Anesthesia ; Cesarean Section* ; Female ; Humans ; Hypnosis ; Incidence ; Intraoperative Awareness ; Pregnancy

Recently introduced tramadol structually similar to morphine, was a new category in analgesia. Also it was reported that that drug could be used in the shale of balanced anesthesia. So we carried out the experiment for evaluation of its effect on sympathoa-drenal system activity, indexed by plasma epinephrine and norepinephrine levels, to compare with other methods of balanced techniques in 18 Patients. Patients in group 1 who received Thalamonal-N2O-O2, patients in group 2 were given pethidine. diazepam-N2O-O2, patients in group 3 were tramadol. diase7am-N2O-O7, Venous samples were obtained before induction of anesthesia, after induction but before skin incision and immediately after skin incision. Sequential results of plasma epinephrine(pg/ml)were 62.0+16.8(mean+s.e.), 134.3+18.7, 127.3+26.2 in group 1, 65.8+13.1, 79.7+13.1, 91.3+22.5 in group 2 and 74.0+24.9, 88.0+17. 1, 108.4+23.2 in group 3. Values of norepinephrine(pg/ml) were 212.5+27.1, 167.7+23.9, 236.2+34.4 in group 1, 213.8+59.1, 162.0+33.2, 246.8+55.7 in group 2 and 236.0+39.6, 197.7+59.4, 208.4+25.6 in group 3. Those values did not differ significantly between three groups. Theae data revealed that this method of balanced anesthesia using tramadol could effectively block the sympathetic response to anesthestic and surgical stress as other method of balanced techniques.
Analgesia ; Anesthesia ; Balanced Anesthesia* ; Catecholamines* ; Epinephrine ; Humans ; Meperidine ; Morphine ; Norepinephrine ; Plasma* ; Skin ; Tramadol*