Arterial hypoxemia is a frequent occurence in the immediate postoperative period. For this reason many patients are given supplemental oxygen after operation. A common method of delivering oxygen is with a catheter placed through one nostril and extended into the oropharynx. An alternative method is the use of a nasal cathetn inserted 2~3cm into one nostril and wedged in place with a small sponge. We have compared these two methods in two groups of post-surgical patients. Eight patients in each group were selected at random for study during the immediate postoperative period. Each .patient received O2 at 6L/min. flow by both methods. In the first group of patients the nasopharyngeal catheter was placed first, and in the other group the nasal catheter with a sponge was placed first. Previously blood from the femoral artery was drawn into aheparinized syringe after 15 to 20 minutes of breathing room air. Two subsequent samples of arterial blood were obtained from each patient. In the first group one sample was drawn after 15-20 minutes of oxygen administration via the nasopharyngel catheter and the other sample after 15-20 minutes of oxygen administration via the nasal catheter with a sponge. In the second group similar samples were taken with the order reversed. Arterial gas tensions were measured with a radiometer apparatus. A majority of patients did have low arterial oxygen tensions when breathing air in the immediate postoperative period. The average PaO2 during breathing of room air was 73.7mmHg. With the 6L/min. O2 flow via the nasopharyngeal catheter, the average PaO2 was 155. 9mmHg while the catheter with a sponge resulted in an average PaO2 of 144. 8mmHg in both groups. Thus the PaO2 of the former is slightly higher than the that of later. However both gave adequate PaO2 values with 6L/min O2 flow. Therefore, the nasal catheter with a sponge compares favorably with the nesopharyngeal catheter because of comfort, convenience, natural humidifying effect and elemination of the possibility of gastric distension or mediasinal emphysema.
Anesthesia, General* ; Anoxia ; Catheters* ; Emphysema ; Femoral Artery ; Humans ; Oropharynx ; Oxygen* ; Porifera* ; Postoperative Period ; Respiration ; Syringes

A 32 year-old man was scheduled for tracheal reconstruction after having special radiological studies and pulmonary function tests. Atropine was given preoperatively. A radial artery cannula was inserted for blood gas sampling and direct arterial pressure monitoring. The E,K.G. was monitored continuously. With the patient breathing a high concentration of oxygen from a mask, halothane was added to the inspired gas. After intramuscular injection of ketamine, halothane was discontinued. Spontaneous respiration was preserved with assistance when necessary. The larynx, pharynx and trachea were topically anesthetized and then a large-bore rubben orotracheal tube was placed in the trachea above the lesion. Anesthesia was maintained with additional ketamine injection. The trachea was explored through an anterior transverse cervical incision with a median sternotomy. The segment distal to the obstruction as dissected and found to be maligant tissue extending down to near the carina and behind the aortic arch. So, it was imperative to postpone further the surgery. Immediately after skin closure, the trachea was almost completely obstructed and PaCO2 value was above 150 mmHg. Therefore the airway was preserved by a pediatric bronchoscope, which was replaced by a pediatric endotracheal tube. Anesthetic management and tracheal resection and reconstruetion have been reviewed problems of induction in a patient with tracheal obstruction are discussed, and the technics for retaining control of the airway and reducing the hazards of hypoxia and hypercarbia are also stressed.
Adult ; Anesthesia* ; Anoxia ; Aorta, Thoracic ; Arterial Pressure ; Atropine ; Bronchoscopes ; Catheters ; Halothane ; Humans ; Injections, Intramuscular ; Ketamine ; Larynx ; Masks ; Oxygen ; Pharynx ; Radial Artery ; Respiration ; Respiratory Function Tests ; Skin ; Sternotomy ; Trachea

It was learned in 1960 that pregnancy could cause respiratory and circulatory changes, and that severe labor pain could cause tachycardia and cardiac arrythmias. We have experienced successful anesthetic management for cessarean section of a full term pregnant woman with multiple premature ventricular contractions under spinal anesthesia. PVC's could be caused by systemic hyposia, hypokalemia, acidosis hypercapnia, hypocalcemia, regional myocardial ischemia, etc. We could not confirm the cause of this woman's PVCs, but we assume that either deterioration of the respiratory and cardiac changes or severe labor pain could be implicated.
Acidosis ; Anesthesia, Spinal* ; Arrhythmias, Cardiac ; Female ; Humans ; Hypercapnia ; Hypocalcemia ; Hypokalemia ; Labor Pain ; Myocardial Ischemia ; Pregnancy ; Pregnant Women ; Tachycardia ; Ventricular Premature Complexes

This was a statistical observation of paraplegia patients who underwent operation at National Veterans Hospital from January 1975 to Mary 1981. The data was analyzed according to anesthetic technique, anesthetic agents, site of injury and etiology of injury. The results were as follows: 1) Only 24 cases or 21 % of the total needed anesthesia during operation. 2) The most common anesthetic technique was inhalation with circle absorption method.(32 cases, 29%) 3) Halothane was used as the main anesthetic.( 17 cases, 53%) 3) The most common etiology of injury was vertebral fracture( 35 cases, 59%) 5) The most common site of injury was lower thoracic.(T2-T1) (33 cases, 56%) 6) The total number of surgical operations performed numbered 59 out of 112 cases as classified in Table 1.
Absorption ; Anesthesia ; Anesthetics ; Halothane ; Hospitals, Veterans ; Humans ; Inhalation ; Paraplegia*