No abstract available.
Intubation* ; Laryngeal Masks*

BACKGROUND: Postintubational sore throat and hoarseness are usually mild symptoms but they are very common complaints among the patients after endotracheal general anesthesia. In addition, some might have severe discomfort and need invasive procedure to relieve these problems. We tried new method of endotracheal tube cuff filling with local anesthetics to reduce postoperative sore throat and hoarseness and evaluated the results. METHODS: Endotracheal cuff filling was done with air 5 ml in healthy 20 patients (ASA I-II, control group). And in another healthy (ASA I-II) 35 patients, the cuffs were filled with 4% lidocaine 3.5 ml and 8.4% sodium bicarbonate 1.5 ml mixture. After 24 hours following general anesthesia, patients were visited and asked whether there were sore throat or hoarseness, if any, how the degree was. RESULTS: In lidocaine-treated group, the incidence of postintubational sore throat was less compared to control group significantly. There was no difference in incidence of hoarseness between two groups. CONCLUSION: Endotracheal cuff filled with lidocaine and sodium bicarbonate mixture is suggested as an effective protective method that reduces the frequency of postintubational sore throat.
Anesthesia* ; Anesthesia, General ; Anesthetics, Local ; Hoarseness* ; Humans ; Incidence ; Lidocaine* ; Pharyngitis* ; Sodium Bicarbonate* ; Sodium*

BACKGROUND: According to the increasing rate of cesarean section, the efforts of seeking safer and more satisfactory obstetric anesthesia techniques have been continued. Propofol, 2,6 di-isopropyl phenol, is a relatively new intravenous anesthetic agent and has been used for induction and maintenance for total intravenous anesthesia (TIVA). Authors examined the anesthetic technique using following anesthetics combinations; N2O-propofol, fentanyl-propofol, ketamine-propofol and made comparison of these ones for intraoperative hemodynamic stability, maternal and fetal safety. METHODS: Sixty patients (ASA physical status 1 or 2) scheduled for cesarean section were randomly allocated into three groups, group N (propofol-N2O, n=20), group F (propofol-fentanyl, n=20), group K (propofol-ketamine, n=20). We checked the changes of blood pressure and heart rates during operation, anesthetic induction time, neonatal status (Apgar score, umbilical vein blood gas analysis), presence of intraoperative awareness and recovery time. RESULTS: No significant differences in intraoperative hemodynamic changes, induction time and baby status. Total propofol dosages were greater in group N than group K (p<0.05) and maternal recovery time was prolonged in group K than group N or F (p<0.05). CONCLUSIONS: Anesthetic management using propofol-N2O or propofol-fentanyl or propofol-ketamine for cesarean section would provide satisfactory anesthesia without significant adverse effects to both mother and fetus.
Anesthesia* ; Anesthesia, Intravenous* ; Anesthesia, Obstetrical ; Anesthetics ; Blood Pressure ; Cesarean Section* ; Female ; Fetus ; Heart Rate ; Hemodynamics ; Humans ; Intraoperative Awareness ; Mothers ; Phenol ; Pregnancy ; Propofol ; Umbilical Veins

The hypoglossal nerve is a motor supply of the tongue. Hypoglossal nerve palsy after general anesthesia is rare but there have been several reports showing an association with oropharyngeal manipulation such as intubation, bronchoscopy, and laryngeal mask airway. The main mechanism considered has been a temporary compression of the nerve along its superficial course at the lateral root of the tongue during oropharyngeal manipulation. We encountered a patient who complained speaking and swallowing difficulties after general surgery. A deviation to the affected side, atrophy, and fasciculation of tongue were observed. Almost all palsies recovered spontaneously. We present a patient with a transient unilateral hypoglossal nerve palsy after an uncomplicated intubation and anesthesia for surgery for humerus fracture in the beach-chair position.
Anesthesia ; Anesthesia, General* ; Atrophy ; Bronchoscopy ; Deglutition ; Fasciculation ; Humans ; Humerus ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Intubation ; Laryngeal Masks ; Paralysis ; Tongue

BACKGROUND: The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults. METHODS: One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths. RESULTS: In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive. CONCLUSIONS: Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope.
Adult* ; Anesthesia, General ; Bronchi ; Bronchoscopes* ; Female ; Humans ; Incisor ; Male ; One-Lung Ventilation