Monitoring of the central venous pressure is a simple, relatively inexpensive method of assessing a patient's cardiac status, circulating blood volume, and vasomotor tone. The simplest way of checking the intrathoraeic location of the catheter tip is by observing oscillation of 2~4cmH2O in the manometer column, synchronous with respiratory cycle. Inaccurate measurements are often obtained by the misplacement of the central venous catheter tip, in addition to the other well-known complications. Radiographic identification of the catheter tip is essential to eliminate these problems. We experienced a case of arrhythmia which appeared upon misplacement of the central venous catheter tip, and confirmed its misplacement by radiographic study.
Arrhythmias, Cardiac ; Blood Volume ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Methods

To determine Whether neoatigmine had different effecta in pediatric patients and adults during vecuronium neuromuscalar blockade, the rate of recovery following neostigmine admimistration was compared in children (n=10, group I) and adulta (n=10, group II) during nitrous oxide-Halothane anesthesia. After induction of anesthesia, patients received 100 ug/kg of vecuronium. Reversal was attempted at 10% spontaneous recovery of twitdi height, Neostigmine (30 ug/kg in children, 40 ug/kg in adults) was injected in a single bolus dose. During the first few minutes following neostigmine admimistration, no differences were obaerved between the two groups, Ten minutes after neostigmine admmistration, the first twitch (mean+/-SD) reached 95+/-2%, 93+/-2% of control value in children and adults respectively. The more complete recovery of the eighth minutes in children could be due to the faster rate of spontaneous recovery from vercuronium induced neuromuscular blockade in children.
Adult* ; Anesthesia* ; Child* ; Halothane* ; Humans ; Neostigmine* ; Neuromuscular Blockade ; Vecuronium Bromide*

Induction of general anesthesia with direct laryngoscopy and tracheal intubation is routine procedure but causes varying degree of sympathetic stimulation such as increasing in blood pressure and heart rate. Many approaches have been tried to attenuate these hemodynamic responses. To evaluate the effects of nicardipine, a new calcium channel blocker, for prevent sympathetic stimulation induced by direct laryngoscopy and tracheal intubation, we administered nicardipine (40 mg P.O.) 60 minutes before laryngoscopy and endotracheal intubation. 60 patients, ASA physical status 1,2, scheduled operation, were selected randomly. We divided these patients into two groups. Group 1: control, valium 0.1-0.2 mg/kg P.O. (N=30), Group 2: valium 0.1-0.2 mg/kg with nicardipine 40 mg P.O. (N=30). We measured systolic blood pressure, diastolic blood pressure and heart rate before premedicstion, before induction and 1,3,5,10 minutes after intubation in both groups and compared with control group. The results were follows ; 1) Systolic blood pressure and diastolic pressure in nieardipine group were significantly decreased before induction after premedication. 2) After induction systolic blood pressure increased in both group (p<0.005) but increasing rate was significantly less than in nicardipine group (p<0.005). 3) After intubation diastolic pressure decreased significantly in nicardipine group (p<0.005). 4) The changes of heart rate were no difference in both groups.
Anesthesia, General ; Blood Pressure ; Calcium Channels ; Diazepam ; Heart Rate ; Hemodynamics ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Nicardipine* ; Premedication

Induction of general anesthesia with direct laryngoscopy and tracheal intubation is routine procedure but causes varying degree of sympathetic stimulation such as increasing in blood pressure and heart rate. Many approaches have been tried to attenuate these hemodynamic responses. To evaluate the effects of nicardipine, a new calcium channel blocker, for prevent sympathetic stimulation induced by direct laryngoscopy and tracheal intubation, we administered nicardipine (40 mg P.O.) 60 minutes before laryngoscopy and endotracheal intubation. 60 patients, ASA physical status 1,2, scheduled operation, were selected randomly. We divided these patients into two groups. Group 1: control, valium 0.1-0.2 mg/kg P.O. (N=30), Group 2: valium 0.1-0.2 mg/kg with nicardipine 40 mg P.O. (N=30). We measured systolic blood pressure, diastolic blood pressure and heart rate before premedicstion, before induction and 1,3,5,10 minutes after intubation in both groups and compared with control group. The results were follows ; 1) Systolic blood pressure and diastolic pressure in nieardipine group were significantly decreased before induction after premedication. 2) After induction systolic blood pressure increased in both group (p<0.005) but increasing rate was significantly less than in nicardipine group (p<0.005). 3) After intubation diastolic pressure decreased significantly in nicardipine group (p<0.005). 4) The changes of heart rate were no difference in both groups.
Anesthesia, General ; Blood Pressure ; Calcium Channels ; Diazepam ; Heart Rate ; Hemodynamics ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Nicardipine* ; Premedication

Postoperative hypoxemia has been well known is adults but not in infants and children, although they are potentially more susceptible to airway closure and to disturbances in pulmonary gas exchange. We measured blood gas parameters of capillary blood in 30 cases of ASA physical status class l infants and children breathing room air, before and after general anesthesis for superficial surgical procedures. The blood samples were taken preoperatively, on arrival and 4~6 minutes later in the recovery room. The results are as follows: 1) The blood gas parameters on arrival in the recovery room showed significant change in pH nad PCO2(p<0.01) and increased PCO2(p<0.01) in comparison with preoperative gases. 2) The blood gas parameters checked at 4~6 minutes later in the recovery room showed insignificant differences from preoperative values of PO2 and SO2, but significantly increased PCO2 and decreased pH(p<0.01). 3) As a results of this study, it is suggested that for the safe management of patients, supplementary oxygen be provided for at least 10 minutes in the early recovery period to all pediatric patients.
Adult ; Anesthesia, General* ; Anoxia* ; Blood Gas Analysis ; Capillaries ; Child* ; Gases ; Humans ; Hydrogen-Ion Concentration ; Infant ; NAD ; Oxygen ; Pulmonary Gas Exchange ; Recovery Room ; Respiration