1.The hemodynamic effects of morphine, pancuronium and diazepam during mechanical ventilation.
Soon Ho NAM ; Sou Ouk BANG ; Hung Kun OH
The Korean Journal of Critical Care Medicine 1991;6(2):107-113
No abstract available.
Diazepam*
;
Hemodynamics*
;
Morphine*
;
Pancuronium*
;
Respiration, Artificial*
2.Intensive care unit outcome prediction by using APACHE II score.
Jin Ho KIM ; Hyo Kun LEE ; Shin Ok KOH ; Hung Kun OH
The Korean Journal of Critical Care Medicine 1991;6(2):93-99
No abstract available.
APACHE*
;
Intensive Care Units*
;
Critical Care*
3.Continuous Epidural Block for Perioperative Pain Control and Treatment of Herpes Zoster - Two Cases Report .
Korean Journal of Anesthesiology 1980;13(3):270-275
Continuous epidural block was used for pain control during and after operation and for herpes zoster in two cases. A 63 year old male patient with herpes zoster on the right T 12 level for 2 weeks was treated by continuous epidural block. After 10 days, elective right inguinal hernioplasty was performed under epidural blocks by the previously inserted catheter. Postoperative pain and herpes zoster have been controlled in the same manner. Two weeks later, he was discharged without post-herpetic sequelae. The second case, a 82 year old man, was admitted with dysuria and also herpes zoster on the right T 10 level for 10 days. Using only continuous epidural block, suprapubic prostatectomy was done and post-operative pain was controlled. Two days later, the catheter was removed by the urological department. However, two weeks after operation, post-herpetic neuralgia developed and continuous epidural block was restarted for 2 weeks. Then epidural methylprednisolone injection, 2 times, and transcutaneous electrical stimulations were required for 3 more months for complete recovery. This indicated that continuous epidural block was beneficial not only for the treatment of herpes zoster but also for the prevention of post-herpetic neuralgia.
Catheters
;
Dysuria
;
Electric Stimulation
;
Herniorrhaphy
;
Herpes Zoster*
;
Humans
;
Male
;
Methylprednisolone
;
Neuralgia
;
Pain, Postoperative
;
Prostatectomy
4.Hexafluorenium-Succinylcholin Relaxation during Clinical Anesthesia .
Chu Yull PARK ; Soo Hun SONG ; Hung Kun OH
Korean Journal of Anesthesiology 1970;3(1):119-126
Hexafluorenium was used to potentiat succinylcholine in 36 patients undergoing major surgery, mainly abdominal, of from 1/2 to 7 hours duration. Anesthesia consisted of thiopental-nitrous oxide-oxygen-ether or haIothane and ventilation was controlled. In a first group, succinylcholine was administered for intubaticn and repeated intermittently as required with a single dose of hexafluorenium after the intubating dose of succinylcholine had worn off. In a second group, succinylcholine was administered similary but hexafluorenium was also given intermittenly. In a third group, a single initial dose of hexafluorenium was given followed by succinylcholine intermittently. In a fourth group, both drugs were given intermittently throughout, 1) The apnea time of succinylcholine was prolonged about 8times after a single dose of hexafluorenium in the first and third groups but the prolongation was gradually lessened with successive doses of succinylchohne. Rut in second and fourth groups, the apnea times were significantly prolonged following successive dose of both drugs. 2) In third and fourth groups, fasieulation following succinylcholine was not observed and nausea, vomiting and muscle pains were not noted. 3) In recovery room, about 80% of patients could raise their heads by themselves but ether required longer recovery than halthane. 4) No bronchospasm or cardiovascular side effects were noted. It is considered that this drug combinations provides excellent relatation for surgery. The technique with a single dose of hexafluorenium seems particularlly suitable in cases which last from 30 minutes up to 2 or 3 hours and repeated doses of hexafluorenium and succinylchloin are advisable for longer major cases.
Anesthesia*
;
Apnea
;
Bronchial Spasm
;
Drug Combinations
;
Ether
;
Head
;
Humans
;
Myalgia
;
Nausea
;
Recovery Room
;
Relaxation*
;
Succinylcholine
;
Ventilation
;
Vomiting
5.Clinical Effects of Hydroxyzine Hydrochloride as a Premedicant .
Korean Journal of Anesthesiology 1979;12(2):129-133
Hydroxyzine hydrochloride, a minor tranquilizer and a ataratic, was tested clinically for effectiveness as a premedicant separate dosages of 1 and 2 mg/kg. Each 30 patients were in the physical status class 1 and 2 by A.S.A. classification, and the age distribution was from 20 to 60 years. The following results were obtained. 1) Emotionally calm response was seen in 70% in the hydroxyzine 1 mg/kg (group 1), and in 93.3%, in the 2 mg/kg (group 2). 2) Mental alertness was seen in 86. 6% in group 1, and in 66. 6% in group 2. 3) Complications after premedication were chilling and shivering, hypertension, nausea, and headache, and were not serious. Therefore this premedication was satisfactory in most cases, especially in group 2.
Age Distribution
;
Classification
;
Headache
;
Humans
;
Hydroxyzine*
;
Hypertension
;
Nausea
;
Premedication
;
Shivering
6.Anesthesia for Aortoeoronary Bypass Surgery .
Korean Journal of Anesthesiology 1981;14(4):516-523
Coronary artery disease is an ever-increasing problem to anesthesiologists as more patients with severe coronary artery are being accepted for surgery. Four cases of aortocoronary bypass graft procedure were done at Severance hospital. The procedure itself can result in perioperative myocardial infarction leading to death. Greater understanding of and constant attention to the myocardial oxygen supply and demand may reduce the incidence of perioperative myocardial infarction. Among the four patients, three tolerated the anesthesia and surgery well without gross pre and postoperative complications. However one patient developed hypotension in the recovery room and died 6 hours postoperatively, in spite of an intensive efforts at resuscitation. The problems, complications and precautions for anesthesia are discussed.
Anesthesia*
;
Coronary Artery Bypass
;
Coronary Artery Disease
;
Coronary Vessels
;
Humans
;
Hypotension
;
Incidence
;
Myocardial Infarction
;
Oxygen
;
Postoperative Complications
;
Recovery Room
;
Resuscitation
;
Transplants
7.Clinical Use of Univent Tube with Movable Blocker for the Patient of Bronchopleural Fistula.
Korean Journal of Anesthesiology 1987;20(3):417-421
The loss of Substantial portion of critically ill patient'a tidal volume through a broncho-pleural fistula may significantly alter the intrapulmonary distribution of ventilation, ventilation-perfusion matching and arterial blood gases. Prompt localization of surgical closure of bronchopleural fistu1a remains the treatment of Choice in most Patients. We had a chance to use a Univent tube with movable blocker to the patienta of breach-opleural fistula whith developed durinf esophageal bougienation. The endotracheal tube has two compartment, a large lumen for conventional air passage and a small lumen where a movable tube is placed. Intubation a accomplished by ordinary technique, advancement of the bronchial tube to the right lowers bronchus being guided by fiheroptic bronchoscopy.
Bronchi
;
Bronchoscopy
;
Critical Illness
;
Fistula*
;
Gases
;
Humans
;
Intubation
;
Tidal Volume
;
Ventilation
8.Clinical Study of Modified Neuroleptanalgesia and Anesthesia using Droperidol-Pentazocine with or without N2O .
Wook PARK ; Dal Sheup PHEUN ; Hung Kun OH
Korean Journal of Anesthesiology 1973;6(2):193-202
Since 1959 neuroleptanalgesia has been used for poor risk patients and open heart surgery. From august 1973 we have used a modified neuroleptanalgesia and anesthesia with droperidol-pentazocine- N2O in 40 cases. Age ranged 10 to 69 years; 22 were male and 18 female. Physical status was. Class I and II except for 4 patients in Class III and IV. In Group I (20 patients) for induction of neuroleptanalgesia, a mixture combining droperidol, 0.25mg/kg, and pentaocine, 1.0~1.2 mg/kg, was administered intravenously. In Group II (20 patients) for induction initially droperidol only, 0.25 mg/kg, was injected intravenously and 5~10 minutes later pentazocine, 1.0~1.2mg/kg, was given intravenously. Endotracheal intubation following a sleep dose of thiopental, 75~100 mg, and succinycholine, 40~60 mg, was performed in 36 cases. During the operation anesthesia was maintained with N2O-O2, supplemented with muscle relaxants. Neuroleptanalgesia without thiopentaJ, relaxants, intubat- ion or N2O, to four patients (laryngeal suspension-2 cases, and percutaneous cordotomy 2 cases). An additional quarter of the initial dose of droperidol was given,if anesthesia time exceeded .3 4 hours. Pentazocine, half the initial dose was also repeated when the patient showed signs of inadequate anesthesia, as body movement, tachycardia, increased blood pressure and lacrimation. The patients were deeply tranquilized but did not sleep with only droperidol and pentazocine. However when N2O inhalation was given, the corneal reflex was lost and the patient quickly went to sleep. The pupils persisted in miosis after pentazocine was given. The course of induction was smooth and there was no sweating, bradycardia or generalized muscular contractions seen at that time. Nausea and vomiting 12 hrs after anesthesia appeared in only 10% of cases. Blood pressure in Group I remained stable after the mixture but in Group II fell somewhat after the droperidol injection. Pulse rates was stable in both groups. Moderate respiratory depression was observed in Group I as soon as the mixture was administered, however during anesthesia and operation, the respiratory rate, tidal volume and minute volume gradually increased and were normal postoperatively. In Group II after pentazocine administration, respiratory depression increased significantly to about the same level in Group I but persisted after the end of the operation. In neither group was there any statistically significant change in pH and Base-Excess values. Recovery from anesthesia was very rapid and patients opened their eyes on command in 2~3 minutes after N2O was stopped and awakened within 5~6 minutes. The analgesic effect of pentazocine as excellent, persisting for 12 hours postoperatively. In conclusion the circulatory and respiratory response to the administration of the droperidol and pentazocine mixture were more stable than when they were administered seperatedly.
Anesthesia*
;
Blood Pressure
;
Bradycardia
;
Clinical Study*
;
Cordotomy
;
Droperidol
;
Female
;
Heart Rate
;
Humans
;
Hydrogen-Ion Concentration
;
Inhalation
;
Intubation, Intratracheal
;
Male
;
Miosis
;
Muscle Contraction
;
Nausea
;
Neuroleptanalgesia*
;
Pentazocine
;
Pupil
;
Reflex
;
Respiratory Insufficiency
;
Respiratory Rate
;
Sweat
;
Sweating
;
Tachycardia
;
Thiopental
;
Thoracic Surgery
;
Tidal Volume
;
Vomiting
9.Respiratory Care in Guillian Barre' Syndrome .
Korean Journal of Anesthesiology 1973;6(2):185-192
Guillian-Barre syndrome may result in severe pulmonary insufficiency and death. Four cases disgnosed as this syndrome were treated with respirators such as Bird Mk-7, Bennett PR-Z, Bennett MA-1 and Ohio-560. All of the patients were tracheostomized and had a cuffed tracheostomy tube inserted. Volume and pressure respirators were fixed according to vital signs and arterial blood gas tensions. Mechanical and ultrasonic nebulizer and a heated humidifier were used for humidification. Lung vibration, postural drainage and breathing exercises were performed as occasion required. To prevent cross-infection aseptic techniques were used far tracheal suction and the sterilizable parts of the respirator and tracheostomy tube were changed daily. During the weaning from the respirator the vital signs, lung volumes and blood gas tensions with pH were carefully observed. Duration of respirator uses were 19 to 79 days and thereafter all were improved without complications. The results were as follows; 1. In 3 of 4 cases pseudomonas aeruginosa were cultured in sputum. 2. Narcosis, due to hypercapnea, and atelectasis were observed in case 1 and 2. 3. Electrolytes remained within normal limits in all cases. 4. The period of complete weaning from respirators required 4 to 30 days. 5. Bennett MA-1 and Ohio-560 respirators were more convinient than pressure limited respirators for humidification and regular deep breathing.
Birds
;
Breathing Exercises
;
Drainage, Postural
;
Electrolytes
;
Hot Temperature
;
Humans
;
Humidifiers
;
Hydrogen-Ion Concentration
;
Lung
;
Nebulizers and Vaporizers
;
Pseudomonas aeruginosa
;
Pulmonary Atelectasis
;
Respiration
;
Sputum
;
Stupor
;
Suction
;
Tracheostomy
;
Ultrasonics
;
Ventilators, Mechanical
;
Vibration
;
Vital Signs
;
Weaning
10.Midazolam Malate as an Intravenous Induction Agent for Open Heart Surgery .
Korean Journal of Anesthesiology 1983;16(2):145-151
Midazolam, a water-soluble benzodiazepine that is shorter-acting, more potent, and less irritating to veins than diazepam, has been suggested for use for induction of anesthesia. The cardiovascular effects of an induction dose(0.2~0.3mg/kg) of midazolam in ASA class lll cardiac surgical patients (N=15) were compared in a couble-blind fashion with a similar group of patients (N=15) receiving thiopental (5.0mg/kg). The patients were premedicated by triflupromasine, pethidine, hydroxyzine, atropine and diazepam. The results were summarized as follows. 1) The thiopental group were more decreased in blood pressure and increase in heart rates than midazolam group. 2) Spontaneous eye closing time and loss of eyelash reflexes were observed. But those were a poor sign of adequate induction became of heavy preanesthetic sedation. 3) The changes of blood pressure and pulse rate after induction and intubation were almost similar in the two groups, but greater individual variation was seen in midazolam groups, depends on preload state before induction. From the above results, midazolam was sufficient as an induction agent for open heart cases. But a hypovolemic patients and completely beta blocked patients should be used cautiously because they may be developed severe hypotension and tachycardia.
Anesthesia
;
Atropine
;
Benzodiazepines
;
Blood Pressure
;
Diazepam
;
Heart Rate
;
Heart*
;
Humans
;
Hydroxyzine
;
Hypotension
;
Hypovolemia
;
Intubation
;
Meperidine
;
Midazolam*
;
Reflex
;
Tachycardia
;
Thiopental
;
Thoracic Surgery*
;
Veins