BACKGROUND: Outpatient procedures account for more than half the operations performed in the United States, but the status of outpatient anesthesia in Korea has not been documented yet. The present study was designed to evaluate the current status of outpatient anesthesia in university hospitals in Korea. METHODS: Thirty-nine university hospitals were surveyed by questionnaire in February 1997. Objects were patients underwent outpatient operations under general, intravenous or regional anesthesia except local anesthesia by surgeon from January 1996 to December 1996. RESULTS: One university hospital started outpatient anesthesia in 1980 and now ten of 39 universities (25.6 %) provide the procedures. In 1995 one of 10 university hospitals has opened day- surgery center having 7 operating rooms and the capability of 24 hours overnight stays. The other 9 hospitals use one of in-patient operating rooms for outpatient procedures. The utility rate per year was 3.06 +/- 1.59 % and 11.49 % in 9 university hospitals and day-surgery center respectively during 1996. Outpatients were mainly classified as physical status 1 and 2 by American Society of Anesthesiologists, and 54.0 38.3 % to 70 % of patients were distributed under 15 years of age. Surgical procedures were relatively simple and 10 surgical departments were participated into the field of outpatient anesthesia. Inhalation techniques and intravenous anesthesia were used predominantly. Complications were sore throat, nausea and vomiting, delayed recovery of consciousness, bleeding at the operative site, fever and so on. CONCLUSIONS: I think that outpatient anesthesia in Korea has grown at very slow rate over the last 4 decades and that it is very low utility rate per year compared to United States. So we have to try to get more interests and supports about the outpatient anesthesia setting.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthesia, Conduction ; Anesthesia, Intravenous ; Anesthesia, Local ; Consciousness ; Fever ; Hemorrhage ; Hospitals, University* ; Humans ; Inhalation ; Korea* ; Nausea ; Operating Rooms ; Outpatients* ; Pharyngitis ; Surveys and Questionnaires ; United States ; Vomiting

No abstract available.
Anesthesia* ; Ventilators, Mechanical*

No abstract available.
Colorectal Neoplasms* ; Humans ; Male*

The Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) is an autosomal dominant disorder of blood vessels associated with mucocutaneous telangiectasis and arterivenous malformations in several organs. A pulmonary arteriovenous fistulae can cause hypoxemia, hemoptysis, polycythemia and clubbing. However the condition is often not recognized until the 3rd decade of life. The authors report a case of a 28-year-old male patient who had been suffering from telangiectasis of the upper lip and upper portion of the chin and unexpedly became undersaturated of hemoglobin through general anesthesia during an operation of the upper lip lesion.
Adult ; Anesthesia, General ; Anoxia ; Arteriovenous Fistula ; Blood Vessels ; Chin ; Hemoptysis ; Humans ; Lip ; Male ; Polycythemia ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

The carpal injury is difficult to diagnose due to anatomical complexity and the like. So, in order to get radiological knowledge of normal wrist, the authors measured the values which will be described on the wrist PA and lateral roengenogram obtained from 440 normal wrists(male : 188 cases, female : 252 cases) in randomly selected patients. The following results were obtained. l. Ulnar variance(mm±standard deviation): Total 1.1±1.2 : negative variance : 9.3%, positive variance : 56.1%, 2. Scapholunate Gap(mm±standard deviation): Total 0.4±0.7, 3. Ulnar Tilt(degrees±standard deviation): Total 23.6±5.3, 4. Volar Tilt, 5. Carpal height rstio : Total 0.52±0.05 male 0.53±0.04 female 0.51±0.05 : Total 13.1±5.9, 6. Carpal ulnsr distance ratio Total 0.05±0.05, 7. Scapholunate Angle : Total 49.9'±10.1', 8. Capitatolunate Angle Total 17.5'±10.0', 9. Radiolunate Angle Total 8.8'±6.7', 10. Carpal width ratio Total 0.72±0.08 11. Carpal thickness ratio Total 0.49±0.07.
Female ; Humans ; Male ; Wrist

No Abstract Available.
Heparitin Sulfate* ; Orientia tsutsugamushi*

BACKGROUND: A circle system can be closed or semiclosed depending on the amount of fresh gas flow. A closed system is one in which the inflow gas exactly matches that being taken up or consumed by the patient. A semiclosed system is associated with partial rebreathing of gases and is the most commonly used system today. The purpose of this study is to examine the actual consumed amount of volatile anesthetic by closed and semiclosed anesthesia systems. METHODS: Forty-seven patients undergoing general inhalation anesthesia with enflurane and thirty-six patients with isoflurane were examined. Each group was divided into two subgroups by the circle system; enflurane-closed (33 patients), enflurane-semiclosed (14 patients), isoflurane-closed (23 patients), and isoflurane-semiclosed groups (13 patients). Closed system was performed by using PhysioFlex anesthesia machine. The difference of initial (just before anesthesia) and remained (just after anesthesia) enflurane or isoflurane volumes measured by 30 ml-syringe was obtained as consumed amount of anesthetics. This amount was calculated on the base of 1% enflurane or isoflurane for 1 hour anesthesia with a given fresh gas flow (4 to 5 L/min). RESULTS: Consumed amount of liquid enflurane and isoflurane when using closed system was 6.99 +/- 0.26 ml/hr and 4.84 +/- 0.27 ml/hr respectively while 15.99 +/- 1.48 ml/hr and 14.01 +/- 0.92 ml/hr respectively when using semiclosed system. Consumption of liquid anesthetics was significantly lower in closed anesthesia and significantly higher in both systems than those of predicted values. CONCLUSIONS: In closed system by using PhsioFlex anesthesia machine consumed amount of liquid anesthetic for 1 hour anesthesia with 1% of endtidal anesthetic concentration at 25 degrees C, 1 atm and 4 to 5 L/min of fresh gas flow was within 35 to 44% of that in semiclosed system.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics* ; Enflurane ; Gases ; Humans ; Isoflurane

In addition to premedicants, adjuvants and inhalation of dried anesthetic gas mixture during anesthesia, pain after upper abdominal operation may cause obtundation of cough reflex, limitation of lung function, and decreased movement of respiratory cilia, resulting in postoperative pulmonary complications such as pneumonia and atelectasis. Epidural injection of local anesthetic may produce enough analgesic action without depression of pulmonary function for the majority of upper abdominal surgery cases, while intramuscular injection of analgesic which has been applied for postoperative pain relief might cause depression of pulmonary function and increase of mortality and morbidity of pulmonary complications. This study was designed to compare the effects of above two pain-relief methods on pulmonary function at the postoperative 24 hour and 44 adult patients who have been operated in upper abdomen which were allocated randomly with either epidural injection group (10 of male, 9 of female) or intramuscular injection group (17 of male, 8 of female). The results were as follows; 1) All patients have markedly decreased pulmonary function in the preoperative period, comparing with the predictive values. 2) The results of postoperative pulmonary function test of all patients in intramuscular injection group was similar to the results of preoperative pulmonay function test and not improved. 3) Patients in epidural injection group have markedly improved in nearly all pulmonary functions after operation. The degree of improvement was increased in order as following; MEF50> MEF75> IRV (or TV)> FEV1/FVC. And there was no difference of results between male and female. 4) Vital capacity in epidural injection group was increased to about 25~42% from the preoperative period, while it was decreased to about 22~29% in intramuscular injection group. With the above results, we suggest that single or continuous epidural injection of local anesthetic will be an appropriate way of postoperative pain-relief methods, especially in the patients who has markedly decreased pulmonary function and upper abdominal surgery.
Abdomen ; Adult ; Anesthesia ; Cilia ; Cough ; Depression ; Female ; Humans ; Inhalation ; Injections, Epidural* ; Injections, Intramuscular ; Lung ; Male ; Mortality ; Pain, Postoperative ; Pneumonia ; Preoperative Period ; Pulmonary Atelectasis ; Reflex ; Respiratory Function Tests* ; Vital Capacity

BACKGROUND: During general anesthesia the adult patient's tidal volume is determined by patient's weight. Therefore patients with severe ascites, huge abdominal mass or pregnancy have considerable ventilatory change during the operation because the great change in their body weight, that might cause unwanted respiratory alkalosis or acidosis. The purpose of this study is to identify the effects of such changes in ventilation between pre-delivery and post-delivery periods during the cesarean section. METHODS: Eighteen 36weeks or older pregnant patients (ASA 1), scheduled for elective cesarean section under general anesthesia, are selected for the study. PhysioFlex was used for ventilation. Pre-induction maternal gas analysis were performed in all cases. They were randomly divided into two groups according to the ventilator setting for minute ventilation, one set by pre-pregnant weight (Group 1) and the other by pregnant (term) weight (Group 2). Blood gas analysis were performed 5 minutes after induction and 20 minutes after delivery. End-tidal CO2 and inspiratory airway pressure were also measured. RESULTS: All patients show mild hyperventilation with normal acid-base status at pre-induction period. There were no significant differences in arterial PCO2 value between two groups. Group 1 shows mild metabolic acidosis compared with group 2 (by pH at 20 minutes after delivery). CONCLUSION: Term(just prior to operation) body weight rather than pre-pregnant weight is preferable for ventilator setting in the case of cesarean section under general anesthesia.
Acidosis ; Adult ; Alkalosis, Respiratory ; Anesthesia, General* ; Ascites ; Blood Gas Analysis ; Body Weight ; Cesarean Section* ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Pregnancy ; Pregnancy* ; Respiration, Artificial* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

BACKGROUND: Adequate humidification of anesthetic gases has been recommended both for the prevention of pulmonary damage during endotracheal anesthesia and for the maintenance of body temperature, especially in long-duration operated patients. Partial rebreathing anesthesia technique frequently lacks adequate humidity. So, this study was designed to compare inspired humidities in partial rebreathing anesthesia method with and without humidifier in the system. METHODS: The author examined inspired humidity using a controlled partial rebreathing anesthesia method with and without Bird humidifier in 10 and 22 healthy adult patients respectively. The patients were divided into two groups (1 and 2). All patients were anesthetized with pancuronium, halothane or enflurane, nitrous oxide-oxygen, 50-50 per cent, and their lungs were mechanically ventilated. Inspired humidity was measured for three hours at 30-min intervals in both groups. RESULTS: Significant differences were found among group 1- and 2-inspired humidities for 3 hours. While group 2-inspired humidity remained constant between 13 and 16 mgH2O/L during entire anesthesia procedure group 1-inspired humidity remained under 9 mgH2O/L. CONCLUSIONS: The humidities in all partial rebreathing anesthesia method with Bird humidifier not only exceeded those of method without humidifier but also seemed to be high enough to prevent dysfunction of tracheobronchial ciliated epithelium, while the standard partial rebreathing anesthesia method does not provide adequate inspired humidity.
Adult ; Anesthesia ; Anesthesia, Closed-Circuit* ; Anesthetics, Inhalation ; Birds* ; Body Temperature ; Enflurane ; Epithelium ; Gases* ; Halothane ; Humans ; Humidity* ; Lung ; Pancuronium