Background: This study was aimed to compare the analgesic effect and side effects of morphine- bupivacaine mixture with those of fentanyl-bupivacaine mixture after Cesarean section. Methods: Eighty patients who were taken continuous epidural catheterization after Cesarean section were divided into two groups. In group 1 (N=40) the mixture of 1% lidocaine 10 ml and morphine 1mg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and morphine 6mg was connected to epidural catheter. In group 2 (N=40) the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg was firstly injected via epidural catheter, and then two day infusor (Baxter(R)) which contained the mixture of 0.15% bupivacaine 100 ml and fentanyl 850 mcg was connected to epidural catheter. Mean arterial pressure (MAP) and heart rate (HR) were checked preoperatively, and at post-injection 10, 20, 30 and 60 minutes. The visual analogue scale (VAS) was checked at postoperative 1/2, 1, 6, 12, 24 and 48 hours. The side effects of epidural analgesia were evaluated. Results: In group 2 MAP was significantly decreased at post-injection 20 minute. VAS was significantly increased at post-injection 1/2 and 1 hour in group 1. The most frequent side effect was pruritus in both groups. Conclusions: The first bolus injection of the mixture of 1% lidocaine 10 ml and fentanyl 100 mcg has more rapid analgegic effect than the mixture of 1% lidocaine 10 ml and morphine 2 mg, but because of shorter duration of action of fentanyl it seems to be better to increase the dosage of fentanyl or replace fentanyl by morphine for more effective epidural analgesia after Cesarean section.
Analgesia, Epidural ; Arterial Pressure ; Bupivacaine ; Catheterization ; Catheters ; Cesarean Section* ; Female ; Fentanyl ; Heart Rate ; Humans ; Infusion Pumps ; Lidocaine ; Morphine ; Pregnancy ; Pruritus

Laryngeal mask airway (LMA) was designed as a new concept of airway management in anesthetic practice and has been successfully used in patients with difficult endotracheal intubation due to an abnormal upper airways. When It is in good position, one can cannulate the trachea either blindly or fiberoptic brochoscopically. In a patient with short neck and large breast, we were forced to use an emergency LMA because couldn't insert the laryngoscope. We decided to replace the LMA with an endotracheal tube to secure a definite airway. A fiberoptic bronchoscope was passed through both the endotracheal tube and the LMA to achieve endotracheal intubation. Then we attempted to remove the LMA for safe and smooth awakening. But the LMA coudln't be removed while keeping the LMA and the endotracheal tube in position. Therefore, surgery had to be proceeded with both the LMA and the endotracheal tube in place and all of which were removed after the surgical procedure. We conclude that the LMA is very useful as an aid of endotracheal intubation in patients with difficult airway.
Airway Management ; Breast ; Bronchoscopes ; Emergencies ; Humans ; Intubation, Intratracheal* ; Laryngeal Masks* ; Laryngoscopes ; Neck ; Trachea

No abstract available.
Lithotripsy* ; Ureter* ; Ureteral Calculi*

PURPOSE: The aim of this study is to investigate the biomechanical and histological changes in the muscles after tendon injury that have been little studied previously. MATERIALS AND METHODS: Triceps insertion was tenotomized on the left hidlimbs of 60 rabbits. Mechanical extension testing with Instron (rate: 10 mm/min) was performed 1, 2, 4, 8, 12 and 16 weeks after tenotomy in vivo. A load deformation curve was obtained, and this was analyzed in terms of strength and deformation at the elastic limit and at the point of maximal load. Histologic changes were observed after H < E staining and Matson s trichrome staining to measure the percentage area of collagen fibers. RESULTS: Between weeks 1 and 4, the excursion range fell gradually, and after that period, this value showed little changes. After its initial period of disequilibrium, the muscle regained its elastic nature within its newly formed excursion range. The average amount of collagen fibers increased gradually after tenotomy until 8th week. CONCLUSIONS: unless tendon ruptures are repaired early, the accompanying muscle would be irreversibly damaged, both bimechanically and histologically.
Collagen ; Muscles ; Rabbits ; Rupture ; Tendon Injuries ; Tendons ; Tenotomy*

No abstract available.

The application of arthroscopic surgery in wrist is not widely advocated because of technical difficulty. We analysed 11(10 patients) wrists of which were performed arthroscopic synovectomy in wrist from July 1991 to September 1992 in Kyung Hee University Hospital. The age of the patients ranged from 23 to 55 years old. Follow up period was from 12 months to 26 months. The application for the arthroscopic synovectomy in that group of patients were based on such disabling clinical symptoms as severe pain, swelling, limitation of range of motion and roentgenographic type from mild to severe stage. Postoperative diagnosis was histologically confirmed with rheumatoid arthritis in nine wrists (nine patients) and gout in two wrists (one patient). The results were assessed subjectively and objectively with pain, swelling and range of motion. Satisfactory overall results were obtained and there were no complications. Conclusively, arthroscopic synovectomy in the wrist is effective produce to relieve pain of the rheumatoid arthritis and gout but arthroscopic synovectomy of wrist is technically demanded.
Arthritis, Rheumatoid ; Arthroscopy ; Diagnosis ; Follow-Up Studies ; Gout ; Humans ; Range of Motion, Articular ; Wrist

No abstract available.

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

A clinical review was made on 2,191 cases of general pediatric surgery under the age of 15 years which were operated upon at the Divisionof Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The number of operations in pediatric age were 13,144 (13.2%) out of total 99,555 operations at Chonnam University Hospital and the most prevalent age group was under 1 year of age (14.3%). The number of operations in Divisionof General Pediatric Surgery were 2,191 (16.7%) out of total 13,144 operations in pediatric age and the incidence of patients under 1 year of age in general pediatric surgery was 42.9% (941/2,191). The prevalent diseases under 1 month of age were anorectal malformations (20.6%) and hypertrophic pyloric stenosis (20.3%) and between 1 month to 1 year of age were inguinal hernia (32.4%) and intussusception (19.6%). The total motality rate in neonatal intensive care unit was 31.3%. Gastroschisis presented highest mortality.
Gastroschisis ; Hernia, Inguinal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intussusception ; Jeollanam-do ; Mortality ; Pyloric Stenosis, Hypertrophic

No abstract available.