1.Critical Point of Anesthetic Management in the Elderly.
Korean Journal of Anesthesiology 2004;46(5):501-516
2.Anesthetic Drug Interactions.
Korean Journal of Anesthesiology 2007;53(1):1-14
No Abstract available.
Drug Interactions*
3.A Report on the Effect of Nitroglycerin in Ischemic Patient during Cardiopulmonary Resuscitation.
Byung Ho LEE ; Keon Hee RYU ; Joo Young CHOI
Korean Journal of Anesthesiology 1986;19(3):297-301
The incidence of myocardial ischemia and silent myocardial infarction are higer in diabetic than in nondiabetic patients. We had a case of a disbetic, myocardial ischemic female patient, 54years old, who had cardiac arrest during an emergency surgery. The patient was admitted via emergency room with the diagnosis of rupture of basilar artery aneurysm. During the dissection for the exposure of the artery. The aneurysm ruptured. causing massive hemorrhage. At this time, cardiac arrest was revealed at the monitoring EKG, cardiopulmonary resuscitation with DC shock were performed to reverse venticular fibriliation but the EKG monitor showed T wave inversion and sinus tachycardia in several leads. And the blood pressure was hardly audible with systolic of about 50mmHg. So nitroglycerin 0.05mg, intravenous bolus injection was given twice and the systolic went up to 110mmHg with a diastolic of 80mmHg. So the operation proceeded and finished. The patient was sent to the ICU. On the third postoperative day, the patient again had cardiac arrest but this time could not be resuscitated. We experienced the dramatic effect of nitroglycerin on this ischemic patient during cardio pulmonary resuscitation and we would like to share this experience with our colleagues.
Aneurysm
;
Arteries
;
Blood Pressure
;
Cardiopulmonary Resuscitation*
;
Diagnosis
;
Electrocardiography
;
Emergencies
;
Emergency Service, Hospital
;
Female
;
Heart Arrest
;
Hemorrhage
;
Humans
;
Incidence
;
Intracranial Aneurysm
;
Myocardial Infarction
;
Myocardial Ischemia
;
Nitroglycerin*
;
Rupture
;
Shock
;
Tachycardia, Sinus
4.Evaluation and Management of Perioperative Hypertension.
The Korean Journal of Critical Care Medicine 2005;20(1):1-13
No abstract available.
Hypertension*
5.Dosage Dependent Neurologic Impairment after Cerebral Air Embolism in Rabbit.
Keon Hee RYU ; Oh Kyung KWON ; Sung Nyeon KIM ; Won Hee HAN
Korean Journal of Anesthesiology 1996;31(6):691-697
BACKGROUND: A long-term objective is to understand the pathogenesis of neurologic injuries associated with cardiac surgery, cardiopulmonary bypass, and circulatory arrest. Our specific aims are to establish a dose of air which results in moderate to severe neurologic defects in normothermic (37degrees C) rabbits. METHODS: To first establish a dose of air which would cause unequivocal neurologic impairment, anesthetized rabbits received either 0, 50, 100 or 150 microgram l/kg of air into the internal carotid artery(n=5 in each group). One hour later, anesthesia was discontinued and animals were recovered. Animal were neurologically evaluated at 24 hours using a zero(normal) to 97(coma) point scale. RESULTS: There was a clear relationship between the dose of air injected and the severity of neurologic impairment at 24 hours, p=1.1x10(-7). Rabbits receiving 50 micrograml/kg of air were minimally affected and were difficult to distinguish from controls. In contrast, rabbits receiving 150 micrograml/kg of air were uniformly and unequivocally impaired. CONCLUSION: we recommend for future cerebral air embolism studies, 150 microgram l/kg as the optimal dose of air which would reliably produce viable subjects for 24 hours with marked unequivocal, neurologic impairment.
Anesthesia
;
Animals
;
Brain
;
Cardiopulmonary Bypass
;
Embolism
;
Embolism, Air*
;
Rabbits
;
Thoracic Surgery
7.Tracheal Perforation Developed during Endotracheal Granulation Tissue Removal with CO2 Laser: A case report.
Jae Yong SHIM ; Keon Hee RYU ; Yoon Ki LEE ; Jae Yub JUNG
Korean Journal of Anesthesiology 1997;32(3):473-477
Airway perforation is a rare but potentially fatal complication following laser surgery. A 66 years old man was admitted for surgery of tracheal stenosis. He had undergone 2 prior anesthesia for similar surgery and had diabetes mellitus due to chronic steroid therapy. 2 hours after surgery, tracheal perforation lead to pneumomediastinum, tension pneumothorax and perforation of innominate artery with potential risk to injury, which lies in the close proximity to perforation site of trachea. Arterial wall was so weak and fragile that it was difficult to repair the ruptured site. During the procedure, hemorrhage persisted and cardiac arrest developed. Immediate CPR(cardiopulmonary resuscitation) with internal cardiac massage was done but the patient did not recover. We believe that in patient with history of multiple operations, chronic steroid therapy and diabetes mellitus, the vascular structure of thin and fragile should be approached with greater caution when using CO2 laser during surgery.
Aged
;
Anesthesia
;
Brachiocephalic Trunk
;
Diabetes Mellitus
;
Granulation Tissue*
;
Heart Arrest
;
Heart Massage
;
Hemorrhage
;
Humans
;
Laser Therapy
;
Lasers, Gas*
;
Mediastinal Emphysema
;
Metabolism
;
Pneumothorax
;
Trachea
;
Tracheal Stenosis
8.Hemomediastinum Caused by Subclavian Catheterization : A case report.
Anesthesia and Pain Medicine 2008;3(3):228-231
Central venous catheterization has been widely used in the anesthetic management. Unfortunately, the use of central venous catheter may be associated with adverse events that are hazardous to patients. We experienced a lethal hemomediastinum following subclavian venous catheterization and we discussed the facts that should be kept in mind to prevent the serious complications.
Catheterization
;
Catheters
;
Central Venous Catheters
;
Humans
9.Severe Metabolic Acidosis during Intraperitoneal Hyperthermic Perfusion in Recurrent Ovarian Cancer: Case report.
Keon Hee RYU ; Dong Eon MOON ; Hyeon Ja KIL ; Young Cheol KIM
Korean Journal of Anesthesiology 1997;32(4):673-676
Intraperitoneal hyperthermic perfusion(IPHP) was performed under combined epidural & general anesthesia in 57 year old female patient with recurrent ovarian cancer. She had past history of diabetes mellitus. Metabolic acidosis & hypokalemia were already developed before IPHP and aggravated during IPHP. NaHCO3 300mEq & KCl 40mEq were administered intravenously for three hours. In this case, we deduced that the causes of metabolic acidosis may be anaerobic glycolysis due to peripheral circulatory impairment from hypothermia, degradation of tumor cells by hyperthermia, and poor general condition with prolonged operation. The causes of hypokalemia were suspected to be continuous infusion of regular insulin, massive NaHCO3 administration, and diabetic ketoacidosis. Therefore, we recommend when performing IPHP in DM patient, precise preoperative evaluation and careful monitoring of arterial blood gas & electrolyte.
Acid-Base Equilibrium
;
Acidosis*
;
Anesthesia, General
;
Diabetes Mellitus
;
Diabetic Ketoacidosis
;
Female
;
Fever
;
Glycolysis
;
Humans
;
Hypokalemia
;
Hypothermia
;
Insulin
;
Middle Aged
;
Ovarian Neoplasms*
;
Perfusion*
10.Bronchospasm on the Way to the Operating Room with Ambu Bagging : A case report.
Anesthesia and Pain Medicine 2008;3(1):71-74
Spastic airway disease including bronchospasm is a common perioperative event. Despite pharmacologic and mechanical approaches for prevention, we could not avoid unexpected attacks on occasion in anesthetic management, especially during airway manipulation. We report an experience of bronchospasm during transportation to the operating room in a 63-year-old female with Ambu bagging through a tracheostomy tube. We also review the potential effect of anticholinergics and airway irritation during transportation in tracheotomized or intubated patients by bagging for ventilatory support.
Bronchial Spasm
;
Cholinergic Antagonists
;
Female
;
Humans
;
Middle Aged
;
Muscle Spasticity
;
Operating Rooms
;
Tracheostomy
;
Transportation