Propofol(2, 6-diisopropylphenol) represents a new class of intravenous anesthetic agent, being chemically unrelated to barbiturate, steroid or eugenol agents. It has been reported as a suitable induction agent for short procedures and day case surgery due to its property of rapid induction and recovery from anesthesia. Induction of anesthesia with propofol 2.0~2.5mg/kg frequently causes decreasing blood pressure and causes apnea that may last 60s or more. And it is well recognized that propofol may causes pain on injection when administered intravelnously. In the present study, we evaluated the hemodynamic and SpO2 changes after propofol injection and the dos-responses to the loss of verbal command response, eyelid reflex and trapezius reflex in premedicated patients. Also we assessed the degree of pain on injection .Patients were divided into five groups with the doses the degree of pain on injection. Patients were divided into five groups with the doses of 1.0, 1.2, 1.5, 2.0 and 2.5mg/kg(group1,2,3,4 and 5, respectively). The systolic, diastolic blood pressure, heart rate and SpO2 were measured after 60 seconds propofol injection in all the patients. And response, to verbal command, eyelid and trapezius reflex and pain complaint were checked. The systolic and diastolic blood pressure were mostly decreased(17.34 and 21.92%) in group5(propofol 2.5mg/kg)(p<0.05). Heart rate increased 10% in group 4 and 5(p<0.05). There was a dose-dependent decreasing tendency of blood pressure and increasing tendency of heart rates. SpO2 was also more reduced in group 4 and 5 (p<0.05). The overall incidence of pain on injection was 47% of the injection sites, the incidence of pain was highest on the dorsum of hand(23%). Also, the degree of pain on injection was wevere on the dorsum of hand. The value of ED50 and ED95 for loss of verbal command response, eyelid reflex and trapezius reflex were 0.81, 1.35, 2.02, 1.91 and 3.60mg/kg. We concluded that the ED95 for loss of eyelid reflex is 2.02mg/kg and it is a sufficient dosage to induction of anesthesia in premedicated patients with little significant hemodynamic changes.
Anesthesia* ; Apnea ; Blood Pressure ; Eugenol ; Eyelids ; Hand ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Propofol* ; Reflex ; Superficial Back Muscles

The dose-response of intravenous thiopental (2.5%) for induction of general anesthesia in cesarean section (C/S) patients and in patients with end stage renal disease(ESRD) was studied at seven doses of 2.0, 3.0, 3.5, 4.0, 4.5, 5.0 and 6.0 mg/kg body weight. Thiopental was injected as an IV bolus into a preexisting IV catheter. Patients were divided into four groups(ESRD-CONTROL, C/S-CONTROL, C/S, and ESRD). Each patient was examined at 60 seconds after injection of thiopental. Presence or absence of verbal command response, lid reflex and trapexius reflex were observed. For each reflex, dose-response curves were analysed using the log probit model to determine ED 50, Ed95 and parallelism. The value of ED50 for verbal command response was lowest in the ESRD patient group (2.2mg/kg) and was similar in the remaining groups(2.5, 2.6mg/kg). The ED50 values for lid and trapezius reflex were lowest in the C/S group(2.9and 4.0mg/kg respectively) and the others had similar values (3.5~3.7mg/kg and 4.7~5.3mg/kg respectively). The ED95 values for trapezius reflex in all patients were distributed between a range of 6.5~9.1mg/kg and this suggests that the usual dose (3~6 mg/kg) is not sufficient to prevent the stress response of tracheal intubation. Also, the results indicate that the dose of thiopental for induction should be reduced because of the increasing sensitivity of the central nervous system with the cesarean section group and the free drug fraction of thiopental in patients with end stage renal disease. Therefore, if a patient with full term pregnancy or renal failure is to be induced with a single injection of thiopental, it is recommended to reduce the rate of injection.
Anesthesia, General* ; Body Weight ; Catheters ; Central Nervous System ; Cesarean Section* ; Female ; Humans ; Intubation ; Kidney Failure, Chronic* ; Pregnancy ; Reflex ; Renal Insufficiency ; Superficial Back Muscles ; Thiopental*

Nausea and vomiting are common problems after strabismus surgery in pediatric patients. We compared the effect of propofol with N2O with the effect of a conventional regimen consisting of halothane - N2O on the occurrence of oculocardiac reflex(OCR), recovery characteristics and the incidence of postoperative emesis after strabismus surgery in 46 ASA physical status I children. After intravenous injection of atropine(0.02 mg/kg), patients were randomly assigned to one of two groups. Group l(conrol) received thiopental, vecuronium, halothane and N2O; Group 2(study), propofol 2 mg/kg and vecuronium bolus followed by infusion of propofol 160 mg/kg/min. Patients in group 2 had more episodes of OCR response than group 1, but had shorter time to recovery from anesthesia(p<0;05). But there was no significant difference in the incidence of postoperative nausea and vomiting between two groups. We conclude that the sufficient doses of propofol only regimen and atropine preadministration(0.02 mg/kg) will be necessary in the strabismus surgery of children for the purposes of the prevention of intraoperative OCR, rapid recovery from anesthesia and reduction of postoperative emesis.
Anesthesia ; Atropine ; Child ; Halothane ; Humans ; Incidence ; Injections, Intravenous ; Nausea ; Postoperative Nausea and Vomiting* ; Propofol* ; Reflex, Oculocardiac ; Strabismus* ; Thiopental ; Vecuronium Bromide ; Vomiting

Single dose glass ampules have been developed for ease of administration, accuracy of measurement of dosage, sterility and use in prepackaged kits. Glass particle contamination of the contents of single dose glass ampules can occur upon opening. In our study, we determined whether different ampule size, different aspiration techniques or different methods of ampule opening had any effect on glass particle contamination. Different ampule sizes (1, 2, 20 ml), different aspiration techniques (19G, 22G needle) and different methods of ampule opening (one point ampule, cutting with circular etching, cutting with one plane etching) were evaluated. There was no signifcant difference in the number of particles aspirated by any given aspiration technique, ampule size and method of ampule opening. But intravenous glass particle administration is associated with patholagic responses, so the use of a filter needle, and in-line filter devices and a low pressure infusion system is advised.
Glass* ; Infertility ; Needles

No abstract available.
Lidocaine* ; Muscle, Smooth*

High frequency ventilation has been used experimentally and clinically in a variety of situations. This report describes two cases in which high frequency jet ventilation was used to provide adequate ventilation during thoracic surgery. A solenoid valve controlled ventilator at rates of 100 breaths/min. with a double lumen tube provided adequate gas exchange for these patients with an open chest. The minimal lung movement during high frequency jet ventilation was found to provide excellent operating conditions without undue cardiovascular embarrassment. This case report demonstrates the use of high frequency jet ventilation in two adults undergoing operation ofr pulmonary lobectomy and biopay with segmental resection.
Adult ; High-Frequency Jet Ventilation ; High-Frequency Ventilation ; Humans ; Lung ; Thoracic Surgery* ; Thorax ; Ventilation* ; Ventilators, Mechanical

Pulmonary edema is a rare complication of acute upper airway obstruction. This serious complication must be carefully recognized and treated promptly to minimize the delayed morbidity and mortality among the patients who recover from acute upper airway obstruction. We present a case of noncardiogenic pulmonary edema that developed in an 1.4/12-year-old pediatric patient after an episode of acute upper airway obstruction.
Airway Obstruction ; Humans ; Mortality ; Pulmonary Edema*

Ventilation during general anesthesia for bronchoscopy has recently been greatly improved by application of the Venturi principle. Ever since 1967 when Sanders published a paper describing the Venturi principle for ventilatory bronchoscopy, this technique has become increasingly popular. Many papers have been published promoting the use of the Venturi principle which in most cases entails a 16-gauge needle aimed distally down the proximal end of a bronchoscope through which a jet of oxygen is intermittently injected to produced positive pressure ventilation in the lungs. In our study, ten patients undergoing bronchoscopy were ventilated with the Venturi stsytem and the patients were bronchoscoped with a Karl Stors bronchoscope lined with a Venturi oxygen injecttimer, Freiberg 8585T, to which oxygen was supplied from an adjustable pressure reducing valve connected to pipeline oxygen at 55 psi. The following results were obtained: 1) Ten patients verying in age from 2 to 53 years were bronchoscoped becaeuse of subglotticedema, granuloma, emphysems, and tracheal stenosis. 2) The internal diameter of the bronchoscopes varied from 3.0mm to 6.5mm and the inflation pressure varies also from 0.4bar to 1.0bar. The inspiration to expiration time ratio was 1:2 and 1:3. 3) The average PaO2 was well maintained during bronchoscopy and in the postanesthetic stage, but the PaCO2 was slightly increased over the preoperative values. The explanation for this result is that the bronchoscope fitted too tightly to the trachea, so that exhalation was incomplete, and the process of exchange inhibited the elimination of CO2 from the lungs. The results obtained from this study suggest that this technic and device, when used properly, should provide adequate ventilation and an improved visual isation of the operative field.
Anesthesia, General ; Bronchoscopes ; Bronchoscopy* ; Exhalation ; Granuloma ; Humans ; Inflation, Economic ; Lung ; Needles ; Oxygen* ; Positive-Pressure Respiration ; Pulmonary Ventilation* ; Trachea ; Tracheal Stenosis ; Ventilation

A 43 years old female patient who had known FSH form(Fascioscapulohumoral type) muscular dystrophy was scheduled for total abdominal hysterectomy due to uterine myoma. Induction of ansthesia was performed without muscle relaxant and maintained with fentanyl, oxygen and nitrous oxide. Muscle relaxation was excellent without neuromuscular blocking agent by the meuromuscular twitch monitoring(too week response to neuromuscular twitch at 70mA). After the end of operation, the patient was awaken without any problem and was transferred to recovery room.
Adult ; Female ; Fentanyl ; Humans ; Hysterectomy ; Leiomyoma ; Muscle Relaxation ; Muscular Dystrophies* ; Neuromuscular Blockade ; Nitrous Oxide ; Oxygen ; Recovery Room

A 43 years old female patient who had known FSH form(Fascioscapulohumoral type) muscular dystrophy was scheduled for total abdominal hysterectomy due to uterine myoma. Induction of ansthesia was performed without muscle relaxant and maintained with fentanyl, oxygen and nitrous oxide. Muscle relaxation was excellent without neuromuscular blocking agent by the meuromuscular twitch monitoring(too week response to neuromuscular twitch at 70mA). After the end of operation, the patient was awaken without any problem and was transferred to recovery room.
Adult ; Female ; Fentanyl ; Humans ; Hysterectomy ; Leiomyoma ; Muscle Relaxation ; Muscular Dystrophies* ; Neuromuscular Blockade ; Nitrous Oxide ; Oxygen ; Recovery Room