After abdominal surgery, it is well known that a significant decrease in ventilatory function, arterial oxygenation, and coughing ability occurs and this may lead to retainment of bronchial secretions and eventually atelectasie. The author selected 32 patients who received abdominal surgery under general anesthesia. A small dose of morphine was administered intrathecally before induction of general anesthesia, in an attempt to relive postoperative pain. The development of pain was observed until it was sufficient enough to require intramusclar or intravenous injections of analgesics. The results of this study were as follows: 1) A small dose of intrathecally injected morphine did not affect postoperative arterial blood pressure and respiratory rate of the patients. 2) Fifty percent of the patients required no analgesics for pain control within 24 hours of postoperative periods. Intrathecal dose of morphine from 0.1 to 0.3 mg had the similar effect for the postoperative pain control. 3) Central nevous system depression was not noted, but side effects such as nausa(44%) and pruritus(19%) were commonly observed.
Analgesics ; Anesthesia, General* ; Arterial Pressure ; Cough ; Depression ; Humans ; Injections, Intravenous ; Morphine* ; Oxygen ; Pain, Postoperative* ; Postoperative Period ; Respiratory Rate

Amiodarone is a di-iodated benzofuran derivative that is commonly used to treat patients with various cardiac arrhythmias. It is associated with side effects that involve the liver, thyroid, and other organs. Approximately 1-3% of patients treated with amiodarone suffer from symptomatic liver disease. Thyroid dysfunction occurs in 10% of patients treated with amiodarone. A 65-year-old woman with coronary heart disease and atrial fibrillation was administered with amiodarone. She developed nausea, vomiting, dyspepsia, and sweating within 9 months of amiodarone administration (200 mg orally once a day). Results of the laboratory finding showed increased hepatic enzymes, and low thyroid hormone levels. A liver biopsy showed irregular arrangement of hepatocytes and diffuse micro- and macrovesicular fatty changes. Electron microscopy findings showed pleomorphic mitochondria with crystalloid inclusions and membrane-bound lysosomal structures. The liver and thyroid functions returned to normal, after the amiodarone was stopped. We describe an unusual case in which amiodarone induced hepatitis and hypothyroidism simultaneously. Physicians should take a close look to the adverse event when using amiodarone which can cause adverse effects in multiple organs.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Arrhythmias, Cardiac/drug therapy ; Drug-Induced Liver Injury/*complications/pathology/*radiography ; Female ; Fibrosis/pathology ; Humans ; Hypothyroidism/*chemically induced/*complications ; Microscopy, Electron ; Mitochondria/drug effects/metabolism ; Tomography, X-Ray Computed ; Treatment Outcome