Morphine administered via the intrathecal or epidural route can produce long-lasting analgesic effect for acute and chronic pain. Unfortunately, little was known about the action of opioid drugs on the peripheral nerve system. The author administered morphine and local anesthetic when performing brachial plexus block in 64 selected cases and observed the effects of morphine on postoperative pain relief and the duration time of the local anesthetic. The following results were obtained. 1) Morphine 10mg administered in the brachial plexus block produced no significant increase in the duration of the block and no significant effect on postoperative pain relief. 2) Morphine 10mg administered in the brachial plexus block produced systemic side effects.
Brachial Plexus* ; Bupivacaine* ; Chronic Pain ; Morphine* ; Pain, Postoperative ; Peripheral Nerves

The residual effect of muscle relaxant given during anesthesia can be assessed by clinical evaluation or by the use of peripheral nerve stimulator. Clinical evaluation of the recovery from neuromuscular blockade is often accompanied by some dangers of residual curarization after anesthsia because many of patinets evaluated by subjective clinical performance often have train-of-four ratio of less than 0.7 that is usually taken to reflect adequate reovery. Clinically the magnitude of antagonism of neuromuscular blockade appears to be dependent on the amount of muscle twitch at the time of anticholinesterase administration rather than on the total dose of muscle relaxant given during anesthesia. Authors evaluated the residual effect of pancuronium after anesthesia by the use of train-of-four(TOF) stimulation to the ulnar nerve. The degree of muscle relaxation was assessed by the train-of-four count, according to which varied dose of anticholinesterase was administered and the reversal time to a train-of-four ratio of 0.7 was checke.The result of this study is summerized below. 1) Reversal time without administration of neostigmine from 4th response to a TOF stimulation to a TOF ratio of 0.7 was 45.4+/-9.3 min. 2) Reversal time to a TOF ratio of 0.7 after adminstration of neostigmine 20ug/kg the 4th response to a FOF stimulation was 14.2+/-3.2 min. 3) Reversal time to a TOF ratio of 0.7 after administration of neostigmine 25ug/kg at the 3rd response to a TOF stimulation was 14.9+/- 4.7 min. 4) Reversal time to a TOF ratio of 0.7 after administration of neostigmine 40ug/kg at the 2nd response to a TOF stimulation was 10.6+/-3.4 min.
Anesthesia* ; Muscle Relaxation ; Neostigmine ; Neuromuscular Blockade ; Pancuronium* ; Peripheral Nerves ; Ulnar Nerve

A case of cardiac arrest due to left ventricular stab wound was resuscitated by open cardiac massage and surgery. The experience was concluded as follows: 1. Under light anesthesia, bleeding was controlled by immediate surgery, which might have increased the survival rate. 2. Sufficient oxygen administration and proper anti-shock therapy provided an excellent prognosis.
Anesthesia* ; Heart Arrest ; Heart Massage ; Hemorrhage ; Humans ; Oxygen ; Prognosis ; Survival Rate ; Wounds, Stab

A case of respiratory paralysis due to Fugu poisoning recovered after 24 hours of artificial respiration with I.P.P.R. 1) Through an endotracheal tube, I.P.P.B. with oxygen was applied and normal ventilation was maintained. 2) Supporting measures including proper management of electrolyte balance promoted the patients recovery. 3) Antibiotics played an important role in prevention of secondary infections.
Anti-Bacterial Agents ; Coinfection ; Humans ; Oxygen ; Poisoning* ; Respiration, Artificial ; Respiratory Paralysis ; Takifugu ; Ventilation ; Water-Electrolyte Balance

No abstract available.
Catheterization* ; Catheters* ; Hemothorax* ; Subclavian Vein*

A case of parathion poisoning has been reported; in which the symptoms of hypoxia resulted from partial airway obstruction, however this was mistaken for parathion poisoning, and the correct diagnosis was proved by removal of hard blood clot in the bronchial bifurcation. Conclusions were as follows: Adquate administration of PAM and atropine presented impressive response of symptoms. 2. Careful and frequent removal of secretion might be the most important problem especially in this poisoning. 3. Massive administration of antibiotics could prevent pulmonary complications. 4. Pulmonary edema, the most common complication, was not present.
Airway Obstruction* ; Anoxia ; Anti-Bacterial Agents ; Atropine ; Diagnosis ; Paralysis* ; Parathion* ; Poisoning* ; Pulmonary Edema

Experiences with propofol in pediatric anesthesia are limited. We undertook a study to evaluate the quantity of induction and recovery from anesthesia with propofol compared to thiopental/halothane. Fifty children received 2mg/kg of propofol as a loading dose followed by a maintenance dose of 9mg/kg/hr for first 30minutes and followed by 6mg/kg/hr there- after. Fifty children received 5mg/kg of thiopental, and maintensnce was provided with halothane (0.5%-1.5%). The interval between the end of the administration of propofol or thiopental/halothane and extubation, as well as discharge to the ward,was significantly shorter with propofol (5.43 versua 10.72 min and 10.30 versus 18.20 min, respectively). Pain on injection site were seen more frequently with propofol, whereas nausea and hiccup were only observed with thiopental. During the first 6 hour after the surgical procedure, an- algesics were needed significantly more often in the thiopental group. In conclusion, propofol used as a single anesthetic for total intravenous anesthesia is a satisfactory agent for oph- thalmic surgery of short duration in children.
Anesthesia ; Anesthesia, Intravenous ; Child* ; Halothane* ; Hiccup ; Humans ; Nausea ; Propofol* ; Thiopental*

In patients undergoing intracranial surgery, the drugs used for anesthesia and the opera-tive procedure can effect an increase in intracranial pressure. Especially in patients whose intracranial pressure has already increased significantly, if the pressure is further increased br these factors, then the patient's neurological condition may be aggravated and the post-operative prognosis may be affected. Thus it is desirable to use drugs which reduce intrac-ranial pressure during this type of surgery. In this study, the spinal subarachnoidal pressures of two groups were compared. One group received a combination of thiopental sodium and lidocaine which are known to relatively reduce intracranial pressure, white the other group was given halothane which is known to increase intracranial pressure. The summary of this study is as follows : 1) The spinal subarachnoidal pressure began to increase 1~4 minutes after the administra-tion of halothane, and the duration of increament was 15-38 minutes with a maximal pressure change from 346+/-63 mmHaO to 417+/-90 mmH2O. Thereafter the pressure returned to the pre-induction level spoataneously. 2) The spinal subarachnoidal pressure began to decrease 2~4 minutes after the admini-stration of thiopental sodium and lidocaine. The greatest decrease in pressure occurred within 10~15 minutes level as the Preseure fell form 324+/-41 mmH2O to 210+/-73 mmH2O, thereafter the pressure remained decreased.
Anesthesia ; Anesthesia, General* ; Halothane ; Humans ; Intracranial Pressure* ; Lidocaine ; Nitrous Oxide* ; Prognosis ; Thiopental*

The authors evaluated the stress response to cardiopulmonary bypass by measuring plasma Ig G, A, M and C3, C4concentrations. Anesthesia was induced with fentanyl, and all patients were underwent open heart surgery using bubble type heart-lung machine. Blood samples were obtained pre-induction, sternotomy, 10 min. and 30 min. after cardiopulmonary bypass, and 10 min. after termina tion of cardiopulmonary bypass and after transport to L.C.U. IgG, A, M and complement C3, C4concentrations were measured by Turbidmeter using Behring Turbidquant. The results were as follows: 1) Plasma concentrations of IgG, A, M and C3, C4 at preinduction period were 1345. 00+/-194. 42, 289. 10+/-100.4, 177.43+/-72.65, 59.20+/-16.33, 20.50+/-7.54 mg/dl., respectively. 2) Ten min. after cardiopulmonary bypass, the plasma concentration was significantly decreased when compared with the baseline values (p<0.01). 3) Thirty min. after cardiopulmonary bypass, the plasma concentration of the complenent C3, C4 were significantly decreascd (p<0.01). 4) In the 1ntensive care unit, Ig and complement C3, C4 were increased, but did not reach control values. Considering the above results, we conclude that the decrease of plasma Ig G, A, M and complenent C3, C4concentrations are related to mechanical stress of the cardiopulmonary bypass, and to certain activators such as denaturated protein, heterogenous RBCs, and foreign materials, etc.
Anesthesia* ; Cardiopulmonary Bypass* ; Complement C3* ; Complement C4 ; Complement System Proteins* ; Fentanyl* ; Heart-Lung Machine ; Humans ; Immunoglobulin G* ; Immunoglobulins* ; Plasma ; Sternotomy ; Stress, Mechanical ; Thoracic Surgery

It is rare to meet an uncontrolled hyperthyroid patient in elective surgery. But, in emergency surgery, recognition of hyperthyroidism may be difficult, as trauma or pain may mask hyperthyroidism. The patient may be unaware of its existence or incapable of transmitting the information. During or after surgery, untreated hyperthyroidism can cause thyrotoxic crisis (thyroid storm), which may be a highly fatal complication. Thyrotoxic crisis is an extreme accentuation of signs and symptoms of throtoxicosis. Clinical manifestations are sinus tachycardia or atrial fibrillation, marked increase in systolic pressure and pulse pressure, high temperature, profuse sweating, tremor, dehydration, tachypnea, extreme restlessness and agitation, delirium, and frank psychosis. In this case, atrial fibrillation and hypertension developed after induction, and severe thyrotoxic symptoms appeared after emergence, which were caused by undetected hyperthyroidism.
Anesthesia* ; Atrial Fibrillation ; Blood Pressure ; Dehydration ; Delirium ; Dihydroergotamine ; Emergencies ; Humans ; Hypertension ; Hyperthyroidism ; Masks ; Psychomotor Agitation ; Psychotic Disorders ; Sweat ; Sweating ; Tachycardia, Sinus ; Tachypnea ; Thyroid Crisis ; Tremor