Anesthesia consent was requested by our anesthesiology department when the patient condition was found to be critical during the preanesthetic visit. To evaluate the trend, one hundred and five anesthesia consent cases among the 6,430 anesthetics from January 1977 to December 1978 at the department of anesthesiology, St. Mary's hospital, Catholie Medical College, were analyzed according to the anesthetic method, age, sex, surgical department, anesthetic agent, physical status, site of operation, diagnosis, preanesthetic problem and cause of death. The results were as follows; 1) Fifteen cases(14%) died among the 105 cases of anesthesia consent during and/or after .surgery, within the first 7 days. 2) Physical status was class ll E in 43% and the ratio of elective to emergency surgery was 1 to 1.4. 3) Upper abdominal surgery was performed in 52 cases(50%), urogenital surgery in 21 cases (20%), head and neck surgery in 18 cases(17%), surgery on extremities in 12 cases(11%) and thoracic surgery in 2 cases(2%), accordingly. 4) Cardiovascular problems were found in 27 cases(26%), hematologic disorders in 13 cases (12%), respiratory problems in 13 cases(12%), sepsis in 9 cases (9%), problems of central nervous system in 9 cases(9%), hepato-renal disorders in 8 cases(8%) and endocrine disorders in 5 cases(5%), respectively, 5) Postanesthetic cause of death was cardiopulmonary disturbance(33%), sepsis(27%) cerebral edema(20%) and hemorrhage(13%).
Anesthesia* ; Anesthesiology ; Anesthetics ; Cause of Death ; Central Nervous System ; Diagnosis ; Emergencies ; Extremities ; Head ; Humans ; Methods ; Neck ; Sepsis ; Thoracic Surgery

The relationship between the Leydig cell of testis and the tropic hormones of the anterior pituitary gland has been inadequately explored in man because of methodological difficulties. Ether anesthesia has been shown to increase testicular blood level of testosterone in man. Some report has appeared on the effect of anesthesia person sex hormone levels in human serum. As testosterone is one of the most important anabolic hormones, it would therefore serve as an index to hormonal response to stress in man. Testosterone levels were measured by Oyama et al by competitive protein binding method. This study was done to investigate the effect of halothane anesthesia and surgery on human sex hormone by radioimmunoassay method. Serum testosterone levels measured at preanesthetic period, 60 minutes after anesthesia and surgery, and full recovery from anesthesia were 4. 18+/-l. 64 ng/ml, 4. 19+/-1.40 ng/ml and 3. 74+/-1. 65 ng/ml, respectively. No statistical significance was noticed each other. The obtained value of testosterone was the lowest compared with the values reported by other authors.
Anesthesia* ; Ether ; Halothane* ; Humans ; Methods ; Pituitary Gland, Anterior ; Protein Binding ; Radioimmunoassay ; Testis ; Testosterone*

Inhalation anesthesia oy endotracheal intubation is commonly used in current anesthetic tech nique. But the increased use of endotracheal tubes in inhalation anesthesia expose the patients to the consequence of increased pressure in the tracheobronchial tree sometimes to a great extent than is true of a patient in whom intubation is not done. In addition, disposable plastic units has been introduced to obviate hazards of cross infection in anesthesia and inhalation therapy and which do not stretch after full inflation. Pressure exceeding 250 cm water may develop within seconds when the plastic units are inadvertently overfilled with gases. Such high pressures transmitted to the airways are harmful. Immediate, prompt and adequate management of the bilateral tension pneumothorax are essential, otherwise the patient becomes rapidly fatal. A case of bilateral tension pneumothorax, which occurred due to a excessive pressure to the airway by use of disposable plastic units was reported.
Anesthesia* ; Anesthesia, Inhalation ; Cross Infection ; Gases ; Humans ; Inflation, Economic ; Intubation ; Intubation, Intratracheal ; Plastics ; Pneumothorax* ; Respiratory Therapy ; Trees ; Water

Cardiopulmonary dysfunction in deformity of the spine had been recognized and complicated with surgical risk. The deformity of the bony thoracic cage reduces its capacity and also impairs the action of the inspiratory muscles will increase work of breathing. Progression of the deformity, the work of breathing and arterial desaturation were further increased. Primary alveolar hypoventilation will produce hypoxemia and resulting in polycythemia and increased pulmonary vascular resistance, and causespulmonary hypertension and congestive heart failure. The end result is similar to the cardiopulmonary failure of primary alveolar hypoventilation and of chronic obstructive bronchitis. Two cases of severe kyphoscoliosis were anesthetised for appendectomy and caesarean section. Anesthetic management of the severe kyphoscoliosis should be focused on the cardiopulmonary dysfunction. In this respect, for the surgical patient with kyphoscoliosis, it is very important to detect the reduced cardiopulmonary function and to consider the prevention or treatment of postoperative pulmonary complication by use an antibiotics, IPPB with oxygen, tracheobronchial toilet, venesection, digitalization and diuretics.
Anoxia ; Anti-Bacterial Agents ; Appendectomy ; Bronchitis ; Cesarean Section ; Congenital Abnormalities ; Diuretics ; Female ; Heart Failure ; Humans ; Hypertension ; Hypoventilation ; Intermittent Positive-Pressure Breathing ; Muscles ; Oxygen ; Phlebotomy ; Polycythemia ; Pregnancy ; Spine ; Vascular Resistance ; Work of Breathing

No abstract available.
Enterotoxigenic Escherichia coli* ; Enterotoxins*

Laryngospasm is a serious complication which may be seen following extubation in children. During laryngospasm either the true vocal cords or the true and false cords become opposed in the midline and close the gllotis. Intravenous lidocaine has been used in adult patients to prevent cough following extubation. The present study was made to see if intravenous 1% lidocaine, 2mg/kg of body weight, can be safely used to prevent or control extubation laryngospasm in children. Anesthesia was maintained with halothane-N2O-O2, in a semiclosed circuit. In 20 children, a bolus of 1% lidocaine 2mg/kg was injected intravenously two to three minutes prior to extubation; in the other 20 children, extubation was carried out without prior injection of lidocaine. The incidence of laryngospasm, coughing, respiratory depression, and changes of blood pressure, pulse rate were measured. The results were as follows: 1) Two cases of laryngospasm (10%), 11 cases of coughing (55%) and 2 cases of stridor (10%) were observed following extubation in the control group. Blood pressure and pulse rate showed a tendency to increase about 20%, in the control group. 2) One case of laryngospasm (5%) and 4 cases of coughing (20%) were observed following extubation in the lidocaine pretreated group. Incidence of trouble following extubation was markedly reduced (75 to 25%) in the lidocaine pretreated group. Blood pressure and pulse rate showed a tendency to decrease about 15% in the lidocaine pretreated group.
Adult ; Anesthesia ; Blood Pressure ; Body Weight ; Child* ; Cough ; Heart Rate ; Humans ; Incidence ; Laryngismus* ; Lidocaine* ; Respiratory Insufficiency ; Respiratory Sounds ; Vocal Cords

The relationship between the Leydig cell of testis and the tropic hormones of the anterior pituitary gland has been inadequately explored in man because of methodological difficulties. A report has appeared on the effect of anesthesia per se on sex hormone levels in human serum. As testosterone is one of the most important anabolic hormones, it would therefore serve as an index to hormonal response to stress in man. Tcsticular blood level of testcsterone in man was increased by ether anesthesia but plasma testcsterone one in man was decreased by halothane anesthesia. Plasma testostercne levels were measured by others. by a competitive protein binding method. This study was performed to investigate the effect of methoxyflurane anesthesia and surgery on human sex hormone by a radioimmunoassay method. Serum testosterone levels measured in the pre-anesthetic period, (60 minutes after anesthesia and surgery, and at full recovery from. anesthesia were 3.80+/-1. 75 ng/ml, 0. 58+/-1. 22 ng/ml and 3. 55+/-1. 85 ng/ml, respectively. No statistical significance was observed. The obtained value of testostercne was the lowest when compared with the values reported by others.
Anesthesia* ; Ether ; Halothane ; Humans ; Methods ; Methoxyflurane* ; Pituitary Gland, Anterior ; Plasma ; Protein Binding ; Radioimmunoassay ; Testis ; Testosterone*

A postanesthetic recovery score to provide objective information on the phsical condition of patients arriving in the recovery room after anesthesia. The status of the patients was judged after arriving in the recovery room and every 30minutes thereafter, until their discharge to the ward or Intensive Care Unit. To study this method, 324 patients were selected at random to include as many variants of anesthesia as possible. The patients were transported to the recovery room within 10 minutes of the completion of the anesthesia; Once there, the first score was made by the anesthesiologist. Thereafter, the evaluation was made by the same anesthesiologist. Depending on the length of stay in recovery room, this evaluation was repeated 30, 60, and 90 minutes after the patients arrival. The various signs were evaluated. The independent variables such as age, sex, physical status, anesthetic agents or technics, type of surgery, use of muscle relaxants, duration of anesthesia were correlated with the proportional number of patients receiving top or safe score 10, 9 or 8, and those given 7 or less, which were considered low or dangerous.
Anesthesia ; Anesthetics ; Humans ; Intensive Care Units ; Length of Stay ; Recovery Room*

The relationship between the Ledig cell of testis and the tropic hormones of the anterior pituitary gland has been ineddquately expiored in man because of methodological difficulties levels in human serum. As testosterone in one of the most important anabolie hormones, it would therefore serve as an index to hormanal response to stress in man. This study was performed to inveatigate the effect of thalamonal-N2O-O2 anesthesia and surgery on human sex hormone by radioimmunoassay method. Measured serum testosterone lexels in the preanesthetic period, 60 minutes after anesthesia and surgery, and at full rectxary from anesthesia were 5.64ng/ml 4.40ng/ml and 5.02ng/ml, respectively.
Anesthesia* ; Humans ; Methods ; Pituitary Gland, Anterior ; Radioimmunoassay ; Testis ; Testosterone*

The tetralogy of Fallot is the commonest cyanotic congenital heart disease and is not a single entity but is classified according to variations in clinical and hemodynamic findings based primarily on the degree of pulmonary stenosis and the size of the ventricular septal defect. Total surgical correction was performed with Sarns 500 pump oxygenator, hypothermia 28 to 30 C and perfusion flow rates of 2. 4 L/min/m2. A successfully performed tetralogy of Fallot discussed mainly fromthe pathophysiological view.
Anesthesia* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Hemodynamics ; Hypothermia ; Oxygen ; Oxygenators ; Perfusion ; Pulmonary Valve Stenosis ; Tetralogy of Fallot*