No abstract available.
Child ; Humans ; Oxygen

No abstract available.

No abstract available.
Anesthetics

No abstract available.
Piperidines

BACKGROUND: Nitrous oxide (N2O) is much cheaper than recently introduced volatile anesthetics such as sevoflurane and desflurane, and can reduce the consumption of these anesthetics. The use of N₂O is under current debate. The purpose of this study was to evaluate economic effect of 50% N₂O during sevoflurane anesthesia in Korea. METHODS: Seventy patients were randomly allocated to Group A or Group N. Anesthesia induction was performed using propofol, rocuronium, and 3–5% of sevoflurane with air (Group A) or 50% N2O (Group N). Fresh gas flow (FGF) was 6 L/min during induction, and 3 L/min for maintenance. Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), and minimum alveolar concentration (MAC) were recorded. The consumption of sevoflurane was measured at every 10 minutes for the first 1 hour. The economic effect was analyzed based on the payment criterion of Korean National Health Insurance Service. RESULTS: MAP, HR, BIS, and MAC showed no differences between the two groups. The sevoflurane consumptions for the first 1 hour were 39.2 ± 6.3 ml in Group A and 29.2 ± 4.9 ml in Group N (P < 0.01); and the N₂O consumption was 93.7 ± 1.5 L in Group N. The total costs of inhaled anesthetics were 16,190 (14.8 USD) and 13,062 (12.0 USD) Korean won for the first 1 hour in Groups A and N, respectively. CONCLUSIONS: Use of 50% N₂O with 3 L/min FGF reduced the sevoflurane consumption by 25% and anesthetic cost by 20% for the first 1 hour.
Anesthesia* ; Anesthetics ; Arterial Pressure ; Cost-Benefit Analysis* ; Heart Rate ; Humans ; Korea ; National Health Programs ; Nitrous Oxide* ; Propofol

BACKGROUND: Although one lung ventilation (OLV) is frequently used for facilitating thoracic surgical procedures, arterial hypoxemia can occur while using one lung anesthesia. Continuous positive airway pressure (CPAP) in 5 or 10 cmH2O to the non-ventilating lung is commonly recommended to prevent hypoxemia. We evaluated the effects of incremental CPAP to the non-ventilating lung on arterial oxygenation and pulmonary shunt without obstruction of the surgical field during OLV. METHODS: Twenty patients that were scheduled for one lung anesthesia were included in this study. Systemic and pulmonary hemodynamic data and blood gas analysis was recorded every fifteen minutes according to the patient's positions and CPAP levels. CPAP was applied from 0 cmH2O by 3 cmH2O increments until a surgeon notifies that the surgical field was obstructed by the expanded lung. Following that, pulmonary shunt fraction (QS/QT) was calculated. RESULTS: There were no significant differences of QS/QT between supine and lateral positions with two lung ventilation (TLV). OLV significantly decreased arterial oxygen partial pressure (PaO2) and increased QS/QT compared to TLV. PaO2 and QS/QT significantly improved at 6 and 9 cmH2O of CPAP compared to 0 cmH2O. However, there were no significant differences of PaO2 and QS/QT between 6 and 9 cmH2O CPAP. In 18 patients (90%), surgical fields were obstructed at 9 cmH2O CPAP. CONCLUSIONS: This study suggests that 6 cmH2O CPAP effectively improved arterial oxygenation without interference of the surgical field during OLV when CPAP was applied from 0 cmH2O in 3 cmH2O increments.
Anesthesia ; Anoxia ; Blood Gas Analysis ; Continuous Positive Airway Pressure ; Hemodynamics ; Humans ; Lung ; One-Lung Ventilation ; Oxygen ; Partial Pressure ; Thoracic Surgical Procedures ; Ventilation

The original article contained an error in Figure and Figure legend.

BACKGROUND: The nasopharyngeal temperature probe should be placed in the upper nasopharynx to reflect accurate core temperature. However, there have been no studies conducted to predict parameters for the optimal depth of the nasopharyngeal temperature probe. The purpose of this study was to examine the correlation between the optimal depth to the upper nasopharynx and the distance from the philtrum to the tragus and height. METHODS: Two hundred patients (100 females and 100 males) were enrolled in the study. The distance from the philtrum to the tragus along the facial curvature was measured, and the optimal depth from the nostril to the upper nasopharynx was evaluated using nasendoscopy. The relationships between the optimal depth to the upper nasopharynx and the distance from the philtrum to the tragus and height were examined. RESULTS: The distances from the philtrum to the tragus were 14.4 +/- 0.5 cm in females and 15.1 +/- 0.6 cm in males (P < 0.01). The depths from the nostril to the upper nasopharynx were 9.4 +/- 0.6 cm in females and 10.0 +/- 0.5 cm in males (P < 0.01). The correlation coefficients between the depth from the nostril to the upper nasopharynx and the distance to the tragus from the philtrum were 0.43 in females and 0.41 in males (P < 0.01). However, there were very weak correlations and no correlations between height and the depth from the nostril to the upper nasopharynx in females and males, respectively. CONCLUSIONS: The depth from the nostril to the upper nasopharynx is correlated weakly with the distance from the philtrum to the tragus. Although the distance from the philtrum to the tragus is not a good predicting parameter for the optimal depth of nasopharyngeal temperature probe placement, subtraction of 5 cm from the distance is helpful to estimate the optimal depth of the nasopharyngeal temperature probe.
Anesthesia ; Female ; Humans ; Lip* ; Male ; Nasopharynx

BACKGROUND: The proper cuff pressure is important to prevent complications related to the endotracheal tube (ETT). We evaluated the change in ETT cuff pressure by changing the position from supine to prone without head movement. METHODS: Fifty-five patients were enrolled and scheduled for lumbar spine surgery. Neutral angle, which was the angle on the mandibular angle between the neck midline and mandibular inferior border, was measured. The initial neutral pressure of the ETT cuff was measured, and the cuff pressure was subsequently adjusted to 26 cmH2O. Flexed or extended angles and cuff pressure were measured in both supine and prone positions, when the patient's head was flexed or extended. Initial neutral pressure in prone was compared with adjusted neutral pressure (26 cmH2O) in supine. Flexed and extended pressure were compared with adjusted neutral pressure in supine or prone, respectively. RESULTS: There were no differences between supine and prone position for neutral, flexed, and extended angles. The initial neutral pressure increased after changing position from supine to prone (26.0 vs. 31.5 +/- 5.9 cmH2O, P < 0.001). Flexed and extended pressure in supine were increased to 38.7 +/- 6.7 (P < 0.001) and 26.7 +/- 4.7 cmH2O (not statistically significant) than the adjusted neutral pressure. Flexed and extended pressure in prone were increased to 40.5 +/- 8.8 (P < 0.001) and 29.9 +/- 8.7 cmH2O (P = 0.002) than the adjusted neutral pressure. CONCLUSIONS: The position change from supine to prone without head movement can cause a change in ETT cuff pressure.
Head Movements ; Head* ; Humans ; Neck ; Prone Position ; Spine

No abstract available.