Hypothermia and/or hypotensive anesthesia are well known technics for surgery of cerebral aneurysm. This study was performed to compare the Iaboratory data from hypotensive anesthesia with trimetaphan (Arfonad) to hypothermic anesthesia without trimetaphan for surgery of cerebral aneurysm For this purpose, the author performed hypotensive anesthesia with trimetaphan. Laboratory data studied were blood gases, hemoglobin, hematocrit, blood chemistry, urine output, specific gravity of urine, dose of trimetaphan, period of hypotensive state and dose of mannitol, etc. Laboratory data were obtained before surgery (Group A), hypotensive period (systolic blood pressure; 50~60 mmHg) (Group B) and immediately after the surgery (Group C) and were analysed. The results of analysis were as follows; 1. In gas studies, metabolic alkalosis and respiratory alkalosis were shown before surgery and the hypotensive period. Metabolic alkalosis and respiratory acidosis were shown after surgery. It is hard to imagine an explanation for the data. Metabolic acidosis and compensatory respiratory alkalosis should be expected due to decreased tissue perfusion by hypotension, presumably. 2. In Hb. and Hct. studies, among the 3 groups shown there was statistical significance (p( 0.001), but no clinical significance was noticed. 3. In blood chemistry; Serum K showed significant decrease (p<0.001) in the hypotensive period and immediate postoperative period compared with before surgery. Serum Na showed significant decrease (p<0.05) in the hypotensive period and significant increase (p<0.001) in the immediate postoperative period. Serum creatinine showed significant increase (p< 0.001) in the hypotensive and immediate postoperative period. Serum NPN showed significant decrease (p<0.001) in the hypotensive period compared with before surgery and the immediate postoperative period, but statistical significance was noticed in the hypotensive period only. There was no clinical significance among the 3 groups. 4. In urine output, significant decrease was noticed in the hypotensive and postoperative periods: but no statistical significance was found. 5. In specific gravity of urine, progressiv increase was found in the hypotensive and postoperative period than before surgery. 6. In ECG study, no significance change was noticed except one atrial premature contraction during hypotensive period. 7. All the above data were suggested no cerebral hypoxia and/or renal failure were encountered. 8. The mean trimetaphan dose was 189.50+/-172.73 mg, the mean mannitol dose was 53.75+/-13.75 g and the mean hypotensive period was 40.50+/-20.91 minutes respectively. In the statistical significance, unreasonable explanations were encountered. And also, clinically significant results were encountered among the non-statistical significance. To conclude through this study, when we present to give a results of statistical significance, there must be needed more careful analysis not only of obtained data but also analysis with more variable aspects, so further study is indicated.
Acidosis ; Acidosis, Respiratory ; Alkalosis ; Alkalosis, Respiratory ; Anesthesia ; Blood Pressure ; Chemistry ; Creatinine ; Electrocardiography ; Gases ; Hematocrit ; Hypotension* ; Hypothermia ; Hypoxia, Brain ; Intracranial Aneurysm* ; Mannitol ; Perfusion ; Postoperative Period ; Renal Insufficiency ; Specific Gravity ; Trimethaphan*

Autoclaving the local anesthetic ampuls has been suggested as a safer method of sterilization. However the method and time necessary to sterilize the ampul has not been standardizzed, and the amount of deterioration of anesthetic agents by this method is unknown, and the effect of injection of the caramelized dextrose has not been determined. If ampuls are autoclaved with the spinal tray or set up, the ampuls are subjected to sterilization for a prolonged time which in turn causes caramelization of dextrose and possible deterioration. We have studied the effect of multiple autoclavings on pH of the drugs whichart used in spinal anesthesia, 1% tetracaine, 10% dextrose, 2% xylocaine and epinephrine at 134C, 36 psi for 5 minutes. Statistieal significance of the pH changes were observed by multiple autoclavings.
Anesthesia, Spinal ; Anesthetics ; Anesthetics, Local* ; Epinephrine ; Glucose ; Hydrogen-Ion Concentration* ; Lidocaine ; Methods ; Sterilization ; Tetracaine

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 effect of nitrous oxide on endotracheal tube cuff pressure was measured during N2O-O2-halothane anesthesia. Intracuff pressure was increased in a time-related fashion up to 150 minutes. Thereafter no significant increase was observed, The other hand, there is no endotracheal tube cuff pressure change during O2-halothane anesthesia. These findings demonstrate that nitrous oxide has the capacity to diffuse into Portex endotracheal tube cuffs in significant volumes and may result in increased intracuff pressure, and in O2-halothane anesthesia, the nitrogea in the cuff was diffused out from the cuffs.
Anesthesia ; Anesthesia, Inhalation* ; Hand ; Inhalation* ; Nitrous Oxide

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*

Patients vary markedly in their responses to d-tubocurarine chloride. Despite an attempt to diminish the variation in responses to relaxants by standardizing experimental techniques, anesthetic concentration kept constant, acid-base status kept constant, premedication omitted, dosage calculated in terms of mg/sq meter body surface, the marked variation was found to persist. The dose related neuromuscular blocking effect of d-tubocurarine chloride was investigated using a rabbit common peroneal nerve anterior tibial muscle preparation. All experimental rabbits tracheas were intubated through tracheostomy under general anesthesia with Nembutal 40 mg/kg intravenously. Reapiration was controlled by a Harvard animal respirator. The body temperature was kept at 35-37 degrees C by a thermoblanket. The degree of neuromuscular block following intravenous d-tubocurarine chloride was measured by single twitch response. The common peroneal nerve was stimulated supramaximally using a square waves of 0. 2 msec duration at a frequency of 0.1 Hz, and each stimulus was repeated once every 10 seconds. The ratio of the twitch height was calculated. The results were as follows: 1) No neuromuscular blocking effect was observed with 0.1 mg/kg of intravenous d-tubocu- rarine chloride. 2) 100% of neuromuscular blocking effect was observed with more than 1mg/kg of intravenous d-tubocurarine chloride. This is 5 to 10 times higher than the human dose. 3) Dose related prolonged neuromuscular blocking effect was observed from d-tubocurarine chloride in rabbits.
Anesthesia, General ; Animals ; Body Temperature ; Humans ; Muscle, Skeletal ; Neuromuscular Blockade* ; Pentobarbital ; Peroneal Nerve ; Premedication ; Rabbits* ; Trachea ; Tracheostomy ; Tubocurarine ; Ventilators, Mechanical

Succinylcholine chloride is the most commonly used muscle relaxant. Its rapid onset of action and relatively brief duration are unique Despite its wide use, certain pharmacologic aspects of auccinylcholine chloride are not as widely appreciated as they should be. There is marked variation in the responses of patients to clinically used doses. Large doses demonstrate that recovery from succinylcholine chloride is slower than is generally appreciated in man. The dose related neuromuscular blocking effect of succinylcholine chloride in cats was investigated using a cat common peroneal nerve anterior tibial muscle preparation. All experimental cats tracheas were intubated through a tracheostomy under general anesthesia with Nembutal 40 mg/kg intravenously. Respiration was controlled by a Harvard animal respirator. The body temperature was kept at 35~37 degrees C by a thermoblanket. The degree of neuromuscular block following intravenous succinylcholine chloride, 0.5 mg/kg and 1 mg/kg, were measured by single twitch response. The common peroneal nerve was stimulated supramaximally by a single stimulus with square waves, 0. 2 msec duration and at a frequency of 0.1 Hz. The ratio of the twitch height was calculated. The results were as follows: 1) The time of neuromuscular blokade to 100% depression was 30.7 sec and to l00% spontaneous recovery was 1,260 sec (21 min.) in the succinylcholine chloride 0.5 mg/kg intravenous group. The recovery index was 258. 5 sec (4. 3 min.). 2) The time of neuromuscular blockade to 100% depression was 30 sec and to 100% spontaneous recovery was 2,004 sec (33. 4 min.) in the succinylcholine chloride I mg/kg intravenous group. No significant time difference was observed in neuromuscular depression in both groups but spontaneous recovery time was markedly prolonged to 744 sec (59% prolongation). The recovery index was also prolonged to 474 sec (83% prolongation).
Anesthesia, General ; Animals ; Body Temperature ; Cats* ; Depression ; Humans ; Muscle, Skeletal ; Neuromuscular Blockade* ; Pentobarbital ; Peroneal Nerve ; Respiration ; Succinylcholine* ; Trachea ; Tracheostomy ; Ventilators, Mechanical

Hypotension immediately after spinal anesthesia has been considered as the result of pre-ganglionic sympathetic paralysis and secondarily due to changes in cardiac output. And also the increase of vascular bed space about 20~25% was pointed ont during spinal anesthesia which was another cause of spinal hypotension. Same degree of increased vascular bed space was produced by vasodilators such as Dibenzyline and Arfonad. Therefore, vasopressors have been used as the drug of choice to prevent and treat this spinal hypotension. This study was attempted to combat the hypotension during spinal anesthesia by filling this increased vascular bed space with Lactated-Ringer's or Dextrose solution instead of giving vasopressors. Lactated-Ringer's or Dextrose solution was administered to 141 cases, before and immediately after. spinal anesthesia was performed. The given amount of fluid was about 12.5~15% of estimated total blood volume (Group A). And no intravenous fluid was given to 101 cases as control (Group B). Changes of the systolic, diastolic blood pressure and pulse rate were observed. In the Group A, significant changes of the systolic (t=2.52, p<0.02) and diastolic blood pressure (t=1.98, p<0. 05) was observed. The changes of pulse rate were found not significant in the both group series.
Anesthesia, Spinal* ; Blood Pressure ; Blood Volume ; Cardiac Output ; Glucose ; Heart Rate ; Hypotension ; Paralysis ; Phenoxybenzamine ; Vasodilator Agents

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

No abstract available.
Cholecystectomy, Laparoscopic*