BACKGROUND: The Korean Journal of Anesthesiology (KJA) was first published in 1968 containing only 16 articles. In 1998, the number is 291. However, the quantitative growth does not mean a qualitative growth. There are many aspects to improving quality. One of them is statistical accuracy. I have examined the statistical methods in our field and checked the accuracy of the methods. Then, I compared the results with the methods in the 1980s and examined what kinds of changes exist. METHODS: I reviewed all the articles except case reports and review articles in KJA published from 1994 to 1998. I focused on the methods of inferential statistics because those kinds of statistics were usually mentioned in the articles. It is based on the mentioned technique in the article to decide which inferential statistics are used, even though sometimes they are not accurate. I adopted the similar statistical error criteria selected by Ko. RESULTS: Basic statistical error, for example no statistics used even though statistical methods are needed, were dramatically reduced compared to the 1980s. It is increased to use the mean comparison methods correctly, but, some statistical methods are still misused frequently, for example Chi-square test, nonparametric analysis, multiple comparison methods and improperly adopted methods based on the variable scale. CONCLUSION: Generally, based on my criteria statistical errors are reduced from about 75% in the 1980s to about 60% in the 1990s.
Anesthesiology*

No abstract available.
Humans ; Jehovah's Witnesses

There are a lot of units used in Anesthesiology field. Sometimes, we could not compare two units describing the same physical category. For example, I cannot find reference materials explaining whether a 7 French catheter is larger than a 16 Gauge catheter. Furthermore, I would like to know why there are so many differences of blood calcium levels between regular check and intraoperative emergency reports. As for liquid drug concentrations, we usually use the mg/ml during a clinical practice, however, basic researchers report it as mole/liter (molarity, M). I would like to answer these questions. So, I have searched some references and have summarized them to explain length, concentration, temperature, particle size, pressure, and ratio units commonly used in our clinical practice, Anesthesiology.
Anesthesiology* ; Calcium ; Catheters ; Emergencies ; Particle Size

No abstract available.
Heparin

BACKGROUND: For a rapid transfusion, pressure is sometimes applied to packed red blood cells during the operation. However, there are neither standard guidelines nor reported data regarding adequate change interval of transfusion kits. The aim of this study is to present relevant data by simulating a surgical situation. METHODS: Each unit of packed red blood cells was mixed with 50 mL of normal saline. Pressure (250 mmHg) was applied to the mixed red blood cells. Each filtration time was measured without change of the transfusion kit. The weight of the mixed red blood cells was measured before and after administration. The passed blood was examined microscopically for detection of possible microaggregation. Eight transfusion sets were tested with 70 packed red blood cells. RESULTS: International guidelines have recommended replacement of the transfusion set if flow rate decreased to less than 100 mL/min. The flow rate of five transfusion sets was recorded as less than 100 mL/min. The flow rate of the third packed red blood cells decreased to less than 100 mL/min. No microaggregate was detected. CONCLUSION: Therefore, we recommended replacement of the blood filter after filtering two units of packed red blood cells with pressure under operation room circumstances.
Erythrocyte Transfusion ; Erythrocytes ; Filtration

BACKGROUND: Procedures in medical papers should be described in sufficient detail to allow other researchers to reproduce the results. The apparatus including anesthesia machine should be given, too. Anesthesia machine has dramatically improved as bioengineering has developed. There are several ventilator settings in modern anesthesia machines. However, it seems that only a few ventilator settings are described even though modern ventilators are used in research. The purpose of this study is to investigate that how many ventilator parameters were described in the papers of the Korean Journal of Anesthesiology from 2001 to 2006. METHODS: All of papers with human general anesthesia were reviewed except case reports, and papers regarding only induction or intubation procedures. Recruited articles were grouped into papers with strongly related to respiratory parameters (STP), and into ones with slightly related to them based on the research topics. The description of following categories was counted in each paper; the type of anesthesia machine, tidal volume, respiratory rate, inspiratory:expiratory ratio, mode of ventilation, pressure set in pressure targeted ventilation, positive end expiratory pressure, inspiratory pause, and inspiratory rising rate. RESULTS: The description rate of each parameters in STP were 36% in the type of anesthesia machine, 66% in tidal volume, 54% in respiratory rate, and 24% in inspiratory:expiratory ratio. The other settings were seldomly mentioned. CONCLUSIONS: Description on the ventilator parameters was sometimes missed. We should describe adequate ventilator settings to reproduce the results because the modern anesthesia machine has additional ventilator options.
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Bioengineering ; Humans ; Intubation ; Positive-Pressure Respiration ; Respiration, Artificial ; Respiratory Rate ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

BACKGROUND: All medical conduct should be practiced under the permission of patients or guardians. Because anesthetic procedures have high risk, every anesthesia practice is done under verbal and/or written consent. However, collecting anesthetic permission is not common in Korean medical anesthesiologists. The purpose of this article is to survey current anesthetic status and to provide some suggestions. METHODS: We had given questionnaire sheet to anesthesiologists participating in an annual meeting of the Korean Society of anesthesiologists. It included the percentage of receiving the anesthetic consent, the reasons why they received the informed consent or not, and the conditions to improve to receive it. RESULTS: The total number of responded anesthesiologists was 187. More than half of the responders had received the informed consents from less than 25% of their patients. And only thirty percent of them had taken the consents from more than 75% of their patients. To increase this rate, they replied, it is needed to strengthen the legal validity of the consent and to improve working conditions. CONCLUSIONS: The rate of receiving the informed consent is very low for the anesthesia practice in Korea. There are some procedures that are needed to improve the current situation so that anesthesiologists can provide better quality to the patients.
Anesthesia* ; Humans ; Informed Consent* ; Jurisprudence ; Korea* ; Patient Rights

Takayasu's arteritis (TA) is a chronic inflammatory disease involving the aorta. Because TA sometimes involves cerebral arteries, anesthetic debates focus on cerebral monitoring. There is limited evidence as to which cerebral monitoring method is most adequate. Furthermore, there is insufficient evidence to determine which anesthetic technique is better for TA parturients. We experienced the case of a TA parturient who developed transient cerebral ischemia during cesarean section. The patient's TA involved her cerebral arteries, and her regional cerebral oxygen saturation (rSO2) was lower in the left side than in the right side. She complained of speech impairment, tinnitus, and stiffness of the posterior neck when the rSO2 levels dropped. The FloTrac/Vigileo(TM) system did not correlate with clinical symptoms, but the cerebral oximeter displayed the low oxygen saturation. We recommend the cerebral oximetry for cerebral monitoring in TA parturients who undergo cesarean sections, especially in hemodynamically unstable patients under regional anesthesia or unconscious patients under general anesthesia.
Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, General ; Aorta ; Cerebral Arteries ; Cesarean Section ; Female ; Humans ; Ischemic Attack, Transient ; Neck ; Oximetry ; Oxygen ; Pregnancy ; Spectroscopy, Near-Infrared ; Takayasu Arteritis ; Tinnitus ; Unconscious (Psychology)

Opioids are widely used as painkillers and anesthetics. Though we use opioids to relieve pain, these drugs can induce mood elevation, dependency, and withdrawal symptoms. This is why opioids are controlled-substances. Most physicians think that some substances should be controlled if they have opioid-like pharmacological properties, especially a long duration, preservation of respiration, and dependency. It is noteworthy that short-acting substances, such as midazolam and thiopental, are included in controlled substances. Their abuse is very dangerous because they frequently induce severe respiratory depression due to a narrow therapeutic window. Teaching point of this article is that designation of a new drug as a controlled substance requires scientific evidence of its link to dependency and/or withdrawal symptoms. However, this does not require abusers' convenience (long duration) or safety (maintenance of respiration). The authors present the addiction and abuse patterns of propofol as an reasons for the Korean Food and Drug Administration to designate propofol as a controlled substance. As a future study, an animal and/or a clinical model for dependency is needed to identify addictive substances. Though several neurotransmitters and their loci in the central nervous system have been studied, the precise mechanism for addiction is unknown. Also, it should be recognized that the potential for drug addiction and abuse could be masked in the early marketing period of a new drug. Physicians should monitor patients' responses carefully when they deal with the drug.
Aluminum Hydroxide ; Analgesics, Opioid ; Anesthetics ; Animals ; Carbonates ; Central Nervous System ; Controlled Substances ; Dependency (Psychology) ; Drug and Narcotic Control ; Marketing ; Masks ; Midazolam ; Neurotransmitter Agents ; Organothiophosphorus Compounds ; Propofol ; Respiration ; Respiratory Insufficiency ; Substance Withdrawal Syndrome ; Substance-Related Disorders ; Thiopental ; United States Food and Drug Administration

No abstract available.
Blood Pressure*