No abstract available.
Korea*

No abstract available.
Asian Continental Ancestry Group* ; Humans

>No abstract available.
Anesthesia* ; Joints* ; Respiratory Insufficiency*

No abstract available.
Anesthesia* ; Great Britain*

To assess the effect of premedication for pediatric cases, flunitrazepam (Rohypnol) was given to small children under 6 years of age. 70 patients were divided into 4 groups to which the drug was given intramuscularly, 0. 06 mg, 0.1 mg, 0.15 mg and 0. 2 mg per kilogram of body weight, of the drug respectively. The dose was given 30 minutes before anesthesia and the maximum dose was limited to 2.0 mg for each patient if the calculated dose of the drug exceeded this amount. 1) The shortest time of onset of sleep was 5 minutes. The group which fell asleep between 5 and 10 minutes did not respond to needle stimulation. The group which fell asleep between 11 and 15 minutes moved upon needle stimuli but an intravennous needle was inserted without difficulty. 2) The group which fell between 16 and 20 minutes and became sedated after 20 minutes. without asleep was induced by anesthesia with an inhalational agent but aroused by needle stick. The last group was sedated in presence of their guardian only and became uncooperative when they were separated from the latter. 3) The patients were not affected at all with the dose of 0.06mg/kg of flunitrazepam. 4) With the dose of 0. 1 mg/kg, the group under 6 months of age did not sleep and in the; group between 4 and 6 years of age, half did sleep. ) With the dose of 0.15 mg/kg, in the group under the age of one year, 50% of the cases slept and in the group between 2 and 6 years of age, 30% of the cases slept. 6) With the dose of 0. 2 mg/kg, the sleep group was 25% under 1 year of age, 30. 8% between one and 3 years of age and 33% between 4 and 5 years of age, but the maximum. dose given was limited to 2 mg for each case. A tendency to increased effect according to the increase of age was noticed. 7) The optimum dose of the drug was suggested to be 0. 15 mg/kg and if a dose was used of more than 2. 0 mg, it was not needed to increase above this amount for the purpose of sedation. 8) Optimal time for premedication was suggested to be 30 minutes before the induction of anesthesia. 9) Respiratory and circulatory depression were not noticed with the above doses. 10) Endotracheal intuhation was faeilitated without the aid of muscle relaxant in about 30% of cases when 0.15mg)kg Of the drug was given. (Acknowledgement: We are grateful to Roche Far East Research Foundation for supplies of flu- nitrazepam for this study and to Dr. R. Lassere for advice.)
Anesthesia ; Body Weight ; Child* ; Depression ; Equipment and Supplies ; Far East ; Flunitrazepam* ; Humans ; Needles ; Nitrazepam ; Premedication

Glossopharyngeal neuralgia, first discribed by Labat in 1928, is a very rare disease of unknown cause. This neuralgia is associated with a characteristic sharp pain of the posterior pharynx, tonsils and larynx, and especially triggered by swallowing action. It is said that this pain is more severe than that of trigerminal neuralgia and the pain may last several up to 30 minutes and the attack repeats intermittently. Diagnosis of glosspharyngeal neuralgia is made by the symptoms and by the elongation of the right side of the styloid process in this case. The glossopharyngeal nerve block by the deposition of local anesthetic solution is useful in the accurate diagnosis of the douleureux or neuralgia in which this nerve is involved and in providing anesthesia for operative intervention upon the posterior third of the tongue. This is a report of a case of glossopharyngeal neuralgia, which did not respond to Tegretol and other analgesic drugs and treated by glossopharyngeal nerve block with 0.5% bupivacaine l.5-2.0 ml. The block was performed every day for 15 days and the neuralgia disappeared without complication.
Analgesics ; Anesthesia ; Bupivacaine ; Carbamazepine ; Deglutition ; Diagnosis ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases* ; Larynx ; Neuralgia ; Palatine Tonsil ; Pharynx ; Rare Diseases ; Tongue

Tracheostomy is done to treat the acute upper airway obstruction. But when the condition. precipitating tracheotomy has resolved, the tracheal cannula cannot be removed sometimes because of the anatomical change at the tracheotomised tissue. This is described that decannulation is delayed. Delayed decannulation is uncommon but occurs more frequently in young children than in adults. The child who is difficult to decannulate is continuously at risk. His family experiences emotional, social and sometimes economic hardships. Many factors may delay decannulation; a frequent cause is posterior displacement of the: anterior tracheal well above the tracheotomy stoma induced by the position and pressure of the tracheotomy cannula itself. High tracheotomy, subglottic edema, emotional dependence increase of upper air-way resistance and delayed laryngeal development are solo the factors. One of the treatment of the difficult decannulation, T-tube stent was inserted through tracheoplasty. in this report, a 24 months old girl, nasotracheal intubation was used in the attempted decannulation. Radiological and endoscopic evaluation indicated that posterior displacement of the anterior tracheal well above the tracheal stoma was the cause of the delay. Dacalnnulation was achieved after 10 days of the intubation therapy. Etiology of the tracheal stenosis, pattern of respiratory difficulty, technic and patient care of nasotracheal intubation as the therapy of delayed decannulation and the role of anesthesiologists and pediatric intensive care was discussed.
Adult ; Airway Obstruction ; Catheters ; Child ; Child, Preschool ; Edema ; Female ; Humans ; Critical Care ; Intubation ; Patient Care ; Stents ; Tracheal Stenosis ; Tracheostomy ; Tracheotomy

Acute obstruction of the upper airway in children demands prompt diagnosis and treatment. The management is complex and therefore demands serious, detalled and expert attention. An artificial airway is often required to alleviate the obstruction and due consideration should then be given to the relative merits of the passage of an endotracheal tube and tracheostomy. These are measures which should be carried out early in the illness and must not be postponed until the child is in a critical condition when emergency intervention is often associated with a high incidence of morbidity and mortality. Tracheostomy has been the procedure of choice to relieve airway obstruction; however, in recent years several investigators have reported the encouraging results of nasotracheal intubation as an alternate procedure in the management of upper airway obstruction in children. The purpose of this report is to evaluate the relative effectiveness of two procedures; nasotracheal intubation ami tracheostomy, Nasotracheal intubation or tracheostomy were employed in the management of 27 cases, and it would appear that the two methods of handling airway obstractiorr wer.e equally satisfactory. It was suggested that nasotracheal intubation was superior to tracheostomy in terms of the duration of hospitalization (13,0 days vs. 21. 3 days) and intubation (108. 4 hours vs 167. 2 hours). All patients tolerated well the nasotracheal tube without accidental extubation.
Airway Obstruction* ; Child* ; Diagnosis ; Emergencies ; Hospitalization ; Humans ; Incidence ; Intubation* ; Mortality ; Research Personnel ; Tracheostomy*

Althesin(CT 1341), a new steroid anesthetic, was tried clinically as an induction agent. All 24 patients were in the physical status class 1 by A.S.A. classification. Dosage of althesin given intravenously was 50ul/kg B.W. and the injection speed for the given dose was 15 seconds. The following results were obtained. 1) Induction time was 42+/-19. 7 seconds. 2) No significant changes in pulse rate were found after intravenous injection of althesin. 3) Systolic blood pressure was decreased 8mmHg (p<0.01) after one minute of injection and 11 mmHg (p<0.01) after three minutes and raised to preanesthetic level after five minutes. No significant change was found in diastolic blood pressure. 4) Respiratory rate was increased 3/min. (p<0.05) after three minutes. 5) Minute volume was decreased 170Gml (p<0.01) after one minute and 700ml (p<0.05> after three minutes. 6) As complications, involuntary muscle movement of extremities was observed in two cases and transient apnea in one case.
Alfaxalone Alfadolone Mixture* ; Apnea ; Blood Pressure ; Classification ; Extremities ; Heart Rate ; Humans ; Injections, Intravenous ; Muscle, Smooth ; Respiratory Rate

Anestheiologists are called upon to undertake, or to assist in the management of severe respiratory and circulatory emergencies that may occur in myasthenics or to administer anesthesia for thymectomy or other surgical procedures to be performed on myasthenic subjects. Consequently the well-trained anesthesiologists must be sufficinetly familiar with the diagnosis and treatment of myasthenia gravis to carry on the therapy. A case of anesthesia for thymectomy in myasthenia gravis was experience. During operation, 0.1% succinylcholine in dripp method was given for adequate muscle relaxation and no respiratory probelms were encountered postoperatively.
Anesthesia* ; Diagnosis ; Emergencies ; Muscle Relaxation ; Myasthenia Gravis ; Succinylcholine ; Thymectomy*