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*

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

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

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

Trachobronchial aspiration of foreign bodies is one cause of fatal acciderts in children. Serious complications and death of these children is avoided by early diagnocsis and early removal of foreign bodies. The purpose of this report is to analyze the alteration of anesthetic method for removal of tracheobronchial foreign bodies in 54 children(62 anesthesia) experienced in St. Mary's hospital, Catholic Medical College, seoul, Korea, From Jan. 1, 1963 to Sep. 30, 1980. The removal of tracheobronchail foreign bodies for all cases was done under general anesthesia. Results were as follows: 1) Most tracheobronchial foreign bodies appeared in the 1~3 year old group (24 cases among 54 children). 2) The kinds of foreign bodies were foods and metals. Most were peanuts and beans, which were not visible on chest X-ray films. These foreign bodies can cause atelectasis and emphysema in 24 hours, which was evidenced by chest X-ray. 3) During bronchoscopy, the chest was compressed manually after mask ventilation. Recently 1005 oxygen was inhaled through a thin plastic catheter lodged side the bronchescope. intravenous ketamine with 100% oxygen through thin catheter allowed safe anesthesia for bronchoscopic procedure. 4) Anesthetic time required for bronchoscopic procedure was 31~60 minutes on the average. 5) Pulse rate was increased in 39 cases during bronchoscopic procedure.
Anesthesia* ; Anesthesia, General ; Arachis ; Bronchoscopy ; Catheters ; Child* ; Emphysema ; Fabaceae ; Foreign Bodies ; Heart Rate ; Humans ; Ketamine ; Korea ; Masks ; Metals ; Oxygen ; Plastics ; Pulmonary Atelectasis ; Seoul ; Thorax ; Ventilation ; X-Ray Film

This is a case report of pulmonary embolism which occurred as a complication of mesenteric venous stasis with sepais. This 49 year old nun was operated upon for an obstructed intestine under general anesthesia with halothane and d-tubocurarine. She had a hystrectomy for myoma 2 years ago and has ailed for 6 days from this condition. The patient became dyspneic and cyanotic suddenly three hours after the surgery. The chest X-ray revealed three or four bilateral, rounded and moderately increased densities, and her ECG showed a large S wave in limb leads, P-pulmonare, and right ventricular strain pattern with right axis deviation. CPPV with 100% oxygen by the manual method improved the condition of the patient for about three hours, but tachycardia and a failing heart could not be corrected in site of digitalis, steroid, diuretics and heparinization. The patient died 11 hours after the operation.
Anesthesia, General ; Digitalis ; Diuretics ; Electrocardiography ; Extremities ; Halothane ; Heart ; Heparin ; Humans ; Intestinal Obstruction* ; Intestines ; Methods ; Myoma ; Nuns ; Oxygen ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tubocurarine

Anestheiologists face the difficulty of mainatining patent airway in performing anesthesia for surgery around vocal cords. Because the simplicity of the above operation, the surgeons and patients tend to avoid the preparatory tracheostomy which is a safe way of maintaining anesthesia. The difficulties and problems occurring during anesthesia without performing tracheotomy were considered. The problems were; 1) Operating field interfering the anesthetic procedures. 2) Possibility of aspiration of blood during operation. 3) Apnea time of surgery limiting to 5 minutes or less. 4) Repeated intubation for anesthesic procedure. Apneic insufflation method was modified by spontaneous respiration. The tehnic was; the endotrachel tube was removed after induction of general anesthesia when patients spontaneous respiration regained Then suction catheter, 12 fr. size, was inserted to above the carina of trachea. Next, for ventilation, oxygen with high flow rate (9~10 L/Min) was insufflated in trachea through the catheter. This insufflation of high flow oxygen brought continuous positive pressure in trachea, also it acted effectively as PEEP (positive end expiratory pressure) effect .and provided protective mechanism from the aspiration. The addition of potent anesthetics such as halothane and ether insufflating oxygen allowed the control of depth of anestheia effectively. With this insufflation technic, two cases of excision of singers nodule were performed uneventfully.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Apnea ; Catheters ; Ether ; Halothane ; Humans ; Insufflation ; Intubation ; Oxygen ; Respiration ; Singing ; Suction ; Trachea ; Tracheostomy ; Tracheotomy ; Ventilation ; Vocal Cords*