No abstract available.
Korea*

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

No abstract available.
Anesthesia* ; Great Britain*

No abstract available.
Asian Continental Ancestry Group* ; Humans

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

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

Attention has been drawn to the possible deliterious effects on operating theatre personnel of breathing in an atmosphere polluted with anaesthetic vapour, in particular, halothane. Whether or not the relation of these effects of anaesthetic vapours has been adequately proved, there is unlikely to be any disagreement that pollution of theatre air with anaesthetic is undesirable. Comparable atmospheric pollution with halothane in the same theatre was studied with and without use of halothane absorber "Aldasorber". The theatre had no device for reducing air pollution. Anaesthetic exhaust fases were drained to the ground. An anaesthetic machine in a semiclosed circle with carbon dioxide absorber was used throughout the anaesthesia. Anaesthesia was maintained with halothane l.0% and 50% oxygen in nitrous oxide, free gas flow rate were oxygen l.5 liter/min and nitrous oxide 1.5 liter/min, Halothane concentrations at various sites of the operating theatre were studied using the method of gas chromatography. 1) Halothane concentrations in the atmosphere of the operating theatre were 0.11 +/-0.07 ppm without halothane absorber and 0.13 +/-0.14 ppm with halothane absorber at the level of 115cm above the operating theatre floor before anaesthesia. 2) Halothane concentrations in the atmosphere of the operating theatre were 7.50 +/-1.32ppm without halothane absorber and 2.82 +/-0.93 ppm with halothsne absorber at the level of 115cm above the operating theatre floor after 3 hours of anesthesia. 3) Comparing this data it was concluded that the concentration of halothane vapour in the operating theatre air after 3 hours of anesthesis could be reduced by 65% W1th halothane absorber Aldasorber.
Air Pollution ; Anesthesia ; Atmosphere ; Carbon Dioxide ; Chromatography, Gas ; Halothane* ; Nitrous Oxide ; Operating Rooms* ; Oxygen ; Respiration

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

A new fluorinated benzodiazepine compound Ro 5-4200 was used for induction in 58 surgical patients to evaluate the possibility of an intravenous anesthetic induction agent (Table 2 and 3). The hypnotic properties as well as respiratory, cardiovascular, muscle relaxant and local effects were observed. 1. Ro 5-4200 in doses of 2mg was slowly injected intravenously to adult patients (body weight ; 54.2+/-10.3 kg) and 1 mg to a child (body weight; 22 kg, 5 yr.) (Table 2). The tim between the start of injection and the loss of consciousness was 110.3"+/-68.6", taken from the beginning of the injection until the patient was asleep and eyelash and corneal reflexes abolished. Sleep did not occur in 2 patients (Table 4). 2. But the time to sleep after the injection varied remarkebly according to the dilution of the drug. When the dose of 2 mg of the drug was injected, undiluted directly to the small vein, the time to sleep was 83.2"+/-31.4" and 69.1"+/-31.4"; in the former case the patients complained of pain along the injected vein and the latter did not. 3. The hypnotic time with the diluted solution of the drug was 144.5" +/-4.6" and 117.3"+/-77.8", in which the former complained of pain during injection, and the latter did not. 4. Blood pressure, pulse rate and respiratory rate were measured immediately prior to induction and again 2 and 5 minutes after induction. A slight but insignificant rise in blood pressure with a mean of 3.4% in systolic and 6.7% in diastolic pressure above control value was observed in 2 minutes after injection. And at 5 minutes there was a significant fall in blood pressure, 11.3% and 4.3% respectively (p<0.05) (Table 5). 5. Pulse rate increased significantly by 12.7 beats (14.2%) a minute in 2 minutes after injection and 15.7 beat (17.5%) a minute in 5 minutes after injection from a control level of 89.6 (p<0.01) ,(Table 6). 6 Respiration became shallower and the rate decreased as the patients fell asleep. Apnea occurred in 4 patients (6.9%). In the apnea cases, respiration was controlled by mask and positive pressure ventilation. It needed that the facilities for positive pressure ventilation be available in case apnea develops. 7. During induction, tremors, abnormal muscle movements, and laryngospasm were not observed. Hiccough was observed in 4 cases (6.9%). Hiccugh had the tendency to recur during intra-abdominal procedure. 32 patients (55.0%) had an antegrade amnesia, that is shortly before the injection of the drug. They did not remember being moved to the operating table or the insertion of the injection needle. 8. Ro 5-4200 caused pain on injection when given undiluted directly into a small vein on the dorsum of the hand, and the pain was also complained of even when the drug was diluted to 5 times with normal saline or intravenous drip infusion. A localized thrombophlebitis was not seen. 9. Laryngeal reflexes were retained on induction but endotracheal intubation was tried successfully without muscle relaxant in three cases. In this procedure the patients tended to be awake and showed some resistance. The help of muscle relaxants in intubation is recommended. As to degree of everity and nature of muscle fasciculation after succinylcholine, there was somewhat delayed appearance but degree was not altered by Ro 5-4200 10. Recovery from anesthesia and reversal of muscle relaxation was unaltered. The induction was satisfactory, but slow, and characterized by minimal change in blood pressure, pulse rate and respiration. Because of this delayed induction time and the varied degree of depth of sleep, the agent seemed to be improper as an intravenous induction agent. Acknowledgements: Samples of Ro 5-4200 have been kindly supplied by Hoffmann La Roche, Hong Kong. The authors wish to thank Dr. S.S.Lo and Dr. P.A. Bulhr of Roche Products Ltd., for their assistance and advice.
Adult ; Amnesia ; Anesthesia ; Apnea ; Benzodiazepines* ; Blinking ; Blood Pressure ; Child ; Fasciculation ; Flunitrazepam* ; Hand ; Heart Rate ; Hiccup ; Hong Kong ; Humans ; Infusions, Intravenous ; Intubation ; Intubation, Intratracheal ; Laryngismus ; Masks ; Muscle Relaxation ; Needles ; Operating Tables ; Positive-Pressure Respiration ; Reflex ; Respiration ; Respiratory Rate ; Succinylcholine ; Thrombophlebitis ; Tremor ; Unconsciousness ; Veins