BACKGROUND: As the frequency of colonoscopic approaches increases, we need a less painful premedication for colonoscopy. We used midazolam as a premedication agent. It has more rapid onset of action than that of diazepam and its duration is shorter. The purpose of this study was to examine the clinical application of midazolam. METHODS: Fifty patients underwent colonoscopies. An average dose of midazolam, 0.07 mg/kg, was given to patients intravenously as premedication. We measured systolic and diastolic blood pressures, pulse rates, respiratory rates, and oxygen saturation (SaO2) using pulse oxymetry before and after the injection. A Trieger test was accomplished before and after the procedures. We examined the levels of consciousness with verbal and physical stimulation during the colonoscopy. The examiners noted the degree of amnesia and pain after colono-scopy. We examined the patients' satisfaction and endoscopists' assessments. RESULTS: 1) Systolic, diastolic blood pressures and respiratory rates showed no significant changes. But, pulse rates increased meaningfully at 15 minutes after the injection of midazolam (p <0.05). 2) The Trieger test showed meaningfully increased numbers of missed dots after the injection of midazolam. 3) The levels of consciousness during the test showed alertness in 22 patients (44%), drowsy mentality in 22 patients (44%) and stuporous mentality in 6 patient (12%). 4) The degree of amnesia after examination showed recall in 26 patients (52%), partial recall in 10 patients (20%) and total amnesia in 14 patients (28%). 5) Forty-five patients (90%) acknowledged this procedures to be more comfortable than previous procedures. CONCLUSIONS: Midazolam stabilized vital signs and oxygen saturation, therefore midazolam can be used safely as premedication for colonoscopy. Thirty-six patients (72%) recalled the procedures totally or partially. But, the relief of pain compared favorably to the degree of amnesia. We concluded that mida-zolam (0.07 mg/kg) was the safe and effective premedication for colonoscopy.
Amnesia ; Colonoscopy* ; Consciousness ; Diazepam ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Physical Stimulation ; Premedication* ; Respiratory Rate ; Stupor ; Vital Signs

We have experienced a case of hepatoblastoma in 22 months old male infant who presented with abdominal distention and hepatomegaly. Diagnosis was confirmed by X-ray of abdomen, liver scan and histological findings. A brief review of literature was also presented.
Abdomen ; Diagnosis ; Hepatoblastoma* ; Hepatomegaly ; Humans ; Infant ; Liver ; Male

During the last decade, non-rebreathing systems have been used extensively for pediatric anesthesia, but if this is used for long periods, invariable dryness of the airway develops, leading to decreased ciliary functionand reduced transport of secretions, thus producing stagnation which interfs with respiratory function postoperatively. The use of a to-and-from system for infant anesthesia had disadvantages, such as the dead space was excessive at the start of each use increased with the exhaustion of soda lime, the apparatus being clumsy and difficult to handle, and the sodalime crurable, and powder was blown into the patient's face and airway. A new circle system was divided for the Ohio infant circle system, two unidirectional valves removed, a Holm's valve attached to the corrugated tubes. It has been used fo 13 anesthetics in children aged from 3 months to 8 years in the Department of Anesthesiology, Hanyang University, College of Medicine from November to December of 1980. The conclusions are as follows: 1) The degree of the oral temperature was lower in the non-rebreathing system than in the new circle system, but was no significance between the two groups. 2) The systemic temperature of the new circle system was 29.8+0.9 degrees C, and the systemic temperature of the non-rebreathing system was 27.5+0.4 degrees C, so there was a meaningful difference between the two groups. 3) Preansthetic temperature of the soda-lime in the new circle system was 24.5+1.6 degrees C, and 30 min. after the induction was 34.5+3.4 degrees C, so it increased by more than 10 degrees C. This might suggest that it was helped the body temperature and the humidification of the airway. 4) The PCO2 levels 30 min. after induction was meaningfully lower in both systems. This might suggest that it was due to hyperventilation. 5) The gas flow of the non-rebreathing system averaged 6L/min. and the gas flow of the new circle system was 2L/min., so the consumption of fresh gas and anesthetic agent was low in the comparison with the former. Theremer this might suggest that it helped the humidity of the airway, the function of the mucous membrane, and the body temperature. 6) As Holm's valve, its weight 12gm, its resistance 0.5cm-H2O, its deadspace 1ml, was used for both spontaneous and controlled respiration in small children with the circle system. It might suggest that of can compensate for the disadvantages of the old circle systems and non-rebreathing systems.
Infant ; Child ; Male ; Female ; Humans