It was obtained following results on changes of various constitutions in the blood of eleven patient who had massive blood transfusion ( average 14. 6 pints of ACD stored blood) in Seoul Natioeal University Hospital. I. It revealed no definite change of hemoglobin and hematocrit value in two days after massive blood transfusion. 2. Counts in platelets in two days after transfusion decreased from normal value to about I00, 000/mm3 except one case who had transfused 35 pints of bleod. 3. No hypearpotasaemia obser ved in two days after massive transfusion with usage of the blood warmer. 4. Temporary increase of blood glueose revealed with tendency of decrease to normal values in two days after massive transfusion. 5. The pattern of respiratory alkalosis revealed in two days after massive blood transfusion. It implies that the alkalizing agent is not recommended to inject routinely for the transfused patients without checking acid-base status. 6. It is highly recommended to check body temperature, hematocrit, hemoglobin, platelets and values in arterial blood gas and apply the blood warmer for cares in massive transfused patients.
Alkalosis, Respiratory ; Blood Transfusion* ; Body Temperature ; Constitution and Bylaws* ; Hematocrit ; Humans ; Reference Values ; Seoul

This report is 5 anesthetic experiences of renal transplantation performed from October 1972 to May 1973 at Central Operating Theater, Seoul National University Hospital. The major considerations about renal transplantation are the states of anemia, uremia, acidosis, electrlytes imbalance with hyperpatassemia, hypertension and immunological problems. In anesthetic management, the following must be considered: 1) Operative method. 1. Concomitant transplantation with nephrectomy 2. Transplantation followed by nephrectomy 2) Duration of operation 3) Degree of hypertension 4) Degree of anemia 5) Degree of pulmonary function 6) Intraoperative arterial blood analysis.
Acidosis ; Anemia ; Anesthesia* ; Hypertension ; Kidney Transplantation* ; Nephrectomy ; Seoul ; Uremia

A 34 year old male patient underwent emergency operation of tracheal resection and primary end-to-end anastomosis to correct of tracheal stenosis following tracheostomy. On admission, a No. 3 Magill plastic Portex tracheostomy tube had been placed in the previous tracheostomy opening. Stenotic narrowing was noted 4 cm above carina. Despite of severe narrowing of the lesion, anesthetic course was uneventful with nitrous oxide, oxygen and halothane by controlled respiration and serial blood gas analyses. Postoperative courses were also favorable with adequate respiratory cares. It is mandatory to perform serial blood gas analyses for the management of corrective operation on tracheal stenosis.
Adult ; Blood Gas Analysis ; Emergencies ; Halothane ; Humans ; Male ; Nitrous Oxide ; Oxygen ; Plastics ; Respiration ; Tracheal Stenosis* ; Tracheostomy

It has recently been reported that chemical evaluations of a new benzodiazepine derivative, flunitrazepam (Ro 5-4200) revealed promising effects as premedicant. We studied on effects of premedication by double blind technique comparing flunitrazepam (Ro 5-4200) 0.03mg/kg I.M. and meperidine HCI 1mg/kg I.M. in 300 cases of preoperative patient by random selection. The questionaire on drowsiness, sleepiness and awareness during transport to the operation theatre, as well as nausea and vomiting were checked by anesthetists who were ignorant of the given premedicant. Following results were obtained; 1) Flunitrazepam has excellent calming effects in preanesthetic period, inducing drowsiness and adequate rest. 2) Flunitrazepam produces good sleep the night before operation. 3) Flunitrazepam has lower incidence of nausea and vomiting than that cf meperidine HCI.
Benzodiazepines ; Flunitrazepam* ; Humans ; Incidence ; Meperidine* ; Nausea ; Premedication ; Sleep Stages ; Vomiting

It has been emphasized that continuous monitorings of arterial pressure, central venous pressure, electrocardiogram, blood gas analysis, serum electrolytes, body temperature, hematacrit and urinary output are mandatory for the anesthetic management of pheochromocytoma. In addition, it is necessary for the anesthetists to understand pharmacologic effects of drugs which influence the peripheral vascular tone and cardiac excitability. We experienced recently anesthetic management of two cases of pheochromocytoma; one raised problems of ventricular arrhythmias and hypertension that aggravated nature of arrhythrmias by increasing blood pressure and responded favorably to treatment with propranolol and trimetaphan. Tumor of this case originated from abdominal aortic wall. The other was managed by injection of d-tubocurarine which induced narrowing of pulse pressure by depletion of increasing systolic pressure and accompanied tachycardia without cardiac decompensation. We have reported proper anesthetic managements of two cases of pheochromocytoma with N2O O2-halothane anesthesia and reviewed literatures in discussion.
Anesthesia ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Body Temperature ; Central Venous Pressure ; Electrocardiography ; Electrolytes ; Hypertension ; Pheochromocytoma* ; Propranolol ; Tachycardia ; Trimethaphan ; Tubocurarine

No abstract available in English.
Flunitrazepam*

To determine the effects of hydrcxyethyl starch upon liver, kidney, serm electrolytes and particularly upon blood coagulation, 500 ml of 6% HES in saline solution was administered intravenously to 15 patients during elective minor surgery. In all cases weighted blood loss was less than 600 ml without replacement. The following laboratory tests were performed immediately before infusion and again 1 hour, 24 hours, 48 hours, and 1 week after the infusion: RBC, WBC, hemoglobin, hematocrit, ESR, platelet, bleeding time, coagulation time, prothrombin time, total protein, albumin, total bilirubin, direct bilirubin, SGOT, SGPT, alkaline phosphatase, BUN, sodium, potassium, and chloride. The results are as follows: 1) No anaphylactic shock or bleeding tendency characteristic of colloids was encountered. 2) No functional disturbance of liver or kidney directly attributable to HES was identified. 3) All laboratory parameters except WBC and ESR decreased after infusion. The decrease was, however, within the normal range and believed secondary to dilational effect of infusion. WBC increased somewhat, but returned to the preinfusion level in a week. 4) Exceptionally erythrocyte sedimentation rate increased notably during the 24 hour period following infusion. As with dextran, this was interpreted not due to direct effect of HES, but due to increased adsorption of fibrinogen, alpha-beta-gamma-glcbulin to red cell surface with changes in electric charge between red cells. 5) Clinical applicability, metabolic aspect, degree of subtitution of hydroxyethyl group and safety with multiple infusion of HES must be carefully determined.
Adsorption ; Alanine Transaminase ; Alkaline Phosphatase ; Anaphylaxis ; Aspartate Aminotransferases ; Bilirubin ; Bleeding Time ; Blood Coagulation ; Blood Platelets ; Blood Sedimentation ; Colloids ; Dextrans ; Electrolytes ; Fibrinogen ; Hematocrit ; Hemorrhage ; Humans ; Kidney ; Liver ; Potassium ; Prothrombin Time ; Reference Values ; Selective Estrogen Receptor Modulators ; Sodium ; Sodium Chloride ; Starch* ; Surgical Procedures, Minor

To determine the effects of Haemaccel upon liver, kidney, serum electrolytos and hemostatic functions, 500 ml. of 3.5% Haemaccel solution was administered intravenously to 20 patients during elective surgery. In all cases estimated blood loss was less than 600 ml. without replacement. RBC, WBC, hemoglobin; hematocrit, ESR, platelet, bleeding time, coagulation time and prothrombin time were determined immediately before, and again 30 minutes and 5 hours after infusion; and total protein, albumin, total bilirubin, direct bilirubin, SGOT, SGPT, alkaline phosphatase, BUN, sodium and potassium were ehecked immediately before, and again 5 hours and 24 hours after the end of infusion. The results are as follows: 1) No anaphylactic shock or bleeding tendency characteristic of colloids was encountered. 2) No functional disturbances of liver or kidney directly attributable to Haemaccel were identified. 3) No pathological changes were noted in general laboratpry parameters except for elevated ESR, probably due to decreased blood viscosity, dilution of blood and to pseudoagglutination of red cells.
Alanine Transaminase ; Alkaline Phosphatase ; Anaphylaxis ; Aspartate Aminotransferases ; Bilirubin ; Bleeding Time ; Blood Platelets ; Blood Viscosity ; Clinical Study* ; Colloids ; Hematocrit ; Hemorrhage ; Humans ; Kidney ; Liver ; Polygeline* ; Potassium ; Prothrombin Time ; Sodium

Cardiac arrhythmias were produced in the dog by injections of epinephrine or isoproterenol during intravenous thiopental or propanidid anesthesia. Propanidid did not increase the pressor response to epinephrine, reduce the depressor response to isoproterenol, or diminish the tachycardia following epinephrine or isoproterenol. Propanidid, however, consistently increased the arrhythmia threshold doses of epinephrine and isoproterenol four times those during thiopental anesthesia. It is concluded, therefore, that the antiarrhythmic effect of propanidid is not related to beta adremergic blockade but to its local anesthetic or quinidine-like action and that propanidid is an excellent intravenous anesthetic in view of its antiarrhythmic action on the heart.
Anesthesia ; Animals ; Arrhythmias, Cardiac* ; Dogs ; Epinephrine ; Heart ; Isoproterenol ; Propanidid* ; Tachycardia ; Thiopental

Fourty-eight mongrel dogs were bled to half the level of their control aystolic blood pressures and infused with Hartmanns solution, low molecular weight dextran, whole blood, or with Hartmann's solution+low molecular weight dextran (1:1 or 1:3) in the amount equivalent to the blood loss. Bleeding time, coagulation time, platelet count and erythrocyte sedimentation rate were examined 6 hours and 24 hours after the completion of infusion. The results are as follows: 1) No changes in blood coagulability other than due to hemodilution were observed in dogs infused with Hartmann's solution, whole blood, or 1:1 Hartmann's solution+low molecular weight dextran. 2) Significant changes in blood coagulability were noted, however, in dogs infused with low molecular weight dextran alone or 1:3 Hartmann's solution+low molseular weight dextran. These changes seem to be related rather to decreased platelet function than to the decease in platelet number.
Animals ; Bleeding Time ; Blood Platelets ; Blood Sedimentation ; Dextrans ; Dogs ; Fluid Therapy* ; Hemodilution ; Molecular Weight ; Platelet Count