• 제목/요약/키워드: Inhalation anesthesia

검색결과 88건 처리시간 0.03초

Propofol Infusion Associated Metabolic Acidosis in Patients Undergoing Neurosurgical Anesthesia : A Retrospective Study

  • Choi, Yoon Ji;Kim, Min Chul;Lim, Young Jin;Yoon, Seung Zhoo;Yoon, Suk Min;Yoon, Hei Ryeo
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.135-140
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    • 2014
  • Objective : Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis. Methods : The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded. Results : In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued. Conclusions : The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.

TREATMENT UNDER GENERAL ANESTHESIA IN PEDIATRIC DENTISTRY OF WONJU SEVERANCE CHRISTIAN HOSPITAL (원주세브란스기독병원 소아치과에서 시행한 전신마취하 치료)

  • Park, Chan-Hee;Lee, Jong-Hyung;Lee, Han-Gil;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • 제14권2호
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    • pp.71-77
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    • 2018
  • This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.

Effects of Inhalation versus Total Intravenous Anesthesia on Postoperative Pulmonary Complications after Anatomic Pulmonary Resection

  • Lee, Soojin;Cho, Jeong Su;Kim, Eunsoo;Kim, Yeongdae;Lee, Jonggeun
    • Journal of Chest Surgery
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    • 제55권1호
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    • pp.30-36
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    • 2022
  • Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

Comparison of Effects of Exhalation and Inhalation Breathing Exercises on Pulmonary Function and Complications in Elderly Patients with Upper-abdominal Surgery (호기 및 흡기호흡운동이 상복부 수술을 한 노인 환자의 폐환기능과 폐 합병증에 미치는 효과 비교)

  • Koo, Mijee;Hwang, Sunkyung
    • Journal of Korean Academy of Nursing
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    • 제46권4호
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    • pp.514-522
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    • 2016
  • Purpose: The purpose of this study was to identify the effects of exhalation breathing exercises using expirometer and that of inhalation breathing exercises using incentive spirometry on pulmonary function and complications in elderly patients with upper-abdominal surgery. Methods: The research design was a nonequivalent control group non-synchronized design. Participants were 63 patients who underwent upper-abdominal surgery under general anesthesia (32 in experiment group, 31 in control group). They were recruited at P university hospital from August 1 to November 30, 2015. Effects were evaluated by measuring pulmonary functions (Forced Vital Capacity [FVC], Forced Expiratory Volume in 1 second [FEV1]) and pulmonary complications. Data were analyzed using SPSS/WIN 18.0 program. Results: There was no difference in FVC between the experimental group and the control group, but FEV1 in the experimental group increased significantly compared to the control group by time change (p=.001). Also, there were no pulmonary complications in the experimental group but there were 5 cases (16.1%)(p=.018) in the control group. Conclusion: Findings indicate that exhalation breathing exercises by elderly patients following upper-abdominal surgery is an effective nursing intervention in enhancing pulmonary function and preventing pulmonary complications.

The Effects of Inhalation Method Using Essential Oils on the Preoperative Anxiety of Hystrectomy Patients (향기흡입법이 자궁적출술 환자의 수술전 불안에 미치는 효과)

  • Oh, Young-Hi;Jung, Hyang-Mi
    • The Korean Journal of Rehabilitation Nursing
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    • 제5권1호
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    • pp.18-26
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    • 2002
  • The purpose of this study was to elucidate the effects of inhalation method using essential oils on the preoperative anxiety of hystrectomy patients, and to provide effective and holistic nursing care to them. The research design was a nonequivalent control group non synchronized design. The data were collected from February 1 to March 31, 2002 at D Medical Center in Busan. The subjects were forty one patients that were operated on under general anesthesia for hystrectomy. They were assigned to two groups, twenty one subjects in the experimental group and twenty subjects in the control group. The tool of the Visual Analogue Scale(VAS) was used to anxiety on all patients the day before surgery and the preoperative period. Then systolic and diastolic blood pressure, pulse rate levels were measured the day before surgery and the preoperative period. The experimental group received two treatments of inhalation method using essential oils of with lavender, ylang ylang, and bergamot oil. The data were analyzed by the $X^2$ test and the independent t-test. The results of this study were summarized as follows: 1. Hypothesis 1: It has been supported that the experimental group received inhalation method using essential oils might cause lower level of the preoperative VAS anxiety than that of the control group(t=-2.93, p=.006). 2. Hypothesis 2: It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative systolic blood pressure than the control group(t=-.120, p=.905). It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative diastolic blood pressure than the control group.(t=1.766, p=.085). 3. Hypothesis 3: It has been supported that the experimental group received inhalation method using essential oils might cause lower level in preoperative pulse rate than the control group(t=5.853, p=.000). According to these results, inhalation method using essential oils can be considered an effective nursing intervention that relieves the preoperative anxiety of hysterectomy patients and stabilizes vital sign partially.

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A Case of Hepatitis Developing after Open Heart Surgery used Halothane Anesthesia (개심술 마취후 발생한 급성간염 1례)

  • Koo, Bon-Up
    • Journal of Yeungnam Medical Science
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    • 제5권2호
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    • pp.183-187
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    • 1988
  • Although halothane is one of the most widely used inhalation anesthetics, it may cause postanesthetic complications such as halothane hepatitis. Halothane hepatitis has been reported intermittentely with variable incidence. However it is not easy to prove halothane as a causative agent, because there are many factors causing postoperative hepatic dysfunction. The author had a case of acute hepatitis developing after open heart surgery used halothane. 37-year-old female underwent an open heart surgery for ASD repair under halothane anesthesia On the 14th postoperative day, she developed high fever of 38 C. Liver function tests showed marked elevation of SGOT, SGPT, and bilirubin, followed by gross jaundice. HB, Ag(-) and HB, Ab(+) were reported. She died of acute respiratory, hepatic, and renal failure on the 19th postoperative day Possible causes of the hepatitis were considered halothane, blood transfusion, and drugs.

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MANAGEMENT OF ADULT DENTAL PHOBIC PATIENTS (성인 치과공포증 환자의 치료)

  • Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • 제34권2호
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    • pp.341-348
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    • 2007
  • We dentists perform many of routine dental procedures and must deal with much of the population's dental anxiety and fear. Dentists have used many non-pharmacological modalities initially to overcome anxiety and fear, including distraction, empathy, desensitization, and so on. However, certain patients need pharmacological backup of anxiety and fear to conquer dental treatment. This article presents four cases to introduce the methods from nitrous oxide and oxygen inhalation to general anesthesia for difficult adult dental phobic patients to deal with.

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Selection of Appropriate Endotracheal Tube in Wild Birds

  • Jang, Jin-Ho;Park, Young-Seok;Kim, Hee-Jong;Kim, Hye Kwon;Yun, Young-Min
    • Journal of Veterinary Clinics
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    • 제35권5호
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    • pp.184-189
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    • 2018
  • Wild birds rescued for various reasons are injured and admitted to a wild animal rescue center. With the case of collision with cars, buildings and wires on a power pole, most wild birds are severely traumatized or get fractured, which need intensive veterinary treatment. In general, inhalation anesthesia to wild birds is the best choice for the medical and surgical procedure, and intubation is recommended for the stable anesthesia. Although the certain size of an endotracheal tube can be chosen depending on the size and morphology of the bird, there are a few standardized guidelines. Therefore, the optimal endotracheal size of the rescued 162 individual birds of 41 species for four years from March 2014 to December 2017 was investigated and sorted empirically, suggesting possibly the appropriate endotracheal sizes for diverse avian species. It may provide practical information data for wildlife veterinarians to select the size of an endotracheal tube according to the size of the domestic wild bird species, especially during surgery in the emergency cases.

CLINICAL STUDY ON POST-INTUBATION GRANULOMA (술후 발생한 기관 삽관성 육아종의 임상적 연구)

  • Lee, Jae-Yeol;Kim, Yong-Deok;Kim, Cheul-Hong;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권5호
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    • pp.417-421
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    • 2007
  • Post-intubation granuloma of the larynx is a rare complication of general inhalation anesthesia, which is associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubations and endotracheal movement. This study was performed retrospectively to evaluate symptoms, incidence, duration and site for prevention of the intubation granuloma. The authors investigated 16 patients of intubation granuloma among 719 patients during 1 year period from August, 2005 to July, 2006 at the Department of Oral & Maxillofacial Surgery, Pusan National University Hospital. The results were as follows. 1. The incidence was 16/719 cases(2.2%) 2. The female to male ratio was 7:1 3. Hoarseness was the main symptom 4. Most cases occurred after 2-jaw orthognathic surgery.

The Effects of Desflurane on Anesthesia Induction (마취유도시 Desflurane의 효과)

  • Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • 제11권1호
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    • pp.22-26
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    • 2011
  • Background: There is controversy regarding the relative perioperative benefits of desflurane when used for induction of anesthesia. Inhalation induction with desflurane alone causes adverse airway events, such as coughing, bronchospasm, laryngospasm, and copious secretion of varying severity. The aim of this study was to determine whether desflurane minimize cardiovascular activation during induction. Methods: Sixty ASA I and II patients were randomized to receive 1 MAC or 1.5 MAC of desflurane during manual vernilation or not. Patients received propofol (2 mg/kg) to induce loss of consciousness (LOC). Rocuronium (0.8 mg/kg) was given at LOC and the trachea was intubated after 90 seconds of manual breathing support with or without inhaled anesthetics. Vital signs and adverse airway events were recorded until 10 minutes post-intubation. Results: A significant increase in blood pressure and heart rate were seen in no desflurane group. The stable vital signs were seen in desflurane groups. The adverse airway events were increased in 1.5 MAC group but 1 MAC group. Conclusions: Desflurane was able to be stable blood pressure and heart rate at 1 MAC but adverse airway events were increased at 1.5 MAC of desflurane.