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박국양(Kook-Yang Park),김주이(Ju-E Kim),박철현(Chul-Hyun Park),김상익(Sang Ik Kim),김정철(Jung-Chul Kim),현성열(Sung-Yol Hyun),심현자(Hyun-Ja Shim),정미진(Mi-Jin Jung),권진형(Jin-Hyung Kwon),신익균(Eak Kyun Shin),임창영(Chang Young L 대한흉부외과학회 1998 The Korean Journal of Thoracic and Cardiovascular Vol.31 No.6
Tracheal necrosis and stenosis are rare complications of prolonged endotracheal intubation. A 62 years old female was performed cerebral aneurysmal neck clipping under general anesthesia via endotracheal intubation and transferred to the 12th intensive care unit. The patient was mechanically ventilated and tracheostomy was done on the postoperative day. Necrotic tissue, pus and stenosis were found around the ballooning site of the trachea. T-tube insertion was done on the both postoperative day and the patient was discharged on the 80th postoperative day.
Coronary artery bypass grafting(CABG) without extracorporeal circulation(ECC) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. We experienced a case of CABG without ECC in a 20 year old female patient with complete occlusion of the right coronary artery. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. Nitroglycerine and dopamine were given to stabilize the hemodynamics during intra- and post-operative periods. And esmolol was administered with a loading dose of 30 mg over 1 min, followed by a continuous infusion of 50∼100 g/kg/min to maintain the heart rate(50∼60 beats/min) and systolic blood pressure(60∼80 mmHg) during distal anastomosis. The patient was recovered uneventfully and discharged on the 8th postoperative day. (Korean J Anesthesiol 1997; 33: 381∼384)
Tracheostomy in infants and children is associated with a high rate of accidental decannulation in the early postoperative period. The most common complication in infants and children, which most often results in death, is accidental decannulation. Other authors advocate suturing tracheostomy tubes in place in infants and children under general anesthesia in operating room for avoiding decannulation. The authors designed tracheostomy tube for the prevention of accidental decannulation following tracheostomy in infant, so report with review of literatures.
Kyphoscoliosis is a disease manifested as lateral curvature of spine and accompanying rotation of the vertebrae, resulting in distortion of rib cage. Restrictive lung disease and pulmonary hypertension progressing to cor pulmonale are the major cause of mortality in patients with kyphoscoliosis. We had experienced a successful spinal and caudal epidural anesthesia for the open reduction and internal fixation with plate of fractured femur shaft in two patients with severe kyphosoliosis. We had chosen regional anesthesia as an anesthetic method because of there poor pulmonary function and severe deformities of thoracolumbar spine. We could achieve the adequate anesthetic sensory dermatome level, T_(5) and T_(8), for operation without any significant deterioration of blood pressure and respiration. We recommended that regional anesthesia is a useful anesthetic method for a patients with severe kyphoscoliosis when the operation on hip or lower extremity is required.