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Intraoperative Carotid Sinus Hypersensitivity and Postoperative Complication of Radical Neck Dissection Retrospective Study
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Tae Il Kim, Hae Ja Lim, Seong Ho Chang, Nan Sook Kim
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Korean J Crit Care Med. 1998;13(1):49-54.
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 Abstract
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- BACKGOUND: Postoperative complications in the geriatric patients undergoing radical neck dissection are generally considered to be more severe than young patients. The incidence of carotid sinus hypersensitivity in elderly patients is also considered to be higher than the young. The comparison between old (above 65 years) and young (below 65 years) aged groups about intraoperative carotid sinus hypersensitivity and postoperative complication is necessary for safe anesthesia.
METHODS
Sixty five adult patients, of either sex, regardless of age, given radical neck dissection from January 1990 to January 1998, were investigated for the incidence of intraoperative carotid sinus hypersensitivity and postoperative hypertension by way of retrospective chart review. The authors also examined the postoperative complications such as high fever, pulmonary, cardiac and renal complications, cerebrovascular diseases and neurologic injuries.
RESULTS
The incidence of intraoperative carotid sinus hypersensitivity were 28% in elderly patients (n=25), 10% in young patients (n=40) but there was no statistical significance. The incidence of postoperative hypertension were 79.1% in patients with hypertension history, 34.1% in patients without hypertension history and there was statistical significance between the two groups (P=0.001).
The incidence of postoperative pulmonary complication were 44% in elderly patients, 20% in young patients, and there was also statistical significance between the two groups (P=0.038). There was no statistical significance in the incidence of postoperative high fever above 38.5degrees C between the two groups (p=0.059).
CONCLUSION
After the radical neck dissection, the geriatric patients had a greater incidence of postoperative pulmonary complications than young patients and the most relating factor to postoperative hypertension was previous history of hypertension. Therefore optimal preoperative preparations for the hypertensive patients and the prevention and immediate treatment of the postoperative pulmonary complications in geriatric patients are very important during the radical neck dissection.
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Pulmonary Edema due to Upper Airway Obstruction after Neck Mass Excision of the Patient with Cerebral Palsy
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Moon Seok Chang, Hun Cho, Hae Ja Lim, Seong Ho Chang, Nan Suk Kim
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Korean J Crit Care Med. 1997;12(2):183-186.
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Abstract
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- Because the emergence from anesthesia may be delayed in the patient with the cerebral palsy, extubation must be delayed until consciousness is recovered completely. Postoperative pulmonary edema has several causes and one of them, upper airway obstruction is rare. We had experienced pulmonary edema due to upper airway obstruction after neck mass excision in the patient with cerebral palsy, who was 21-year-old, 50 kg, male and normal preoperative laboratory data. There was no significant change in blood volume during operation for 1 hour. After operation, the patient breathed spontaneously and the endotracheal tube was extubated in the operating room. When the patient was transfered to the recovery room, he had cyanosis, intercostal and substernal retraction, and the pulse oximeter showed very low oxygen saturation. We supplied oxygen to the patient and reintubated him, and recognized the pinkish frothy sputum by suction of the endotracheal tube. On the portable chest X-ray film of the patient at the moment, hazy increased density on both lung fields indicating pulmonary edema, but the heart size was not increased. By routine treatment for pulmonary edema, the symtoms and signs of the patient were improved. He had stayed for 1 day in the SICU and then transfered to the general ward.
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Clinical studies on anesthesia for emergency operation of 915 cases
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Joung Uk Kim, Eun Hee Jeun, Hye Won Lee, Hae Ja Lim, Byung Kook Chae, Jung Soon Shin, Seong Ho Chang
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Korean J Crit Care Med. 1992;7(2):147-153.
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Abstract
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- No abstract available.
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Clinical survey of patients in intensive care unit from march 1990 to february 1992 in Korea University Anam Hospital
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Jae Hwan Kim, Joung Uk Kim, Hye Won Lee, Hae Ja Lim, Byung Kook Chae, Jung Soon Shin, Seong Ho Chang
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Korean J Crit Care Med. 1992;7(2):121-130.
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Abstract
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- No abstract available.
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Blood pressure monitoring with UV-101 noninvasive beat to beat finger blood pressure monitor
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Young Cheol Woo, Jong Uk Kim, Po Sun Kang, Hye Won Lee, Hae Ja Lim, Byung Kook Chae, Seong Ho Chang, Jung Soon Shin
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Korean J Crit Care Med. 1992;7(1):47-52.
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- No abstract available.
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