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Moon Seok Chang 2 Articles
The Effect of Epidural Block on Renal Function in Patients Undergoing Subtotal Gastrectomy with General Anesthesia
Moon Seok Chang
Korean J Crit Care Med. 2005;20(1):44-48.
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AbstractAbstract PDF
BACKGROUND
Epidural block is widly used for anesthesia or analgesia, so many researches has been done in the field of cardiovascular system. And we reported the effects of epidural block on renal function in patients undergoing total abdominal hysterectomy with general anesthesia. In this research I evaluated the effect of epidural anesthesia on renal function in patients undergoing subtotal gastrectomy with general anesthesia. The earlier was in lumbar level and the later was in thoracic level. METHODS: We studied 15 patient who were in ASA 1 or 2. The epidural catheter was inserted via 17 gauge Tuohy needle through the T10-T11 intervertebral space of the patients before general anesthesia. Anesthesia for all the patients were maintained with isoflurane, nitrous oxide and oxygen. We measured urine output and hemodynamic profiles such as mean arterial pressure, pulse, CVP, cardiac output during 2 hours of general anesthesia period. And then we injected 10ml of 0.15% bupivacaine to the epidural space and measured the same parameters as those of general anesthesia period during another 2 hours of epidural anesthesia combined with general anesthesia. We also compared urine output and renal function (creatinine clearance, Na clearance, fractional excretion of Na and free water clearance) between each of the two periods. RESULTS: Mean arterial pressure and pulse were lower after epidural injection than before (p<0.05), but Cardiac output and CVP were not significantly different between two periods. Renal function data were not significantly different between the two periods.
CONCLUSIONS
Renal function was maintained during sympathetic block by thoracic epidural anesthesia combined with general anesthesia.
Pulmonary Edema due to Upper Airway Obstruction after Neck Mass Excision of the Patient with Cerebral Palsy
Moon Seok Chang, Hun Cho, Hae Ja Lim, Seong Ho Chang, Nan Suk Kim
Korean J Crit Care Med. 1997;12(2):183-186.
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  • 7 Download
AbstractAbstract PDF
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.

ACC : Acute and Critical Care