개심술시(開心術時) 마취에 대한 임상적 고찰

Abstract

[한글]

Clinical Observation of Open-heart Surgery by Hypothermia and Cardiopulmonary

By-pass under General Anesthesia

Gang Choi, M.D.

Department of Medical Science, The Graduate School, Yonsei University

(Directed by Prof. Hung Kun Oh, M.D.)

Under hypothermia and extracorporeal circulation 187 cases of open-heart surgery

were done between December 1963 and October 1974.

The results obtained are summarized as follows.

1. Out of 187 cases, 116 cases were male (62.0%) and 71 cases were female(37.9%).

2. There were 134 cases (72%) in A.S.D., V.S.D., and T/F and 70 cases (37%) in

the 0-10 age group and 154 eases (82%) in the 0-30 age group.

3. Premedicants were secobarbital (83.8%) and atropine(sulfate 27.9%).

4. Induction was mainly by the use of thiopental and succinylcholine after

preoxygenation with 100% O^^2, and anesthesia was maintained by N^^2O - O^^2,

halothane or methoxyflurane during maintenance. In case of right to left shunt,

more O^^2 was used.

5. During by-pass, anesthesia was maintained by hypothermia, muscle relaxants or

ketamine.

6. From 1963 to 1970, low flow and hypothermia were used with a Zuhdi-Greer

oxygenator and a sigma pump and since then high flow was used, utilizing various

bubble oxygenators with a De-Bakey's roller pump.

7. Blood pressure, E.L.G. pluse rate, C.V.P, respiration, temperature, urine

output, hemoglobin, hematocrit, blood gas study, pH, and electrolytes were

monitored before and during anesthesia.

8. There were 28 fatalities (15%) among 187 cases.

Death were mostly from bleeding, renal failure, and in A V block cases.

[영문]

Under hypothermia and extracorporeal circulation 187 cases of open-heart surgery were done between December 1963 and October 1974.

The results obtained are summarized as follows.

1. Out of 187 cases, 116 cases were male (62.0%) and 71 cases were female(37.9%).

2. There were 134 cases (72%) in A.S.D., V.S.D., and T/F and 70 cases (37%) in the 0-10 age group and 154 eases (82%) in the 0-30 age group.

3. Premedicants were secobarbital (83.8%) and atropine(sulfate 27.9%).

4. Induction was mainly by the use of thiopental and succinylcholine after preoxygenation with 100% O^^2, and anesthesia was maintained by N^^2O - O^^2, halothane or methoxyflurane during maintenance. In case of right to left shunt, more O^^2 was used.

5. During by-pass, anesthesia was maintained by hypothermia, muscle relaxants or ketamine.

6. From 1963 to 1970, low flow and hypothermia were used with a Zuhdi-Greer oxygenator and a sigma pump and since then high flow was used, utilizing various bubble oxygenators with a De-Bakey's roller pump.

7. Blood pressure, E.L.G. pluse rate, C.V.P, respiration, temperature, urine output, hemoglobin, hematocrit, blood gas study, pH, and electrolytes were monitored before and during anesthesia.

8. There were 28 fatalities (15%) among 187 cases.

Death were mostly from bleeding, renal failure, and in A V block cases.