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Due to the development of anesthetic drugs and techniques, and the progress of monitor system. The rate of cardiac arrest during anesthesia has declined during the last decades. We report two cases of sudden cardiac arrest which happened during transurethral resection of the prostate, and discuss the mechanism, treatment, and the methods of prevention.

A case of severe hypoglycemia (30 mg/dL) after resection of unilateral pheochromocytoma is reported. Consciousness regained after 20 gm dextrose water was given intravenously. Rebound insulin storm is highly suspected as the main mechanism for the development of post-operative hypoglycemia. Administration of alpha and beta adrenergic blockers may also contribute to the severity of the hypoglycemia. Closely monitoring blood sugar level during the perioperative period is the only way to prevent the occurrence of such a catastrophe.

The safety and efficacy of patient-controlled analgesia used for postoperative pain relief were evaluated. Cumulative 24-hour requirements were analyzed for possible correlation with patient characteristics. All patients who used a patient-controlled analgesia device for postoperative pain relief were reviewed from June to October 1991. The device Baxter's basal/bolus infusor with patient control module, was used to deliver fentanyl in 379 patients. The fentanyl requirement, verbal analog pain score, first passage of flatus, side effects, sedative score, and degree of satisfaction were examined. The fentanyl requirement during the first 24 hours after operation was analyzed with regard to age, body weight, and sex. The daily fentanyl consumption in the first three postoperative days was 928 +/- 352 micrograms (n = 338), 553 +/- 259 micrograms (n = 220), and 490 +/- 222 micrograms (n = 71), respectively. The requirement for fentanyl during the first 24 hours after surgery was significantly higher than for the next two days (p-value < 0.001). Fentanyl consumption correlated well with body weight, and inversely with age. No difference was found between fentanyl consumption and sex (p-value = 0.4687). The mean time to the first passage of flatus in patients with abdominal surgery was 54.6 +/- 26.4 hours. The incidence of nausea, vomiting, and dizziness was similar, about 20% of patients. Itching was noted in 7% of patients. Oversedation (class 4) was found in three patients during the first operative day, the sedative score for other patients were around class 1-3. No patient exhibited signs of respiratory depression or withdrawal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

For hospital personnel, transmission of virus is a common and serious occupational hazard. Other than suffering from physical discomfort, these infected hospital staffs may also transmit the disease to patients through their blood, mucous or secretion contamination. The purpose of this study is intended to understand the condition of hepatitis B virus infection between anesthetists and hospital administration staffs. Forty-six anesthetists (study group) and 90 hospital administration staffs (control group) were volunteers of the study. Blood samples for serologic and biochemical test of hepatitis B virus infection in each participant were proceeded from October to December 1990. To investigate personal recognition about hepatitis B infection, each was requested to fill up a questionnaire after blood sampling. We also retrieved the chart of all participators for their annual hepatitis B serologic result in order to find out the incidence of seroconversion. Among the 136 participators, 20 (14.7%) were HbsAg carriers. Only 28 (20.6%) of all the participators were free from infection and seronegative. However, it was found that there was no significant difference (P greater than 0.05) between the two groups, no matter in HbsAg positive or seronegative incidence. There was 10 (1.27%) incidence of seroconversion during 790 times of person-year observation. Though not significant (P less than 0.05), there was a double fold (2.2 times) seroconversion rate in the study group than that of the control group. Twenty (19.9%) seropositive participators knew that they are hepatitis B carrier or had been infected. Generally, anesthetists seemed better than hospital administration staffs in realizing that they were infected or carrier from the data of serological test.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of a disposable non-electronic patient-controlled analgesia (PCA) device (Baxter) was evaluated in this study. Every patient under trial was instructed thoroughly how to use the PCA device before operation. The PCA device delivers a 25 mg IV injection of pethidine upon patient demand with a delay of 15 min between allowable administrations. The degree of patient satisfaction, the drug consumption, and the duration of using analgesia were compared with those in IM pethidine group. The results showed that, in the PCA group, the duration of using analgesic was longer; the drug consumption was greater (especially during the first 20 h after operation); and the degree of patient satisfaction was higher. The series comprised a total of 54 patients, 14 of whom complained of mild dizziness or nausea which did not require specific treatment. In sum, giving analgesic by the Baxter PCA device was a safe and effective alternative for IM analgesic in postoperative pain control.

A 60 year-old hypertensive male was operated with resection of epidermoid carcinoma of buccal mucosa. He was expired postoperation complicated with left middle cerebral artery infarction. The cerebral infarction may be induced by acute hypotension, improper position during operation and underlying disease associated with old age. Prevention methods included preoperative evaluation, immediately injection vasopressor when acute hypotension occurred during anesthesia, and avoidance of improper position to compress vertebral or carotid artery which may leading to cerebral perfusion insufficiency.