F. Y. Huang

Differences in Temperature Changes Between Pediatric and Adult Patients After Cardiopulmonary Bypass

Nasopharyngeal (NPT) and rectal (RT) temperatures were continuously monitored in 51 adult or pediatric patients undergoing cardiac surgical procedures until 1 hour after the termination of cardiopulmonary bypass (CPB). The measurement also included the lowest NPT achieved and the dwelling time at that temperature on CPB, the rewarming time, the time on CPB, and the time that the chest remained opened after CPB. After the termination of CPB, the decrease of NPT (afterdrop) was significantly greater in the adult group than in the pediatric group. The mean decrease in adult patients was 1.34 +/- 0.65 degrees C versus 0.63 +/- 0.8 degrees C in pediatric patients. The combination of the NPT at the end of bypass (EndNPT), body weight times the EndNPT, and the dwelling of the lowest temperature times the EndNPT could predict 45% of the afterdrop. It is concluded that afterdrop occurs to a lesser degree in pediatric patients than in adults. This may be due to more efficient supplying of external heat to pediatric patients in whom there is a larger body surface area to weight ratio.

Suppression of hemodynamic change before extubation—lidocaine through modified endotracheal tube

Twenty females, aged 31 to 49 years, scheduled for abdominal total hysterectomy were randomly divided into two groups in this study. An epidural catheter was placed at T11-12 before general anesthesia. All patients receive the combination of epidural anesthesia and general anesthesia for the operation and relief of pain postoperatively. The modified endotracheal tube we used is shown in Fig. 1. For patients in group I (Lidocaine group), 2 mL 4% lidocaine solution was injected through the catheter to desensitize the tracheal mucosa around the cuff after the surgeon had removed the uterus. In group II (Control group), no special management was made. All patients were not extubated until they were considered to be awake. Systolic blood pressure at three and one minute before extubation and pulse rate recorded at one minute before extubation showed in patients of group I were statistically smoother than those recorded in group II (p less than 0.01). All patients had gag reflex just after awake extubation.