[Transcutaneous P(CO2) (TcP(CO2)) reflects Pa(CO2) of previous 1 or 2 minutes].

BACKGROUND: TcP(CO2) has been known to have delayed response compared with Pa(CO2). METHODS: We examined the degree of response delay in human adults. TOSCA500 (Radiometer) was used to measure TcP(CO2). Arterial blood was withdrawn every 1 minute for 20 times. Pa(CO2) was measured with Bayer348 blood gas analyzer. TcP(CO2) value was recorded simultaneously. RESULTS: TcP(CO2) values which are forwarded 0, 1, 2, 3 and 4 minutes are examined against Pa(CO2) by means of Bland and Altman analysis. Means of the difference in TcP(CO2) and Pa(CO2) are 0.9 mmHg, +0.9 mmHg, +1.0 mmHg, + 1.0 mmHg, + 1.0 mmHg and 2 SD are +/- 7.1 mmHg, +/- 6.2 mmHg, +/- 6.2 mmHg, +/- 7.2 mmHg, +/- 8.2 mmHg, respectively (N=105). CONCLUSIONS: In human adults values of TcP(CO2) measured by TOSCA500 are 1 or 2 minutes late compared with values of Pa(CO2) and considered to be a good monitor of Pa(CO2).

[A case of endotracheal intubation in prone position utilizing PENTAX-Airwayscope for morbidly obese patient].

We experienced the airway management of a morbidly obese patient in prone position utilizing PENTAX-Airwayscope (AWS) which is a novel airway device for endotracheal intubation. A 29-year-old man, who was 150 kg in weight and 51.9 kg x m(-2) in body mass index, was scheduled for the discectomy for lumbar disc herniation. After the topical anesthesia with lidocaine spray, the patient lay on his stomach by himself on the table. Following the induction of general anesthesia with ketamine and dexmedetomidine in prone position, an anatomically curved blade (INTLOCK) was inserted to his oral cavity first, then the body of AWS was attached. With the patient breathing spontaneously, we successfully inserted the reinforced endotracheal tube. After the maintenance of anesthesia with continuous infusion of dexmedetomidine, ketamin and remifentanil, the patient awoke clearly without pain and endotracheal tube was removed safely in the prone position. Although the prone position is not the standard position for endotracheal intubation under general anesthesia, our technique could be performed in emergency situations.

Comparison of sprotte and Quincke needles with respect to spinal fluid leakage using artificial spinal cord.

PURPOSE: This research investigated whether the Sprotte needle causes less leakage of CSF than the Quincke needle in the artificial spinal cord. METHODS: The changes in intradural pressure, extradural pressure, and leaked volume of CSF were evaluated following puncture with Sprotte and Quincke needles in the artificial spinal cord. RESULTS: The decrease in intradural pressure was 9.7±1.8 mm H2O with the Sprotte needle and 20.5±2.7 mm H2O with the Quincke needle (P<0.05). The volume of leakage of artificial CSF was 2.0±0.3 ml with the Sprotte needle and 3.3 ±0.3 ml with the Quincke needle (P<0.01). The extradural pressure increase was 166.1±8.2 mm H2O with the Sprotte needle and 186.8±13.2 mm H2O with the Quincke needle (P<0.05). CONCLUSION: The Sprotte needle produces less CSF leakage than the Quincke needle.