Journal of Yeungnam Medical Science

Il Sook Seo

6 Articles

Management of Perioperative Hypothermia: Il Sook Seo; Yeungnam Univ J Med. 2007;24(2 Suppl):S87-95. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S87

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Anesthesia and surgery commonly cause substantial thermal perturbations. Mild hypothermia (33.0∼36.4℃) results from a combination of anesthetic-induced impairment of thermoregulatory control, a cool operating room environment, and factors unique to surgery that promote excessive heat loss. Perioperative mild hypothermia is extremely common and associated with adverse outcomes such as excessive sympathetic nervous system stimulation, prolonged drug metabolism, impaired platelet activity, impaired immune function and postanesthetic shivering. Prevention of perioperative hypothermia and post-anesthetic shivering improves the outcome in terms of reduced cardiac morbidity and blood loss, improved wound healing and shorter hospital stay. Core temperature monitoring, accompanied by passive and active methods to maintain normothermia, should be part of routine intraoperative monitoring for patients at high risk of perioperative hypothermia, particularly patients undergoing body-cavity surgery, surgery greater than 1 hour duration, younger children and the elderly.

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Effect of the ASPAN Guideline on Perioperative Hypothermia Among Patients With Upper Extremity Surgery Under General Anesthesia: A Randomized Controlled Trial
Sookyung Kang, Soohyun Park
Journal of PeriAnesthesia Nursing.2020; 35(3): 298. CrossRef

Management of Unilateral Airway Obstruction During Nasotracheal Intubation: Il Sook Seo; Yeungnam Univ J Med. 2007;24(2 Suppl):S702-709. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S702

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Abstract PDF: Nasotracheal intubation is commonly used in patients undergoing maxillofacial surgery. The tracheal tube is passed through the nasal cavity after induction of anesthesia, followed by direct laryngoscopy to insert the tube into the trachea under direct vision by using Magill forceps. Various complications resulting from nasal passage of the tube, such as epistaxis, turbinectomy or retropharyngeal dissection, have been reported. The most common complication of nasotracheal intubation is epistaxis and several recommendations have been made to reduce its incidence. In spite of efforts such as local application of vasoconstrictive drugs, thermosoftening of the tube, and use of a nasopharyngeal airway as a pathfinder, epistaxis cannot be prevented entirely. This case report describes an 18-year-old female patient with difficult nasal intubation due to narrow nasal passageway. The patient was admitted for mandible angle splitting ostectomy and angle resection for cosmetic purpose. Epistaxis had occurred due to repeated nasotracheal intubation attempts, and blood had been aspirated. After intubation, the patient was desaturated (SpO₂<92%) with asymmetric inflation of the chest wall during controlled ventilation. We took frequent suction and tube lavage with saline, thereafter changed patient’s position to right lateral decubitus, and chest percussion was done with a face mask and the palm of the hand. About 20 minutes after aspiration, the SpO₂ was restored to 98%, and the operation proceeded, which finished uneventfully. On the next day, the chest x-ray revealed segmental atelectatic change in the right lung field, and nasal packing was done because of recurrent epistaxis. The patient was discharged on the 4th postoperative day without complications.

Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet.: Gul Jung, Woo Mok Byun, Hyung Jun Lim, Jong Gyun Kim, Dong Min Kwak, Deok Hee Lee, Sae Yeon Kim, Sun Ok Song, Il Sook Seo, Dae Lim Jee, Heung Dae Kim, Dae Pal Park; Yeungnam Univ J Med. 2007;24(2):344-344. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.344

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Abstract PDF: Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia.: Ji Yoon Kim, Dong Won Lee, Il Sook Seo, Sae Yeon Kim; Yeungnam Univ J Med. 2007;24(2):206-215. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.206

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Abstract PDF

BACKGROUND
The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. MATERIALS AND METHODS:Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by NICO(R). We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. RESULTS: In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. CONCLUSION: The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions
Ji Young Moon, Bo Hwan Kim
Journal of Korean Biological Nursing Science.2015; 17(2): 114. CrossRef

Pediatric Outpatient Anesthesia.: Il Sook Seo; Yeungnam Univ J Med. 2001;18(2):145-169. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.145

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Abstract PDF: In recent years, health care cost containment concerns have resulted in an increase in outpatient (or same-day) surgery. Many procedures previously performed on an inpatient surgery basis have been shifted to outpatient settings. Anesthesia for outpatient surgery is exactly the same as inpatient anesthesia, except that the primary concern is the selection of patients who can be discharged safely on the day of surgery. The anesthesiologist should have a sound rational basis for choice of pharmacologic agents that are geared to expeditious patient discharge from the hospital. Cost concerns aside, outpatient surgery has many additional advantages in the pediatric setting. It minimizes the length of time the child is hospitalized, decreases separation anxiety, promotes parental involvement in the child's postoperative care in the more congenial environment of home, and decreases risk of nosocomial infection and iatrogenic illness.

Analgesic Effects of Lumbar Epidural Narcotics for Relief of Upper Abdominal Post-operative Pain.: Il Sook Seo, Bon Up Koo; Yeungnam Univ J Med. 1985;2(1):39-44. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.39

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Abstract PDF: To assess the effect of postoperative pain control of upper abdominal surgery through lumbar epidural narcotic injection, the 3rd or 4th lumbar epidural puncture was done, and were injected 1 mg of morphine (Group I) or 10 mg of demerol (Group II) mixed with 10 ml of normal saline into the epidural space, after operation of the cholecystectomy in 10 patients and antrectomy and vagotomy, subtotal or total gastrectomy in 10 patients. Time interval of the postoperative analgesic effect between morphine and demerol groups were compared. The results of this study were as follows: 1. In the group I, average analgesic duration was 29.4 hours. 2. In the group II, average analgesic duration was 4.0 hours. It is concluded that postoperative pain control of upper abdominal surgery through the lumbar epidural narcotic injection was effective, and morphine injection was more effective than demerol.

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