老人麻醉의 臨床的 考察 = Clinical Observation on Geriatric Anesthesia

국문 초록 (Abstract)

노인인구가 점차 증가함에 따라 노인마취례가 늘어나고 있으며 노인환자들은 젊은 연령층과 달리 높은 사망률과 위험한 술후 합병증을 초래할 수 있는 여러가지 요소를 가지고 있으므로 이에 저자는 노인마취에 있어서 적절한 술전평가와 준비, 마취중 관리 및 술후 합병증 예방을 위해 과거 5년간 본대학 마취과학교실에서 실시한 총 484예의 노인마취례를 분석하여 다음과 같은 결과를 얻었다.
총 10,310 마취례에 대한 노인마취례의 빈도는 4.7%였으며 매년 증가 추세를 나타내었고, 남녀비율은 1.3 : 1 이었으며 60~69세군이 358예(74.0%)로 가장 많았다. 일반외과 환자가 228예(47.1%)로 가장 많았고 선택수술이 응급수술의 2.5배였으며 응급수술중에서는 충수돌기절제술이 수위를 차지하였다. 전신마취는 272예(56.2%)에서, 척추마취는 167예(34.5%)에서 행하였으며 전신마취시에는 neuroleptanesthesia를 가장 많이(46.1%) 사용하였다. 동반질병으로는 고혈압이 118예(24.4%)로 가장 많았고 마취중 합병증으로는 저혈압이 54예(11.2%)로 가장 많았다. 마취중이나 마취후 회복실에서의 사망률은 없었다.

다국어 초록 (Multilingual Abstract)

As geriatric population has increased annually, geriatrics has become increasingly important in recent years.
The author analyzed 484 cases of geriatric anesthesia, who were over 60 years of age, out of 10, 310 cases of total anesthesia performed from January, 1976 to December, 1980 at Dept. of Anesthesiology, Ewha Womans University Hospital.
The results obtained were as follows:
1) Out of the total 10, 310 cases, geriatric cases over 60 years of age were 484 cases(4.7%) and showed gradually increasing tendency for the last 5 years.
2) Among the 484 cases of geriatric anesthesia, 272 cases were male(56.2%) and 212 cases female(43.8%). In the age distribution the majority was the age group of 60-69 years.
3) In the section of surgery, 229 cases(47.1%) were general surgery, 103 cases(21.3%) urology, 81 cases(16.7%) orthopedic surgery, 31cases (6.5%) gynecology and 28 cases(5.8%) neurosurgery.
4) Elective operations were 347 cases (71.7%) and emergency 137 cases (28.3%).
5) General anesthesia was performed in 272 cases(56.2%), 167 spinal cases (34.5%), 26 intravenous cases(5.4%) and 19 epidural cases(3.9%).
6) Thiopental, as an induction agent, was injected in 212 cases(80.6%) and diazepam in 51 cases (19.4%).
7) Diazepam and meperidine, as primary agent of general anesthesia, was used for 223 cases(46.1%), halothane for 49 cases(10.1%), diazepam alone for 17 cases(3.5%) and N_2O for 6 cases(1.2%). In regional anesthesia, tetracaine was used for 167 cases(34.5%), lidocaine for 16 cases(3.3%) and bupivacaine for 2 cases(0.4%).
8) Among the pre-existing diseases, hypertension was the most frequent disease(118 cases, 24.4%), and cardiac arrhythmia, pulmonary tuberculosis and diabetes mellitus were the diseases occuring in the order of frequency.
9) Complications during anesthesia were hypotension in 54 cases(11.2%), delayed recovery of consciousness in 9 cases(1.9%), cardiac arrest in 5 cases(1.0%) abd respiratory arrest in 1 cases(0.2%).
10) There was no mortality during anesthesia and recovery room care.