Intravenous anesthesia


Anesthesia and Pain Medicine. 2004 Mar. 8(1): 8-14
ⓒ Korean Society for Intravenous Anesthesia
Preanesthetic Evaluation of Electircal Burns: High-Voltage vs Low-Voltage
Jung-won Hwang, M.D., Jeong-ki Lee, M.D.*, Young-tae Jeon, M.D., Jong-man Kang, M.D., Yong-Seok Oh, M.D., Gyu-jeong Noh, M.D.*, and Hyun Chul Kim, M.D.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, *Asan Medical Center, College of Medicine, University of Ulsan, Department of General Surgery, Hanil General Hospital, Seoul, Korea

Background: Electrical burn causes multi-organ damages even though skin lesion is small. In many cases, electrical burn also needs early operation to prevent further injuries (eg. extension of injury and amputation). But, it is difficult to know the patient\'s exact state at admission. So, we performed this study to get useful information from the patients with electrical burn. To perform this study, we reviewed clinical records of patients with electrical burn, who had undergone operations during recent 8 years.
Methods: We reviewed total 891 patients with electric burn: 294 patients with low-voltage injuries (group L) and 597 patients with high-voltage injuries (group H). We tried to find out the characteristics of high-voltage injury and low-voltage injury, and analyzed clinical differences between them. We reviewed clinical informations (age, sex, type of burn, entry and exit of burn) and laboratory data (EKG, CPK, CK-MB, LDH, AST, ALT) of patients with electrical burn.
Results: Most of the patients were male (90.5% in group L, 98.3% in group H). The patients\'mean age in group L was younger than that in group H. The most common cause of injury was direct contact in both groups. The second one was flame injury and arc injury followed next in both groups. Mean extent of injury was larger in group H (15.9%) than in group L (6.3%). The most common entry site was hand in both groups (80.3% in group L, 70.4% in group H), but the most common exit site was head (39.8%) in group L, and foot (43.0%) in group H. All laboratory values and incidence of abnormality were higher in group H than in group L. Mean period of abnormal AST and ALT was longer in group H than in group L.
Conclusions: Electrical burn causes multi-organ injuries involving muscle, liver and heart. High-voltage injury was more severe and normalized later than low-voltage injury. But, early operation before full recovery of organ function is necessary to prevent more damages. Discrimination of damaged organ by laboratory data is difficult. So it is impotant to know the mechanism of electrical burn, and history taking.
Key words : Electrical burn, high-voltage, low-voltage, AST, ALT
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