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      • KCI등재

        Effect of ketorolac on the prevention of emergence agitation in children after sevoflurane anesthesia

        Deokkyu Kim,고성훈,A Ram Doo,임형선,Ji Seon Son,Jun-Rae Lee,한영진 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.64 No.3

        Background: The purpose of this study was to evaluate the effects of ketorolac on the incidence and severity of emergence agitation in children recovering from sevoflurane anesthesia. Methods: Eighty-five children aged 3 to 7 years were randomly assigned to the control group or the ketorolac group (1 mg/kg ketorolac). The children were evaluated by the Pediatric Anesthesia Emergence Delirium Scale and a four-point agitation scale. Results: The median agitation scores did not differ significantly between the two groups. The overall incidence of emergence agitation was similar in the two groups (41% in the control group vs. 32% in the ketorolac group, P = 0.526). The number of children who received rescue drugs for treatment of emergence agitation was not significantly different between the two groups. Conclusions: The administration of 1 mg/kg of ketorolac is not effective in decreasing the incidence and severity of emergence agitation in children aged 3 to 7 years after sevoflurane anesthesia.

      • SCOPUSKCI등재
      • SCOPUSKCI등재

        증례보고 : 전신마취하 제왕절개술 중 발생한 뇌실내 출혈

        구희완 ( Hui Wan Koo ),손지선 ( Ji Seon Son ),한영진 ( Young Jin Han ),고성훈 ( Seong Hoon Ko ),송희선 ( He Sun Song ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2

        An intracranial hemorrhage is a fatal complication associated with general anesthesia. It can occur in patients with an intracranial aneurysm, hypertension, cerebral vascular malformation, and blood dyscrasia, etc. A sudden hemodynamic change during intubation and extubation in general anesthesia is dangerous, particularly in these patients. We encountered an intraventricular hemorrhage in a 42 year old pregnant woman after a cesarean section. The patient was induced with 300 mg of thiopental and 45 mg of rocuronium. The anesthesia was maintained with N2O/O2 and sevoflurane after endotracheal intubation. Five hours after surgery, the patient had a seizure at the ward. A MRI and CT scan of the brain showed a right intraventricular and basal ganglia hematoma. The CT 3-D brain angiography showed an unruptured small aneurysm on the right posterior communicating artery. (Korean J Anesthesiol 2006; 51: 257~60)

      • KCI등재

        The preanesthetic interview by anesthesiology residents: analysis of time and content

        Deokkyu Kim,Sung Nyu Lee,Dong-Chan Kim,Jeongwoo Lee,고성훈,Sang-Kyi Lee,Ji-Seon Son 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

        Background: A preanesthetic visit can increase a patient’s satisfaction. However, it is uncertain whether a preanesthetic visit by an anesthesiology resident can achieve the goal. We studied the time distribution for content of preanesthetic interviews (PI) and evaluated the patient’s satisfaction with the PI. Methods: We recorded the PI duration of 200 patients by a voice recorder. The degrees of patient satisfaction with the PI and the changes of anxiety level after the PI were quantified by a questionnaire. We analyzed the time distribution for content of the PI and the correlation between patient characteristics and PI duration or a patient’s satisfaction. Results: The total PI duration was 184 (134-286) sec (median, 25-75%), and the time distributions for content of the PI were 8 (5-10) of greeting, 45 (23-70) of history taking, 15 (10-20) of physical examination, 50 (25-98) for obtainingan informed consent, 20 (10-30) of explanation for anesthetic planning, 15 (5-28) for explanation of patient controlled analgesia, and 10 (0-4) sec for questions and answers. Age, ASA physical status, and educational level were correlated with PI duration (P < 0.001). The patient’s level of satisfaction was “very satisfied” in 39%,“satisfied” in 50%, and “moderate” in 11% of interviews. The anxiety level was “decreased” in 50%, “increased” in 8%,and “not changed” in 42% of patients. Conclusions: Although the duration of a PI given by residents was a relatively short, 89% of patients of were satisfied with the interview. The PI took a longer time to complete in patients of older age, higher ASA physical status, or lower educational levels. Background: A preanesthetic visit can increase a patient’s satisfaction. However, it is uncertain whether a preanesthetic visit by an anesthesiology resident can achieve the goal. We studied the time distribution for content of preanesthetic interviews (PI) and evaluated the patient’s satisfaction with the PI. Methods: We recorded the PI duration of 200 patients by a voice recorder. The degrees of patient satisfaction with the PI and the changes of anxiety level after the PI were quantified by a questionnaire. We analyzed the time distribution for content of the PI and the correlation between patient characteristics and PI duration or a patient’s satisfaction. Results: The total PI duration was 184 (134-286) sec (median, 25-75%), and the time distributions for content of the PI were 8 (5-10) of greeting, 45 (23-70) of history taking, 15 (10-20) of physical examination, 50 (25-98) for obtainingan informed consent, 20 (10-30) of explanation for anesthetic planning, 15 (5-28) for explanation of patient controlled analgesia, and 10 (0-4) sec for questions and answers. Age, ASA physical status, and educational level were correlated with PI duration (P < 0.001). The patient’s level of satisfaction was “very satisfied” in 39%,“satisfied” in 50%, and “moderate” in 11% of interviews. The anxiety level was “decreased” in 50%, “increased” in 8%,and “not changed” in 42% of patients. Conclusions: Although the duration of a PI given by residents was a relatively short, 89% of patients of were satisfied with the interview. The PI took a longer time to complete in patients of older age, higher ASA physical status, or lower educational levels.

      • SCOPUSKCI등재

        임상연구 : 전신마취 중 심전도의 교정 QT 간격에 대한 Ondansetron의 영향

        김종익 ( Jong Ik Kim ),이상귀 ( Sang Kyi Lee ),손지선 ( Ji Seon Son ),고성훈 ( Seong Hoon Ko ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

        Background: Prolongation of the corrected QT interval (QTc) has a potential risk of inducing life-threatening cardiac dysrhythmia. Although 5-HT3 antagonists are useful antiemetics, several cases of cardiac dysrhythmia after administration of 5-HT3 antagonists have been reported. Therefore, this study was conducted to evaluate the changes in QTc interval that occur after administration of a clinical dose of ondansetron during general anesthesia. Methods: Seventy-five patients, who underwent elective surgery under standardized general anesthesia were evaluated. After anesthetic induction, the patients were given either normal saline, 2 mg or 4 mg of iv ondansetron. The QTc on the electrocardiogram was measured immediately prior to administration of the treatment drug and then every minute after injection of the study drug for 10 minutes, 12 and 15 minutes. Results: There were no differences observed in the baseline QTc of the different treatment groups. In addition, there were no significant changes in the QTc interval of the control group, however, the QTc interval was prolonged significantly in both the ondansetron 2 mg and 4 mg groups. Further, ΔQTc (the difference in QTc interval from the baseline value) was significantly prolonged in the ondansetron 2 mg and 4 mg groups when compared with the control group. There were no differences in the number of patients who showed abnormal QTc and there were no incidences of dysrhythmia in any of the three groups. Conclusions: Ondansetron administration for emesis prophylaxis during general anesthesia was associated with statistically significant prolongation of the QTc interval. The authors recommend that caution be used when ondansetron is administered to prevent and/or treat postoperative nausea and vomiting, particularly in patients who have a prolonged QTc interval. (Korean J Anesthesiol 2007; 53: 704∼8)

      • KCI등재
      • KCI등재
      • KCI등재

        Tracheal rupture after endotracheal intubation - A report of three cases -

        임형선,Jung Hee Kim,Deokkyu Kim,Jeongwoo Lee,Ji-Seon Son,Dong-Chan Kim,고성훈 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

        Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change. Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change.

      • SCOPUSKCI등재

        상복부 수술 환자에서 경막외 Morphine의 술전 투여와 술중 투여시 진통 효과 비교

        김윤희(Yun Hee Kim),유래호(Rae Ho Yoo),고성훈(Seon 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1

        N/A Background: Preoperative analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurans and therefore may preempt postoperative pain. Although preemptive analgesia has shown to decrease postinjury pain in animals, studies in human are not consistent. We studied whether epidural morphine injection before surgical incision could affect postoperative pain and analgesic demands, compared with injection after removal of specimen. Methods: Forty patients scheduled for radical subtotal gastrectomy were randomly assigned to one of two groups for prospective study in a double-blind manner. Group 1 received an epidural injection of 3 mg of morphine in 8 ml of 0.9% saline before surgical incision, and group 2 after removal of specimen. Postoperative pain relief was provided with I.V. patient controlled analgesia (PCA) system. Numerical rating scales for pain and mood, Prince Henry Hospital scores for pain, cumulative PCA analgesic consumptions, and incidence of side effects were assessed at 2, 6, 12, 24, 48 hours after operation. Results: Cumulative PCA analgesic consumption in group 1 was significantly less than in group 2 at 2, 6 hours after surgery. Pain scores and the incidence of side effects were similar in both groups. Conclusions: Preoperative analgesia with epidural morphine showed little difference in patient controlled analgesic consumption after upper abdominal surgery compaired to intraoperative morphine

      • SCOPUSKCI등재

        양측성 안면신경 마비 치험 예

        최 훈(Huhn Choe),한영진(Young Jin Han),고성훈(Seon 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

        Facial nerve palsy is not an uncommon disease encountered at the department of otolaryngology or pain clinic. It usually occurs following viral infection(Bells palsy, BP), However, it is rare to develop bilaterally, and that not simultaneously. We experienced a rare case of bilateral facial nerve palsy. Patient first experienced left side paralysis, then right side paralysis approximately two months later. We treated the patient with serial bilateral stellate ganglion blocks(SGB), When left side paralysis improved, we performed unilatertal SGB for right side paralysis. Patient was also treated with intermittent electro-acupuncture stimulations, to right side first, then left side. Four months of treatment provided good results. This may be the first case, in Korea, of facial nerve paralysis bilaterally within a certain interval, treated with serial SGB and electro-acupuncture stimulation. However, the etiology of this bilateral BP was not fully confirmed as being a cause of viral origin.

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