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민경태 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.2
Many historical general anesthetics have been waxed and waned in the market of anesthetic field, mostly due to organ toxicities related to their metabolism, active metabolites and biodegradation,or other reasons. Modern anesthetics available now are known to undergo metabolism to the extent of clinical insignificance compared with the old ones. However, animal studies provided extensive evidences showing that general anesthetics are neurotoxic or neuroprotective in certain circumstances along with the advancement of knowledge on simultaneous neural injury and healing processes. Until now, there have been few prospective randomized clinical trials conducted to reveal these two issues. In fact, the concerns of the long-term effect of anesthetics on cognitive and behavior decline seem to be in arrears compared with those of the immediate effect of anesthetics, such as the rapidity of onset/offset of action, intraoperative hemodynamic controls or postoperative nausea and vomiting, etc. At present, we anesthesiologists, are challenged with the rapidly changing environments, in which the elderly population grows or a variety of sedation depth are required especially for patients of extreme ages. Concerns on anesthetics’effects with double edged sword are mounting from basic scientists and/or anesthesiologists, as well as public society, such as FDA in US. Therefore, I review the current findings from animal and human researches regarding the anesthetic potentials for neuroprotection and/or neurotoxicity under certain circumstances and their links with findings of clinical researches.
복강경 담낭절제술시 호기말 이산화탄소 분압과 동맥혈 이산화탄소 분압의 상관관계
민경태,박윤곤,박병석 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.6
During the laparoscopic cholecystectomy, the ventilatory and hemodynamic changes could occur due to the peritoneal insufflation of CO_2 as well as the position change. Various sults of the relationship between arterial and end-tidal PCO_2 in different conditions have been reported. The authars studied to determine how closely end-tidal PCO_2 reflects arterial PCO_2 before, during, and after laparoscopic cholecystectomy. Peak inspiratory airway pressures, arterial blood pressures and heart rates were also measured simultaneously. Peritoneal insufflation of CO_2 resulted in significant increase in peak inspiratory airway pressure and arterial blood pressure, but there were no significant changes in heart rates. Arterial and end-tidal PCO_2 increased during laproscopy and, although there was no statistical significance in P_(a-ET)CO_2, P_(a-ET)CO_2 increased during laparoscopy and retumed to perinsufflation level after deflation of CO_2. There was positive correlation between arterial and end-tidal PCO_2 before CO_2 insufflation, 10 minutes after CO_2 insufflation and 10 minutes after deflation of CO_2. However there was no correlation at 30 and 50 minutes after CO_2 insufflation. These results suggested that the arterial PCO_2 could not reflect end-tidal PCO_2 exactly, and intermittent arterial blood gas studies should be warranted during laparoscopic cholecystectomy.
요통한자(腰痛患者)에 대(對)한 경천골공(經薦骨孔) 경막외(硬膜外) 스테로이드 주입요법(注入療法) -병례보고(病例報告)-
민경태,윤덕미,오흥근,Min, Kyeong-Tae,Yoon, Duck-Mi,Oh, Hung-Kun 대한통증학회 1989 The Korean Journal of Pain Vol.2 No.1
Steroid and local anesthetics were injected into the epidural space through the posterior sacral foramen or lumbar approach in 4 patients for the purposes of relieving severe low back pain and radiculopathy. These patients were referred from other sections dealing with low back pain and radiculopathy, because one could not tolerate the surgical stress due to a heart problem, another two did not want the operation and the last had post-laminectomy status. All patients were satisfied with the results subjectively.