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Propofol 마취하 후두 미세 수술시 Clonidine 전투약이 술중의 활력징후와 술후 회복에 미치는 영향
신상욱,유길준 대한정맥마취학회 1999 정맥마취 Vol.3 No.4
서론: 현수 후두경하 수술은 환자에게 짧은 시간 동안 강한 자극을 주어서 술중의 활력징후에 많은 변동을 야기한다. 이를 둔화시기 위해 환자에게 clonidine을 전투약하고 이에 의한 혈압과 심박수의 변화 및 회복 시간을 clonidine을 전투약하지 않은 대조군과 비교하였다. 방법: 42명의 환자를 두 군으로 나누어 clonidine 전투약군(C군)에는 clonidine 150 ㎍을 전추약하고 대조군(N군)은 clonidine 전투약을 하지 않았다. Fentanyl 1 ㎍/㎏, propofol 2 ㎎/㎏, succinylcholine 1 ㎎/㎏으로 마취를 유도하고, propofol 6 ㎎/㎏/hr로 마취를 유지하면서 현수 후두경하의 후두 미세수술을 시행하였다. 기관내 삽관 전후, 술중, 술후의혈압과 심박수를 측정하였고 두 군간의 차이를 비교하였다. 또 술중에 투여된 esmolol의 양, 자발호흡의 회복 시간, 발관까지의 시간, 마취회복 후의 부작용 등을 조사하고 비교하였다. 결과: 마취유도, 기관내 삽관, 마취회복 등에서 활력징후의 변화 양상은 두 군간에 차이가 없었고, 마취회복 시간에서도 두 군간의 차이는 없었다. 추가로 투여된 esmolol의 양에서도 두 군간의 차이가 없었다. 마취회복 후의 부작용은 모든 환자에서 관찰되지 않았다. 결론: Propofol을 이용한 정맥마취에서 현수 후두경하 수술을 시행할 시 clonidine 150 ㎍ 전투약은 술중 활력징후의 변화와 마취회복에 영향을 미치지 못한다. Background; Anesthetic techniques for laryngeal microsurgery aims on modulation of sympathetic stimulation, good relaxation and rapid recovery from deep anesthesia. This study was designed to compare the effects of the clonidine premedication on the cardiovascular responses and the anesthetic recovery during suspension laryngoscopic microsurgery under propofol anesthesia. Methods: 42 patients scheduled for suspension laryngoscopic microsurgery were divided into two groups randomly. one group was premedicated with 150 ㎍ of oral clonidine 1 hour before surgery, and the other was not. All patients were administered fentanyl (1 ㎍/㎏), propofol (2 ㎎/㎏) and succinylcholine (1 ㎎/㎏), and then intubated. Propofol (6 ㎎/㎏/hr) was continuously infused for anesthetic maintenance. We compared systolic and diastolic arterial pressures and heart rates before anesthetic induction(baseline), after induction, 1, 3, 5 minutes after intubation, end of surgery, 5, 30, 60 minutes and 6 hours after surgery between two groups. We also checked the recovery time of self-respiration, the time to extubation. total amounts of esmolol administerd for additional control of vital signs and anesthetic complications including delayed recovery. Results: The blood pressures and heart rates during operation were not different between two groups, anesthetic recovery times and total amounts of esmolol were not different also. There was no anesthetic complication in all patients. Conclusions: From this results, it seems that the premedication with 150 ㎍ of oral clonidine had not additional benefits on the blood pressure and heart rate during suspension laryngoscopic microsurgery under propofol anesthesia.
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투여시기에 따른 경막외 모르핀의 술후 진통효과에 대한 비교
신상욱,김해규,노창기 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.3
Background : The initiation of treatment seems to be important in provoking preemptive analgesia and to provide excellent postoperative pain control. To verify the effectiveness of postoperative analgesia and preemptive effects, pre-incisional and post-incisional epidural infusion of morphine and bupivacaine mixture were compared. Methods : Patients scheduled for elective upper abdominal surgery were divided into 2 groups. Each group received 2 mg of morphine in 10 ml of 0.25% bupivacaine as a bolus followed by 0.1 mg/ml/hr of morphine infusion in 0.125% bupivacaine epidurally. In post-incisional group, the epidural injection of mixture was started 15 minutes after skin incision and in pre-incisional group, the epidural infusion of mixture was started 15 minutes before skin incision. Each groups were evaluated in visual analogue scales(VAS) for pain, pain scores in movement, and total administered doses in postoperative 1, 2, 4, 8, 24, 48, and 72 hours and compared with each others. Results : There were no differences between pre-incisional and post-incisional start of continuous epidural mixture infusion of morphine and bupivacaine in VAS for pain, pain scores at movement, and total amount of infused doses for 72 hours postoperatively. Also, there were no differences in the incidence of complications and satisfactions of patients between two groups. Conclusions : The continuous epidural mixture infusion of morphine 0.1 mg/ml/hr in 0.125% bupivacaine following a bolus dose of 2 mg morphine in 0.25% 10 ml bupivacaine has no difference in postoperative analgesic effect whether it starts after or before surgical incision. (Korean J Anesthesiol 1997; 33: 523∼528)
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신상욱,송창영,이상범,김용수 대한건축학회지회연합회 2007 대한건축학회연합논문집 Vol.9 No.4
Construction work, in its special quality, has a wide open risk according to the escalation. In case of the public construction, the national law of contract and the subcontracting law regulates the control of contract amount in order to curtail contractor's burden of this risk and enable original contractors and subletting contractors to be applied by the regulation of the law. In this sense, it has been necessary for the original contractors and the subletting contractors to be arbitrated by the appropriate amend of the related constitution in the wake of the possible occurrence of disadvantage due to quite a different interpretation for the control of contract amount between them caused by the various amount of production for the escalation with their argument in different views from their subletting amount because of the ambiguity of the subcontracting law clauses. This study aims at presentation of an appropriate alternative idea of controlling the contract amount according to escalation between the original contractors and the subletting contractors, analyzing the current articles related to escalation in the subcontracting law
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해안방어 무기체계 효과분석 방법론: 사례연구를 중심으로
신상욱,최봉완,오천균,조한무 한국군사과학기술학회 2019 한국군사과학기술학회지 Vol.22 No.1
As the types of North Korea's provocation are diverse and unexpectable in the costal area, ROK navy needs to develop countermeasures, such as costal defence guided rockets. Recently ROK navy developed the PKX-B which is equipped with the new 130 mm guided rocket. The most popular rockets are LOGIR for short range targets, 130 mm guided rocket for middle range targets and Spike-NLOS for long range targets. As various guided rockets are developed, it is required to develop a guided rocket analysis model and it's analysis methodology. In addition, these guided rockets can be installed on any platforms; ground vehicle, aircraft and warship. The paper proposes systematic methodology to estimate the operational effectiveness of costal defence guided rockets. A case study exploiting the ARENA simulation model is explained to demonstrate the implementation of the proposed methodology.
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