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임상연구 : 복강경하에 담낭절제술을 받는 환자에서 Propofol과 Remifentanil을 이용한 전 정맥마취와 Sevoflurane과 Alfentanil을 이용한 마취의 비교
구은혜 ( Eun Hye Koo ),김현정 ( Hyun Jung Kim ),김희주 ( Hee Zoo Kim ),오혜란 ( Hye Ran Oh ),이일옥 ( Il Ok Lee ),김난숙 ( Nan Sook Kim ),이미경 ( Mi Kyung Lee ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Background: The aim of this prospective, double-blind randomized study was to compare the clinical properties of sevoflurane-alfentanil with propofol-remifentanil anesthesia in patients undergoing a laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery received total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-alfentanil. The TIVA group was induced with propofol 5μg/ml and remifentanil 4.5 ng/ml. The anesthesia was maintained with a continuous infusions of propofol 2.5μg/ml and remifentanil 3 ng/ml. The sevoflurane-alfentanil group was induced with alfentanil 15μg/kg and propofol 1.5 mg/kg IV. Maintenance was obtained with 2.0 vol% sevoflurane and a bolus of alfentanil 10μg/kg IV where needed. Results: There were no significant differences in the systolic and diastolic blood pressure and heart rate between the two groups. There were no significant differences in the time to eye opening, the time to extubation, post-anesthetic recovery room stay time and the incidence of postoperative nausea and vomiting between the two groups. Conclusions: Propofol-remifentanil (TIVA) and sevoflurane-alfentanil both provided satisfactory anesthesia for a laparoscopic cholecystectomy. (Korean J Anesthesiol 2006; 51: 24~8)
증례보고 : 복직근의 통증 유발점에 의해 발생한 복부 통증
김현정 ( Hyun Jung Kim ),구은혜 ( Eun Hye Gu ),오혜란 ( Hye Ran Oh ),공명훈 ( Myoung Hoon Kong ),이미경 ( Mi Kyung Lee ),최상식 ( Sang Sik Choi ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Three cases of the abdominal pain, which are derived from the rectus abdominis, were presented. The abdominal pains of unknown origin are frequently misdiagnosed as arisen from visceral sources. That brings inappropriate diagnostic tests and unsatisfactory treatments. If patients have no intraabdominal cause, we must pay attention to the possibility that patients with abdominal pain may suffer from this presumed nerve entrapment syndrome or myofacial pain syndrome. Rectus abdominis syndrome is causes by entrapment of an anterior cutaneous branch of one or more thoracic intercostal nerves. Myofacial pain syndrome is defined as the sensory, motor and autonomic symptoms caused by the myofacial trigger points. The authors report three cases of abdominal pain caused by trigger point in the rectus abdominis muscle. On physical examination, trigger points in the rectus abdominis muscle were found, and abdominal pain was successfully treated by trigger point injections. (Korean J Anesthesiol 2006; 51: 243~5)
신장 ; 혈액투석 환자에게서 Biohole(TM) 쐐기를 이용한 Buttonhole 천자법의 임상적 유용성
최수정 ( Soo Jeong Choi ),이설형 ( Seol Hyoung Lee ),조은희 ( Eun Hee Cho ),오혜란 ( Hye Ran Oh ),김은정 ( Eun Jung Kim ),박무용 ( Moo Yong Park ),김진국 ( Jin Kuk Kim ),황승덕 ( Seung Duk Hwang ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Background/Aims: Buttonhole cannulation has been popular because it provides an easy puncture, is less painful, and requires less time for hemostasis. However, the technique requires a skilled staff and a long time to form the tract. A new buttonhole technique using Biohole(TM), which shortens the time needed for tract formation, has been introduced in Europe, North America, and Japan. Methods: We prepared a cannulation tract using the buttonhole technique and Biohole(TM) over a two-week period and compared the 12-week outcomes between patients who underwent the rope-ladder versus buttonhole techniques. Results: The 40 patients (27 males) had a mean age of 49.1±14.2 years. Thirteen and 27 patients were cannulated with the rope-ladder and buttonhole techniques, respectively. Patients who underwent the buttonhole technique had more initial pain than did those who received the rope-ladder technique (p=0.044). The Biohole(TM) procedure improved puncture pain (5.6 vs. 3.4, p=0.003) and shortened hemostasis time (1.8 vs. 1.3, p=0.001). Over a two-week period, patients using Biohole(TM) experienced dislocation (20.8%), bleeding at peg sites (8.6%), and pain during peg change (2.4%). Over the 12 week study period, patients who underwent the buttonhole technique had insignificantly less pain than did those who received the rope-ladder technique (p=0.088), but the former had less bleeding time than the latter (p=0.000). One patient who received the buttonhole technique experienced one episode of infection (p=0.327). Conclusions: The new buttonhole technique using Biohole(TM) is safe and useful in the short term. A long-term, larger, multicenter study is required to confirm these results. (Korean J Med 2012;82:307-312)
증례보고 : 단계적 양측성 경동맥소체 종양 제거술 후 발생한 급성 폐부종
기유미 ( You Mi Ki ),공명훈 ( Myoung Hoon Kong ),오혜란 ( Hye Ran Oh ),이일옥 ( Il Ok Lee ),이미경 ( Mi Kyoung Lee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
We report a case of pulmonary edema developed in a 33-year-old female who underwent two-stage bilateral carotid body tumor excision. About 1 month ago, she had undergone a left carotid body tumor excision. After the operation, her tongue was deviated to left side. Bilateral hypoglossal nerve injury was suspected. These injuries should be carefully monitored in patients who will undergo a similar procedure on both sides because a bilateral deficit of the hypoglossal nerve is poorly tolerated, resulting potentially serious pulmonary edema. In recovery room, she became pale and SpO2 was fall down. We reintubated her immediately and the pulmonary edema was treated using a supportive management. She was discharged without any signs of dyspnea or airway obstruction, but hypoglossal nerve injury remained. We discuss the possible etiology of the upper airway obstruction after the neck surgery and review the literatures associated with the pulmonary edema following upper airway obstruction. (Korean J Anesthesiol 2007; 53: 274~6)