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탈극성근이완제 사용후 나타난 근육통과 전해질변동의 예방에 관한 연구
최세진,박성택,김영진 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.2
Postoperative muscle pain and transient increase in serum potassium concentration are well known to occur in man following intravenous administration of succinylcholine. A number of methods for prevention of muscle pain and serum electrolyte changes have been suggested but none of the technics has proved entirely effective. To investigate methods for the prevention of muscle pain and electrolyte changes after intravenous injection of succinylcholine, we studied four groups, a succinylcholine group and three pretreatment groups(d-Tc+succinylcholine, mioblock+succinylcholine, gallamine+succinylcholine). The results were as follows: 1) The incidence of muscle pain was 100% in the succinylcholine group and 63% in the pretreatment groups. Especially in the mioblock pretreatment group was noticed good result. 2) The muscle pain usually appeared within 24 hours after operation and disappeared within two days in pretreatment groups. 3) The degree of muscle fasciculation showed a significant decrease (from 80% to 30%) with pretreatment groups. 4) The degree of muscle relaxation during intubation in four groups were not significantly different. 5) In succinylcholine administration group, potassium concentration was slightly increased at 15 minute but significantly decreased at 45 minute. 6) In mioblock or d-Tc pretreatment group, sodium conentration was significantly decreased at 30 minute. 7) In gallamine pretreatment group, chloride concentration was significantly decreased at 45 minute.
Succinylcholine으로 유발된 Fasciculation과 Myalgia에 대한 Diazepam과 d-tubocurarine 전처치의 비교효과
최세진,길기진,이정은 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2
Succinylcholine-induced muscle pain well documented. It is common to use subparalyzing dose of a non-depolarizing muscle relaxant before succinylcholine and accepted in clinical practice forpreventing of succinylcholine-induced fasciculation and it's associated sequalae. But it is needed to give large dose of succinylchcline to offer adeguate relaxation for tracheal intubation in these pretreated cases. This present study was undertaken to compare the effect of diazepam with d-tubocurarine on succinylcholine induced side effects. Sixty cases were studied if four different groups. In 1st group : no pretreatment, 2nd group : diazepam(0.05mg./kg.), 3rd group : diazepam(0.1 mg./kg.), 4th group : d-Tc.(0.05mg./kg.). The following results were obtained : 1. Diazepam pretreatment groups had no significant changes for the prevention of muscle fasciculation following succinylcholine compare to control group, but prevention of muscle fasciculation by d-Tc. pretreatment were significant. 2. Conditions for intubation were excellent in all groups. 3. In the prevention of muscle pain, there was no significant difference between the control and diazepam pretreatment group but significant difference between the control and d-Tc. prtreatment. 4) There was no specific relationship between muscle fasciculation and muscle pain.
최세진,신효철 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2
Over the past several decades, blood and blood components have been increasingly recognized as medication rather than innocuous fluids used to replace modest blood lose at operation. But blood transfusions have the potential for many harmful side effects. Therefore, modern hemotherapy practice focuses on the benefits and risks, along with profer dosage, items with which blood component transfusion is concerned, when blgod transfusions are indicated. only that fraction of the blood that the patient requires should be administered. Most blood donations are separated into components after collection : red blood cells, platelet concentrates, and/or cryoprecipitates and plasma. No longer is "fresh whole blood" an appropriate response to a hemotherapeutic problem. This study was undertaken to evaluate transfusion according to surgical department, sex, preoperative hemoglobin values, blood type, transfusion amounts and blood component therapy. 3847 transfused patients among the total 21371 surgical cases done at the Chung-Nam National University Hospital from 1985 to 1989 were reviewed. The results are summerized as follow : 1. The numbers of transfused patients among the 21371 operative cases were 3847 cases (18%). 2. The number of male transfused was greater than that of female and third decade patient was the greatest incidence among the transfused patients. 3. Mostly hemoglobin value in preoperative state was maintained more than 10g/dl. 4. The blood types of transfused blood were in the great order of A. B, O, AB type. 5. The percentage of one pint transfusion was gradualy decreased and 2-5 pint transfusion was greatest percentage namely 57.94% 6. As the amount of blood transfused was increased, the percentage of blood compoent therapy was increased, and mixed case of PRC and FFP was the greatest incidence. 7. The greatest percentage of blood component therapy was in the cases of the orthopedic surgical operation.
체외순환시 Fentanyl 마취가 혈당 및 전해질의 변동에 미치는 영향
최세진,이정은,김태관 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.1
The effects of fentanyl anesthesia on the changes of hemodynamic(HR, BP), blood suger, electrolytes and ABGA during induction of anesthesia and cardiopumonary bypass under fentanyl anesthesia were studied in three groups of 30 patients. The results were as follows: 1) The changes of HR & BP were significatly decreased under fentanyl anesthesia compaired to morphine anesthesia. 2) The level of blood sugar was increased during whole procedures in all groups and it was the least in large dose fentanyl group. 3) The changes of electrolyte and arterial blood gas value during CPB were not remakable.
마취분야에서 Atropine과 Glycopyrrolate의 비교 연구
최세진,손수창 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2
When antagonism of nondepolarizing neuromuscular block is required, atropine has been used as an anticholinergic drug to counteract the muscarinic actions of neostigmine. Glycopyrrolate is a potent, long-acting anticholinergic agent and recently it has been recommended as a suitable alternative to atropine. This study was undertaken to determine whether glycopyrrolate does offer any difference from atropine in heart rate, arrhythmia, blood pressure, and oropharyngeal secretion. On 40 patients anesthetized with balanced techniques, the neuromuscular block produced by pancuronium was reversed with (Group I) atropine-neostigmine (1.0mg : 2. 5mg) or (Group II) glycopyrrolate-neostigmine (0. 4 mg : 2.5mg) mixture. The results are as follows : 1. The safety and effectivenss of both groups in antagonizing the muscarinc actiosn of neostigmine were demonstrated. 2. Glycopyrrolate group was superior to atropine group in producing less increased heart rate. 3. Glycopyrrolate group was superior to atropine group in producting lower incidence of bradycardia. 4. Glycopyrrolate was superior to atropine in the antisalivary action. 5. There were no significant differences on the incidence of arrhythmias in both groups. It is concluded that glycopyrrolate is an effective antimuscarinic agent and could be safely used as an alternative to atropine.
Labetalol 이 기관내 삽관에 의한 심혈관계 변동에 미치는 영향
최세진,손수창,조옥희 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.5
Arterial blood pressure, pulse rate and rate pressure product changes following tracheal intubation were studied in 50 patients undergoing elective surgical procedures who received a thiopental-succinylcholine anesthetic intubation sequence. Three treatment groups and a control group were observed. Intravenous labetalol doses of 0.25 mg/kg, 0.5 mg/kg and 1.0 mg/kg, injected prior to anesthesia, were compared with respect to their effect on the cardiovascular sequences to direct laryngoscopy followed by the passage of an endotraeheal tube. The increases in heart rate and rate-pressure product associated with tracheal intubation were significantly prevented in labetalol treated patients, significantly. The increase in arterial pressure was prevented, insignificantly. However, it was dose-dependent. From the above result, a pre-induction dose of labetalol was effective in attenuating the pressure response to laryngoscopy and intubation.