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복부 수술 환자에서 술 중 고농도 산소와 수액요법이 술 후 초기 PONV와 통증에 미치는 효과
곽미숙,최수주,윤진선,이상민,함태수,길종윤,김명희 대한마취통증의학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Background: The previous studies on the influence of perioperative supplemental oxygen or generous fluid on postoperative nausea and vomiting (PONV) were inconsistent. We hypothesized in this trial that together with supplemental intraoperative oxygen and liberal fluid therapy would decrease PONV and pain. Methods: Two hundred ASA 1 or 2 patients undergoing laparotomy and laparoscopic abdominal or gynecological surgery were randomly assigned to one of 4 groups: intraoperative FiO2 0.3 and crystalloid 6 ml/kg/h; FiO2 0.3 and 18 ml/kg/h; FiO2 0.8 and 6 ml/kg/h; FiO2 0.8 and 18 ml/kg/h. The incidence of PONV, nausea and pain scores, and amount of rescue antiemetic and analgesic drugs were studied. Results: Overall incidence of PONV was 38%, 50%, 48%, 44% for group 1, 2, 3, and 4, respectively. There were no statistically significant differences among the 4 groups in the incidence of PONV, degree of nausea and pain, and the amount of antiemetics and analgesics in 2, 6, and 24 h postoperatively. The number of laparotomy and laparoscopy, and gender ratio were similar among the groups. Conclusions: We could not demonstrate an advantage of combination of intraoperative supplementary oxygen and liberal fluid in reducing PONV, pain, and amount of antiemetics and analgesics after intra-abdominal surgery.
추가적 산소의 주입이 수술 후 오심, 구토, 통증과 스트레스 호르몬에 미치는 영향
곽미숙,최수주,윤진선,김명희 대한마취통증의학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Background: Supplemental oxygen has been reported to diminish postoperative nausea and vomiting (PONV). Surgical trauma causes increased response of stress hormones. Therefore, we aimed to investigate whether supplemental oxygen attenuates release of adrenocorticotrophic hormone (ACTH) and cortisol as well as PONV in patients undergoing thyroidectomy. Methods: One hundred female patients were randomly assigned to two groups: 30% oxygen (Group 30) and 80% oxygen (Group 80). The incidence and the severity of PONV and pain score were evaluated 2, 6, 24 h postoperatively. PaO2, ACTH and cortisol were measured in 40 patients before tracheal intubation under 100% oxygen and at the end of surgery under designated oxygen concentration. Results: The PaO2 at induction was similar between the groups, but significantly higher in the group 80 than group 30 at the end of surgery. There were no differences in the incidence and the severity of PONV and pain score postoperatively between the groups. ACTH increased significantly at the end of surgery in both groups, but cortisol did not. There were no differences in ACTH and cortisol between the groups. Conclusions: Supplemental oxygen during thyroidectomy did not reduce the incidence and severity of PONV, postoperative pain, and stress hormone responses.
곽미숙,최현주 한국교육치료학회 2023 교육치료연구 Vol.15 No.3
This study conducted a meta-analysis to assess the effectiveness of dance movement therapy programs in South Korea. We selected 58 studies from 2005 to January 2022 that met specific criteria, such as degree theses and pre-post experimental design. The overall effect size, calculated using a random-effects model, was found to be substantial at 1.43. We found that the programs targeting males and older adults had the highest effect size, those explicitly incorporating a theoretical approach showed better results, and there were no significant differences based on dependent variables. Additionally, programs with 16 to 20 participants, 10 to 14 sessions, and session durations of 60 to 90 minutes demonstrated the most significant effect sizes. This research provides valuable insights into the development and operation of dance movement therapy programs in South Korea.
전신 마취후 발생한 전율현상에 대한 Meperidine, Doxapram, Fentanyl 의 치료 효과
곽미숙,강양자,최윤정,염광원 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.2
Background : Shivering is a common postanesthetic complication. Because all shivering patients feel uncomfortable and increase oxygen consumption, various attempts have been made to prevent its occurrence or to control it. Among the pharmacological methods of treating shivering, meperidine has been known to be the most effective. This study was designed to evaluate whether there was any difference among meperidine, fentanyl, doxapram and normal saline in the treatment of post-anesthetic shivering. Methods : Forty patients (ASA class I or II) who showed postoperative shivering were randomly assigned into four groups(n=10): Normal saline group: normal saline 5 ml, Doxapram group: doxapram 1.5 mg/kg, Meperidine group: meperidine 25 mg, Fentanyl group: fentanyl 25 g. And all patients received routine care: oxygen by T-piece and heat-reflective blanketrol (cincinati Subzero, U.S.A.). Evaluation of the state of shivering was done every 5 minutes from the beginning of the treatment by the same investigator who had injected the drugs intravenously for treatment of shivering. The age, sex, weight and duration of surgery were recorded. Results: There were no significant statistical differences in age, sex, weight and duration of surgery among the four groups. By 5 minutes, 90% of doxapram group and 30% of meperidine group had stopped shivering. By 10 minutes, 90% of doxapram group and 70% of meperidine group had stopped shivering. But in fentanyl and normal saline group, only 20% had stoppd shivering by 10 minutes. Conclusions: We conclude that both meperidine and doxapram are effective on post-anesthetic shivering. In cases of patient with respiratory depression, doxapram is especially effective because it stimulates the respiratory center. (Korean J Anesthesiol 1998; 34: 389∼393)