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      • KCI등재

        Heart rate variability may be more useful than pulse transit time for confirming successful caudal block under general anesthesia in children

        송인경,지상환,김은희,이지현,김진태,김희수 대한마취통증의학회 2017 Anesthesia and pain medicine Vol.12 No.2

        Background: Confirming a successful caudal block is challenging in the pediatric population. Pulse transit time (PTT) may reflect the decrease in arterial resistance and may act as a potential indicator for confirming successful peripheral nerve or axial block. Heart rate variability (HRV) is also a possible candidate because it may be influenced by variation in sympathetic tone. We expected an increasing PTT pattern and change in HRV parameters after caudal block. Methods: We enrolled 27 male patients (range, 1–4 years old) who were scheduled for urological surgeries. Caudal block was performed with 1 ml/kg of 0.25% ropivacaine and 1 : 200,000 epinephrine under sevoflurane anesthesia after the surgery. Successful block was confirmed by auscultation and ultrasonography. PTT and HRV parameters, such as standard deviation of normal-to-normal intervals, root mean square of successive differences, very low-frequency power, low-frequency power (LF), high-frequency power (HF), LF/HF ratio, approximate entropy (ApEn) were calculated based on electrocardiography from 1 min before to 5 min after the block. Those variables were analyzed by repeated measures analysis of variance. Results: No significant change was found in PTT with time interval after caudal block. Heart rate and ApEn of the R-R interval decreased with time interval (P = 0.001, 0.033, respectively). Some HRV parameters showed notable changes, although statistically insignificant. Conclusions: The PTT pattern may not be an indicator for successful caudal block. However, heart rate with parameters of HRV analysis may be alternatives.

      • KCI등재

        Pediatric lung ultrasound: its role in the perioperative period

        송인경 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.1

        There have been a number of recent advancements in the field of point-of-care ultrasound, including lung ultrasound for adult and pediatric populations. Evidence-based guidelines on the use of point-of-care lung ultrasound have been published. Lung ultrasound is superior to chest radiography in diagnosing several disorders of vital importance in the perioperative period. This review presents a discussion of techniques and clinical applications of lung ultrasound in pediatric patients focusing on usage in the perioperative period.

      • KCI등재

        The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery

        송인경,김동연,김윤진 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.5

        Background: Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications,especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Methods: Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixtyfive years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO2) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. Results: The decrease of rSO2 was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P < 0.05). There was no relationship between a maximal decrease of MAP and rSO2. Conclusions: In aged patients undergoing total knee replacement surgery under general anesthesia, tourniquet deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients. Background: Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications,especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Methods: Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixtyfive years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO2) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. Results: The decrease of rSO2 was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P < 0.05). There was no relationship between a maximal decrease of MAP and rSO2. Conclusions: In aged patients undergoing total knee replacement surgery under general anesthesia, tourniquet deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.

      • KCI등재

        구연산과 칼슘이 치아침식증의 발생에 미치는 영향

        송인경,이광희,김대업,양영숙 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

        산성 음료의 치아침식증 유발력을 감소시키기 위한 연구의 일환으로, 0.1%, 0.3%, 0.5%, 1.0% 구연산용백의 5분, 15분, 30분, 60분간의 사람 소구치 법랑질의 치아침식증 유발력 및 구연산용액에 첨가되는 칼슘 0.05%, 0.1%, 0.2%에 따른 치아침식증 발생 억제효과를 표면미세경도를 측정하여 연구하였다. 전체적으로 볼 때, 구연산 농도가 높을수륵, 탈회시간이 길수록, 칼슘농도가 낮을수록 탈회후 경도가 하락하였다. 탈회 5분 후 경도는 칼슘 무첨가의 경우에 76~90%이었고 칼슘 첨가에 따른 5분간의 탈회억제량은 2~l5%이었다. 탈회 15분 후 경도는 칼슘 무첨가의 경우에 65~84%이었고 칼슘 첨가에 따른 15분간의 탈회억제량은 3~l7%이었다. 탈회 30분 후 경도는 칼슘 무첨가의 경우에 53~72%이었고 칼슘 첨가에 따른 30분간의 탈회억제랑은 6~22%이었다. 탈회 60분 후 경도는 칼슘 무첨가의 경우에 43~66%이었고 칼슘 첨가에 따른 60분간의 탈회억제량은 7~l9%이었다. 탈회억제량의 분포를 전체적으로 보면, 구연산 농도에서는 1.0%에서 가장 크게 나타났고, 칼슘농도에서는 0.2%에서 가장 크게 나타났으며, 탈회시간에서는 0,1% 구연산용액에서는 탈회시간이 증가함과 더불어 탈회억제량도 함께 커지는 경향을 보였으나, 0.3% 이상의 구연산용액에서는 30분에 가장 크고 60분에 약간 감소하는 경향을 보였다 이상의 결과는 구연산에 의한 치아침식증 발생에 칼슘이 억제효과를 나타낼 수 있음을 시사한다. The purpose of study was to observe the effect of calcium and citric acid on the dental erosion of human premolar enamel. Enamel specimens were demineralized in 0.1%, 0.3%, 0.5%, or 1.0% citric acid solutions with 0.05%, 0.1%, or 0.2% calcium for 5, 15, 30, and 60 minutes, and then the surface microhardness of the enamel was measured. The hardness decreased as the concentration of citric acid and the demineralization time increased. Hardness after 5 minutes was 76~90% in case of no calcium and the inhibition of dental erosion by calcium addition was 2~15%. Hardness after 15 minutes was 65~84% in case of no calcium and the inhibition of dental erosion by calcium addition was 3~17%. Hardness after 30 minutes was 53~72% in case of no calcium and the inhibition of dental erosion by calcium addition was 6~22%. Hardness after 60 minutes was 43~66% in case of no calcium and the inhibition of dental erosion by calcium addition was 7~19%. The inhibition was the highest in 1.0% citric acid and 0.2% calcium. In 0.1% citric acid the inhibition increased as the demineralization time increased, but in 0.3% to 1.0% citric acid the inhibition was most high at 30 minutes and decreased a little at 60 minutes. These results suggest that calcium has a inhibitory effect on the citric acid induced dental erosion.

      • 국내 항공산업과 지속가능경영(환경경영)

        송인경 한국항공경영학회 2006 한국항공경영학회 추계학술대회 Vol.2006 No.-

        과거에는 겉으로 쉽게 드러나는 규모나 많은 매출이 기업의 명성을 높여주고 가치를 평가하는 요소들이었으나, 회계 부정 스캔들이나 환경사고로 인한 기업의 파산, 인권에 대한 부적절한 대응과 같은 사회적 이슈로 인해 기업의 주가가 크게 하락하는 등 지속가능성과 관련된 이슈들이 기업의 가치를 크게 좌우하게 되었다. 선진기업들은 이런 이해관계자들로부터의 요구에 대응하고 존경받는 기업, 지속가능한 기업으로 인정받아 기업의 가치를 높이고, 언제 다가올지 모르는 리스크에 대응하기 위해 다양한 이슈들을 통합적이고 체계적으로 관리할 수 있는 지속가능경영을 도입하여 글로벌 리더십을 발휘하고자 하고 있다. 특히 ``90년대 중반부터 해외 선진기업은 지속가능경영을 기업경영의 핵심과제로 추진하고 있으나, 국내에서는 최근 들어 대기업을 중심으로 일부 관심을 보이고 있는 수준이다. 이에 해외 선진기업의 지속가능경영 동향과 국내 항공산업의 지속가능경영 실태를 비교?분석하여 그 갭을 줄이기위해 국내 항공산업이 나아가야 할 방향을 제시하고자 한다. 우선 국내 항공산업의 지속가능경영 실태를 파악하기 위해서 국내 항공산업을 포함한 국내 대기업들을 대상으로 설문조사를 수행하였다. 또한 해외 선진기업들의 지속가능역량을 파악하기 위해 국내 대기업들의 지속가능경영 역량을 측정한 프레임워크와 동일하고 측정 척도도 동일하게 유지하였다. 이러한 결과들을 통해 국내 항공산업과 국내 대기업 및 해외선진 기업의 각 분야별 지속가능경영역량을 비교분석을 수행하고 해외선진 항공사의 지속가능경영 사례를 통해 국내 항공산업에 대한 시사점을 도출하였다. 단 본 연구는 지속가능경영의 삼대 영역 중 환경측면을 위주로 연구를 진행하였으며, 지속가능 경영의 전체적인 측면에 대해서는 개념적인 부분에 대한 소개를 하고 있는 수준으로 진행되었다. 추후 경제, 사회측면과 통합된다면 지속가능경영의 전체 영역을 다룰 수 있을 것으로 기대된다.

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