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이영양성 수포성 표피박리증(Epidemolysis Bullosa Dystrophica)환자의 마취
신옥영,강화자,홍성표,고한진 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.1
Epidermolysis bullosa dystrophica is rare, chronic non-inflammatory disease of hereditary trait, which easily ptoduces bullae spontaneously or by heat and minor trauma such as pressure or friction. We present two cases of epidermolysis bullosa dystrophica that seems to be a dominant type considering the presence of family history with histopathologic and electron microscopic findings. Successful anesthetic management of two patients with epidermolysis bullosa dystrophica was accomplished with general anesthesia. The special concerns which relate to airway management in this disease are discussed. Early diagnosis and institution of preventive measures can minimize the need for restorative and surgical management in these children. However, when anesthetic management is necessary, the use of appropriate consultants and adjuncts can provide valuable support.
구혈기 설치 부위의 Lidocaine 침윤 마취가 혈압과 심박수에 미치는 영향
신옥영,강화자,원시권 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.6
Background: A tourniquet is commonly used to achieve a bloodless field in surgery of the extremities. However, the anesthesiologist is concerned about the adverse effects of hypertension which occur during general anesthesia. In this study, we assessed the effects of lidocaine infiltration in the tourniquet site on blood pressure and heart rate during tourniquet inflation under general anesthesia. Methods: Forty patients of ASA class I or II, scheduled for knee surgery, were randomly divided into two groups. In group 1 underwent general anesthesia and in group 2 also underwent general anesthesia and combined with 1% lidocaine infiltration in the tourniquet site. The changes of systolic and diastolic blood pressure and heart rate were measured before and after toumiquet inflation, after skin incision and 30 min after inflation. Results: Comparing group 1 with group 2, there were significant increases after tourniquet inflation to 30 min after inflation in systolic and diastolic blood pressure in group 1 (p$lt;0.05). However, there were no significant changes in heart rates in either group. Conclusions: The above results demonstrate that patients who received lidocaine infiltration in the tourniquet site showed less increase in blood pressure during tourniquet inflation.
소아에서 전신마취시 Propofol 과 Thiopental 에 의한 마취유도 양상에 관한 비교
신옥영,김동옥,김건식 대한정맥마취학회 2001 정맥마취 Vol.5 No.1
Background: This study was designed to compare propofol with thiopental-isoflurane on the anesthesia induction characteristics in children. Methods: We studied 60 children, aged 3-10 years. Patients were randomly assigned to receive propofol anesthesia (group P) or thiopental-isoflurane (group I). The pain and movement at injection and changes of blood pressure and heart rate were compared. Results: The incidence of pain were 63% (19) of group P and 7% (2) of group I. the incidences of movement were 83% (27% monor, 57% major) in group P and 17% (5 minor) in group I. The elevation in systolic and diastolic pressure and heart rate were significantly greater after thiopental-isoflurane (P < 0.05) during induction. The heart rate increased significantly in group I than group P during induction (P < 0.05). Conclusions: We conclude that propofol appears to be an effective and well tolerated in hemodynamic changes during induction but pain and movement at injection were greater high in children. Further investigation is required to reduce pain and movement at injection and to evaluate the merit of propofol in children.
후두현미경 수술 시 Propofol 마취와 Thiopental-Enflurane 마취의 비교
신옥영,정수상,최영규,신광일 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.3
Background: Laryngomicrosurgery has some special characteristics. It is stressful due to intubation and direct laryngoscopy during a short operation time. Therefore both adequate anesthesia and quick recovery for the slience therapy after the operation are needed. This study compared the cardiovascular responses and recovery pattern between propofol and Thiopental-Enflurane anesthesia. Methods: Sixty outpatients of ASA class 1 or 2 for microlaryngoscopy were randomly assigned to receive either anesthesia with propofol (Group P, n = 30) and thiopental-enflurane (Group E, n = 30). Group P was induced with propofol 2 mg/kg and succinylcholioe 1 mg/kg and maintained with vecuronium 0.04 mg/kg, propofol 10 6 mg/kg/h, and N_2O: O_2/3 L/min: 2 L/min. Group E was induced with thiopental 5 mg/kg and succinylcholine 1 mg/kg and maintained with vecuronium 0.04 mg/kg, enflurane 1-3 vo1%, and N_2O: O_2/3 L/min: 2 L/min. Ketorolac (30 mg) and hydrocortisone (100 mg) were added for postoperative pain in both groups. The chs in blood pressure and heart rate, pre and post induction, were compared in both groups. In addition, we compared energence time and the state of recovery (Stewards score) 5 minutes and 15 minutes after extubation and the frequencies of other complications. Results: No significant differences in age, wt, sex and anesthesia time of the two groups were observed. Mean arterial pressures were significantly different after anesthesia and after intubation between the two groups. However the heart rates were not different among the groups. The extubation time was significantly shorter in Group P, The recovery score at 5 min and 15 min after extubation was significantly higher in Group P. Conclusions: We conclude that propofol with nitrous oxide may be useful in laryngeal microsurgery, especially, when silence therapy is needed.