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Clonidine의 투여가 수술 후 통증 조절에 필요한 morphine 요구량에 미치는 효과
신용섭,한규철 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2
To investigate the effect of intravenous clonidine on morphine requirements in the postoperative period, 20 ASA physical status 1 patients who had undergone spinal surgery were studied. Clonidine group (10 patients) received clonidine 3 ㎍/kg intravenously 30 min before endotracheal extubation and received morphine infusion through a patient-controlled analgesia device (bakground infusion, morphine 10 ㎍/kg/hour ; subsequent dose, morphine 20㎍/kg on demand ; lockout time 10 minutes). The control group (10 patients) received only morphine with same device. At the following times : 30 min, 1, 3, 5 and 24 hour after endotracheal extubation, pain intensity and sedation score were evaluated. Also, arterial blood pressure, respiratory rate and any side effects were recorded. There were no significant differences between the clonidine and control groups with respect to postoperative pain. The amount of morphine delivered was lower in the clonidine group compared to the control group, but there was no significant difference between clonidine and control groups. The clonidine group was accompanied by sdation and decreased arterial blood pressure 30 min after endotracheal extubation. There was no significant difference in respiratory rate at any time interval. These results suggest that during the 24 hours following spinal surgery, postoperative morphine requirements could not be reduced significantly by single intravenous administration of clonidine 3 ㎍/kg.
전신마취 유도시 소량의 diazepam과 fentanyl의 사용이 심혈관계와 동맥혈 산소 포화도에 미치는 영향
신용섭 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2
The effetcs of induction of anesthesia with low-dose diazepam and fentanyl on cardiovascular system and arterial oxygen saturation after diazepam and fentanyl injection and endotracheal intubation were investigated in this study. Gruop control subjects(n=10) not received diazepam nor fentanyl. Group diazepam subjects(n=10) received diazepam, 0.15 mg/kg. Group fentanyl subjects(n=10) received fentanyl 3㎍/kg. Group diazepam-fentanyl subjects(n=10) received diazepam 0.15 mg/kg and fentanyl 3㎍/kg. All patients received thiopental 5 mg/kg and vecuronium of priming and intubating dose. Systolic, diastolic and mean arterial pressure were measured and arterial oxygen saturations were monitored with pulse oximeter 1, 3, 5 minute after the drug injection and 1, 3, 5 minute after endotracheal intubation. Systolic, diastolic and mean arterial pressure decreased more significantly during injection and following intubation in diazepam and fentanyl group. Heart rates did not increased significantly in diazepam and fentanyl group during induction. But all groups had increased heart rates significantly following intubation. In control, diazepam and fentanyl group arterial oxygen sasturation were not significantly changed. However, in diazepam-fentanyl group eight patients became hypoxemic (SaO_2<85%). This study demonstrated that the use of low-dose diazepam combined with fentanyl may be a effective method to protect patients with hypertension from the responses during anesthetic induction. However caution should be used because significant respiratory depression can occur. Therefore Continuous arterial oxygen monitoring with pulse oximetry and adequate oxygenation are necessary.
Clonidine-Fentanyl의 투여가 전신 마취 후 전율의 발생에 미치는 효과
신용섭 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1
The effects of intravenous combined clonidine and fentany on the incidence of shivering and hemodynamic changes after general anesthesia were assessed in patients undergoing elective peripheral surgery. Forty ASA class 1 or 2 patients were randomly assigned in a double blind manner to one of two groups. 20 patients received intravenous clonidine 2μg/kg and 20 patients received clonidine 1μg/kg and fentanyl 1μg/kg at 5 minute before general anesthetic emergence. Shivering was determined objectively by observing involuntary muscle activity. Mean arterial pressure, heart rate and sedation score were measured at 5 minute intervals during the first 60 minutes following intravenous pretreatment. There was no significant differences between the two groups in the incidence of shivering, mean arterial pressure, heart rate and sedation score. In conclusion, intravenous clonidine 2μg/kg and a combination of clonidine 1μg/kg and fentany 1μg/kg were not significant different in preventing postanesthetic shivering with minor hemodynamic and conscious changes in patients recovering from general anesthesia.
신용섭 慶星大學校 環境問題硏究所 1995 環境硏報 Vol.5 No.1
Under the several operating conditions, combustion characteristics of sewage sludge(waste activated sludge) were investigated using fluidized bed incinerator. Moisture content of sewage sludge was very high, about 98%, and had heating value of 3,200 kcal/kg dry solid. Before being burnt out, sludge was conditioned with polymer, dewatered and dryed up to moisture content of 14.7%. As the operating conditions were relatively mild and varied in small range, combustion efficiencies were detected very high values of above 99% and almost insensitive to changes of operating conditions. Bed temperature showed very uniform distributions in fluidized bed and temperature decreased along the freeboard height during the whole range of operations. Especially, temperature of just above bed surface showed maximum value by the combustion of gasified volatile matter. Temperatures in the freeboard region increased as bed temperature and superficial air velocity increased. When superficial air velocity increased elutriation rate of fine particles increased by the increased. When superficial air velocity increased elutriation rate of fine particles increased by the increment of sturation carrying capacity of flue gas. Thus, elutriation loss of combustible was determining factor of combustion efficiency.
Vecuronium에 의한 기관내 삽관시 안압 및 심맥관계에 미치는 영향
신용섭,이정은,최세진 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.1
The effects of muscle relaxants(vecuronium, pancuronium, d-tubocurarine, and succinylcholine) for endotracheal intubation on intraocular pressure, blood pressure, heart rate, and arrhythmia were studied in 60 patients undergoing general anesthesia, The patients were divided into 4 groups : vecuronium group (0. 1 mg/kg), pancuronium group (0.08 mg/kg), d-tubocurarine group(0.4 mg/kg), and succinylcholine group(1 mg/kg) according to be administrated. Before induction of anesthesia, initial measurement of intraocular pressure (control value) was taken with Schiotz tonometer after instilling of a 0. 5% pontocaine on conjunctival sac. Subsequent measurement were undertaken as soon as the lid reflex was lost after thiopental sodium injection and then at 75-100% depression of first twitch height of train-of-four after intravenous administration of muscle relaxants. It was measured at 1, 3, 5, 10 minutes after endotracheal intubation too. Blood pressure (systolic and diastolic), heart rate, and ECG abnormalities were observed in all cases. The results were as follows; 1. After thiopental sodium injection, intraocular pressure(IOP) decreased than the control value. 2. At 70-100% depression of first twitch height, IOP decreaeed significantly in vecuronium, pancuronium and d-tubocurarine group, but increased significantly in succinylcholine group than the control value. 3. After 1 minute of endotracheal intubation, IOP increased in all groups. There was no stastistical significance in vecuronium group compared with the control value. 4. After 3 minutes of endotracheal intubation, IOP decreased in all groups. 5. The changes of systolic and diastolic blood pressure and heart rate in vecuronium group were the smallest value among all groups. 6. There was no arrythmia in vecurouium group.