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전신마취유도 중 발생한 심방세동과 회복중 발생한 발작성 상심실성 빈맥
방윤식,신동욱,이태규,박정현,길현주,이종연 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.2
A healthy 35-year-old man who was scheduled for closed reduction of nasal bone fracture developed atrial fibrillation during induction of general anesthesia after intravenous glycopyrrolate injection. During emergence of general anesthesia, atrial fibrillation was suddenly changed to paroxysmal supraventricular tachycardia with 200 beat per minute and lasted for about 10 seconds. Because blood pressure was stable, esmolol was used to reduce ventricular response. At recovery room, ventricular response reduction about 55 beat per minute was observed after intravenous injection of verapamil 5 mg. Thereafter, the rhythm was returned to normal sinus rhythm with bradycardia.
Anesthetic Consideration for Peroral Endoscopic Myotomy
Yun-Sic Bang,Chunghyun Park 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6
A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective asHeller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse eventssuch as bleeding, perforation, and carbon dioxide insuffation-related complications was lower in POEM under endotracheal generalanesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, andaccompanying hemodynamic instability can be caused by carbon dioxide insuffation. Treatment of possible physiological changesand adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspectiveon improving patient safety. The territory of therapeutic endoscopy can be expanded through cooperation with other departments,including anesthesia services. Efforts to understand different perspectives will certainly help not only secure patient safety but alsoexpand the area of treatment.
Yun-Sic Bang,박정현,Su-Yeon Lee,김민구,Juho Lee,Taegyu Lee 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.64 No.5
Background: The use of monitored anesthesia care (MAC) as the technique of choice for a variety of invasive or noninvasive procedures is increasing. The purpose of this study to compare the outcomes of two different methods, spinal anesthesia and ilioinguinal-hypogastric nerve block (IHNB) with target concentrated infusion of remifentanil for inguinal herniorrhaphy. Methods: Fifty patients were assigned to spinal anesthesia (Group S) or IHNB with MAC group (Group M). In Group M, IHNB was performed and the effect site concentration of remifentanil, starting from 2 ng/ml, was titrated according to the respiratory rate or discomfort, either by increasing or decreasing the dose by 0.3 ng/ml. The groups were compared to assess hemodynamic values, oxygen saturation, bispectral index (BIS), observer assessment alertness/sedation scale (OAA/S), visual analogue scale (VAS) for pain score and patients’ and surgeon’s satisfaction. Results: BIS and OAA/S were not significantly different between the two groups. Hemodynamic variables were stable in Group M. Thirteen patients in the same group showed decreased respiratory rate without desaturation, and recovered immediately by encouraging taking deep breaths without the use of assist ventilation. Although VAS in the ward was not significantly different between the two groups, interestingly, patients’ and surgeon’s satisfaction scores (P = 0.0004, P = 0.004) were higher in Group M. The number of the patients who suffered from urinary retention was higher in Group S (P = 0.0021). Conclusions: IHNB under MAC with remifentanil is a useful method for inguinal herniorrhaphy reflecting hemodynamic stability, fewer side effects and higher satisfaction. This approach can be applied for outpatient surgeries and patients who are unfit for spinal anesthesia or general anesthesia.
Brugada Syndrome Patient Undertaken Brachial Plexus Block
Yun-Sic Bang,Seon-Yi Lee,Daeun Ko,Junbeom Park,Sowoon Ahn,Chunghyun Park 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.4
Brugada syndrome is an arrhythmic syndrome characterized by right bundle branch block, ST segment elevation in the precordial lead (V1–V3), and sudden death caused by ventricular fibrillation, which is not effectively prevented by anti-arrhythmic drug therapy. We are reporting a 30-year-old male patient with Brugada syndrome who got an exploratory laparotomy and a tenorrhaphy due to stab wound which was managed with general anesthesia and brachial plexus block without any complications.
Thalamic Pain Misdiagnosed as Cervical Disc Herniation
Lim, Tae Ha,Choi, Soo Il,Yoo, Jee In,Choi, Young Soon,Lim, Young Su,Sang, Bo Hyun,Bang, Yun Sic,Kim, Young Uk The Korean Pain Society 2016 The Korean Journal of Pain Vol.29 No.2
Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.
Case Report : Thalamic Pain Misdiagnosed as Cervical Disc Herniation
( Tae Ha Lim ),( Soo Il Choi ),( Jee In Yoo ),( Young Soon Choi ),( Young Su Lim ),( Bo Hyun Sang ),( Yun Sic Bang ),( Young Uk Kim ) 대한통증학회 2016 The Korean Journal of Pain Vol.29 No.2
Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease. (Korean J Pain 2016; 29: 119-22)