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        임상연구 : 무릎 관절경 수술 시 Ketorolac 투여가 압박띠 사용에 따른 혈압 변화에 미치는 영향

        김운영 ( Yoon Young Kim ),신연식 ( Youn Sik Shin ),민두재 ( Doo Jae Min ),이윤숙 ( Yoon Sook Lee ),김재환 ( Jae Hwan Kim ),박영철 ( Young Cheol Park ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.5

        Background: The use of a tourniquet can produce pain and cause increased blood pressure. Ketorolac is known to have analgesic effects at the peripheral and central levels, however, its effect on the increased blood pressure due to a tourniquet is unknown. Therefore, the effects of ketorolac on the tourniquet-induced changes in the systolic, and diastolic blood pressures (SBP & DBP), as well as the heart rate (HR), were investigated. Methods: ASA physical status I and II patients, who were scheduled for knee arthroscopic surgery using a tourniquet, were assigned to control (n = 20), K30 (n = 20) and K60 groups (n = 20). Anesthesia was maintained with enflurane, N2O and O2. Either 30 or 60 mg ketorolac was injected 10 min prior to tourniquet inflation in both the K30 and K60 groups. The changes in the SBP, DBP and HR were measured before and 10, 20, 30, 40, 50, and 60 min after tourniquet inflation. Results: There were no differences in the baseline SBP, DBP, and HR values. The SBP was higher than the baseline value at 10, 20, 30, 40, 50, and 60 min in the control and at 30, 40, 50, and 60 min in the K30 groups, but only at 60 min in the K60 group. At 60 min, the SBP was lower in the K60 than the control group. The DBP was higher than the baseline value at 50, and 60 min in the control, but not in the ketorolac groups. Conclusions: A 60 mg ketorolac injection prior to tourniquet inflation can attenuate the tourniquet induced increase in blood pressure in knee arthroscopic surgery patients. (Korean J Anesthesiol 2007; 52: 511~5)

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        무릎 관절경 수술 시 Fentanyl 투여가 압박띠 사용에 따른 혈역학적 변화에 미치는 영향

        이윤숙 ( Yoon Sook Lee ),김재환 ( Jae Hwan Kim ),차문호 ( Moon Ho Cha ),민두재 ( Doo Jae Min ),김운영 ( Woon Young Kim ),장문석 ( Moon Seok Chang ),박영철 ( Young Cheol Park ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1

        Background: The use of a tourniquet can produce pain and increase in blood pressure. It is known that fentanyl reduces central sensitization, however its effect on blood pressure increase due to tourniquet is unknown. So we investigated the effect of fentanyl on tourniquet-induced changes of mean arterial blood pressure (MBP), heart rate (HR), and cardiac index (CI). Methods: ASA physical status I and II, who were scheduled for knee arthroscopic surgery using a tourniquet, were assigned into control (n=30) and fentanyl group (n=30). Anesthesia was maintained with enflurane, N2O and O2. Fentanyl was injected 1.5 ug/kg at 10 min before inflation of the tourniquet in the fentanyl group. Changes of the MBP, HR, CI were measured before and 10, 20, 30, 40, 50, 60 min after inflation of the tourniquet. Results: There were no differences in the baseline values. MBP was increased at 40, 50, 60 min in the control group. At 60 min, MBP was lower in the fentanyl than the control group. HR was decreased at 10 min in the fentanyl group. CI was decreased in all groups after tourniquet inflation. At 60 min, CI was more decreased in the control than the fentanyl group. Conclusions: Fentanyl injection prior to tourniquet inflation can attenuate the tourniquet induced hemodynamic changes in the knee arthroscopic surgery patients. (Korean J Anesthesiol 2009;56:6~10)

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