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비삽관하의 Thalamonal-Ketamine 점적정맥마취
오흥근,박윤곤,정화성 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.2
Despite its many disadvantages ketamine may offer a partial answer to the pollution of the operating room by gases and vapours. It is a relatively long-acting drug with good analgesic action and does not require supplementation with nitrous oxide. This study was carried out to investigate the efficency of the ketamine I.V. drip technique in patients undergoing operations not requiring tracheal intubation, muscle relaxation and controlled ventilation. The only contraindications to the use of its technique were hypertension, a history of a cerebrovascular accident or undetermined history of psychiatric upset. Twenty patients, ranging in age from 20 to 60 years, were premedicated with atropine and secobarbital, diazepam or hydroxyzine. Anesthesia was induced with 0.15mg/kg droperidol in Thalamonsl and wss maintained with 0. 1% ketamine in 5% dextrose or balanced salt solution. The average dosage of ketamine was 1.175 mg/kg/hr for induction and 2. 33 mg/kg/hr for maintenance during operations with duration from 20 minutes to 5 hours and 35 minutes. No supplementary general anesthesia was given, but when the depth of anesthesia was :not adequate, the rate of the ketamine infusion was increased. After the induction with Thalamonal the respiration rates were decreased temporarily, but the tidal volume and arterial gas study were clinically within normal lirnits. The incidences of complications of anesthesia, namely increased B.P. (20mmHg above preoperative value), involuntary movements, dreams and hallucinations were 60, 40, 10 and 5% respectively. The verbal response time from the end of operation was within 30 minutes in 75% cases. It may be concluded that Thalsmonal and ketamine I.V. drip anesthesia without intubation can be used relatively satisfactorily in operations in which muscle relaxation, endotracheal intubation and controlled respiration are not needed.
기관지 확장증 수술에 적용한 일측폐 환기법 및 지속적 기도양압(CPAP)에 의한 좌우 분리 폐환기
오흥근,박윤곤,남순호,방서욱 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.3
One lung ventilation with a double lument endobronchial tube during thoracic anesthesia is necessary for the protection of the healthy lung from contamonation by the diseased lung and offers acceptable condigions for the surgeon. During one lung ventilation hypoxemia can frequently occur even with the adminstration of 100% oxygen. Recently we experienced markedly improved oxygenation during one lung anesthesia with a right sided double lumen endobronchial tube with application of CPAP 10cmH_2O in the nondependent lung in a left lower lung vrochiectatic patient. The healthy dependent right lung was ventilated by a conventional mechanical ventilator with FiO_2 1.0, tidal volume 10 ml/kg and respiration rate 12/min., Anesthesia was maintained with O_2-halothane. Fifteen minutes after two lung ventilation in the right lateral decubitus position, the PaO_2 and PaCO_2 were 400 and 33 torr respectively. 15 minutes after one lung ventilation PaO_2 decreased to 99 torr. 15minutes following application of CPAP 10 cmH_2O,. the PaO_2 increased to 229 torr, 30 minutes after CPAP 331 torr, and 2 hours after CPAP it rose to 373 torr. The nondependent lung was motionless and slightly expanded, and the surgical field was suitable for surgery.
항문부 암성동통에 대한 지주막하(蜘蛛膜下)10 % Phenol-Glycerine 차단
오흥근,남용택,이예철 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.4
Phenol-glycerine subarachnoid blocks were performed in 5 patients, who had intractable perianal pain from postoperative rectal csncer. An initial diagnostic subarachoid block with 0. 25 ml of 0.5% tetracaine in 10% glucose through L 5-S 1 was performed with the patient in a sitting position tilted about 15 degree to the affected side. After evaluation of the test block, the following day a therapeutic block was undertaken by injecting 0. 15-0. 2 ml of 10% phenol-glycerine. Excellent relief occured in all cases and in one of them the repeated block for recurrent pain was done and 5 months after the first block. One case required of successive blocks 3 times during 8 days with the old phenol glycerine solution over 1 year. Life duration ranged from days to more than 12 months after the blocks. As to complication, dysuria developed temporarily in 3 cases. The one-sided saddle block with 10% phenol glycerine for perianal cancer pain is remarkably safe as well as effective and should be employed more frequently.