척추마취 시 저용량 Propofol이 중심체온과 주변체온에 미치는 영향

남신우,권성범,김성기,김종선,손수창 대한마취과학회 2005 Korean Journal of Anesthesiology Vol.49 No.1

Diazepam과 Lidocaine이 노인환자의 기관내삽관시 심전도 및 심맥관계에 미치는 영향

김경희,권성범,신용섭,최세진 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

We selected at random 30 geriatric patients who had received operation under the general anesthesia with endotracheal intubation. The patients were divided into 3 groups. Group 1 (control) had received endotracheal intubation without diazepam and lidocaine. Group 2 had received endotracheal intubation with diazepam. Group 3 had received endotracheal intubation with lidocaine. The changes of arterial blood pressure and pulse rate, and the appearance of arrhythmia were compared in each group. The results were as follows : 1. The increase of blood pressure and heart rate were less in group 2, 3 than the control group which showed significant increase of blood pressure and heart rate with endotracheal intubation. 2. The incidence of arrhythmias with endotracheal intubation was less in group 2(20%), group 3(50%) than the control group(80%). 3. The electrocardiographic change in the group 2 and 3 were not significant compared to group 1(control).

노인환자에서 경막외마취후 체온및 심혈관계에 미치는 영향

최세진,권성범,허동식,이상묵 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

We selected at random 29 patients who had recieved operation under the epidural anesthesia. The patients were divided into two groups. Group I (control) were 12 cases below 59 years old. Group II were 17 cases above 60 years old. The changes of heart rates, systolic and diastolic pressure, and body temperature were compared in two groups The results were as follows; 1. The changes in heart rate after epidural anesthesia were not significant between two groups. 2. The changes in systolic and diastolic pressure were significantly decreased in both groups and were not significant difference between two groups. 3. Body temperature was significantly decreased in both groups and showed significant difference between two groups in an hour after epidural anesthesia. 4. Hypotension(systolic pressure < 85 torr) occured in 1 patient in group I and 4 patients in group II.

삽입형 제세동기(Implantable Cardioverter Defibrillator)를 장착중인 환자의 충수돌기 절제술시 마취경험

박채근,남신우,권성범,김성기,김종선 대한마취과학회 2004 Korean Journal of Anesthesiology Vol.47 No.6

회복실 환자의 현황 및 SaO_2의 변동

최세진,김만수,권성범 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

We have reviewed 2059 cases admitted at the recovery room of Chung Nam National University Hospital from Jan. 1, 1995 to April 30, 1995 to use of the results for better guidance and management. The cases were statistically analysed by various parameters, the number of patients of recovery room admission, department, anesthetic methods, recovery score, duration of stay and change of SaO_2. The results were as follows ; 1. Patients undertook anesthesia ; case of general or regional anesthesia were 2059 among the overall recovery room admission cases 2059. Admission rate of recovery room was 83.7% (2059/2630). 2. Among the 2059 cases in the recovery room, case of obstetric and gynecology were 464 (22.5%), followed by cases of orthopedic surgery (16.9%) and cases of general surgery (15.4%). 3. Operation were carried out in most case (84.7%) under general anesthesia, followed by case under regional anesthesia (15.3%). 4. The large part of the patients (79%) have postanesthetic recovery score 9-10 at the moment of admission in the recovery room and the most part of the patients (100%) have postanesthetic recovery score 9-10 at the moment of discharge in the recovery room. 5. Most of patients (92.6%) stayed less than 1 hour in the recovery room. 6. SaO_2 of patients were greater than 96% on arrival and discharged.

백서의 적출된 흉부대동맥에서 Protamine 의 이완작용과 Heparin 이 미치는 영향

이정은,윤석화,최세진,김윤희,김혜자,권성범 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.4

Background : When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. Method : To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3±10-6M phenylephrine and then exposed to increasing concentrations of protamine(final organ bath concentration, 40∼400 g/ml) both in the absence and presence of heparin(200 U/ml). Results : Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly eater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin(3×10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin(200 U/ml). In endothelium-denuded strips, protamine(400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine(NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin(40 U/ml). Conclusion : This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of itric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores. (Korean J Anesthesiol 1997; 33: 591∼603)

임상연구 : 슬관절 전치환술 시 경막외강, 슬관절강 및 슬관절 주위 조직에 병용 투여한 Bupivacaine과 Morphine이 술 후 통증에 미치는 영향

최현기 ( Hyun Gee Choi ),김성기 ( Seong Gee Kim ),권성범 ( Seong Bum Kwon ),김종선 ( Jong Sun Kim ),권희욱 ( Hee Uk Kwon ),강포순 ( Po Soon Kang ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

Background: Epidural opioids and local anesthetics provide excellent postoperative analgesia. In addition, soft tissue and intra-articular injection of bupivacaine and morphine may have a beneficial analgesic effects after total knee arthroplasty (TKA). This study was designed to assess the additional analgesic effect of combined soft tissue, and intra-articular injection of morphine and bupivacaine in patients undergoing TKA under spinal anesthesia with continuous epidural morphine and bupivacaine injection. Methods: Forty patients aged 55 to 75 years for a TKA under spinal anesthesia were randomly divided into 2 groups. The both group of patients received a continuous epidural infusion using a two-day infusor containing morphine 5 mg in 100 ml of 0.125% bupivacaine. The experimental group of patients (n = 20) received soft tissue, and intra-articular injection containing 10 mg morphine in 100 ml bupivacaine 0.125%. The control group of patients (n = 20) received soft tissue, and intra-articular injection of 100 ml normal saline. Postoperative pain was assessed using the visual analog scale (VAS) at 1, 2, 4, 8, 12, 24, and 48 h postoperatively and side effects, such as hypotension, nausea, vomiting, pruritus, and respiratory distress were recorded. Whenever patients demanded supplemental analgesia, diclofenac sodium 75 mg was injected intramuscularly and the need for additional analgesic requirement was recorded. Results: The experimental group of patients had significantly lower pain score and analgesic requirements than the control group for 2 days. There was no difference in the incidence of side effects between groups. Conclusions: Combined soft tissue, and intra-articular injection of morphine and bupivacaine with continuous epidural morphine and bupivacaine infusion reduces postoperative pain and supplementary analgesic requirements than continuous epidural morphine and bupivacaine infusion only in patients undergoing TKA. (Korean J Anesthesiol 2006; 50: 546~51)