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실험연구 : Lidocaine 또는 Bupivacaine과 Enflurane 투여가 Histamine에 의한 기니픽 기도평활근 수축에 미치는 영향
권오경 ( Ou Kyoung Kwon ),배현민 ( Hyun Min Bae ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Background: The effects of local and inhalation anesthesia on the contraction of the tracheal smooth muscle have been reported. However, when inhalation and local anesthesia are administered simultaneously, their effects on the contraction of the airway smooth muscle are not well known. Therefore, this study evaluated the effects of lidocaine, bupivacaine, with or without enflurane, on the histamine induced tracheal smooth muscle contraction in guinea pigs. Methods: Isolated tracheal rings of guinea pigs were suspended in Krebs solution. The contractions were recorded isometrically using a transducer. A contraction was induced by histamine (10-5 M). Enflurane (1 MAC) was administered for 15 min after administering the histamine. The cumulative dose responses of the lidocaine and bupivacaine (10-8 M, 10-7 M, 10-6 M, 10-5 M, 10-4 M, and 10-3 M), enflurane-lidocaine and enflurane-bupivacaine groups were checked. Results: The contraction by histamine were inhibited by lidocaine (10-4 M and 10-3 M) and bupivacaine (10-5 M, 10-4 M and 10-3 M). In addition, the contractions were inhibited more significantly in the bupivacaine group (10-7 M, 10-6 M, 10-5 M, 10-4 M and 10-3 M) after administering enflurane. Conclusions: Lidocaine and bupivacaine inhibited the contractions induced by histamine. The contractions by bupivacaine were further inhibited after administering enflurane. (Korean J Anesthesiol 2006; 51: 733~7)
제왕절개시 저농도의 Halothane 과 Enflurane 마취가 Succinylcholine 작용에 미치는 영향
권오경,한영문 대한마취과학회 1983 Korean Journal of Anesthesiology Vol.16 No.3
The volatile anesthetic agent, halothane and ethrane, are most commonly used in general anesthesia practice and a depolarizing neuromuscular blocker, succinylcholine, is also used for endotracheal intubation, if not contraindicated. There were many reports that the volatile anesthetics affect the neuromuscular transmission in akeletal muscles and potentiate the neuromuscular black induced by depolarizing muscle relaxant in moderate to high concentration. But in halothane, a result was different from those of others. It was well known fact that in pregnant woman, the MAC of the volatile anesthetics is decreased. Therefore, present study was performed to determine whether halothane and ethrane may affect the action of succinylcholine or not, in their low concentration, in 40 healthy pregnant women and we divided them randomly in two groups: halothane administered group(group A), ethrane administered group(group B). Ulnar nerve was stimulated at the wrist through surface electrode, using a peripheral nerve stimulator with supramaximal single twitchimpulse of 0.2 msec duration at a rate of 1.0 Hz. The responses of the adduction of thumb were measured with a force displacement transducer and recorded with a biophysiograph(San Ei, Japan). The single twitch were measured before and after intravenous succinylcholine 1 mg/kg and when full paralysis occurred, 0.5% halothane administered in group A and 1% ethrane administered in group B and observed the effects of halothane and ethrane on the neuromuscular blocking action of succinylcholine. The results were as follows. The time from intravenous succinylcholine onset of paralysis was 15.5±3.21 sec in halothane group, and 14.8±3.17 sec in ethrane group. The time from onset of paralysis to full paralysis was 42.2±5.98 sec in halothane group, and 47.1±13.55 sec in ethrane group. Duration of full paralysis was 283.9±68.02 aec in halothane group, and 270.8±44.49 sec in ethrane group. Recovery index(T26-T76) was 68.4±16.11 aec in halothane group, and 75.4±21.93 sec in ethup. We conclude that there is no significant difference between the effects of halothane and ethrane on the neuromuscular blocking actioa of succinylchpline, in their low concentraction, in healthy pregnant women.
하복부 수술 중 과도한 충전에 의한 심혈관계 및 호흡계 불안정
권오경,이윤기,최해성,유경아 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.5
Retractor and packing usually aid to expose the surgical field and fascilitate surgical procedures. but excessive packing can impede venous return and reduce cardiac output. We experienced severe hypotension and ventilatory difficulty associated with excessive packing and traction in a patient undergoing radical hysterectomy. After removing the packing and extracting the intestine exterior to abdominal cavity, patients ventilatory condition improved immediately and cardiovascular stability was achieved. (Korean J Anesthesiol 2000; 38: 931~935)
토끼의 양측 신장경결찰이 Mivacurium 의 신경근차단작용에 미치는 영향
권오경,이윤기 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.10
Mivacurium, a new neuromuscular blocking agent, is known not to rely greatly on the renal function for its elimination, therefore, is recommended for the renal failure patient. In these studies, we investigated neuromuscular blocking action of mivacurium in case of bilateral ligation of renal pedicles to prevent the renal excretion and compared its action to that of pancuronium, which is mainly excreted by the kidney. Rabbits were divided into 4 groups: the mivacurium control group, the mivacurium group, the pancuronium control group, and the pancuronium group. Both renal arteries were ligated in the mivacurium group and the pancuronium group. After intravenous administration of mivacurium or pancuronium, the6neuromuscular blocking actions were observed. The results were as follows: 1.There was no significant difference in onset time between the mivacurium group(77±18.6 sec) and the mivacurium control group(100±36 sec). No significant difference between the pancuronium group(90±42 sec) and the pancuronium trol group(101±43.8 sec), too. And no significant difference in change of onset time was found between the mivacurium group and the pancuronium group. 2.There was no significant difference in duration of action between the mivacurium group ,(664±85.2 sec) snd the mivacurium control group(500±134.4 sec). But significant difference was found between the pancuronium group(3453±1088.4 sec) and the pancuronium control group(1041±304.2 sec)(P$lt;0.05). In the pancurounium group, the prolongation of duration of action was significantly greater than that in the mivacurium group(P$lt;0.05). 3.There was no significant difference in recovery index between the mivacurium group (316±99.6 sec) and the mivacurium control group(230±66.3 seo). But there was significant difference between the pancuronium group(676±162.3 sec) and the pancuronium control group(274±92 sec)(P$lt;0.05). The prolognation of recovery index in the pancuronium group was significantly greater than that in the mivacurium group(P$lt;0.05).
잡견에서 HCI Aspiration에 의한 급성호흡부전시 인공폐 Surfactant의 보충요법이 폐 Compliance, 평균기도압 및 기도저항에 미치는 효과
권오경 中央醫學社 1991 中央醫學 Vol.56 No.10
To evaluate of the effect of pulmonary surfactant replacement on the pulmonary compliance, mean airway pressure and airway resistance in acute respiratory failure induced by HCl-aspiration in dog. Dogs were aspirated HCl (pH 2.0) into trachea by a catheter and wait until the Pa02 level fall into the 100 mmHg level and then, in experimental group, we administered pulmonary surfactant by using high frequent jet ventilation and, in control group, same amount of saline administered instead of pulmonary surfactant by same method of experimental group and after administration of pulmonary surfactant, intermittent positive pressure ventilation was continued during experiment and measured pulmonary compliance, airway pressure, and resistance. Results showed that there were no significant differences between experimental group and control group. These results can be from the insufficient amount of pulmonary surfactant replacement to overcome the pathology caused by acid aspiration, severe pulmonary edema.