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- 저자 : 김양렬 ( Yang Lyoul Kim ) (검색결과 2 건)
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임상연구 : Desflurane 흡입 마취가 Sevoflurane과 달리 수술 후 장관 기능의 회복을 지연시키는가?
김덕경 ( Duk Kyung Kim ),김혜경 ( Hae Kyoung Kim ),우남식 ( Nam Sik Woo ),김태엽 ( Tae Yop Kim ),권원경 ( Won Kyoung Kwon ),김양렬 ( Yang Lyoul Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Background: Sympathetic nervous hyperactivity presents in response to surgical stress has been implicated as an important component of postoperative ileus. Because desflurane induces sympathetic activation, the effects of desflurane and sevoflurane on the recovery of bowel function were compared. Methods: Forty patients undergoing a laparoscopic appendectomy were randomly assigned to receive either sevoflurane (Group S, n = 20) or desflurane (Group D, n = 20). The anesthetic, operative, and postoperative pain managements were standardized. The CRP (C-reactive protein), total leukocyte count, and ratio of the neutrophil to leukocyte counts were measured preoperatively and 12 hours postoperatively. The mean arterial blood pressure (MABP), heart rate, and end-tidal anesthetic concentration were measured at 10-min intervals during the surgery. The degree of postoperative pain, 11-graded surgical difficulty score, time to the first passage of flatus and first oral intake of clear fluid, as well as the postoperative hospital stay were also evaluated. Results: Finally, 16 and 17 subjects in Groups S and D were included the analyses. There were no significant differences in the MABP, heart rate, and end-tidal anesthetic concentration between the two groups. The clinical and laboratory parameters related to the severities of inflammation and surgical trauma were similar in both groups. There were no significant differences in the times to the first passage of flatus and first oral intake of clear fluid and the postoperative hospital stay between the two groups. Conclusions: Although desflurane induces sympathetic activation, unlike sevoflurane, it does not delay the return of bowel function following a laparoscopic appendectomy. (Korean J Anesthesiol 2007; 52: 630~6)
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증례보고 : 원발성 신부전이 동반된 간부전 환자의 간이식술의 마취 관리
김덕경 ( Duk Kyung Kim ),김혜경 ( Hae Kyoung Kim ),김태엽 ( Tae Yop Kim ),임정애 ( Jeong Ae Lim ),김양렬 ( Yang Lyoul Kim ),장성환 ( Sung Whan Jang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Renal failure frequently accompanies advanced hepatic failure. Even if adequate renal function is not considered as a prerequisite for transplant candidacy, impaired renal function prior to liver transplantation has been regarded as an independent risk factor of graft dysfunction and mortality. Liver transplantation in such a patient also presents a number of challenges to the anesthesiologists. Optimal fluid therapy, prompt and aggressive correction of electrolytes and metabolic disturbances, careful selection of anesthetic techniques and agents, and close monitoring of cardio-respiratory function help reduce the graft failure and perioperative mortality. In such cases, continuous renal replacement therapy (CRRT) is used with increasing frequency during or after the surgery. So, anesthesiologists need to understand the basic principles, potential applications, and anesthetic implications of several CRRT options. We therefore present the anesthetic experience in a patient with hepatic failure combined with primary renal failure, successfully managed during or after liver transplantation. (Korean J Anesthesiol 2007; 53: 547∼553)
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