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The Effects of Systemic Morphine to Analgesic Level in Spinal Anesthesia
이강창,김태요,윤재승,이의상,Lee, Kang-Chang,Kim, Tai-Yo,Yun, Jae-Seung,Lee, Eui-Sang The Korean Journal of Pain 1995 The Korean Journal of Pain Vol.8 No.1
척추마취는 국소마취제를 지주막하강에 주입하여 척수신경 전근과 후근을 차단하는 방법으로 하복부나 하지 수술 뿐 아니라 만성 통증과 암성 통증의 치료에도 이용되고 있는데 마취시간이나 제통시간의 연장 및 적절한 피부분절의 마취나 진통의 달성은 척추마취에서 중요한 사항이다. 본 연구에서는 morphine정주가 척추마취에 어떤 영향을 주는지 알아보기 위해 척추마취하에서 하지 수술을 받은 40명의 환자를 대상으로 척추마취를 시행한 80분에 척추마취 레벨, 수축기 및 이완기 혈압, 맥박 그리고 호흡수를 조사한후 morphine 10 mg을 정맥내로 주사후 20분후에 척추마취 레벨과 혈압, 맥박, 호흡수를 조사하여 다음과 같은 결과를 얻었다. 1) 척추마취 레벨은 morphine 투여진 $T_{7.5{\pm}0.32}$에 비해 morphine 투여 20분후에 $T_{6.0{\pm}0.31}$로 의의있게 상승하였다 (p<0.005). 2) 수축기 및 이완기 혈압과 맥박수는 morphine투여전과 투여후에 의의있는 변화가 없었다. 3) 호흡수는 morphine 투여전에 비해 투여후 감소가 있었다(p<0.005). 이상의 결과로 척추마취하에서 수술을 시행할 때나 통증치료시 전신적으로 morphne을 투여하여 마취와 진통부위를 넓일 수 있을 것으로 사료된다.
임상연구 : 이비인후과수술을 받는 환자에서 수술 전 Dexamethasone 투여가 Profopol 정주통 및 수술 후 오심과 구토에 미치는 효과
이철 ( Cheol Lee ),김태요 ( Tai Yo Kim ),송윤강 ( Yoon Kang Song ),손용 ( Yong Son ),정용관 ( Yong Kwan Cheong ),김민수 ( Min Soo Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5
Background: Induction with propofol has a high incidence of pain, as well as postoperative nausea and vomiting (PONV). The aim of this study was to assess the effect of a course of dexamethasone on the pain, postoperative nausea and vomiting associated with a Propofol injection, in patients undergoing otolaryngology-head and neck surgery. Methods: One hundred twenty adults, 20-60 years of age, ASA physical status I or II, were allocated to one of two groups. Either dexamethasone 5 ml (8 mg) or saline 5 ml was administered intravenously to each group. After 60 seconds, propofol was injected into the patients` hand veins over a 30 second period and the patient was asked questions regarding the injection pain after 10 seconds. Postoperative nausea, vomiting and post-tonsilectomy pain were recorded in the recovery room (1 h after surgery) and in the hospitalization area (6 h after surgery). Results: The severity and incidence of pain at the time of the propofol injection, PONV, and the level of post-tonsillectomy pain were significantly lower in the dexamethasone group than in the control group. Conclusions: The prophylactic intravenous administration of 8 mg dexamethasone is effective in reducing the severity of pain after a propofol injection and after the tonsillectomy, and decreased the incidence of PONV. (Korean J Anesthesiol 2006; 50: 490~4)
증례보고 : 전신마취 후 회복실에서 발생한 일과성 전기억상실증 -증례보고-
이철 ( Cheol Lee ),김태요 ( Tai Yo Kim ),송윤강 ( Yoon Kang Song ),손용 ( Yong Son ),정용관 ( Yong Kwan Cheong ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Transient global amnesia is characterized by a sudden inability to form new memories (anterograde amnesia) that usually last for minutes to several hours but never longer than 24 hours. and there are no other focal neurologic signs or symptoms. Retrograde amnesia from a few hours to many years may also be associated with this condition. We report a case of a 56-year-old female patient who experienced transient global amnesia in the recovery room after general anesthesia. She repeated the same queries several times to persons nearby and appeared perplexed. A detailed neurologic examination was otherwise entirely normal. Her symptoms resolved completely the next day. (Korean J Anesthesiol 2006; 51: 130~2)
임상연구 : 어깨 관절경 수술 후 Ropivacaine과 Fentanyl의 어깨 관절 내 지속 주입의 진통 효과
정용관 ( Yong Kwan Cheong ),손용 ( Yong Son ),송윤강 ( Yoon Kang Song ),김태요 ( Tai Yo Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.4
Background: Arthroscopic shoulder surgery can result in moderate to severe postoperative pain. This study compared the postoperative analgesic effects of an intra-articular patient-controlled analgesia (PCA) infusion of 0.25% ropivacaine used with or without fentanyl after arthroscopic shoulder surgery. Methods: Sixty patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to three groups. After surgery, normal saline 21 ml (group 1; n = 20), and 0.25% ropivacaine 21 ml (group 2 and group 3; n = 20 respectively), was infused into the articular space through a PCA catheter, which was followed by an infusion of normal saline 99 ml (group 1), 0.25% ropivacaine 99 ml (group 2), or 0.25% ropivacaine 99 ml, including fentanyl 400μg (group 3) through the intra-articular PCA catheter at 2 ml/hr with a bolus dose of 0.5 ml with a lock out time of 15 minutes. The level of pain was assessed using a visual analogue scale (VAS) and a verbal pain score (VPS) 2, 4, 6, 8, 12, 24 and 36 hours after the intra-articular bolus injection. Results: The pain scores were significantly lower after 2, 4, 6 hours in group 2 and 3 than in group 1. However, after 8 hours, the pain scores were significantly lower in group 3 than in the other two groups. Conclusions: An intra-articular continuous infusion of 0.25% ropivacaine after arthroscopic shoulder surgery is more effective when used in conjunction with 400μg fentanyl. (Korean J Anesthesiol 2006; 50: 449~53)
증례보고 : Charcot-Marie-Tooth병 환자에서 발생한 Rocuronium에 의한 근이완에서의 회복 지연
정용관 ( Yong Kwan Cheong ),이철 ( Cheol Lee ),손용 ( Yong Son ),송윤강 ( Yoon Kang Song ),김태요 ( Tai Yo Kim ),김대중 ( Dea Jung Kim ),오세리 ( Se Ri O ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Charcot-Marie-Tooth disease, which is also known as hereditary motor and sensory neuropathy, is a heterogenous group of inherited diseases of the peripheral nerve. The spectrum of severity varies from asymptomatic individuals to those with severe limb abnormalities requiring corrective surgery. We report two brothers who had previously been diagnosed with Charcot-Marie-Tooth disease 3 years earlier and were scheduled to undergo a correction osteotomy of both feet under general anesthesia. General anesthesia was induced with propofol 2 mg/kg, rocuronium 0.8 mg/kg and was maintained with O2-N2O-Sevoflurane. The younger brother showed no delay in recovery of the neuromuscular blockade but the elder brother showed a delay. (Korean J Anesthesiol 2007; 53: 145~9)
김태요,송윤강,정경술 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.4
Preoxygenation is routine preior to induction of general ancsthesia for the purpose of maintaining oxygenation during laryngoscopy and tracheal intubation. A common method of preoxygenation is 3∼5 minutes of 100% O_2 breathing. In some emergency states, there may not be adequate time for a full 3-5 min of preoxygenation. Recently, Gold and some others showed that four maximally deep inspirations of 100% O_2 within 30 seconds are as effective as 5minutes of inhaltion of 100% O_2 for increasing the PaO_2 We compared the changes of arterial blood gas beween a group which took deep breaths for 1 mimute with 100% O_2 and a group breathing spontaneously for 5 minutes with 100% O_2.