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옥시영 ( Si Young Ok ),배상철 ( Sang Chul Bae ),김혜하 ( Hye Ha Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
A Swan-Ganz catheter is a useful monitoring device for measuring the pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac output, but its insertion brings about many complications, including dysrhythmias, pulmonary artery rupture, thrombosis and infection. We report here on a case of malposition of a Swan-Ganz catheter in a 49-year-old female patient who had undergone liver transplantation due to alcoholic liver cirrhosis. (Korean J Anesthesiol 2006; 51: 476~9)
임상연구 : 한국인에서 Propofol-Remifentanil 전정맥 마취시 기관내 삽관에 따르는 혈압과 맥박수의 증가를 예방하기 위한 Remifentanil의 효과처 농도
신혜란 ( Helen Ki Shinn ),이홍식 ( Hong Sik Lee ),이춘수 ( Choon Soo Lee ),정종권 ( Chong Kweon Chung ),차두천 ( Doo Cheon Cha ),김혜하 ( Hye Ha Kim ),송장호 ( Jang Ho Song ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.3
Background: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4μg/ml) and to find any sexual differences. Methods: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4μg/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. Results: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 ng/ml) in male group and 1.05 ng/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. Conclusions: Relatively small dosages of remifentanil (0.68-1.81 ng/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences. (Korean J Anesthesiol 2006; 51: 312~7)