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Lidocaine 정주가 기관내 삽관에 의한 안압상승에 미치는 영향
한영진,민기철 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.4
To investigate the effect of lidocaine on the intraocular pleassure during induction of general anestheaia, intraocular pressure (lOP) was measured together with mean arterial pressure (MAP) , pulse rate, before and after intratraoheal intubation under several conditions (saline 5cc, lidocaine, 2 mg/kfr, lidocaine 2 mg/kg plus succinlrcholine 1 mg/kg). The results were as follows 1) Changes in mean arterial Preesure was not significantly different between lidocaine treated group and non-treated group (p $lt;0.05), 2) Changes in pluse rate was also not significantly different between lidocaine treated group and non·treated group (p$lt;0.05). 3) A decrease in lOP was net statistically significant after either lidocaine or saline administration comparing with the control baseline level. 4) lOP was markedly increased above the control baseline level after succinylcholine (S.C.C.) administration. 5) A increase in lOP produced by intratracheal intubation wart reduced significantly by pretreatment with lidocaine comparing with non-treated group (P$lt;0.01). 6) Simultaneous administration of lidocaine and succinylcholine did not prevent increase in lOP produced by intratracheal intubation. The abode data suggest that it would be most preferable to intuhate the patients under the general anesthesia with lidocaine pretreatment without using succinlycholine in the patients with eye hall Perforation or the patients who have recent surgical ocular incision.
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김동찬,최 훈,강금이,민기철 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.2
Evaluation of inadvertent dural puncture occuring among 30g epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1,6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspira- tion of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.
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최훈,송희선,최영덕,민기철 대한마취과학회 1985 Korean Journal of Anesthesiology Vol.18 No.4
Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, an low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytic blocks of celiac plexus were given to the patients suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via para verterbral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid on to three times. Other peripheral verve blocks and regional corticosteroid therapy were given to the rest of the patients. Fair to excellent result was obtained in 71% of th patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.
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한영진,송희선,박종관,민기철 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.6
Clinical analysis was done of 284 head injured patients admitted to the hospitals in the Chombuk area from January to December 31, 1984. The results were the following. 1) Head in jury occurred mostly in the 3rd and 4th decade and male patients were 3.7 times as friquent as the female patients. 2) The main cause of head in jury was traffic accidents(79%) Other causes were blunt trauma, falls, and gunshot in that order. Many of the traffic accidents inbolved motorcycles. 3) The accidents were prevalent between 6 and 12 P.M. on Wedenesday and Thursday, and in spring and autumn. 4) There was close relation between the level of the consciousness and the death rate of the victims. That is, everyone who was clear or in a stuporous mental state at the time of operation survived, while most of the patients who were semi-or fully comatose died. 5) The time lag between the accident and the surgical operation was 1 to 3 hours. 6) 71% of the in juries were epidural and subdural hematomas, and the rest of the in juries were compressed skull fracture, hemorrage inside the brain parenchyme, in that order. 7) The auesthesia was induced mostly with thiopental sodium and maintained with halothane-N_2O-O_2 sequence(91.5%). NLA was used in the rest for anesthesia(9.1%). 8) Total auesthesia time lapsed for the operation was 2∼3 hour in 38%, 3∼4 hour in 25% and less than 1 hour in 1.7%.
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술후 진통을 위해 투여한 Ketorolac이 혈액응고 기능에 미치는 영향 : 혈전탄성묘사도를 이용한 평가 A Thromboelastographic Evaluation
최인범,고성훈,김동찬,한영진,최훈,민기철 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.6
Background: Thromboelastography (TEG) has recently become popular for assessment of whole blood coagulation in the operating room. Ketorolac, a potent injectable nonsteroidal anti-inflammatory drug (NSAID), is commonly used for postoperative analgesia. NSAID inhibit plated aggregation in coagulation process. This study was designed to determine whether ketorolac used for postoperative analgesia can affect hemostatic function using a TEG. Methods: Seventy-four female patients, ASA physical status 1 or 2, scheduled for an elective gynecologic surgery were randomly allocated into one of four groups (Group 1: n=10, control without patient-controlled analgesia (PCA); Group 2: n=21, PCA with morphine 60 mg; Group 3: n=20, PCA with morphine 30 mg + ketorolac 90 mg; Group 4: n=23, PCA with ketorolac 180 mg). Blood samples were obtained for TEG analysis preoperatively and 24, 48 and 72 h after surgery. Cumulative drug dosage, visual analog pain scale, satisfaction degree and side effects were measured at 24, 48 and 72 h after surgery. Results: There were no significant differenced in TGE parameters among the four groups at each time. There were no significant differenced in visual analog pain scales and satisfaction degree among the three groups using PCA for postoperative analgesia. Among the three groups using PCA for postoperative analgesia, Group 2 experienced more side effects. Conclusions: Ketorolac does not affect hemostatic function for 3 days after surgery when administrated as a PCA drug. (Korean J Anesthesiol 2002; 43: 755~762)
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