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        증례보고 : ProSeal(TM) 후두마스크를 사용한 전신마취 후 발생한 연구개점막의 대칭형 파열

        전인숙 ( In Suk Jeon ),김상백 ( Sang Baek Kim ),이동기 ( Dong Gi Lee ),박진규 ( Jin Gue Park ),배상철 ( Sang Cheul Bae ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4

        ProSeal(TM) laryngeal mask airway (PLMA) was developed to be more effective especially with glottic airway sealing and is suppose to be an improved device over the classic laryngeal mask airway (cLMA). The PLMA`s cuff is bulkier, softer, and more pliable than the cLMA. We reviewed a case were a patient had hand surgery under general anesthesia using the PLMA. After having the hand surgery, the patient suffered from dyspnea and had difficulty with their respirations at a supine position. The problems with dyspnea and respiration after surgery resulted because of difficulties from inserting PLMA No.5 into the patient. We suspect from this case that the problems in dyspnea and respiration were due to the folded cuff and incomplete placement of the PLMA, which resulted in lacerations of the mucosa in the soft palate of the patient. In this paper, we considered the probable causes for lacerations of the mucosa in the soft palate and reviewed all of the relevant literature, especially about the proper placement of the PLMA. (Korean J Anesthesiol 2009;56:438~42)

      • Propofol을 이용한 정맥마취시 Nicardipine의 정주가 기관내 삽관시 혈역학적 변화에 미치는 영향

        배상철 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

        Background: Laryngoscopy and tracheal intubation often provoke an undesirable increase in blood pressure and heart rate. Many approaches have been tried to attenuate these hemodynamic responses. This study was designed to determine the optimal dose of nicardipine(N) for maintenace of hemodynamic stability during intravenous with propofol. Methods: Sixty ASA physical class 1 patients were randomly divided four groups of fifteen patients. Saline (control), N 0.5mg(N0.5), N 1mg(N1), and N 1.5mg(N1.5). Tracheal intubation under direct laryngoscopy was perfomed. After intravenous thiopental 5mg/kg, vecuronium 0.12mg/kg, 0.5, 1 and 1.5mg of nicardipine was given intravenously followed by mask ventilation of three minutes with propofol, nitrous oxide and oxygen. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure(MAP) and heart rate(HR) were recorded at the resting state, preintubation, immediately after intubation, 1, 2, 3, 4 and 6 minutes following intubation. Results: After tracheal intubation, the increase of systolic blood pressure was suppressed significantly by nicardipine 1 and 1.5mg group compared with the control group. But the increase of heart rate was the greatest in the nicardipine 1.5mg group. Condusions: We suggest that the appropriate dose of nicardipine during induction with propofol for attenuation of pressor response to laryngoscopy and intubation in healthy patients is 1mg.

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