http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
장시간 수술시 Propofol과 Enflurane의 마취 유지 효과 및 술후 각성도에 대한 비교
김태요,윤재승,이강창,정영표,안선연 圓光大學校 1995 論文集 Vol.30 No.2
There has not been particular attention focused on the comparative benefits and risks of propofol anesthesia with inhalation anesthesia in the operations of long duration. This study was assessed the anesthetic efficacy and the speed of recovery from propofol or enflurane anesthesia in patients undergoing the long term operations. The propofol group (n=25) receiver 2.0 - 2.5mg/kg propofol intravenously for the induction of anesthesia and followed by propofol infusion(6 - 12mg/kg/h). The enflurane group (n=25) was induced as the propofol group and followed by enflurane(1-2 MAC) addministration. All patients received nitrous oxide (50%) in oxygen immediately after tracheal intubation. All anesthetic agents were stopped at the time of last stitch. The hemodynamic changes were recorded and the recovery was assessed with the time from discontinuation of all anesthetics to extubation and the indices of consciousness at early recovery(recall name, eye opening on command, raise hand on request and coughing on request). The recovery tests showed no differences between the groups. Systolic pressure after intubation in propofol group was significantly increased (p<0.05), compared with enflurane group. In propofol group, seven patients received fentanyl because of light anesthetic depth. The frequency of nausea and vomiting was similar between the groups. In conclusion, the long propofol anesthesia was not associated with faster recovery than enflurane anesthesia and propofol as an agent of anesthetic maintenance was unfavorable.
경막외 Morphine의 첨가제로 사용한 Fentanyl과 Bupivacaine의 술후 진통효과 비교
안선연(Sun Yeon An),손 용(Yong Son),정영표(Young P 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2
N/A Backgound: The present study was undertaken to determine whether fentanyl or bupivacaine is a better adjuvant to epidural morphine with respect to postoperative analgesic use and with fewer incidence of side effects. Methods: We evaluated the clinical effects in 62 patients having cesarean section, divided in 3groups randomly. Group I(n 19) was received epidural marphine 4 mg, group II(n=22) was received epidural morphine 2 mg plus fentanyl 50 μg and group III(n=21) was received morphine 2 mg plus 0.25% bupivacaine 10 ml epidurally. We measured the first request time of analgesic for postoperative pain, the number of supplemental analgesics within 24 hours and the incidence of side effects postoperatively. Results: The first request time of analgesic for postoperative pain was significantly shorter in group III than in group I and IL The analgesic use in the first 24 hours was significantly more in group III than in group I and II. The side effects were significantly fewer incidence in group II than in group I and III. Conclusions: In conclusion, the combined use of epidural morphine and fentanyl provided better analgesia than the combined of epidural morphine and bupivacaine.
흰쥐 해마에서 Ketamine이 Norepinephrine 유리에 미치는 영향
김태요,채영남,안선연 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.4
Background : Since it has been reported that ketamine, an intravenous anesthetic, is a non-competitive antagonist of N-methyl-D-aspartic acid (NMDA) receptors, a large number of experimental data on the several mechanism of this process have been accumulated. But the mechanism about the effect of ketamine on neurotransmitter release in central nervous system has not been clearly elucidated yet. Therefore the present study was undertaken to investigate the effects of ketamine and thiopental sodium on hippocampal norepinephrine (NE) release, and also to examine the relationship between ketamine and NMDA receptor mechanisms in the rat hippocampus. Methods : Slices from rat hippocampus were equilibrated with [3H]norepinephrine ([3H]NE) and the release of labelled products was evoked by electrical stimulation (3 Hz, 5 V/cm, 2 ms, rectangular pulses, 2 min), and the influence of various agents on the evoked tritium-outflow and the basal rate of release were investigated. Results : In rat hippocampal slices, ketamine (1∼30uM) and thiopental sodium (1∼30uM) did not affect the evoked NE release and the basal release in the normal and Mg2 free medium. NMDA (3∼100uM) did not alter the NE release in the normal medium, but NMDA (1∼30 M) increased the basal rate of NE release in the Mg2+ free medium. The increasing effects of NMDA on basal release were completely abolished by ketamine treatment in a concentration dependent manner. But, thiopental sodium did not affect the NMDA effect. Conclusions : These results suggest that increment of the basal rate of NE release is mediated by NMDA receptor in the rat hippocampus and ketamine completely block this effect, but thiopental sodium is not involved in these process. (Korean J Anesthesiol 1998; 35: 591∼598)
경부 경막외 차단 시 약물의 용량에 따른 분포 양상 비교
조대현,이강창,김명희,안선연,박사현 대한통증학회 2007 The Korean Journal of Pain Vol.20 No.1
Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were 4.88 ± 0.78 segments and 4.53 ± 0.49 segments, respectively. Spread levels to the caudad for patients in the two groups were 4.59 ± 0.93 segments and 4.47 ± 0.51 segments, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.(Korean J Pain 2007; 20: 46-49)
박수경,김태요,정영표,안선연,최덕화 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.5
Background : There were several studies for the incidence of gastroesophageal reflux associated with the laryngeal mask airway(LMA), but the results of those studies were much different from one another. This conflicting results may be due to the time of the removal of LMA, which has been usually after the arousal(when the patient can open the mouth on command). So, the authors investigated the incidence of the gastroesophageal reflux and the regurgitation of gastric contents above the upper esophageal sphincter associated with the difference of the time of the removal of LMA. Methods : Sixty three patients scheduled for elective orthopedic surgery with a standardized general anesthetic technique were allocated randomly to Group A(n=34, LMA was removed when the rejection signs such as struggle, restlessness, swallowing and cough came out.) or Group B(n=29, LMA was removed after arousal). For the detection of reflux and regurgitation episodes during anesthesia, a pH monitoring probe was positioned in the lower esophagus and a methylene blue(50 mg) gelatine capsule was swallowed just before induction. At the end of anesthesia, the episodes of reflux and regurgitation of gastric contents were analyzed according to the pharyngeal blue staining or pH≤4. Results : The incidence of reflux(pH≤4) from the time of the rejection signs to the removal of LMA and the total incidence of reflux in Group B were significantly higher than that of Group A. No patient in both group showed pharyngeal staining of methylene blue. There was no clinical evidence of aspiration of gastric contents in either group. Conclusion : Maintenance of LMA until the patient can open the mouth on command seems to increase the incidence of the gastroesophageal reflux. (Korean J Anesthesiol 1998; 34: 956∼960)