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가토에서 Sodium Nitroprusside 에 의한 유도 저혈압이 혈장 Renin 활성치 및 혈청 Aldosterone 치에 미치는 영향
문세호,진수남,채준석,이승균,옥광익 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.2
The renin-angiotensin system plays an important role in maintaining blood pressure in various pathologic and physiologic states. To investigate the effects of the sodium nitroprusside (SNP)-induced hypotension on plasma renin activity and serum aldosterone level, SNP 2.0 ㎎/kg/min was infused to seven unanesthetized rabbits. The mean arterial pressure and heart rate were measured three times; at the start of, 15 and 30 minutes after SNP inusion and 30 minutes after the discontinuation of SNP infusion. The measurement of the plasma renin activity and the serum aldosterone levels during SNP infusion were done by means of radioimmunoassay. The results were as follows: 1) The mean arterial pressure was 117.6±6.9 mmHg at zero time ans decreased significantly to 84.0±19.6mmHg and 72.9±21.6mmHg at 15 and 30 minutes after SNP infusion, respectiely(P$lt;0.01). 2) The heart rate was 124.8±9.3 beats/min at zero time and increased significantly to 139.7±6.4 beats/minute and 155.6±7.9 beats at 15 and 30 minutes after Ssion, respectively(P$lt;0.05). 3) The plasma renin activity was 2.31±0.53 ng/ml/hr at zero time and increased significantly to 5.17±1.39 ng/ml/hr and 4.97±1.52 ng/ml/hr in 15 and 30 minutes after SNP infusion, respectively. 4) The serum aldosterone level was 28.8±13.5ng/dl at zero time and increased to 42.3±14.6ng/dl and 39.5±13.9ng/dl at 15 and 30 minutes after SNP infusion and it continued to increase up to 30 minutes after discontinuation of SNP infusion. In conclusion, it was postulated that the plasma renin activity and serum aldosterone level were closely related to the change of the mean arterial pressure and heart rate during SNP-induced hypotension.
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이은주,임용걸,강유진,옥광익 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.2
Apert's syndrome is rare autosomal dominant defect characterized by craniosynostosis, midface hypoplasia and symmetrical syndactyly. Multiple surgical procedures will be needed for the child with this syndrome. Especially surgery for craniosynostosis is most often performed between 2 and 6 months of life, a period of physiologic anemia. Perioperative complications can occur from numerous sources-massive blood loss, venous air embolism, cerebral edema, hypothermia and hazardous airway management, thus more monitoring, large bored central venous line and early transfusion are recommended. We report a case of 5 month-old female Apert patient undergoing frontal bone advancement and cranioplasty. At the end of uneventful surgery, we removed endotracheal tube in operating room and permitted early feeding because the procedure was limited above the orbital ridge. As soon as feeding the patient presented cyanosis with generalized seizure. Patient was immediately intubated, sucked out secretions and inhaled with oxygen. Blood gas showed moderate hypoxemia which was improved by oxygen therapy. Suspicious aspiration pneumonia was marked on chest film but disappered I week later. The condition was favorable thereafter and discharged without complication. Keypoints in management of Aperts syndrome are close observation, early detection and preventive treatment of possible complications in perioperative period. (Korean J Anesthesiol 1995; 29: 30D~303)
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Capnometer 를 이용한 과한기시 혈중 칼륨, pH,(a-Et)PCO2 에 미치는 변화 및 이에 대한 환기정도의 평가
최종호,심재용,김은성,문동언,지승은,이승균,옥광익 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.5
Capnometer has been used in anesthesia for the evaluation of pulmonary ventilation because of its nonivasive and continuous monitoring advantges. We studied pulmonary ventilation effects with arterial blood gas parameter between normoventilation and hyperventilation with capnometric control during 1 hr duration. We devided two group. Control group was maintained PetCO₂ 38 mmHg and experimental group PetCO₂ 28 mmHg and four times arterial blood gas sample were done. The results were as follows. 1) Serum K+ concentration was decreased siginifcantly in hyperventilation group. 2) Arterial pH changes were observed respiratory alkalosis in experimental group and respiratory acidosis in control group. 3) (a-t)PCO₂ differnce were increased in both group and especially control group with correlation of time duration. 4) No arrhythmia were detected in both group. We conclude that only capnometric control of pulmonary ventilation is not suffieient and it has to be combined periodic ABGS and resetting of ventilation m.
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