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Esmolol 투여가 기관내튜브 발관후 나타나는 심혈관계 반응에 미치는 영향
손주태,우민규,천현준 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.4
Transient increases in blood pressure and heart rate(HR) at the end of anesthesia and during extubation are common. Tomori and Widdicombe observed that mechanical stimulation of four areas of the upper respiratory tract (nose, epipharynx, laryngopharynx, tracheobnchial tree) induced reflex cardiovascular responses associated with enhanced neuronal activity in the cervical sympathetic efferent fibers. In susceptible patients, even this short period of hypertension and tachycardia can result in myocardial ischemia or increased intracranial pressure. The purpose of present study was to evaluate the effect of esmolol in attenuating cardiovascular responses to extubation under general anesthesia with endotracheal intubation. A sixty healthy patients who underwent elective noncardiac operation under general anesthesia (N₂O-O₂-enflurane) with endotracheal intubation were randomly divided into two groups : one was placebo group that received intravenous injection of 0.1 cc/kg normal saline, the other was esmolol group that received intravenous injection of 1 mg/kg esmolol. Extubation was performed when the patients could breathe spontaneously and open their eyes on command. In practice extubation was done between 2 and 4 minutes after drug(esmolol or saline) injection. The measurement of systolic blood pressure and heart rate was obtained one minute before extubation and every minute for 5 minutes after extubation, then rate-pressure product was calculated. The results were as follows; 1) When compared to pre-extubation systolic blood pressure, systolic blood pressure for 2 minutes after extubation in both groups increased significantly but systolic blood pressure was more rapidly returned to pre-extubation level in the esmolol group than in the placebo group. When compared to pre-extubation systolic blood pressure, after extubation the number of patients in whom systolic blood pressure increased more than 20% was significantly fewer in the esmolol group than in the saline group. 2) When compared to pre-extubation heart rate, heart rate at 1 minute after extubation in the placebo group increased significantly but heart rate after extubation in the esmolol group did not change significantly. 3) When compared to pre-extubation rate-pressure product, rate-pressure product for 2 minutes after extubation in both group increased significantly. At 4 minutes after extubation, rate-pressure product in the saline group increased significantly when compared to rate-pressure product in the esmolol group. These results suggest that intravenous injection of 1 mg/kg esmolol before extubation blocks heart rate elevation following extubation under general anesthesia and is effective for rapid return to the pre-extubation level of systolic blood pressure.
이국현,손주태,우민규 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.6
Background: The induced hypotension was used to decrease blood loss, thereby decreasing the need for blood transfusion and/or improving operating conditions at the surgical site. It was hypothesized that SNP-induced hypotension with fixed concomitant esmolol infusion(75 ㎍/kg/min) might prevent side effects such as reflex tachycardia and reduce SNP dose requirement during SNP-induced hypotension. Method: The concomitant infusion of 75 ㎍/kg/min esmolol was used to potentiate hypotension(30% reduction of mean arterial blood pressure) induced with sodium nitroprusside in six dog during halothane(lvo1%)-N₂O(50%)-O₂(50%) anesthesia. Mean arterial blood pressure, heart rate, cardiac output, mean pulmonary arterial blood pressure, central venous pressure, arterial blood gas analysis, and mixed venous oxygen saturation were measured and systemic vascular resistance was calculated in the each periods. Result: The results run as follows; 1) Compared to SNP-induced hypotension, there was significant reduction in SNP se requirement to maintain a 30% reduction of mean arterial pressure at the concomitant infusion of 75 ㎍/kg/min esmolol. 2) There were significant reduction in heart rate, mixed venous oxygen saturation and cardiac output, but significant increase in systemic vascular resistance and mean pulmonary arterial pressure at the coneomitant infusion of 75 ㎍/kg/min esmolol. 3) No rebound hypertension was observed at 30 minute after SNP and esmolol infusions were simultaneously discontinued. Conclusion: The result of present study suggests that esmolol infusion is a safe and effective pharmacologic means of potentiating SNP-induced hypotension during halothane-N₂O-O₂ anesthesia. Probably esmolol may act by counteracting side effects such as acute tolerance during SNP-induced hypotension.
폐의 림프관평활근종증(lymphangioleiomyomatosis)을 동반한 임산부의 제왕절개술을 위한 경막외 마취경험 1 예
손주태,이헌근,정영균,우민규 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.6
Lymphangioleiomyomatosis result from the proliferation of immature smooth muscle cells in the peribronchial, perivascular and perilymphatic areas of the lung. The disease primarily affects women of childbearing age, which has dyspnea, recurrent episodes of pneumothorax, pulmonary edema, chylous effusion and hemoptysis as symptoms. Most patients die from respiratory failure within 10 years after diagnosis. Definite diagnosis depends on histologic findings. We report our experience of anesthetic management for a pregnant woman with lymphangioleiomyomatosis which was confirmed with biopsy of inguinal lymph nodes.
홍영민(Young-Min Hong),송영철(Young-Cheol Song),우민규(Min-Kyu Woo),이인성(In-Sung Lee),박명근(Myoung-Keun Park) 대한전기학회 2010 대한전기학회 학술대회 논문집 Vol.2010 No.7
일반적으로 3상 유도전동기의 역률 보상을 위한 콘덴서 회로는 중성선에 흐르는 전류나 전압을 통하여 고장 진단 및 제어를 한다. 이러한 제어 회로는 Δ결선 상에서 제어가 불가능하고, 사고 시 고속도 계전기의 동작시간인 3사이클 이전에 사고가 진행되는 경우 실제 동작이 불가능한 문제점이 제기된다. 전력용 콘덴서의 경우 소손 시 폭발 또는 화재를 유발하게 됨에 따라 전력공급중단 뿐 아니라 용수공급중단 등 사회적 문제를 야기하게 됨에 따라 사전에 사고를 예방하는 기술이 시급하다. 이에 따라 본 논문에서는 내부소자 소손 시 저항 감소에 의한 전류 변화 검토 및 열에 의한 절연유 팽창 및 그에 따른 외함의 폭발 사고에 대하여 그 이전에 콘덴서를 차단 및 교체할 수 있는 방법을 제안하고 그 이론적 적합성을 증명한다.