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임상연구 : Rocuronium 정주 방법에 따른 회피 반응과 기관내삽관 조건 비교
우철민 ( Cheol Min Woo ),백승훈 ( Seung Hoon Baek ),김철홍 ( Chul Hong Kim ),권재영 ( Jae Young Kwon ),김해규 ( Hae Kyu Kim ),신상욱 ( Sang Wook Shin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Background: Rocuronium may replace succinylcholine for intubation in general endotracheal anesthesia. However, intravenous bolus injection of rocuronium produces the responses of pain and withdrawal. We hypothesized that the infusion of rocuronium during endotracheal intubation could decrease these responses without influencing the intubating condition. Methods: One hundred and twenty patients were randomly assigned to one of four groups (B2, I2, B3, and I3), divided by the injection methods (B2 and B3: bolus injection, I2 and I3: infusion injection for 60 sec) and doses of rocuronium (B2 and I2: 0.6 mg/kg, B3 and I3: 0.9 mg/kg). After loss of consciousness with thiopental sodium (5 mg/kg), rocuronium was injected intravenously as arranged in every groups. Withdrawal response to rocursonium injection was assessed by 4-grade scale (score 0-3). Muscle relaxation was monitored by fade out time of single twitch stimulation, and the intubating condition was assessed by the total score of 4-grade scales (score 0-3) of jaw relaxation, vocal cord opening and response to intubation. Results: The withdrawal scores of the infusion groups (I2 and I3) were lower than those of the bolus groups (B2 and B3) (P < 0.05). The fade out time of single twitch stimulation was shorter in large dose (0.9 mg/kg) of rocuronium (P < 0.05), but it was not different regardless of injection methods (bolus vs. infusion). Intubating condition was also better in large dose group than small dose regardless of their injection methods. Conclusions: The infusion of rocuronium for endotracheal intubation effectively reduces the withdrawal response compared with bolus injection, and it neither delays the onset of muscle relaxation nor deteriorates the intubating condition during endotracheal intubation. (Korean J Anesthesiol 2006; 51: 663~8)
증례보고 : cis AB 환자에서 나타난 부적합수혈반응
우철민 ( Cheol Min Woo ),이현정 ( Hyeon Jeong Lee ),곽희숙 ( Hi Suk Kwak ),신상욱 ( Sang Wook Shin ),권재영 ( Jae Young Kwon ),김해규 ( Hae Kyu Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.5
AB blood group is determined by A and B genes located on each chromosome which inherited from parents. But unusual inheritance of A and B genes on the same chromosome has been reported as cis AB. Recently the authors have experienced one case of patients with cis AB blood type undergoing emergency adhesiolysis of small bowel obstruction. We transfused the patient with Rh A+ packed red blood cell and fresh frozen plasma with atypical delayed hemolytic transfusion reaction. (Korean J Anesthesiol 2006; 51: 632~7)