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구혈기 설치 부위의 Lidocaine 침윤 마취가 혈압과 심박수에 미치는 영향
신옥영,강화자,원시권 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.6
Background: A tourniquet is commonly used to achieve a bloodless field in surgery of the extremities. However, the anesthesiologist is concerned about the adverse effects of hypertension which occur during general anesthesia. In this study, we assessed the effects of lidocaine infiltration in the tourniquet site on blood pressure and heart rate during tourniquet inflation under general anesthesia. Methods: Forty patients of ASA class I or II, scheduled for knee surgery, were randomly divided into two groups. In group 1 underwent general anesthesia and in group 2 also underwent general anesthesia and combined with 1% lidocaine infiltration in the tourniquet site. The changes of systolic and diastolic blood pressure and heart rate were measured before and after toumiquet inflation, after skin incision and 30 min after inflation. Results: Comparing group 1 with group 2, there were significant increases after tourniquet inflation to 30 min after inflation in systolic and diastolic blood pressure in group 1 (p$lt;0.05). However, there were no significant changes in heart rates in either group. Conclusions: The above results demonstrate that patients who received lidocaine infiltration in the tourniquet site showed less increase in blood pressure during tourniquet inflation.
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사각근간 차단을 이용한 어깨 관절경수술에서 좌위에 따른 Bezold - Jarish 반사
이두익(Doo Ik Lee),원시권(Shi Gwen Won),김동우(Don 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2
N/A Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISR) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred 39+ 18 min after sitting position and 22+18 min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-Jarish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex
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