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경비기관 삽관시 비출혈 빈도와 용이도에 대한 비인두 기도의 효과
진영호,송희선,한영진,유래호 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.6
Background : When the insertion of endotracheal tube (ETTs) though the nostril, the tube may be encountered some resistance. Forcing ETTs into the nasal cavity develope mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstictor and/or lubricant tube are employed. Therefore, We determined whether nasopharyngeal airway (NPA) insertion reduces the incidence of epistaxis and increase the ease of the tube advancement in the nasal cavity during nasotracheal intubation. Methods : Two hundred adult patients who schesuled for elective surgery were divided into two groups, control (n=100), and NPA (n=100). The NPA insertion group received an armored tube after nasoparyngeal airway inserts, while control group received a plain armored tube. All patients in both groups was inserts ETTs by conventional nasotracheal insertion techniques. Result : The NPA insertion group had a significantly low incidence of epistaxis (11%) than control group (34%) (p<0.05). But, provided nt easier passage during nasotracheal intubation than control group. Conclusion : We conclude that nasophryngeal airway reduces the incidence of epistaxis during nasotracheal intubation, but not to increase easy passage of the tube advancement. (Korean J Anesthesiol 1999; 36: 955∼959)
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상복부 수술 환자에서 경막외 Morphine의 술전 투여와 술중 투여시 진통 효과 비교
김윤희(Yun Hee Kim),유래호(Rae Ho Yoo),고성훈(Seon 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1
N/A Background: Preoperative analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurans and therefore may preempt postoperative pain. Although preemptive analgesia has shown to decrease postinjury pain in animals, studies in human are not consistent. We studied whether epidural morphine injection before surgical incision could affect postoperative pain and analgesic demands, compared with injection after removal of specimen. Methods: Forty patients scheduled for radical subtotal gastrectomy were randomly assigned to one of two groups for prospective study in a double-blind manner. Group 1 received an epidural injection of 3 mg of morphine in 8 ml of 0.9% saline before surgical incision, and group 2 after removal of specimen. Postoperative pain relief was provided with I.V. patient controlled analgesia (PCA) system. Numerical rating scales for pain and mood, Prince Henry Hospital scores for pain, cumulative PCA analgesic consumptions, and incidence of side effects were assessed at 2, 6, 12, 24, 48 hours after operation. Results: Cumulative PCA analgesic consumption in group 1 was significantly less than in group 2 at 2, 6 hours after surgery. Pain scores and the incidence of side effects were similar in both groups. Conclusions: Preoperative analgesia with epidural morphine showed little difference in patient controlled analgesic consumption after upper abdominal surgery compaired to intraoperative morphine
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노인 환자에서 고관절 치환술 중 발생한 심정지와 술후 섬망
김동찬,한영진,고성훈,유래호,김우선 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.2
An Eighty-year-old female patient was transferred to the operating room for hip arthroplasty under the general anesthesia. Immediately after injection of two units of methylmethacrylate bone cement into the intramedullary canal, systolic blood pressure rapidly decreased and cardiac arrest occurred. The patient was turned to the supine position and was successfully resuscitated with intravenous administration of fluids, injection of epinephrine and external cardiac massage. In the intensive-care unit, she was treated for acute pulmonary edema. Three days later, postoperative delirium was developed. She spoke incoherently, was disoriented, and showed impairment of memory and attention. She was treated with haloperidol, lorazepam and sedative drug, five days later recovered. The patient was discharged to home without any sequelaes, but she died due to pneumonia two months later postoperatively at home. (Korean J Anesthesiol 1999; 36: 365∼369)
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