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- 저자 : 이기흥(Kee Heung Lee) (검색결과 4 건)
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부인과 수술 후 Ondansetron 과 병용한 Dexamethasone 의 오심 , 구토 예방과 제통 효과의 비교
이기흥(Kee Heung Lee),신효상(Hyo Sang Shin),전영훈(Young Hoon Jeon),김시오(Si Oh Kim),홍정길(Jung Gil Hong) 대한통증학회 2001 The Korean Journal of Pain Vol.14 No.1
N/A Background: Postoperative nausea and vomiting (PONV) are common after general anesthesia and patient controlled analgesia (PCA) using opioids. This study was designed to compare the effectiveness of ondansetron plus dexamethasone versus ondansetron alone in the prevention of PONV in a patient undergoing a PCA. Methods: We studied 166 ASA I, and II in-patients undergoing general anaesthesia for major gynecological surgery. After induction of anesthesia, Group 1 (n 64) received intravenous (IV) dexamethasone 10 mg and Group 2 (n 102) received IV saline 2 ml before the surgical incision. Each patient received IV meperidine 50 mg as a loading dose. Meperidine 5 mg/kg, ketorolac 3.6 mg/kg and ondansetron 8 mg diluted in 40 ml solutions were connected to PCA pump for postoperative pain control. Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 1, 4, 8, 16, 24, and 36 hours after the PCA connection. Results: For Group 1 and Group 2, respectively, the overall incidence of PONV was 12.5% and 23.5%. The pain scores were lower in patients receiving a combination of ondansetron and dexamethasone than those on ondansetron alone at 4 hr (P < 0.05), 8 hr (P < 0.05) and 16 hr (P < 0.05). Conclusions: This study suggests that the combination of ondansetron and dexamethasone is not more effective than ondansetron alone in the prevention of postoperative nausea and vomiting in women having PCA following major gynecological surgery but is more effective for pain control.
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늑막강내 카테터를 이용한 난치성 상복부통증의 치료경험 2예
이기흥(Kee Heung Lee),이근보(Geun Bo Lee),박성식(S 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2
Since Reiestad and Stromskag reported interpleural insallation of local anesthetic solutions as a technique for the management of postoperative pain in the patients undergoing cholecystectomy, renal surgery and breast surgery, many physician applied this technique for upper abdominal pain from various reasons such as technically simple, effective pain relief, less respiratory depression. So we tried interpleural analgesia in two patients who suffered from severe upper abdominal pain. One had upper abdominal pain due to chronic pancreatitis and the other had right upper abdominal pain after PTBD (percutaneous transhepatic bile drainage) for biliary cirrhosis and systemic jaundice. Both were injected 10 ml of 1% lidocaine and infused continuously with 1% lidocaine (2 ml/hr) using 2-Day Baxter infusor. After bolus injection of lidocaine, pain scores (VAS 0 ~ 100) were recorded below 25mm and had not exceed that level during continuous infusion. After removing the catheters, two patients were all satisfied with this therapy. Our experiences with this technique showed that continuous infusion of local anesthetics through an interpleural catheter is effective in the control of refractory upper abdominal pain without any complication.
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Thiopental 마취 흰쥐에서 출혈시 심박수 및 혈압 변이도의 스펙트럼 분석
김형진,이기흥,홍정길,구양희 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.3
Background : This study was aimed to elucidate the effect of thiopental anesthesia on circulatory response to hemorrhage in rats by power spectral analysis of heart rate and blood pressure variability. Methods : Sixteen male Sprague-Dawley rats weighing 350∼475 g were divided into thiopental(50 mg/kg, ip)-anesthetized(T, n=10) and conscious(C, n=6) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3 ml/kg/min for 5 min. Arterial pressure was measured with a pressure transducer connected to the contralateral femoral artery for 5 min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of sytolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency(VLF, 0.02∼0.26 Hz), low frequency(LF, 0.26∼0.75 Hz) and high frequency(HF, 0.75∼5.00 Hz) band were expressed as percent of total power. Results : BefHemorrhage blood pressure was lower in T(113 6/83 6 mmHg) than in C(157 4/101 2) rats, but was not changed by hemorrhage in both groups. Before Hemorrhage HR was lower in T(331 22 beats/min) than in C(378 27) rats. HR was significantly increased to 412 26 beats/min in C, but was not changed in T during hemorrhage. Total powers of Before Hemorrhage blood pressure and HR variability were lower in T than in C. During hemorrhage, total power of blood pressure variability tended to increase in both groups, and that of DP was significantly increased during hemorrhage in T. Total power of HR was significantly increased in C, but was not changed in T. T rats showed lower LF and higher HF power of blood pressure, and lower VLF and LF and higher HF power of HR than C rats. During hemorrhage, both groups showed no significant change in spectral distribution of HR power, except for a significant increase in LF of HR after hemorrhage in C. Spectral distribution of blood pressure power was not changed by hemorrhage in C. In T rats, VLF of DP was significantly increased and HF of DP was decreased during hemorrhage. Conclusions : It suggests that autonomic activity, especially cardiac sympathetic activity is increased in response to hemorrhage in C. Thiopental anesthesia depresses overall autonomic activity, especially sympathetic activity, and vasomotor tone. Hemorrhage under thiopental anesthesia induces depression of baroreceptor reflex activity, while increased levels of vasoconstrictor hormones help to maintain the blood pressure. (Korean J Anesthesiol 1997; 33: 399∼406)
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LIm, Dong Gun,Lee, Kee Heung,Park, Jin Woong 경북대학교 의학연구소 1999 경북대학교병원의학연구소논문집 Vol.3 No.1
서 론: Nitric oxide synthase (NOS)가 L-alginine - nitric oxide (NO)계의 주 조절인자로 밝혀졌다. Hydroxocobalamin은 NO와 결합하기에 NO의 혈관 평활근 이완을 억제한다. 본 연구는 패혈증시 thiopental에 의한 혈관 수축반응에 hydroxocobalamin (10-6~10-4 M)과 NOS 억제제인 Nw-nitro-L-arginine methyl ester (L-NAME, 10-6~10-4 M)과 aminoguanidine (10-6~10-4 M)의 수축 강화작용을 서로 비교하고자 한다. 방 법: 패혈증은 lipopolysaccharide의 복강내 주사로 유도 하였고 phenylephrine 누적 투여로 확인하였다. 홍부 대동맥을 적출하여 hydroxocobalamin, L-NAME 또는 aminoguanidine을 처치한 후 thiopental에 의한 등장성 수축력을 측정하였다. 결 과: Thiopental에 의한 혈관 반응은 농도 의존적 수축 반응이었다 (10-4~3×10-3 M). Hydro-xocobalamin 처치군에서L-NAME 또는 aminoguanidine 처치군 보다 thiopental의 혈관 수축력이 더 증가 되었다. 결 론: 패혈증 혈관의 thiopental에 의한 수축력 증가에 NOS의 억제 보다는 NO의 직접적인 제거가 더욱 효과적인 것으로 판단된다. (Korean J Anesthesiol 1998; 35: S1∼S7)
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