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폐질환이 동맥혈 이산화탄소 분압과 호기말 이산화탄소 분압의 차이에 미치는 영향
김재환,장문석,임춘학,박영철 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.5
Background : The purpose of this study was to evaluate the effects of lung disease on the difference between arterial and end-tidal carbon dioxide tension by placing patients from the supine to the lateral decubitus position and by the changes from two lung ventilation (TLV) to one lung ventilation (OLV) during thoracic surgery. Method : Fifteen patients who had no parenchymal lung disease were selected for control group and 15 patients who had parenchymal lung disease on non-dependent lung were selected for disease group. All patients had been intubated with double lumen endobronchial tubes and respiration was controlled with a rate of 14∼15 breaths per minute and tidal volume 8 ml/kg. End-tidal and arterial carbon dioxide tension were measured at three different measurement periods (supine plus TLV, lateral decubitus plus TLV, lateral decubitus plus OLV). Results : The arterial to end-tidal carbon dioxide tension difference was more increased in disease group than control group. But there was no significnt difference in arterial to end-tidal carbon dioxide tension with position change, ventilation method change in each groups. Conclusion : We conclude that the arterial to end-tidal carbon dioxide tension difference is increased in lung disease, but it does not changed with position and ventilation method change. (Korean J Anesthesiol 1999; 36: 818∼822)
장성호,김난숙,채병국,임춘학,임혜자,이혜원 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.1
Background : A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. Methods : The records of 31,806 patients who received operation under general anesthesia were reviewed. Results : 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51∼60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8∼30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. Conclusion : We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure. (rean J Anesthesiol 1997; 33: 147∼153)
기관내 삽관시 윤활제 튜브 도포 및 석시닐콜린 사용 여부가 술후 인후통에 미치는 영향
김재환,김난숙,장성호,임혜자,채병국,임춘학,전은희 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.5
Background: Sore throat has been reported to occur in 24-90% of intubated patients after general anesthesia. This study was done to evaluate the influence of succinycholine and tracheal tube lubrication on postoperative sore throat. Methods: Three hundred and two patients requiring orotracheal intubation for surgery were randomly allocated to one of three groups according to kinds of lubricants on endotracheal tube: control group, 2% lidocaine jelly group, K-Y jelly group. All patients were premedicated similarly and anesthesia was induced with thiopental sodium. Patients were paralyzed with succinylcholine or non-depolarizing muscle relaxants and endotracheal intubation was done by one anesthesiologist. All patients were interviewed postoperatively after 24 hour by individals who did not know which lubricants and muscle relaxants were used. Results: The incidence of postoperative sore throat was no statistically significant difference in three groups when non-depolarizing agents were used for endotracheal intubation. And the incidence of postoperative sore throat was increased in control group with succinylcholine compared with control group with non-depolarizing muscle relaxants(p$lt;0.05). But the incidence of postoperative sore throat was decreased in K- Y jelly group and 2% lidocaine jelly group compared to control group when succinylcholine were used for endotracheal intubation(p$lt;0.05). Conclusions: We suggest that succinylchoine can induce the sore throat, but lubrication of tracheal tubes provide advantage in terms of reducing sore throat when succinylcholine was used for intubation.