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질식전자궁적출술 후 통증에 대한 Gabapentin의 효과
김현미 ( Hyun Mi Kim ),김은옥 ( Eun Ok Kim ),송지은 ( Ji Eun Song ),박성호 ( Sung Ho Park ),전현아 ( Hyun Ah Jun ),김홍배 ( Hongbae Kim ),이근영 ( Keun Young Lee ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.3
목적: Gabapentin은 새로이 개발된 항전간제이다. 수술 전 Gabapentin의 투여가 수술 후 환자에서 제통 효과와 항오심 효과를 나타내기도 한다고 한다. 이번 연구 목적은 수술 전 Gabapentin 복용 후 질식전자궁적출술을 경험하는 환자에서 아편유사제 사용량 감소와 제통 효과를 알아보기 위한 것이다. 방법: 무작위추출, 이중 맹검, 실험-대조군 연구로, 선택적 질식전자궁적축술을 시행받은 환자 40명이 연구대상으로 선출되었다. 환자들은 무작위 방법으로 세 군으로 나누어 수술 전날 저녁과 수술 2시간 전에 gabapentin 1,200 mg을 경구 투여한 GABA 2군 (n=17), 900 mg을 경구 투여한 GABA 1군 (n=13), 아무것도 투여하지 않은 대조군 (n=10)으로 나뉘었다. 모든 환자들은 수술 후 통증치료를 위한 IV-PCA를 사용하였다. 결과는 수술 후 1, 2, 4, 8시간과 20시간에 측정한 PCA 소모량과 VAS로 통증정도와 아편제재의 부작용 (오심, 구토, 어지럼증)을 측정하였다. 결과: 대조군과 실험군 사이에 fentanyl 소모량에는 통계적으로 유의한 차이가 있었다 (GABA 2 group, 57.51±8.95 mg, GABA 1 group, 52.21±5.78 mg, Control group, 50.63±2.55 mg)(P<0.05)) 각 군 간의 부작용에서는 유의한 차이를 보이고 있지 않았다. 결론: 수술 전 gabnapentin의 투여가 좋은 진통 효과와 수술 후 아편유사제 소모량을 줄여줄 수 있다. Gabapentin을 질식전자궁적출술 전 사용함으로써 수술 후 진통제 필요량을 효과적으로 줄여줄 수 있을 것으로 사료된다. Objective: Gabapentin is a new generation anticonvulsant drug. Preemptive gabapentin may produce analgesic effect in postoperative patient and have antiemetic effect. The aim of the present study was to investigate the opioid-sparing and analgesic effect of preemptive gabapentin on postoperative pain in patient undergoing vaginal hysterectomy. Methods: In a randomized, double-blind, controlled study, 40 patients scheduled for an elective vaginal total hysterectomy were investigated/-. The patients were randomized to receive either oral gabapentin 1200mg (GABA group 2, n=17) or 900mg (GABA group 1, n=13) with premedication the night before and again 2hours before surgery. The other group (control group, n=10) had only routine premedication without gabapentin. All patients received patient-controlled analgesia (PCA). Postoperatively, pain was assessed using a visual analogue scale (VAS, 0-10) at time 1, 2, 4, 8, and 20 hours. Cumulative PCA consumption and opioid-related adverse events (nausea, vomiting, dizziness) was recorded. Results: There was significant decrease of fentanly consumption in gabapentin group (GABA 2 group : 57.51±8.95 mg, GABA 1 group : 52.21±5.78 mg) compared to control group (50.63±2.55 mg)(p<0.05). There was no significant difference in side-effect (nausea, vomiting, dizziness) were observed between case and control group. Conclusions: Preemptive gabapentin has a good analgesic effect and reduce postoperative fentanyl consumption on postoperative pain after vaginal hysterectomy. Gabapentin effectively rescue analgesic requirement in post-operative patients with vaginal total hysterectomy.
부인과 복강경 수술시 이산화탄소 기복형성 후 트렌델렌버그 자세가 동맥혈 가스 분석과 중대뇌동맥 혈류속도에 미치는 영향
조현진 ( Hyun Jin Cho ),김정식 ( Jung Sik Kim ),이주열 ( Ju Yeul Lee ),전현아 ( Hyun Ah Jun ),김홍배 ( Hong Bae Kim ),이근영 ( Keun Young Lee ),강성원 ( Song Won Kang ),원임수 ( Im Su Won ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11
목적: 부인과 복강경 수술은 수술시야를 좋게 하고 기구조작을 하는 공간을 확보하기 위하여 복강 내로 가스 주입과 트렌델렌버그 자세를 유지하게 되는데 이러한 과정은 환자에서 여러 가지 생리적인 변화를 일으킨다. 본 연구는 동맥혈 가스분석과 중대뇌동맥 혈류속도에 미치는 영향을 알아보고자 하였다. 연구 방법: 환자 20명을 대상으로 동맥혈가스분석, 중대뇌동맥 혈류속도, resistance index, pulsatile index를 마취 후 바로 누운 자세에서 Objective: The purpose of this study was to identify arterial acid-balance and cerebral hemodynamics in patients undergoing gynecologic laparoscopic operations according to induction of CO2 pneumoperitoneum and Trendelenburg position. Methods: Twenty pati
곽경진 ( Kyoung Jin Kwak ),전현아 ( Hyun Ah Jun ),김홍배 ( Hong Bae Kim ),이근영 ( Keun Young Lee ),강성원 ( Song Won Kang ),유종우 ( Jong Woo Yoo ),박희철 ( Hee Chul Park ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.8
Primary malignant melanoma of the vagina is a very rare disease with incidence of 0.026 per 100,000 women. The opinion of several types of treatment is suggested but the prognosis is extremely poor. Although malignant melanoma is generally regarded as a r
중증임신전자간증 임산부에서 임신 후반기 발생한 심장근육병증을 동반한 급성폐부종
조혜연 ( Hye Yon Cho ),전현아 ( Hyun Ah Jun ),문철용 ( Cheol Yong Moon ),권형준 ( Hyoung Jun Kwon ),김선숙 ( Sun Suk Kim ),송지은 ( Ji Eun Song ),이근영 ( Keun Young Lee ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
Women with severe preeclampsia or eclampsia who develop pulmonary edema most often do so postpartum and some of these women have cardiac failure. Peripartum cardiomyopathy is defined as a cardiac failure occurring in the latter part of pregnancy or in the peripartum, without obvious cause and prior evidence of heart disease. It is very rare but the mortality rate is as high as 10~50%. Here, we describe a case of a woman who has undergone emergency Cesarean section due to complicated severe preeclampsia with acute pulmonary edema and peripartum cardiomyopathy at 33+1 weeks of gestation.
임신성 당뇨 임신부에서 발생한 고중성지방혈증에 의한 급성 췌장염
김근희 ( Geun Hee Kim ),전현아 ( Hyun Ah Jun ),송지은 ( Jin Eun Song ),이근영 ( Keun Young Lee ),김선숙 ( Sun Suk Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.6
Hypertriglyceridemia is a rare cause of pancreatitis in pregnancy. Pregnancy is related with hypertriglyceridemia especially in the 3rd trimester due to increase of estrogen. Diabetes is known as a common cause of secondary lipid metabolism disorder and is often associated with hypertriglyceridemia. Shock and sepsis related to pancreatitis in pregnancy result in a relatively high morbidity and mortality rate for both the mother and the fetus. Hypertriglyceridemic pancreatitis complicated in gestational diabetes has not previously been reported. We report a case of 26(+4) weeks gestational aged primigravida with acute pancreatitis induced by hypertriglyceridemia in gestational diabetes. We reviewed the clinical courses and treatments of acute pancreatitis in pregnancy with the literatures.
기왕자궁절개술 후 발생한 자궁 동정맥 기형으로 인한 질출혈에서 혈관조영술 및 경동맥색전술 치료
신우균 ( Woo Kyun Shin ),김동진 ( Dong Jin Kim ),김현미 ( Hyun Mi Kim ),박성호 ( Sung Ho Park ),전현아 ( Hyun Ah Jun ),이근영 ( Keun Young Lee ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.5
Uterine arteriovenous malformation are very rare but life-threatening disease with massive uterine bleeding. These lesions may be congenital or acquired, the diagnosis is made by Doppler ultrasound, CT, MRI, pelvic angiography. We have experienced a patient, 33-year-old woman with vaginal bleeding after a cesarean section episode. The diagnosis was established by angiography, and the treatment was done successfully by uterine artery embolization. We report a case of uterine arteriovenous malformation, which is presented with a brief review of the literatures.
Advanced-Stage Sertoli-Leydig Cell Tumor 치료
김정식 ( Jung Shick Kim ),윤영민 ( Young Min Yoon ),유종우 ( Chong Woo Yoo ),전현아 ( Hyun A Jun ),김홍배 ( Hong Bae Kim ),이근영 ( Guen Young Lee ),강성원 ( Sung Won Kang ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11
Sertoli-Leydig cell tumors belong to the group of sex-cord stromal tumors of the ovary. They account for less than 0.5% of all ovarian tumor. They occur predominantly at premenopausal women and rarely at postmenopausal and prepubertal. Most common symptom