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Propofol과 Remifentanil을 이용한 정맥마취 중 Butorphanol이 Bispectral Index에 미치는 영향
정규돈 대한마취통증의학회 2007 Anesthesia and pain medicine Vol.2 No.4
Background: The aim of this study was to investigate the effect of butorphanol on the Bispectral Index (BIS) during the administration of intravenous anesthesia with propofol and remifentanil. Methods: Forty adult patients, ASA I-II, scheduled for an emergency laparoscopic appendectomy were studied. The doses for the anesthetics were adjusted to keep the BIS value between 40 and 50. After 20 minutes of stable anesthesia, the subjects were randomly allocated to receive intravenous saline (control group) or 0.02 mg/kg butorphanol (butorphanol group). The BIS values, mean arterial pressure, and heart ratewere recorded every five minutes for a period of 20 minutes. Results: The mean BIS values after butorphanol administration were not significantly different from the values following the administration of saline, throughout the observation period. No patients were able to recall explicitly any events under anesthesia. No significant changes in mean arterial pressure and heart rate were noted after butorphanol administration. Conclusions: Butorphanol given to prevent postoperative pain does not modify the BIS value during anesthesia maintained with remifentanil and propofol.
정규돈 韓國財政政策學會 2013 財政政策論集 Vol.15 No.1
재정위험은 환율 및 이자율위험과 서로 긴밀히 연결되어 있으며, 당기 GDP대비 부채 변화는 이자율, 성장률 및 기초재정수지에 좌우된다. 이를 바탕으로 본 연구는 재정위험관련 변수에 연결된 재정위험 요인을 재정범위 검토, 중장기정부 및 공공기관 부채비율을 통해 도출하였다. 또한 본 연구는 현재 상황에서 증분 비용흐름인 위험이 크고 재정위험요인으로 환관리와 관련된 외국환평형기금, 이자율 관리와 관련된 예금보험공사채권상환기금 보증채무 국채 전화 부분 및 잔존분과 예금보험기금, 기초재정수지와 관련된 공적연금 보전 및 충당부채, 일부 공기업 부채를 파악하였다. 한편 본 연구는 이사의 재정위험에 대한 위험관리 개선방안을 제시하였다. 구체적으로 본 연구결과는 정부기관 및 공기업 모두 지속 가능한 공공부채를 위해서는 감가상각후 이익이 자본지출 부채 이자비용을 보전할 수 있게 부채를 관리할 뿐만 아니라 이를 담보하는 장치가 중요하다는 사실을 시사한다. Fiscal risk is interconnected with exchange rate and interest rate risk, and The ratio of debt to GDP depends on interest rate, growth rate and primary Fiscal balance. Fiscal risk factors come from the review on the scope of Public finance and the projection of long term government and public Corporation debt ratio. Foreign exchange equalization fund, bail out related Fund, public pension fund. And partly public corporations as main fiscal risk Factors are managed to reduce major incremental cost flow and high Likelihood of shifting cost burdens to public finance. The main results of this Paper suggest that profit after depreciation must cover the interest cost of Capital expenditure to maintain the sustainable public debt and this principle Must be guaranteed.
증례보고 : 안면 혈관종이 심한 Sturge-Weber 증후군 환자의 마취 경험
정규돈 ( Kyu Don Chung ),손윤숙 ( Youn Suk Son ),홍상현 ( Sang Hyun Hong ),조현숙 ( Hyun Sook Cho ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.3
Sturge-Weber syndrome is characterized by congenital skin angiomas throughout the facio-trigeminal region, which can cause difficulty in airway management in the case of general anesthesia. The problems with this syndrome include glaucoma, seizures, severe mental retardation, intracranial cavernous hemangioma, etc. We report a case of a patient with Sturge-Weber syndrome with severe facial hemangioma who underwent septoplasty and inferior turbinectomy under general anesthesia. We also review the literature on the anesthetic management for the Sturge-Weber syndrome and discuss methods for avoiding complications. (Korean J Anesthesiol 2006; 51: 371~4)
증례보고 : 심한 척주관 협착증 환자에서 척추 마취 후 발생된 마미 증후군
정규돈 ( Kyu Don Chung ),유승준 ( Sung Jun Yu ),이상묵 ( Sang Mook Lee ),조현숙 ( Hyun Sook Cho ),손윤숙 ( Youn Suk Son ),윤건중 ( Keon Jung Yoon ),윤은경 ( Eun Kyeung Yoon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3
Cauda equina syndrome is a well-known but rare complication of spinal anesthesia. An 80-year-old man was scheduled for both herniorrhaphy. Spinal anesthesia was performed at the L3-4 interspinous space with 0.5% hyperbaric bupivacaine 12 mg. Eight hours after anesthesia, the patient complained bilateral sensorimotor deficits of the lower extremities and peroneal region. Urinary and fecal incontinence were also observed. MRI and myelography showed severe central spinal stenosis at L3-4 and L4-5. EMG showed cauda equina syndrome. Seven weeks after the procedure, left decompressive subtotal laminectomy L2-L5 was done. The patient still complains the neuropathic pain in the both lower extremities and ambulates using a walker. The local anesthetic was injected into thecal sac between maximum stenoses, and it is likely that there was poor upward spread leading to maldistribution of local anesthetic and resultant local anesthetic toxicity. (Korean J Anesthesiol 2009;57:364∼6)
당뇨병성 자율신경 장애 환자의 전신 마취시 심혈관계의 변화
손수창,정규돈 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6
Background : Autonomic reflex dysfunction in patients with diabetes is associated with unstable cardiovascular response in perioperative period. In this study we wanted to investigate the extent to which the intraoperative cardiovascular responses depend on the degree of autonomic dysfunction. Methods : The influence of diabetic autonomic neuropathy upon the behavior of the circulatory system was investigated in 35 patients who had undergone ophthalmological surgery. A standardized test combination was used to study the patient's cardiovascular refractory reactions. The patients were then divided into a control group, non-diabetics without autonomic neuropathy (n = 18), and an experimental group, diabetics with autonomic neuropathy (n = 17). The anesthetic and surgical procedures (vitrectomy) were standardized and always identical. Results : During the induction of anesthesia, patients in the experimental group didn't experience changes in mean arterial blood pressure and heart rate as compared to patients in control group. During the maintenance of anesthesia, there were significant decreases in mean arterial blood pressure and heart rate in the experimental group, but in the state of emergence of anesthesia, there were no significant differences in either group. Conclusions : Autonomic neuropathy represents a perioperative risk factor, especially during induction and maintenance of anesthesia. I therefore recommend an autonomic nervous function test for evaluation of diabetic autonomic neuropathy in preoperative anesthesiological examination. (Korean J Anesthesiol 1999; 37: 1034∼1040)
손윤숙,정규돈,조현숙,이상묵,박건,이종호,정지현 대한마취통증의학회 2006 Korean Journal of Anesthesiology Vol.50 No.3
A tracheoesophageal fistula (TEF) was detected in a woman who received chemotherapy for acute lymphoblastic leukemia. The fistula biopsy confirmed the aspergillus infection. A large fistula was located at the lateral wall of the carina involving the proximal left main bronchus, and the orifice of left main bronchus was almost completely obstructed by white mass-like plaque. Primary repair was planned using the right thoracotomy approach. We originally planned to selectively intubate the left lung with the aid of fiberoptic bronchoscope without success. Therefore, we selectively intubated the right lung. Hypoxemia developed during surgery and the level of oxygenation was improved by selectively intubating the left bronchus from the surgical field once the defect had been exposed. We review the ventilation technique and anesthetic problems encountered in patients with a large distal TEF. (Korean J Anesthesiol 2006; 50: 346~50)