초록보고 분만시(分娩詩)의 마취(麻醉)가 모체혈장(母體血漿) Prolactin치 및 Cortisol치에 미치는 영향

정종달,오세량,한세준,최영희,고성민,장하종 대한산부인과학회 1986 대한산부인과학회 학술대회 Vol.58 No.-

Effects of a preemptive alveolar recruitment strategy on arterial oxygenation during one-lung ventilation with different tidal volumes in patients with normal pulmonary function test

정종달,유병식,김혜지,김상훈 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.2

Background: Hypoxemia during one-lung ventilation (OLV) remains a major concern. The present study compared the effect of alveolar recruitment strategy (ARS) on arterial oxygenation during OLV at varying tidal volumes (Vt) with or without positive end-expiratory pressure (PEEP). Methods: In total, 120 patients undergoing wedge resection by video assisted thoracostomy were randomized into four groups comprising 30 patients each: those administered a 10 ml/kg tidal volume with or without preemptive ARS (Group H and Group H-ARS, respectively) and those administered a 6 ml/kg tidal volume and a 8 cmH2O PEEP with or without preemptive ARS (Group L and Group L-ARS, respectively). ARS was performed using pressure-controlled ventilation with a 40 cmH2O plateau airway pressure and a 15 cmH2O PEEP for at least 10 breaths until OLV began. Results: Preemptive ARS significantly improved the PaO2/FiO2 ratio compared to the groups that did not receive ARS (P < 0.05). The H-ARS group showed a highest PaO2/FiO2 ratio during OLV, the L-ARS and H groups showed similarly improved arterial oxygenation, which was significantly higher than in group L (P < 0.05). The plateau airway pressure in group H-ARS was significantly higher than in group L-ARS (P < 0.05). Conclusions: Preemptive ARS can improve arterial oxygenation during OLV. Furthermore, a 6 ml/kg tidal volume combined with 8 cmH2O PEEP after preemptive ARS may reduce the risk of pulmonary injury caused by high tidal volume during one-lung ventilation in patients with normal pulmonary function.

Epinephrine 을 혼합한 고비중 Bupivacaine 에 의한 척추마취효과

정종달,채종한 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.3

The effect of spinal anesthesia with hyperbaric bupivacaine with and without 1: 1000 epinephrine were studied in 35 patients. Patients in group A received 0.4% hyperbaric bypivacaine 20 mg and patients in group B received the same anesthetic, only 0.2 mg of epinephrine was mixed to it. The following results were obtained. 1) The highest level of sensory loss was similar in both groups. 2) The duration of sensory loss was significantly longer in group B(391±12.9 vs 289±18.8min, p$lt;0.05) The duration of motor block was also significantly longer in group B than group A(254 ±13.7 vs 17l±4.4 min). 3) The systolic blood pressure significantly decreased at 20-40 minutes after spinal anesthesia in both groups. 4) The pulse rate in group A significantly increased at 2-10 minutes after spinal anesthesia and in group B, it decreased significantly at 45-50 minutes after spinal anesthesia.

제왕절개분만시의 마취가 모체혈장내 Prolactin치와 Cortisol치에 미치는 영향

정종달,고성민,최영희,한세준,오세량 대한산부인과학회 1987 대한산부인과학회 학술대회 Vol.59 No.-

북부 동-정맥루공 전신마취 1례

정종달 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

36 years old male patient admitted for surgical correction of an arteriovenous fistula between right common iliac artery and inferior vena cava. Thiopental sodium and succinylcholine were injected for tracheal intubation and the anesthesia was maintained with nitrous oxide, oxygen and halothane. The EKG, blood pressure, Pulse rate, CVP were monitored continuously. After aorta was cross-clamped, arterial systolic and diastolic pressure rose moderately, CVP was slightly decreased and no significant changes were seen after declamping. This patient was discharged after 1 month in good condition.

Ketamine 정맥마취가 호흡기능에 미치는 영향

정종달,강철,민주홍,김광모,권병연 대한마취과학회 1983 Korean Journal of Anesthesiology Vol.16 No.4

An increasing interest in intravenous anesthetic techniques has resulted from the availability of more efficacious intravenous agents, possible discomfort of the patient on endotracheal intubation and the concern over anesthetic pollution in the operating room. This study was done to investigate the effect of intravenous anesthesia with ketamine on the respiratory system by comparing arterial blood gas analysis before and after the procedure. Analysis of arterial tlood for PCO_2, PO_2, pH, and base excess were carried out. Heart rate and blood pressure were monitored on 15 paienta in ASA class I for diagnostic or short procedures. Each patient was premedicated with atropine 0.01 mg/kg and Talium 0.2 mg/kg intramuscularly 30 minutes before the procedure. Ketamine was adnlinisteree intravenously 1.0-1.5 mg/kg or interamuscularly 3-5 mg/kg for induction of anesthesia. The anesthesia was maintained with ketamine 0.5~l.Omg/kg and Valium 0.1 mg/kg every 5 to 10 minutes. The results of this study showed that ketamine anesthesia soomed not to cause any untoward effect on respiratory function. In other words, ketamine aeems to be a safe and good intravenous anesthetic agent for diagnostic or short surgical procedures.

수술후 발생한 간염 2 예

정종달,강철,조남수 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.4

소아에서 Rocuronium 정주 시 발생하는 회피반응에 대한 Remifentanil 용량에 따른 효과

정종달,안태훈,송호석 대한마취통증의학회 2009 Anesthesia and pain medicine Vol.4 No.2

Background: The injection of rocuronium causes pain and withdrawal responses. This study was designed to determine an appropriate dose of remifentanil to prevent the withdrawal responses associated with injection of rocuronium in children. Methods: Fourty five ASA physical status I and II pediatric patients were randomly allocated into three groups; Group I (placebo; normal saline 3 ml, n = 15), Group II (remifentanil 0.3μg/kg, n = 15), Group III (remifentanil 0.5μg/kg, n = 15). After the induction of anesthesia with 5 mg/kg of thiopental sodium, patients in groups I, II, and III received normal saline 3 ml, remifentanil 0.3μg/kg, and remifentanil 0.5μg/kg, respectively. After one minute, rocuronium 0.6 mg/kg was injected over 10 seconds. The patient's response after injection was graded using a four-point scale. The patient's heart rate (HR), mean arterial pressure (MAP) were measured at pre-anesthesia (T0), 1 minute after injection of thiopental sodium (T1), test drug (T2), and rocuronium (T3). Results: The incidence of withdrawal responses was 100%, 66.7%, and 20% in groups I, II, and III, respectively. In addition, the severity of withdrawal responses was lowest in group III. Conclusions: Remifentanil 0.5μg/kg was an appropriate dose to prevent the withdrawal responses on injecting rocuronium.

제왕절개 분만시의 마취가 모체 혈장 Prolactin 치와 Cortisol 치에 미치는 영향

정종달 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.5

The effects of general and spinal anesthesia on maternal plasms levels of prolactin and Cortisol in response to the stress of cesarean section were studied. Surgery under general anesthesia resulted in significant increases in both the mean maternal plasma prolactin and cortisol levels. However, onty the cortisol level exhibited a significant increase when surgery was performed under spinal anesthesia It is concluded that prolactin and cortisol responses to the stress of labor and delivery are modified by the anesthetic method, and that the mechanism of hormonal response under general anesthesia as compared with spinal anesthesia remains to be clarified.

부인과 복강경 수술 시 Sevoflurane, Desflurane 그리고 Isoflurane의 체온조절반응

정종달 ( Jong Dal Jung ),안태훈 ( Tae Hun An ),송호석 ( Ho Seok Song ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5

Background: Core temperature decreases rapidly after the induction of general anesthesia, because the heat is redistributed to peripheral tissues. Thermoregulatory responses of volatile anesthetics have been tested, but their effects have not been directly compared. Therefore, we evaluated the thermoregulatory responses to sevoflurane, desflurane, and isoflurane. Methods: Sixty healthy patients scheduled for laparoscopic myomectomy or radical hysterectomy were allocated into three groups; Group S (sevoflurane, n=20), Group D (desflurane, n=20), and Group I (isoflurane, n=20). Anesthesia was maintained with 1 minimum alveolar concentration (MAC) of sevoflurane, desflurane, and isoflurane in a 50/50 mixture of N2O/O2. Patients were maintained in a normovolemic and normocapnic state. The core temperature and forearm minus fingertip skin-temperature gradient (an index of peripheral vasoconstriction) were monitored after the induction of general anesthesia. Results: Each of the seven patients given sevoflurane, desflurane, and isoflurane vasoconstricted at a core temperature of 35.3±0.5℃, 33.6±0.4℃, and 35.2±0.4℃, respectively. The vasoconstriction threshold was the lowest in patients anesthetized with desflurane. The core temperature gradient (Ti-Tf) was significantly higher in patients that were anesthetized with desflurane than in those that were anesthetized with sevoflurane or isoflurane. The core temperature of desflurane was significantly lower than that of sevoflurane or isoflurane 15 minutes after the induction of anesthesia until 180 minutes of anesthesia. Conclusions: These results indicate that the core temperature is maintained at a higher level in patients that have been anesthetized with sevoflurane or isoflurane than in those that have been anesthetized with desflurane. (Korean J Anesthesiol 2009;56:525~30)