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조성경 ( Seung Kyung Cho ),김기환 ( Ki Whan Kim ) 대한내과학회 1971 대한내과학회지 Vol.14 No.6
A clinical observation was made on 20 cases of neurosyphilis seen at Seoul St. Marys Hospital from San, 1966 to Dec, 1970. Results; (1) The incidence of neurosyphilis was 0.046% of total inpatient (obstetric patients were excluded) and the most patients we
제왕절개술을 위한 경막외마취시 국소마취제의 Alkali 화가 마취작용에 미치는 영향
이상화,노운석,조성경,백승희,김건수 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.1
Several studies have indicated that the addition of sodium bicarbonate and opioid to solutions of lo?? anesthetics shortens the onset time, increases the intensity and prolongs the duration of neural blockade. This study was performed to compare onset times and duration of neural blockade in each groups. Eighty-two parturients scheduled for cesarean section at term unter epidural anesthesia were assigned to three groups. Group 1 (n=19) received 1.5% lidocaine hydrochloride (pH 6.32±0.01), group 2 (n=26) received 1.5% lidocaine hydrochloride plus fentanyl 50 mcg (pH 6.27±0.02) and group 3 (n=37) received 1.5% lidocaine hydrochloride plus fentanyl 50 mcg plus 8.4% sodium bicarbonate (sodium bicarbonate 1 mEq/lidocaine 10 ml)(pH 7.32±0.03). All groups were given 22-28 ml of local anesthetic solutions according to their height. Onset times and duration of sensory blockade were evaluated using pin prick test at two minutes interval after epidural injection at L2, T6, T4 dermatomes. Onset times (time between the completion of anesthetic injection and loss of pin prick sensation at each dermatome) of sensory blockade at L2 dermatome were 3.1±0.2 minutes in Group 3, which were shorter than 5.0±0.3 minutes in Group 1 and 4.7±0.4 minutes in Group 2 (p<0.05). At T6 dermatome, onset times of sensory blockade were 6.9±0.6 minutes in Group 3, which were shorter than 15.4±1.2 minutes in Group 1 and 12.9±1.0 in Group 2 (p<0.05). At T4 dermatome, onset times of sensory blockade were 10.1±0.2 minutes in Group 3, which were shorter than 22.3±1.2 minutes in Group 1 and 18.8±1.1 in Group 2 (p<0.05). The duration (time between loss of pin prick sensation and complete recovery of pain at each dermatome) of sensory blockade at T4 dermatome in Group 3 were 74.0±3.8 min, which were longer than 52.9±2.4 minutes in Group 1 and 52.7±1.4 minutes in Group 2 (p<0.05). The duration of sensory blockade at L2 dermatome in Group 3 were 119.6±4.4 minutes, which were longer than 78.6±4.8 minutes in Group 1 and 81.6±2.5 minutes in Group 2 (p<0.05). The above results seggested that alkalinization of lidocaine solution is an effective way to shorten the latency and to prolong the duration of epidural block for cesarean section. (Korean J Anesthesiol 1995; 29: 106~111)
임신 2기 계류유산환자에서 경관확장 자궁소파수술시 발생한 양수색전증
이상화,김봉일,노운석,조성경,백승희,이상평 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.4
Amniotic fluid embolism(AFE) is a rare but devasting obstetric emergency. We experienced a case of AFE during dilatation and curettage(D&C) in a 15 2/7 weeks pregnant woman, age 30, who was diagnosed as having a missed abortion. Sudden rapid hypoxemia, low SpO2, hypotension, low PETCO2, high CVP, and tachycardia, right axis deviation and right bundle branch block in 12 leads ECG were developed during D&C under general anesthesia, and signs of disseminated intravascular coagulation(DIC) followed after the operation, which are consistent with the findings of AFE. Even though there was no definite pathologic and radiologic confirmation of AFE, laboratory findings showed 100 times higher level of α-fetoprotein in her central venous blood than same weeks of missed abortion woman's blood. Though it is rare, the anesthesiologist should always suspect the possibility of AFE, when the patient shows an unexplained collapse, cyanosis, low PETCO2, high CVP, low SpO2, ECG change and DIC during any kind of obstetric proceure. (Korean J Anesthesiol 1997; 33: 778∼783)
예상하지 못한 어려운 기관내 삽관 조작후 발생한 경부 피하기종
이상화,김봉일,노운석,조성경,박태숙,백승희 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.1
Subcutaneous emphysema is one of the rare complication of tracheal intubation and it's mechanism has been known as airleakage to subcutaneous tissue from the perforated site of larynx, trachea and esophagus by the trauma of laryngoscopic blade, stylet and endotracheal tube. We experienced a case of subcutaneous emphysema during unexpected difficult endotracheal intubation. At the initial laparoscopic examination, the patient's laryngeal view was grade IV of Cormack and Lehane's calssification. After several trial of the intubation, cervical subcutaneous emphysema developed by the trauma of laryngoscopic blade, stylet and endotracheal tube, even though failed to confirm the perforated site at postanesthesia one day. (Korean J Anesthesiol 1997; 33: 178∼181)