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성인에서 술전 섭취한 수액이 위액량 및 산도에 미치는 영향
강포순,조재군,이규창,우남식,이예철,정정일 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.3
Background: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. Methods : Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. Results : The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. Conclusions : We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia. (Korean J Anesthesiol 1998; 34: 510∼513)
전신마취중 발생한 혼합응혈괴에 의한 기관내 튜브 완전폐쇄-증례보고-
정정일,조재군,김정성,이규창,강포순,이예철 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.7 No.-
A fifty seven year old female patient was scheduled for emergent craniectomy and removal of hematoma, open reduction and internal fixation of frontal bone with miniplate and wire under general anesthesia. Preoperative checked datas for emergent operation were within normal limits and vital signs of the patient were stable. During the induction of general anesthesia, an orotracheal intubation was done in operating room. About 50 minutes after induction of anesthesia, signs of complete airway obstruction developed suddenly. so we inserted suction tip into the lumen of the endotracheal tube, but the suction tip into the lumen of the endotracheal tube. After we stopped the operating procedure, we removed the tube and intubated another endotrcheal tube. We found that the distal part of lumen of extubated tube was obstructed completely by blood clots and mucus.
이근상,강포순,조재군,김정성,이규청 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.6
A 62-year-old female patient was scheduled for emergent explo-laparotomy under general anesthesia because of traffic accident. Preoperative checked chest x-ray showed multiple fractures of the ribs but didn't show the sign of pneumothorax or hemothorax. she had no dyspnea. Compared with previous value(PaO2; 210.5 mmHg), Arterial PO2 value(PaO2; 143.0 mmHg) was reduced significantly two hours after starting general anesthesia. Chest x-ray was taken in the operating room, which showed pneumothorax in the right side lung. The patient was treated with immediate closed thoracostomy. She recovered uneventfully three days later with complete resorption of the pneumothorax. (Korean J Anesthesiol 1997; 32: 1028∼1030)
류창환,이승진,조재구,최익준,최윤석,홍용태,정수연,김지원,이도영,이동군,이길준,이상준,이영찬,이용상,남인철,박기남,박영민,성의숙,손희영,서인효,이병주,임재열 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.1
Voice change is a common complaint after thyroid surgery and has a significant impact on quality of life. The Korean Society of Laryngology, Phoniatrics and Logopedics assembled a task force to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations encompass preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, and include in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQs) in three categories—preoperative (KQ 1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management—and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. A detailed evidence profile is presented for each recommendation. The level of evidence for each recommendation was classified as high-quality, moderate-quality, or low-quality. The strength of each recommendation was designated as strong or weak considering the level of evidence supporting the recommendation. The guidelines are primarily targeted toward physicians who treat thyroid surgery patients and speech-language pathologists participating in patient care. These guidelines will also help primary care physicians, nurses, healthcare policymakers, and patients improve their understanding of voice changes and voice care after thyroid surgery.
제왕절개술후 통증치료시 지속적 경막외 국소마취제와 Tramadol의 병용투여의 효과
강포순(Po Soon Kang),조재군(Jae Kun Cho) 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1
N/A Background: Tramadol administered epidurally is known to have one-thirtieth the potency of morphine for treatment of pain following abdominal surgery. We designed a prospective, randomized, controlled study to evaluate the analgesic efficacy and safety of combined epidural infusion of bupivacaine and tramadol with 2-day infusor as ompared to bupivacaine and morphine combined epidural infusion. Methods: Sixty healthy women scheduled for Cesarean delivery were assigned randomly in double- blind fashion: Group 1 (n=20) were given a mixture of morphine 10 mg(1 ml), 0.5% bupivacaine 40 ml a#nd normal saline(NS) 40 ml; Group 2(n=20) a mixture of tramadol 300 mg(6 ml), 0.5% bupivacaine 40 ml and NS 54 ml; Group 3(n=20) or a mixture of tramadol 500 mg(10 ml), 0.5% bupivacaine 50 ml and NS 50 ml, of continuous dose via epidural route following 1% lidocaine 6 ml as bolus dose for 48 hours postoperatively. We evaluated the analgesic efficacy and side effects of these three groups using visual analogue pain scale (VAPS) and verbal rating scale (VRS). Results: VAPS of group 1 and 3 were lower than group 2, and VAPS of group 1 was lower than group 3(12, 24, 36, 48 hours), VRS of group 1 and 3 were lower than group 2 (12, 24, 36 hours). There were incidences of pruritus was 16 patients in group l. Conclusions: Tramadol does possess the analgesia effect of morphine, but has the added analgesia following increment. Further research to determine the most effective administration method and reguired dosage of tramadol is further needed.