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기관내 삽관이 어려운 환자에서 후두마스크를 통한 기관튜브삽관의 경험
정수진,차두갑 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.5
Laryngeal mask airway (LMA) was designed as a new concept of airway management in anesthetic practice and has been successfully used in patients with difficult endotracheal intubation due to an abnormal upper airways. When It is in good position, one can cannulate the trachea either blindly or fiberoptic brochoscopically. In a patient with short neck and large breast, we were forced to use an emergency LMA because couldn't insert the laryngoscope. We decided to replace the LMA with an endotracheal tube to secure a definite airway. A fiberoptic bronchoscope was passed through both the endotracheal tube and the LMA to achieve endotracheal intubation. Then we attempted to remove the LMA for safe and smooth awakening. But the LMA coudln't be removed while keeping the LMA and the endotracheal tube in position. Therefore, surgery had to be proceeded with both the LMA and the endotracheal tube in place and all of which were removed after the surgical procedure. We conclude that the LMA is very useful as an aid of endotracheal intubation in patients with difficult airway. (Korean J Anesthesiol 1998; 35: 988∼992)
정태호,차두갑,정가원 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.1
A 68 year old, ASA physical status 11, hypertensive male patient underwent open reduction, angulated blade plate fixation, and bone graft of femur intertrochanteric fracture due to non-union. Anesthesia was induced with thiopental and succinylcholine and maintained with vecuronium- Halothane-nitrous oxide-oxygen. Three uints whole blood was transfused and any significnat change in vital signs and EKG were not found during 4 hours operation. Soon after the patient was recovered. But he was found to be hemiplegia and sensory disturbance on the next day. Brain CT revealed infarction of middle cerebral artery territory. He expired 7 days following the surgery despite strenuous supportive measure.
Verapamil 이 성숙 가토의 신장 수질 조직내 Na+-K+-ATPase 의 활성에 미치는 영향
김현숙,박정환,차두갑,박정란 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.4
The Na^+ -K^+ -activated ATPase is required to maintain osmotic balance and stabilize cell volume. The Na^+ -K^+ -ATPase has a more direct role in regulating cell volume; it controls the solute concentrations inside the cell, thereby regulating the osmotic forces that can make a cell swell or shrink. The impotance of the Na^+ -K^+ -ATPase in controlling cell volume is indicated by the observation that animal cells swell, and may burst, if they are treated with ouabain, which, inhibits the Na^+ -K^+ -ATPase. The present experiment was designed and carried out to determine the effect of verapamil, a calcium blocker, on the activity of Na^+ -K^+ -ATPase prepared from renal medulla in the normal rabbit. It was reported that verapamil, a well known coronary vasodilator, possessed negative inotropic effects. The mechanism of action of verapamil was initially thought to be due to coronary vasodilation and blockade of myocardial β-adrenergic receptors. 1t was termed such agent calcium antagonist. A derivative of verapamil, D-600, was subsequently shown to block the movement of calcium through the slow channel and thereby after the plateau phase of the cardiac action potential. Verapamil do not directly antagonize the effects of calcium. Rather, it inhibit the entry of ealcium into cells or its mobilization form intracellular stores and, as such, have been termed a calcium channel blocker.
Armored Tube 내벽 박탈로 인해 발생한 기관내 튜브 폐쇄
정혜정,김형남,이지아,차두갑 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.3
Endotracheal intubation has many advantage such as airway protection, maintenance of patent airway, pulmonary toilet, application of positive pressure ventilation, and maintenance of adequate oxygenation. But risks that develop complications related to endotracheal tube always present, when we insert a tube into the trachea. We have experienced an armored tube obstruction with bulged inner wall after EO gas sterilization. So, it is important that we have to pretest a tube and check pateney of the inside of a tube, before endotracheal intubation.
Dexamethasone의 경막외 주입이 경막외 마취후 요통에 미치는 효과
한상보,정태호,정수진,차두갑 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.5
Background : Lumbar epidural anesthesia is widely used regional blockade method. But postepidural back pain is most common cause that experienced patients refuse epidural anesthesia. We planned this study to evaluate the effect of epidural dexamethasone injection for postepidural back pain. Methods : Adult patients free of back pain were randomly allocated into two groups. In both group anesthesia was induced with 2% lidocaine 20∼25 ml mixed with 1:200,00 epinephrine and fentanyl 0.1 mg. After surgery, epidural catheter was removed after epidural dexamethasone injection in one group (group 2). In other group (group 1), catheter was removed without treatment. We visited patients and asked existence of back pain, and the intensity of back pain was measured by visual analogue scale at 24, 48 and 72 hours after surgery. Statistical analysis was done by Student's t-test and Mann-Whitney test. Results : In group 2, there was significant decrease in number of patients suffering from back pain and intensity of back pain. Conclusion : Epidural dexamethasone injection results in decreased number of patients suffering from back pain and also less in intensity of back pain. (Korean J Anesthesiol 1998; 35: 970∼974)