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- 저자 : 차두천 ( Doo Cheon Cha ) (검색결과 3 건)
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임상연구 : 한국인에서 Propofol-Remifentanil 전정맥 마취시 기관내 삽관에 따르는 혈압과 맥박수의 증가를 예방하기 위한 Remifentanil의 효과처 농도
신혜란 ( Helen Ki Shinn ),이홍식 ( Hong Sik Lee ),이춘수 ( Choon Soo Lee ),정종권 ( Chong Kweon Chung ),차두천 ( Doo Cheon Cha ),김혜하 ( Hye Ha Kim ),송장호 ( Jang Ho Song ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.3
Background: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4μg/ml) and to find any sexual differences. Methods: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4μg/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. Results: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 ng/ml) in male group and 1.05 ng/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. Conclusions: Relatively small dosages of remifentanil (0.68-1.81 ng/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences. (Korean J Anesthesiol 2006; 51: 312~7)
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Propofol 마위유도 시 10% Lidocaine 인후두 분무가 근이완제 주입없는 기관내 삽관에 미치는 영향
김명희,조대현,차두천 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.40 No.2
Backgroond: Tracheal intubation is usually carried out under a combination of general anesthesia and muscle relaxation. Recent sutdies have found satisfactory conditions for intubation of the trachea without using muscle relaxants. However, these studios have used large amounts of propofol or expensive opioids like alfentanil and remifentanil. In this study, we evaluated intubation conditions and success rate with midazolam, fentanyl, propofol and either 10% lidocaine applied topically into the larynx and trachea or not. Methods: Forty patients of ASA class I or II were randomly allocated to one of two groups. All patients received glycopyrrolate 0.2 mg, midazolam 0.03 mg/kg and fentanyl 2 mcg/kg IV before induc-tion of anesthesia and propofol 2 mg/kg IV for induction of anesthesia. Group I patients (n = 20) received 10% lidocaine into the larynx and trachea topically, and group II patients (n = 20) did not. After loss of the eyelid reflex, laryngoscopy and endotracheal intubation were attempted and airway conditions were graded. The success rate of intubation was evaluated. Results: Intubation without a muscle relaxant was possible in 19 of 20 (95%) patients in group I and 8 of 20 (40%) patients in group II. There were no significant differences in scoring criteria for various airway conditions such as jaw tone, vocal cord exposure and cord position. Conclusions: Induction of anesthesia with midazolam 0.03 mg/kg, fentanyl 2 mcg/kg and propofol 2 mg/kg combined with 2 ml of 10% lidocaine spray into the larynx and trachea offered a satisfactory success rate of intubation without muscle relaxants. (Korean J Anesthesiol 2001: 40: 169~174)
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