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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.
기관내 삽관시 Slow induction과 Fentanyl 정주가 심혈역학적 변화에 미치는 영향
윤재천,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2
Tracheal intubation is accompanied by varying degrees of sympathetic stimulation as reflected by increases in blood pressure and heart rate. Several clinical trials to reduce these effects by deepening anesthesia, using pharmacologic agents such as alpha and beta blockers,calcium channel blockers, fentanyl and lidocaine have been reported. To evaluate the effects of slow induction and fentanyl on responses of cardiovascular system induced by endotracheal intubation, we administered thiopental sodium 5㎎/㎏ (group Ⅰ), slow induction with O_(2)-N_(2)O-halothane( group Ⅱ), fentanyl 3uμ/㎏ with thiopental sodium 4㎎/㎏(group Ⅲ) for induction of anesthesia, and measured systolic and diastolic pressures, and heart rates before induction, and at 1,2,3,4, and 5 minutes after intubation. 1) In group Ⅰ, intubation caused a significant increase in systolic pressure (10%) diastolic pressure (15%) and heart rate (28%) at 1 min. after intubation but each parameter returned to the normal level within 5 min. 2) In group Ⅱ, increases in systolic pressure (12%), diastolic pressure (22%) and heart rate (23%) at 1 min. after intubation but there were no significant differences compared to group Ⅰ. 3) In group Ⅲ, the increase in systolic and diastolic pressure induced by intubation was abolished by fentanyl and showed significant decrease compared to group Ⅱ, increase in heart rate (4%) at 1 min. after intubation but were of no significance, and showed significant decrease compared to group Ⅱ but not at 3 min., 4 min. after intubation. These results suggested that a low dose of fentanyl significantly blunts postintubation hypertenion and tachycardia when used as an adjunct to thiopental sodium.
Bupivacaine이 배양 백서 심근세포에 미치는 세포독성에 관한 연구
김태요,채종한 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.2
In an attempt to evaluate the cardiotoxicity of bupivacaine, beating rate, tetrazolium MTT and lactate dehydrogenase activity were investigated in the medium containing bupivacaine for 24 hours after neonatal rat myocardial cells were cultured for 72 hours. Light and electron microscopic studies were also carried out. The results were as follows ; 1) Beating rate decreased dose-dependently, and beating cells were not observed over 10(-4) M concentration of bupivacaine. 2) MTT50 value was 0.32 ㎍/ml (1,000 uM). 3) The amount of lactate dehydrogenase released into the medium was 192% of control cells at 10(-3) M concentration of bupivacaine. 4. In light microscopy, myocardial cells were decreased in number dose-dependently, and showed a few cytoplasmic processes and lots of granules in cytoplasm at 10 M concentration of bupivacaine. 5. Electron microscopy of bupivacaine-treated cells showed smooth endoplasmic reticulum, destruction of mitochondria and Golgi apparatus and increase of vacuoles and dense bodies. It also showed dilatation of rough endoplasmic reticulum and loss of myofibrils. These results suggest that high concentration of bupivacaine (≥10(-4) M) induee remarkable toxicity on cultured rat myocardial cells.
비탈분극성 근육이완의 길항시 Atropine, Pyridostigmine과 Glycopyrrolate, Pyridostigmine의 혼합정주가 심박수에 미치는 영향
소금영,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1
Changes in heart rate during reversal of neuromuscular block have been a subject of clinical investigation for many years. A number of studies, have compared the effect used anticholinergics and anticholinesterase. In most studies, the drugs were administered simultaneously. Atropine and glycopyrrolate were studied in dose of 15㎕/㎏, 20㎕/㎏ and 7㎕㎕/㎏, lO㎕/㎏, given intravenously in a mixture with pyridostigmine 200㎕/㎏ at the end of operation. 15 ASA Class Ⅰ, Ⅱ patients, aged between 16 to 65, were selected in each group. Anesthesia was maintained with halothane(1.0 vol%), N20(3L/ min), O2(3L/min) and vecronium bromide 0.07㎎/㎏ was used as a muscle relaxant. The results were as follows ; 1) Atropine 15㎕/㎏, 20㎕/㎏, showed significant initial increase in pulse rate, atropine ZO㎕㎕/㎏ showed more initial increase than atropine 15㎕/㎏ Atropine 15㎕/㎏ showed more rate decrease than atropine 20㎕/㎏. 2) Gylcopyrrolate 7㎕/㎏ 10㎕/㎏ showed significant initial increase in pulse rate gylcopyrrolate 7㎕/㎏, 10㎕/㎏ showed less initial increase than atropine 15㎕/㎏, 20㎕/㎏. Atropine 20㎕/㎏ showed more late decrease than glycopyrrolate 10㎕/㎏.