Ketamine으로 마취유도한 마취유도한 서혜부 탈장수술 받는 영아와 유아에서 Sevoflurane의 MAC incision의 차이

한종인,김치효 대한소아마취학회 2003 소아마취 Vol.7 No.2

30kg 이상의 학령기 소아에서 성인용 Diprifusor(TM)를 이용한 Propofol 목표 조절주입 마취는 안전한가?

한종인 대한마취과학회 2004 Korean Journal of Anesthesiology Vol.47 No.5

신경자극기를 이용한 액와부 상박신경총 차단의 효과

한종인 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.4

말초신경자극기를 이용한 액와부 상박신경총 차단법이 시행된 30명의 환자에서 저자들은 다음과 같은 결론을 얻었다. 말초신경자극기를 사용하는 경우에도 완전 성공률이 73.3%로 성공률의 향상을 가져오지는 않았으나 숙련도가 낮은 초심자의 경우에도 합병증의 유발없이차단을 가능케 하므로 유용하고, 특히 전박의 내피신경, 척골신경, 상박의 내피신경과 정중신경 지배영역 시 유용하리라 생각된다. Objectives : Axillary block is a common anesthetic technique for operation on the hand and forearm. Many variations of the axillary approach have been described. Therefore we studied the results obtained when the axillary approach to brachial plexus blockade is attempted utilizing peripheral nerve stimulation(PNS). Methods : Axillary brachial plexus block with PNS(0.5mA, 2Hz) was used in 30 adult patients undergoing hand and forearm surgery. 20ml of 1.5% lidocaine and 20ml of 0.375% bupivacaine solution was injected. A pin prick test was performed at 5, 10, 15 20, 25 and 30 min. and quality of the clock in the distribution of 7 peripheral nerve of the brachial plexs was evaluated. Results : Block were 28 cases(93.3%) including 6 cases(20%) of incomplete block and total failure were 2 cases. Average number of blocked peripheral nerve of upper extrmity was 4.4±1.7. The order of rate of block was medial cutaneous n. of forearm, ulnar n., medial cutaneous n. of arm, median n., radial n., musculocutaneous n. and axillary n.. Conclusion : We found that a PNS can be utilized to establish blockade of the upper extrimity, but the success rate is not different than other methods, But it is appropriate for blocks established by beginner without complication.

노인환자에서 척추마취시 Power Spectrum에 의한 심박수 변이도의 평가

한종인 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.2

Objectives : Spectral analysis of heart rate variability(HRV) resulted in a characteristic power spectrum with two main regions, a high frequency at 0.15-0.5Hz(HFP) corresponding to the parasympathetic system and a low frequency at 0.017-0.l5Hz(LFP) corresponding to both parasympathetic and sympathetic influences. The ratio of low : high frequency(LFP/HFP) has been postulated as an index of sympathetic activation. We propose that the LFP/HFP ratio will provide important information concerning autonomic nervous system activity during spinal anesthesia especially geriatric patients. Methods : LFP, HFP and LFP/HFP were checked in 30 patients at the baseline and 5, 10, 15, 20, 25 and 30 minutes after subarachnoidal block. We divided patients into two groups: group 1 is 15 patients under 60 years old and group 2 is 15 patients over 65 years old, and we compared those parameters in both groups. Results : Spinal anesthesia did produce a significant decrease in LFP and HFP in both groups. But sympathetic-parasympathetic balance(LFP/HFP) increased at 5 minutes after spinal block. In group 1, LFP/HFP decreased at 10 minutes after spinal block, thereafter increased gradually. In group 2, LFP/HFP decreased at 10, 15 and 20 minutes and increased at 25 and 30 minutes after spinal block. Conclusion : These data suggest that autonomic tone decreased with spinal anesthesia and sympathetic-parasympathetic balance decreased for a long time in geriatric patients.

전신마취 환자에서 산소 유량이 아산화질소 배출에 미치는 영향

한종인,이현주,김수미,이춘희,이귀용,정락경 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.9

Nitrous oxide is the least potent and soluble inhalation anesthetics in current use. After 1 minute of administration of nitrous oxide, the alveolar coneentration reaches 60-80% of the inspired concentration and 90-100% within 10-15 minutes. Concentration effect and low solubility of N₂O causes rapid increase in the concentration of N in rebreathing (circle-absorber) system. High inflow rate (5-10 L/min) results in a rapid rise in inspired concentration. The purpose of this study is to evaluate the effect of different oxygen inflow rates on excretion of N₂O by observing the end-tidal N₂O concentration using Capnomac II. ASA class 1 and 2 patients (n=21) undergoing general anesthesia were selected and induced with thiopental sodium 4 mg/Kg and succinylcholine 2 mg/Kg followed by administering N₂O and O₂ each with 2 L/min with fentanyl, midazolam and pancuronium. Administration of N₂O was stopped after about 45 minutes when vital signs and ETCO₂ concentration were stable with tidal volume 10 ml/Kg at ventilatory rate of 12/min. Oxygen was given at 4 L/min (group I) and 8 L/min (group II). End-tidal N₂O concentration was measured every 15 seconds until 3 mins and every 1 minute thereafter. Pharmacokinetic parameters were obtained for each patient. During recovery, end-tidal N₂O concentration decreased exponentially in both groups. The time from the end of N administration of until the moment end-tidal N₂O concentration reaches 3% is 16.8 minutes with group A and 8 minutes with group B. Area under curve (AUC) and clearance (CL) were not significantly different between both groups but, volume of distribution at steady states and mean residence time decreased significantly in group II compared to group I. Recovery of N₂O is affected by the oxygen inflow rate. Therfore high oxygen inflow rate which accellerates excretion of this poorly soluble anesthetics will hasten patient's recovery.

개에서 Isoflurane 과 Nitroglycerin 의 조절저혈압 마취후 Doxapram 이 심혈관계에 미치는 영향

한종인,이춘희,김치효 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.4

Isoflurane causes little myocardial depression, rapid onset and recovery during controlled hypotensive anesthesia. Nitroglycerin, vasodilating agent, has short plasma half-life and myocardial protective effect, is easy to cantrol, and has no direct toxic effect. Doxapram hydrochloride(doxapram Hcl), respiratory stimulant, has been found to be safe and significantly potent, but also has significant pressor effect when larger doses are administered. The purpose of this study was to evaluate the effects of doxapram on the hemodynamics after isoflurane and nitroglycerin-induced hypotensive anesthesia in dogs. Hemodynamic measurement including the value of left ventricular pressure, aortic pressure, pulmonary eapillary wedge pressure, pulmonary artery pressure, heart rate, cardiac output, maximal and minimal dP/dT were determined in 8 dogs before doxapram Hcl administration, Smin, 15min and 30min after doxapram Hcl administration. 1) Left ventricular pressure and aortic pressure increased at 5min and 15min after doxapram Hcl administration but did not change significantly at 30min compared to the preadministration values. 2) Pulmonary capillary wedge pressure and pulmonary artery pressure increased significantly at Smin and 15min, but did not change significantly 30min compared to the preadministration values. 3) Heart rate increased significantly at Smin, but did not change significantly at 15min and 30min compared to the preadministration value. 4) Cardiac output and body temperature did not change significantly at 5min, 15min compared to the preadministation values. 5) Maximal dP/dT increased signifieantly at Smin and 15min, but did not change at 30min compared to the preadministration value, minimal dP/dT increased significantly at 5min, but did not change at 15min and 30min compared to the preadministration value.

소태산의 불교혁신론

韓鍾萬(한종만) 회당학회 1993 회당학보 Vol.2 No.-

요추 경막외 마취에서 카테테르 삽입 방향과 지각차단범위

한종인,김종학,이춘희,이귀용,김치효,정락경,백은주 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.2

Background : Endoscopic urologic surgery including transurethral resection of prostate(TURP) requires adequate sacral analgesia for insertion of resectoscope. But epidurally administered local anesthetic does not produce anesthetic effects uniformly. Failure to completely block S1 during epidural anesthesia because of the large size of nerve root has been noted. The purpose of this study to compare the relation between catheter direction and sensory anesthesia. Methods : Thirty patients scheduled for endoscopic urologic surgery were enrolled. The epidural catheter was inserted at L3-4 using a standard 18 gauge Tuohy needle. In group A(n=15), the Tuohy needle with bevel pointed in a cephalad direction during catheter insertion. In group B(n=15), it pointed caudally. And the catheter was introduced 3 cm into the epidural space. After test dose, 2% lidocaine 5 cc, 0.5% bupivacaine 5 cc and 2% lidocaine 3 cc were administered with fractionate dose through it. The extent of the sensory anesthesia to loss of cold sensation and pin prick test was measured every 5minute for 30 minutes. Results : Analgesia spread to loss of cold sensation and pin prick test was no significant statistical difference between the two groups. In 15 minutes after injection of surgical dose, complete blockade in L5, S1 dermatome was present in both groups. Conclusion : Our results conclude that epidural catheter direction is not significantly influence the epidural anesthetic spread including sacral area in continuous lumbar epidural anesthesia in elderly patients. (Korean J Anesthesiol 1997; 33: 291∼296)

눈꽃 외 1편

한종인 고요아침 2022 한국동시조 Vol.- No.20

호기말 산소농도를 이용한 사전 산소투여

한종인,오은정,이춘희,이귀용,정락경 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.11

Preoxygenation is a standard anesthetic technique for preventing hypoxemia during the in- duction of anesthesia. This is achieved by alveolar denitrogenation while ventilating the lungs with 100% oxygen. Until recently there was no satisfactory nitrogen monitoring device except mass spectrometry which is not generally available. We used a convinient and readily available measuring technique to evaluate the effectpreoxygenation. In 31 healthy volunteers breathing 100% oxygen, end-tidal oxygen concentration have been measured at 15 seconds interval from the start of preoxygenation. A circle system was flushed with 100% oxygen and flow rate of 8 liter per minute. The gas sampling line of the Capnomac II (Datex, Finland) was placed in nasal cavity. At 1, 2, 3 minutes, mean end-tidal oxygen concentration was 78.7%, 89.2%, 91.9 % respectively. End-tidal nitrogen concentration was approximately 16.1 %, 5.8%, 3.2%. We conclude end-tidal oxygen concentration is a good indirect measure of denitrogenation.