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- 저자 : 허봉하 ( Bong Ha Heo ) (검색결과 2 건)
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Propofol과 Remifentanil을 이용한 목표농도조절 주입 전정맥마취에서 이중관 기관내관 삽관 시 혈역학적 반응을 억제하는 Remifentanil의 효과처 농도
허봉하 ( Bong Ha Heo ),윤명하 ( Myung Ha Yoon ),이형곤 ( Hyung Gon Lee ),김웅모 ( Woong Mo Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Background: This study was undertaken to determine the effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endobronchial intubation during target controlled infusion (TCI)-total intravenous anesthesia (TIVA) using 4.0 μg/ml of propofol with remifentanil. Methods: Sixty patients (American society of anesthesiologists physical status classification 1 or 2) were randomly allocated according to the target effect-site concentration of remifentanil (R3.0: remifentanil 3.0 ng/ml; R3.5: remifentanil 3.5 ng/ml; R4.0: remifentanil 4.0 ng/ml). The effect-site concentration of propofol at loss of consciousness was recorded. Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) were recorded at just before remifentanil administration (baseline), at the time of target effect site concentration of remifentanil and propofol, at just before intubation and 1, 2, 3 min after intubation. Results: MAP was significantly increased compared with baseline at 1, 2 min after intubation in R3.0, but was significantly decreased in R4.0. MAP of R3.5 was not different from the baseline after intubation. HR was significantly decreased compared with baseline at the time of target effect site concentration of propofol and immediate before intubation in R3.5 and R4.0. After intubation, HR was significantly increased compared with baseline at only 1 min after intubation and returned to the baseline in R3.0. However, HR was continuously decreased in R4.0. Conclusions: These findings suggest that effective target effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endotracheal intubation was 3.5 ng/ml during TCI-TIVA using 4.0 μg/ml of propofol with remifentanil. (Korean J Anesthesiol 2009; 57: 8~12)
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진단받지 않은 후두개와 후두개곡사이낭종으로 인한 어려운 기관 내 삽관
이정하(Jung Ha Lee),허봉하(Bong Ha Heo),윤대훈(Dae Hun Yun) 조선대학교 의학연구원 2020 The Medical Journal of Chosun University Vol.45 No.1
Laryngeal cyst in adults is a rare condition. However, if these cysts are unexpectedly discovered after anesthesia induction, an emergency situation immediately poses a life-threatening condition if proper airway management is not done. The authors report that in the case of difficult intubation tubes after anesthesia induction caused by laryngeal cyst, which was not diagnosed as asymptomatic, the oral intubation was successful without complication using the Clarus Video System (Clarus Medical, USA), an semi-rigid optical stylet. A 67-year-old male presented for laparoscopic radical prostatectomy. We discovered an undiagnosed epiglottic cyst obscuring laryngeal inlet. Fortunately, mask ventilation was possible, and after failed attempts of direct laryngoscopy, we could perform oral semi-rigid optical stylet-aided intubation. We experienced difficult intubation due to laryngeal cyst, which had no symptoms of respiratory closures before anesthesia, and in such cases it is believed that systematic preparation for “difficult airways” should be made to prevent hypoxic damage that can result from unexpected intubation failure.
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