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임상연구 : 부인과 수술환자에서 Sufentanil과 병용한 0.1% Levobupivacaine 또는 0.1% Ropivacaine의 술 후 경막외 진통 비교
양춘우 ( Chun Woo Yang ),박정민 ( Jeong Min Park ),임영수 ( Young Su Lim ),조춘규 ( Choon Kyu Cho ),김경식 ( Kyong Sik Kim ),김응균 ( Eung Kyun Kim ),정성미 ( Sung Mee Jung ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Background: Ropivacaine and levobupivacaine are recently introduced amide local anesthetics that are structurally similar to bupivacaine. In this study, we compared the quality of postoperative analgesia and the side effects of 0.1% ropivacaine/sufentanil and 0.1% levobupivacaine/sufentanil. Methods: Sixty patients scheduled for gynecologic surgery under general anesthesia were randomized to receive either 0.1% ropivacaine with sufentanil (ropivacaine group) or 0.1% levobupivacaine with sufentanil (levobupivacaine group) for postoperative epidural analgesia using a patient-controlled analgesia pump at a rate of 5 ml/h during the 48 hour period following surgery. Visual analogue scale (VAS) scores at rest and on coughing, sitting and movement, the degree of ambulation, additional analgesic requirements and side effects were assessed. Results: In the levobupivacaine group, VAS scores at rest and on coughing, sitting and movement were lower than in the ropivacaine group (P < 0.05). In the ropivacaine group more patients were able to walk unaided (P < 0.05). There were no differences in local anesthetic consumption, additional analgesic requirements and side effects between the groups. Conclusions: Both 0.1% ropivacaine with sufentanil and 0.1% levobupivacaine with sufentanil provided effective postoperative epidural analgesia, but ropivacaine produced lesser motor block. (Korean J Anesthesiol 2007; 53: 746~52)
임상연구 : 제왕절개술을 위한 경막외 마취 시 0.5% Levobupivacaine과 0.5% Ropivacaine 비교
양춘우 ( Chun Woo Yang ),정성미 ( Sung Mee Jung ),권희욱 ( Hee Uk Kwon ),강포순 ( Po Soon Kang ),류승훈 ( Seung Hun Ryu ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.3
Background: Ropivacaine and levobupivacaine, both single S-enantiomers, show less toxicity on the central nervous and cardiovascular system than racemic bupivacaine. Earlier studies have shown that levobupivacaine and bupivacaine are almost equipotent while ropivaciane was 60% less potent than bupivacaine. The aim of this prospective, double blinded study was to compare the clinical efficacy and safety of epidural anesthesia produced by 0.5% levobupivacaine and 0.5% ropivacaine for a cesarean section. Methods: Sixty-two parturients undergoing an elective cesarean section were randomized to receive either epidural levobupivacaine 0.5% 20 ml (n = 31) or epidural ropivacaine 0.5% 20 ml (n = 31). Surgery was commenced when the sensory block had reached the dermatome level, T6. The onset, duration, quality of the sensory and motor block and abdominal muscle relaxation were evaluated. The blood pressure and heart rate of the mother and neonatal outcome, as assessed by the Apgar score and umbilical pH, were also recorded. Results: There was no difference in the onset time, the segmental spread of sensory block and analgesic supplement between the two groups. However, levobupivacaine produced a longer duration of sensory block than ropivacaine (levobupivacaine 224.1 ± 66.6 min, ropivacaine 176.5 ± 32.8 min, P < 0.05). The onset time (except Bromage scale 2), intensity and duration of the motor block and muscle relaxation were similar in both groups. There was no difference in the maternal and neonatal outcomes between the two groups. Conclusions: 0.5% levobupivacaine and 0.5% ropivacaine produced equivalent efficacy and safety in epidural anesthesia for a cesarean section, but levobupivacaine resulted in a longer duration of sensory block. (Korean J Anesthesiol 2007; 52: 284~90)
슬관절 전치환술 후 슬관절 주위주입과 병용한 지속적 정맥 진통과 지속적 경막외 진통의 비교
박정민 ( Jeong Min Park ),임영수 ( Young Su Lim ),이우석 ( Woo Suk Lee ),구자현 ( Ja Hyun Ku ),강포순 ( Po Soon Kang ),권희욱 ( Hee Uk Kwon ),조춘규 ( Choon Kyu Cho ),정성미 ( Sung Mee Jung ),양춘우 ( Chun Woo Yang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Background: Postoperative continuous intravenous analgesia may not provide effective postoperative analgesia following total knee arthroplasty. This study was conducted to determine if combined continuous intravenous analgesia and peri-articular infiltration provided a better quality of analgesia following total knee arthroplasty than epidural analgesia. Methods: A prospective, double-blind study involving 50 patients who had undergone total knee arthroplasty was conducted. Patients were divided into control group and an experimental group. Patients in the control group (n=25) received peri-articular infiltration with 47 mL normal saline prior to closure of the wound and postoperative epidural analgesia for 48 hours. Patients in the experimental group (n=25) received a mixture of peri-articular infiltration of 16 mL of 0.75% ropivacaine, 6 mg morphine, 0.2 mg of epinephrine and 25 mL normal saline prior to closure of the wound and postoperative continuous intravenous analgesia for 48 hours. The analgesic efficacy was then evaluated using the verbal numeric rating scale at 1, 2, 6, 12, 24, and 48 hours postoperatively. The side effects and the dosage of rescue analgesics were then recorded. Results: The experimental group showed a significantly higher pain score than the control group 2 and, 6 hours postoperatively at rest and 2 hours postoperatively following passive knee movement (P<0.05). In addition, the rescue analgesic requirement was higher for the experimental group during the first 24 hours following surgery than for the control group (P<0.05). Conclusions: We found that combined continuous intravenous analgesia and peri-articular infiltration of a mixture of ropivacaine and, morphine injected into the peri-articular tissue provided minimal benefits for pain control during the early postoperative period when compared to epidural analgesia after total knee arthroplasty. (Korean J Anesthesiol 2009;56:47~53)
증례보고 : 다발성 골절 환자에서 족관절 개방골절 외부고정술 후 진단된 뇌지방 색전증 -증례보고-
김병건 ( Byung Gun Kim ),송장호 ( Jang Ho Song ),양춘우 ( Chun Woo Yang ),차영덕 ( Young Deog Cha ),이춘수 ( Choon Soo Lee ),한정욱 ( Jung Uk Han ),임현경 ( Hyun Kyoung Lim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6
Even though cerebral fat embolism develops rarely after long bone fracture, it may be very important complication because it can be fatal and the early detection is not easy. Neurologic symptoms include confusion, restlessness, disorientation, seizure, and stroke with focal deficits. High intensive T2 signal MRI of the brain is most sensitive for diagnosis of cerebral fat embolism. We report a case of cerebral fat embolism diagnosed after external fixation of ankle open fracture in a 46 year old woman patient with multiple fracture. (Korean J Anesthesiol 2006; 50: 731~5)
빗장 아래 팔신경얼기 차단 환자에서의 0.75% 또는 0.5% Ropivacaine의 비교
박정민 ( Jeong Min Park ),정성미 ( Sung Mee Jung ),조춘규 ( Choon Kyu Cho ),임영수 ( Young Su Lim ),구자현 ( Ja Hyun Ku ),허윤무 ( Youn Moo Heo ),송장호 ( Jang Ho Song ),양춘우 ( Chun Woo Yang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
Background: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.75% vs 0.5% ropivacaine for upper limb surgery. Methods: We included 80 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.75% or 0.5% ropivacaine. By observation, we determined nerve type was stimulated and scored the level of sensory block and motor block. The quality of blocks was assessed intra-operatively. The duration of sensory block and motor block and their complications were assessed. Results: There were no significant differences in the frequency of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant differences in the duration of sensory block and motor block. Vascular puncture was noted in 1 patient in the 0.75% ropivacaine. Conclusions: Both the 0.75% and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block. (Korean J Anesthesiol 2009;57:572∼8)
정중법을 이용한 빗장 아래 상완 신경총 차단 환자에서의 0.5% Levobupivacaine과 0.5% Ropivacaine의 비교
조춘규 ( Choon Kyu Cho ),김중연 ( Joong Yeoun Kim ),정성미 ( Sung Mee Jung ),권희욱 ( Hee Uk Kwon ),강포순 ( Po Soon Kang ),김철웅 ( Chul Woung Kim ),한정욱 ( Jeong Uk Han ),양춘우 ( Chun Woo Yang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.2