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하지 수술을 위한 척추마취 시 척수강내로 주입한 Fentanyl의 효과
이상진 ( Sang Jin Lee ),김상훈 ( Sang Hun Kim ),정종달 ( Jong Dal Jung ),유병식 ( Byung Sik Yoo ),임경준 ( Kyung Joon Lim ),소금영 ( Geum Young So ),안태훈 ( Tae Hun An ),이여진 ( Yeo Jin Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3
Background: Intrathecal opioids in combination with bupivacaine has been shown to provide adequate sensory blockade and early recovery from spinal anesthesia. This study was investigated the added effects of intrathecal fentanyl 10 μg to bupivacaine for spinal anesthesia. Methods: Sixty patients undergoing lower extremity surgery were into three groups. Group I received bupivacaine 10 mg (0.5%), gruop II received bupivacaine 5 mg with normal saline 1 ml, and group III received bupivacaine 5 mg with fentanyl 10 μg and normal saline 0.8 ml. Results: There was no significant difference between group I and group III in the peak level and duration of sensory block. But the intensity of motor blockade was decreased in group III compared with group I and side effects of spinal anesthesia with local anesthetics was decreased in group III compared with group I. In Group II, 7 patients were complained the pain during surgery. Conclusions: Intrathecal fentanyl 10 μg with bupivacaine 5 mg on spinal blockade provide reliable anesthesia for lower extremity surgery. (Korean J Anesthesiol 2009; 56: 280∼3)
Pierre Robin syndrome 환아에서 기관내 삽관 경험 : 증례보고
김상훈,이현영,소금영,유병식,정이남 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S
Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Neonates with Pierre Robin are at risk of upper airway obstruction and may require surgical fixation of the tongue to the mandible. Such neonates are at high risk of hypoxia and difficult to intubation during induction of anesthesia. We report a case of an 11-day old neonate with Pierre Robin syndrome was intubated in operative room and emergency room. While under general anaesthesia, awake intubation was attempted and facilitated oxygenation. After a 4 day discharge, he revisited to emergency room due to airway obstruction symptom. Repeated attempts at intubation (again with spontaneous breathing) failed. Finally, laryngeal mask airway (LMA) was introduced, and as a result of this ventilation was achieved. The next day, we awake fiberoptic intubation through the laryngeal mask and were easily achieved.