수술후 통증관리를 위한 Buprenorphine의 지속적 경막외 투여효과

윤희동(Hee Dong Yoon),박영철(Young Chul Park),임혜 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

N/A Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid p-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can pos- sibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and sid effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg mor- phine(M group), O.l5mg buprenorphine(0.15B group), 0.3 mg buprenorphine(0.3B group) com- bined with 0.125% bupivacaine 10ml, and subsequent continuous infusion doses were 6mg morphine plus 0.125% bupivacaine 100ml(M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml(0.15B, 0.3B group during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group(P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group(P<0.05). Conclusion: The above results suggest that continuous epidural infusion of bupre- norphine combined with low-dose bupivacaine is an advisable method of postoperative an- algesia.

고리원전의 온배수 방출이 주변 해조군집에 미치는 영향

김영환,안중관,윤희동,장민아,Kim, Young-Hwan,Ahn, Jung-Kwan,Yoon, Hee-Dong,Jang, Min-A 한국조류학회(藻類) 2007 ALGAE Vol.22 No.4

This study is intended to clarify the effects of heated effluents on intertidal benthic marine algal community in Korea. The species composition and biomass of marine algae at the discharge canal of Gori nuclear power plant on the southeastern coast of Korea were investigated seasonally from February 2001 to October 2006. As a result, 54 species (7 blue-green, 12 green, 9 brown and 26 red algae) of marine algae were found at the discharge canal during the past six years. In general, the number of species observed was abundant during winter to spring and less in autumn. Enteromorpha compressa, E. intestinalis, E. prolifera and Caulacanthus ustulatus were common species found more than 80% frequency during the study period. Seasonal fluctuations of mean biomass were 1-440 g dry wt m?2 and dominant species in biomass were Enteromorpha spp. (contribution to a total biomass proportion 28%), Sargassum horneri (14%) and Amphiroa beauvoisii (14%). It is evident from the floristic composition and biomass data that unique micro-environment of the discharge canal support different communities from those on the intake or control area. Results from the large numbers of surveys before and during plant operation showed that, in the regions influenced by thermal effluents such as the discharge canal of power plants, the process of ecological succession has been proceeded. It is assumed that the uni-directional water flow and the time of overhaul largely affect the development and succession of benthic marine algal communities of the discharge canal.

실시간 임베디드 UAV 시스템을 위한 딥러닝 기반 물체 검출기 최적화

박정빈(Jeongbin Park),박승일(Seungil Park),김찬영(Chanyoung Kim),서재규(Jae Kyu Suhr) 대한전자공학회 2021 대한전자공학회 학술대회 Vol.2021 No.11

서해안 태안반도 해조군집의 종조성과 수직분포

안중관 ( Jung Kwan Ahn ),유경동 ( Kyong Dong Yoo ),오지철 ( Ji Chul Oh ),이재일 ( Jae Il Lee ),윤희동 ( Hee Dong Yoon ),김영환 ( Young Hwan Kim ) 한국수산과학회(구 한국수산학회) 2017 한국수산과학회지 Vol.50 No.1

Seasonal variability in algal community structure was examined at the intertidal zones of five study sites on the Taean Peninsula, on the western coast of Korea, from February 2014 to November 2015. A total of 118 species of marine algae, comprising 17 green, 24 brown and 77 red algae, were identified. The maximum number of species was observed at the Mohang site (75 species), and the minimum at the Yeonpo site (46 species). The seaweed biomass was 160.24 g dry wt./m² on average, and was maximal at Uihang (519.04 g dry wt./m²) and minimal at Yeonpo (19.03 g dry wt./m²). Based on biomass, the dominant seaweeds at Taean peninsula were Sargassum thunbergii and Corallina pilulifera. Community indices were as follows: richness index (R), 3.21-5.01; evenness index (J`), 0.33-0.38; and diversity index (H`), 0.90-1.12. Based on evaluation of the environmental states by the community indices, the ecological evaluation index (EEI) of Taean peninsula was “moderate”. The overall species and biomass of seaweeds decreased after the oil spill. However, Hakampo previously showed a similar algal community structure. In conclu-sion, the algal community was temporarily affected by the oil spill, but rapidly recovered.

자궁적출술 후 정맥 내 자가통증조절 시 저용량의 Naloxone 이 술 후 진통효과와 부작용에 미치는 영향

윤희동 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.6

Enflurane이 Diltiazem을 전처치한 흰쥐의 적출심장의 좌심실기능에 미치는 영향

윤석민,임상호,윤희동,박영철 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.6

Background : Calcium channel blockers and volatile anesthetics have depressant effects on cardiac function. Both of them appear to exert, qualitatively and quantitatively, different effects on myocardial contractility, coronary flow, and myocardial oxygen balance. The aim of this study was to examine the direct cardiac effects of the enflurane in the presence of diltiazem. Methods : Isolated Sprague-Dawley rat hearts (N=45) were perfused at constant pressure with oxygenated Modified-Krebs solution (pH 7.4, 37oC). Isovolumetric left ventricular pressure (LVP) and dP/dt were measured via a latex balloon and transducer. Also, coronary flow and oxygen tensions at the coronary inflow and outflow were measured. After stabilization period, all hearts were subjected to the application with diltiazem (100 ng/ml). Thereafter, they were subdivided into three groups; group 1, 2, 3. Groups subjected to the combination of diltiazem (100 ng/ml) with enflurane 1.1, 2.2, or 3.3 vol%, respectively. Results : After the application of diltiazem, myocardial contractility and heart rate were significantly decreased, and coronary flow were significantly increased. The combination of diltiazem with enflurane depressed myocardial contractility, heart rate, myocardial O2 consumption, and percentage of O2 extraction more than diltiazem alone, and their effects were dependent on the concentration of enflurane. However, there was no difference in the change of coronary flow and oxygen delivery between diltiazem and the combination of diltiazem with enflurane. Conclusions : These in vitro findings demonstrate that the combination of diltiazem with enflurane shows greater direct negative inotropic and negative chronotropic effect, and is associated with less attenuation of coronary autoregulation, but with a larger reduction in O2 utilization. The present results suggest that high enflurane anesthesia in the diltiazem-pretreated patients could result in profound cardiac depression. (Korean J Anesthesiol 1998; 35: 1035∼1046)

Rocuronium 과 Lidocaine 의 전투여가 Succinycholine 투여 후 나타나는 생화학적 변화와 속상수축 및 근육통에 미치는 영향

김재환,장문석,윤희동,박영철 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.40 No.5

Background: The purpose of this study was to assess the changes in serum potassium and creatine kinase concentrations and the incidence of fasciculations and myalgia when rocuronium and lidocaine were used in combination and separately as pretreatment before succinylcholine. Methods: We studied 60 patients undergoing a minor elective surgery, in a prospective double blinded method. Three groups each with 20 patients were pretreated before a 1.5 mg/kg succinylcholine administration with 0.05 mg/kg rocuronium three min before (group R), 1.5 mg/kg lidocaine 30 sec before (group L), or both rocuronium and lidocaine (group RL). Serum potassium and creatine kinase were respectively measured 5 min after succinylcholine administration and 24 h after the operation. Fasiculations and myalgia on postoperative day 1 and day 2 were evaluated. Results: The increase in creatine kinase and incidence of myalgia on postoperative day 1 was less in the RL group than in the R group and L group. The incidence of fasiculations was higher in the L group than in the R group and RL group. There was no increase in serum potassium in any group. Conclusions: The combined use of rocuronium and lidocaine was more effective in reducing creatine kinase and postoperative myaliga than when they were used separately. However, the fasciculations were only reduced by the use of rocuronium.

노인환자에서 질식 자궁절제술중 발생한 심한 저혈압의 증례 보고

조헌,장성호,임혜자,공명훈,윤희동,김난숙 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.12

An anesthesiologist should keep in mind the various risk factors during anesthetic man- agement of geriatric patients. Unlike young patients, elderly patients may manifest more than one pathophysiologic process associsted with progressive degenerative changes in various organs. The successful anesthetic management requires detailed information about the cause and severity of the underlying disease, thorough understanding of geriatric specific hemodynamic particularities, and more careful monitoring by experienced personnel. We experienced a case of profound hypotension during general anesthesia for vaginal hysterectomy in a 67 year-old female patient. Anesthesia was induced with thiopental-vecuronium and was maintained with nitrous oxide, oxygen and enflurane. One hundred and five minutes after the induction, profound hypotension and bradycardia with S-T segment depression developed without specific events and were corrected by vigorous therapeutic managements. She discharged from the hospital on 7th postoperative day without complications.

정맥내 자가통증조절시 Morphine과 Fentanyl의 혼합사용 효과

김태일,윤석민,조헌,이혜원,장성호,임혜자,윤희동 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.5

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods : Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results : The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions : The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period. (Korean J Anesthesiol 1998; 35: 975∼982)

개에서 관상동맥 협착유발후 흉추 경막외마취가 심근과 전신순환에 미치는 영향

김영기,김영훈,장성호,임혜자,윤희동 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.5

Thoracic epidural combined with general anesthesia is used for thoracic and upper abdominal surgery and postoperative pain control. This technique has advantages of reducing the hemodynamic demand on the heart because of cardiac sympathetic block and stable intraoperative hemodynamics, but it may have a potential hazard of reducing coronary perfusion pressure due to hypotension. Decreased coronary perfusion pressure may be critical hazard to coronary insufficiency patients, but coronary vascular resistance may be decreased also due to blockade of sympathetic coronary constriction. This study was done to investigate the effect of thoracic epidural anesthesia on myocardial and systemic circulation during coronary occlusion limiting flow to 50% of preocclusive value. Comnary occlusion of left circumflex coronary artery was achieved with hydraulic vascular occluder with blood flow meter distal to occluder in 20 dogs. Five of them were dead during preparation. Coronary stenosis was maintained for 30 minutes, then epidural anesthesia was done with 0.5% bupivacaine (bupiva group) or saline (saline group) 5 ml through the surgically introduced epidural catheter. Arterial, mixed venous and coronary sinus blood was collected for the measurement of metabolites and myocardial and systemic oxygen comsumption and extraction ratio. Hemodynamic parameters and blood samples were obtained before(control), 30 minutes after stenosis(stenosis), 15, 30, 60, 90 and 120 minutes after epidural blockade. The results were as follows; The thoracic epidural block caused decrease in blood pressure, heart rate, cardiac index, level of free fatty acid and glucose, and increase in lactic acid level of mixed veous and coronary sinus blood, myocardial oxygen extraction ratio, arterio-venous oxygen content difference, and systemic oxygen extraction ratio. In conclusion the high thoracic epidural block may cause hypotension thus decrease oxygen supply to myocardium but the degree of which is less than that of total body, in the dogs with acute coronary stenosis. The reason is that the high thoracic epidural block decrease myocardial oxygen consumption, and make effective distribution of blood flow in ischemic myocardium, but the normal myocardium has the highest oxygen extraction in the body, so the high thoracic epidural block in coronary stenosis may cause ill effect on myocardial oxygen equlibrium.