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증례보고 : 내경정맥을 통한 중심정맥도관 삽입 실패 후 초음파로 발견된 혈전
정종권 ( Jong Kwon Jung ),한정욱 ( Jeong Uk Han ),신헬렌키 ( He Len Ki Shinn ),정인준 ( In Jun Jung ),고두현 ( Du Hyun Ko ),임흥순 ( Heung Soon Im ),임현경 ( Hyun Kyoung Lim ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Right internal jugular vein catheterization is performed frequently as central venous catheterization by the landmark method. This procedure, however, might prove difficulty due to anatomic variations or thrombosis of internal jugular vein. We failed to catheterize right internal jugular vein by the landmark method in 70-year-old female patient. And then, we detected right internal jugular vein thrombosis by ultrasound scan. Left internal jugular vein catheterization was performed by the ultrasound guided technique. Central venous catheterization has possibility to fail despite several attempts by the landmark method. Then, ultrasound guided approach is a good choice to aid central venous catheterization when difficulties or complications have been encountered. (Korean J Anesthesiol 2008; 55: 744~6)
증례보고 : 복와위에서 요추 후방 융합술 중 발생한 횡문근융해증 환자의 치료 경험 2례
임현경 ( Hyun Kyoung Lim ),박상규 ( Sang Kyu Park ),정종권 ( Jong Kwon Jung ),이춘수 ( Choon Soo Lee ),이두익 ( Doo Ik Lee ),한정욱 ( Jeong Uk Han ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
The spine surgery performed in the prone position could cause severe complications such as visual acuity impairment, spinal infarct and rhabdomyolysis. When treating rhabdomyolysis, it is important to prevent acute renal failure from accompanying rhabdomyolysis due to the poor prognosis. We have experienced two cases of rhabdomyolysis after spine surgery where dark urine was present during spine surgery under general anesthesia. Anesthesiologists should pay attention for early diagnosis and treatment of the rhabdomyolysis developing during the spine surgery. (Korean J Anesthesiol 2009;57:528∼30)
증례보고 : 전신마취 유도 중 발생한 Vecuronium에 의한 아나필락시스
신헬렌키 ( Helen Ki Shinn ),임현경 ( Hyun Kyoung Lim ),송장호 ( Jang Ho Song ),한정욱 ( Jeong Uk Han ),고두현 ( Du Hyun Ko ),정인준 ( In Jun Jung ),정종권 ( Jong Kwon Jung ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.5
Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Muscle relaxants are the most common cause of anaphylaxis during anesthesia. A 54-year-old woman was scheduled for thyroidectomy. She had no history of allergy and had never previously undergone general anesthesia, Lidocaine, propofol and vecuronium were injected sequentially to induce general anesthesia. Two minutes after the vecuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. The patient recovered without any significant complications after immediate proper intensive care. The operation was delayed and a skin test was performed on the 7th day after discharge. She revealed a positive skin test for vecuronium. The anesthesia was re-induced without muscle relaxant and maintained with propofol and remifentanil infusion. Surgery was completed uneventfully, and the patient recovered without any adverse reaction. (Korean J Anesthesiol 2008;55:613~7)
증례보고 : 내경 정맥을 통한 중심 정맥 도관술시 발생한 의인성 척추 동정맥루
신혜란 ( Helen Ki Shinn ),송장호 ( Jang Ho Song ),한정욱 ( Jeong Uk Han ),고희창 ( Hee Chang Ko ),조병권 ( Byung Kwan Cho ),음선형 ( Son Hyoung Eum ),정종권 ( Jong Kwon Jung ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Iatrogenic vertebro-vertebral arteriovenous fistula (AVF) is an uncommon complication resulting from various procedures such as central venous catheter insertion. The incidence may be underestimated since the diagnosis is not easy because of its rarity. A central venous catheterization via the internal jugular vein was attempted in a 43-year-old female who presented for intracranial aneurysmal clipping under general anesthesia. Inadvertent arterial puncture was recognized as pulsatile arterial blood flow through the needle. The needle was removed and local compression was applied to the puncture site. The catheter was inserted via the right femoral vein. After surgery, the patient recovered from anesthesia without any complications. On postoperative day 5, thrill and bruit on the right side of the neck were noted on physical examination. Angiography confirmed vertebro-vertebral AVF, which was successfully obliterated with a stent 3 months later. (Korean J Anesthesiol 2007; 53: 806∼9)