부인과 복강경 수술 시 Sevoflurane, Desflurane 그리고 Isoflurane의 체온조절반응

정종달 ( Jong Dal Jung ),안태훈 ( Tae Hun An ),송호석 ( Ho Seok Song ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5

Background: Core temperature decreases rapidly after the induction of general anesthesia, because the heat is redistributed to peripheral tissues. Thermoregulatory responses of volatile anesthetics have been tested, but their effects have not been directly compared. Therefore, we evaluated the thermoregulatory responses to sevoflurane, desflurane, and isoflurane. Methods: Sixty healthy patients scheduled for laparoscopic myomectomy or radical hysterectomy were allocated into three groups; Group S (sevoflurane, n=20), Group D (desflurane, n=20), and Group I (isoflurane, n=20). Anesthesia was maintained with 1 minimum alveolar concentration (MAC) of sevoflurane, desflurane, and isoflurane in a 50/50 mixture of N2O/O2. Patients were maintained in a normovolemic and normocapnic state. The core temperature and forearm minus fingertip skin-temperature gradient (an index of peripheral vasoconstriction) were monitored after the induction of general anesthesia. Results: Each of the seven patients given sevoflurane, desflurane, and isoflurane vasoconstricted at a core temperature of 35.3±0.5℃, 33.6±0.4℃, and 35.2±0.4℃, respectively. The vasoconstriction threshold was the lowest in patients anesthetized with desflurane. The core temperature gradient (Ti-Tf) was significantly higher in patients that were anesthetized with desflurane than in those that were anesthetized with sevoflurane or isoflurane. The core temperature of desflurane was significantly lower than that of sevoflurane or isoflurane 15 minutes after the induction of anesthesia until 180 minutes of anesthesia. Conclusions: These results indicate that the core temperature is maintained at a higher level in patients that have been anesthetized with sevoflurane or isoflurane than in those that have been anesthetized with desflurane. (Korean J Anesthesiol 2009;56:525~30)

임상연구 : 무릎 관절경 수술을 위한 일측성 척추마취에서 고비중 Bupivacaine에 첨가한 Fentanyl의 효과

임영재 ( Young Jae Lim ),정종달 ( Jong Dal Jung ),임경준 ( Kyung Jun Lim ),소금영 ( Keum Young So ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

Background: Unilateral spinal anesthesia prolongs sensory blockade and provides hemodynamic stability. Intrathecal opioids enhance spinal anesthesia without prolonging motor recovery or hemodynamic side effects. The author evaluated the effect of intrathecal fentanyl on unilateral spinal blockade with hyperbaric bupivacaine for knee arthroscopy. Methods: Thirty-six healthy patients undergoing unilateral knee arthroscopy randomly received unilateral spinal anesthesia with 0.5% hyperbaric bupivacaine 4 mg (Group I) or 0.5% hyperbaric bupivacaine 4 mg combined with fentanyl 10μg (Group II). A lateral decubitus position was maintained for 15 minutes after intrathecal injection. The level and duration of sensory and motor blockade were recorded. Results: The regression time of sensory block by two segments on dependent site was prolonged on Group II more than Group I (P < 0.05). There was no significant difference between two groups in recovery time of sensory and motor block. Unilateral sensory block was observed in 18 patients in Group I (100%) and in 2 patients in Group II (11%). Hemodynamic side effects were minimal in both groups, but pruritus was observed in 6 patients in Group II (33%). Conclusions: Small dose of intrathecal fentanyl with bupivacaine unilateral spinal anesthesia prolonged the duration of sensory block on operated site, but did not increase side effects and the duration of motor block and recovery. But intrathecal fentanyl with bupivacaine made disturbance of successful unilateral spinal block by the sensory block of nonoperated site. (Korean J Anesthesiol 2006; 50: 530~5)

실험연구 : Propofol이 백서 자궁 평활근의 수축에 미치는 영향

오경희 ( Kyung Hee Oh ),안태훈 ( Tae Hun An ),정종달 ( Jong Dal Jung ),소금영 ( Keurn Young So ),임형석 ( Hyung Suk Lim ),송창훈 ( Chang Hun Song ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1

Background: Propofol is an alternative to thiopental as an intravenous induction agent for cesarean section. It is also used as a sedative for supplementation of regional blockade during cesarean section. It has been reported that propofol relaxes not only vascular smooth muscle but also other smooth muscles. The aim of this study was to investigate the effect of propofol on rat uterine smooth muscle in an isolated preparation in the rat. Methods: Uterine smooth muscle tissues were obtained from rats (n = 21). The muscle strips were suspended in tissue baths and isometric tension was recorded. After spontaneous or oxytocin induced activity had been accomplished in the buffer solution as a control, propofol (1 to 20μg/ml) in fat emulsion was applied cumulatively to the bath and the effects were continuously recorded. Results: In vitro, propofol induced a dose-dependent inhibition of spontaneous as well as oxytocin induced myometrial contractile activity. Propofol concentration of 1 μg/ml had no significant effects on the resting tension, active tention, and frequency of contraction developed by spontaneous and oxytocin induced uterine contractility. However, Complete muscular relaxations on spontaneous and oxytocin induced contractility were obtained at a concentration of 10 μg/ml and 20μg/ml, respectively. Conclusions: Propofol inhibits spontaneous and oxytocin-induced uterine smooth muscle contractions in dose dependent pattern. (Korean J Anesthesiol 2007; 52: 76~80)

가공유제의 환경피해와 대책

김남경(Nam Kyung Kim),김해지(Hae Gi Kim),정종달(Jong Dal Jung) 한국생산제조학회 2002 한국공작기계학회 춘계학술대회논문집 Vol.2002 No.4

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)

전신마취시 경막외강에 Bupivacaine과 함께 투여한 Neostigmine의 술호 진통 효과

안태훈,소금영,정종달,김길범,유병식,임경준,김훈정 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.3

Background: Intrathecal injection of analgesic agents such as opioids, clonidine, ketamine and nalbuphine with a local anesthetic produces analgesia in patients. Recently, the analgesic effect of intrathecal neostigmine has been investigated; however, the use of epidural neostigmine has not been investigated. The purpose of this study was to define the analgesic effectiveness and the side effects of epidural neostigmine. Methods: Forty patients undergoing a total abdominal hysterectomy were divided into 4 groups. After intramuscular 0.1 mg/kg midazolam premedication, patients were randomized to receive epidural bupivacaine with saline (control group), 1 ㎍/kg epidural neostigmine (Group I), 2 ㎍/kg epidural neostigmine (Group II), or 3 ㎍/kg epidural neostigmine (Group III) postoperatively. The concept of the visual analog scale, which consisted of a 10-cm line with 0 equaling $quot;no pain at all$quot; and 10 equaling $quot;the worst possible pain$quot; was introduced. Pain was assessed by using the visual analog scale at 1, 6, 9, 12, and 24 h postoperatively, and intramuscular 90 mg diclofenac was available at the patient's request. Results: The visual analog scale score at first rescue analgesic and the incidence of adverse effects were similar among neostigmine groups. The analgesic consumption in 24 hours and the pain visual analog scale score at 3 h, 12 h, and 24 h were significantly decreased in neostigmine groups compared with control groups. Conclusions: Epidural neostigmine coadministered with bupivacaine produces a dose-independent analgesic effect compared to the control group and a reduction in postoperative rescue analgesic consumption without increasing the incidence of adverse effects.

가공유제의 환경피해와 대책

김남경,김해지,정종달 한국공작기계학회 2002 한국공작기계학회 춘계학술대회논문집 Vol.2002 No.-

This paper presented on an environment estimation of cutting fluid which is a mouse model of acute bacterial rhinosinusitis using cutting fluid in grinding and cutting. Above results will be remarked the necessity of friendly environmental cutting skill when it had used in workshop. The results of a mouse experimental using cutting fluid showed that it are occurred to the respiratory organs sickness. Also cutting fluid are occurred to hurtfulness a person when it used to grinding and cutting in workshop. Also, the results of grinding experiments in avitation materials showed that surface roughness are superior to more emulsion type oil than vegetable type oil according to increase of the depth of cut. Grinding force are similar to both emulsion type oil and vegetable type oil.

Eisenmenger씨 증후군 산모의 긴박 제왕절개술시 전신마취 경험

김준,고우석,정종달,유병식,임경준,소금영,안태훈,한승룡 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Eisenmenger's syndrome describes a situation in which the left-to-right intracardiac shunt is reversed as a result of increased pulmonary vascular resistance. The patients with Eisenmenger's syndrome are poorly tolerated and markedly increased maternal mortality to 30 - 50% during pregnancy, Physiological change of pregnancy decreases systemic vascular resistance that further aggravates the bi-directional or left shunt associated with Eisemnenger's syndrome. We report a case of 37 weeks a pregnant woman with an urgent cesarean section under general anesthesia for preterm labor. She was a pregnant patient with Eisenmenger's syndrome and did not receive antenatal care during pregnancy. Anesthesia was induced with ketamine-midazolam-fentanyl and maintained with ketamine-midazolam. The patient was ventilated with 100% O₂. Blood pressure was maintained with intravenous phenylephrine, crystalloid solution, and blood. Phenylephhne was used to maintain systemic vascular resistance (SVR). Even though the patient was carried rapid and adequate medical management, the patient was transferred to the ICU in an intubated state and died 2 days after surgery. We conclude that the parturients with Eisenmenger's syndrome require more regular, careful antenatal care, monitoring, and adequate management.

Armored Tube 의 내벽팽창에 의한 기도의 부분폐쇄

조남수,임경준,김병철,정용훈,조수형,소금영,안태훈,정종달,유병식 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.2

수분산형 불소계 방오가공 우레탄 개발 : Part Ⅱ. Scale-up Part Ⅱ. Scale-up

강나경,박인준,김동권,이수복,김희철,이형달,김경재,손석호,정종국 한국공업화학회 2002 응용화학 Vol.6 No.1

The fluorinated soil repellent agents has been widely utilized in textile finishing processes particularly in pile fabrics, and is classified from typical water and oil repellent agents in their soil repellent mechanism, usage and performances. In the application, the fluorinated soil repellent agents have not only water and oil repellency but also soil repellency which contains dry, liquid soil, and mixture of them. In this study, the scale-up test for the main compound of novel water dispersion type fluorinated soil repellent agents was done. The performance tests such as water, oil and stain repellencies of the synthesised products will be described.