The preanesthetic interview by anesthesiology residents: analysis of time and content

Deokkyu Kim,Sung Nyu Lee,Dong-Chan Kim,Jeongwoo Lee,고성훈,Sang-Kyi Lee,Ji-Seon Son 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

Background: A preanesthetic visit can increase a patient’s satisfaction. However, it is uncertain whether a preanesthetic visit by an anesthesiology resident can achieve the goal. We studied the time distribution for content of preanesthetic interviews (PI) and evaluated the patient’s satisfaction with the PI. Methods: We recorded the PI duration of 200 patients by a voice recorder. The degrees of patient satisfaction with the PI and the changes of anxiety level after the PI were quantified by a questionnaire. We analyzed the time distribution for content of the PI and the correlation between patient characteristics and PI duration or a patient’s satisfaction. Results: The total PI duration was 184 (134-286) sec (median, 25-75%), and the time distributions for content of the PI were 8 (5-10) of greeting, 45 (23-70) of history taking, 15 (10-20) of physical examination, 50 (25-98) for obtainingan informed consent, 20 (10-30) of explanation for anesthetic planning, 15 (5-28) for explanation of patient controlled analgesia, and 10 (0-4) sec for questions and answers. Age, ASA physical status, and educational level were correlated with PI duration (P < 0.001). The patient’s level of satisfaction was “very satisfied” in 39%,“satisfied” in 50%, and “moderate” in 11% of interviews. The anxiety level was “decreased” in 50%, “increased” in 8%,and “not changed” in 42% of patients. Conclusions: Although the duration of a PI given by residents was a relatively short, 89% of patients of were satisfied with the interview. The PI took a longer time to complete in patients of older age, higher ASA physical status, or lower educational levels. Background: A preanesthetic visit can increase a patient’s satisfaction. However, it is uncertain whether a preanesthetic visit by an anesthesiology resident can achieve the goal. We studied the time distribution for content of preanesthetic interviews (PI) and evaluated the patient’s satisfaction with the PI. Methods: We recorded the PI duration of 200 patients by a voice recorder. The degrees of patient satisfaction with the PI and the changes of anxiety level after the PI were quantified by a questionnaire. We analyzed the time distribution for content of the PI and the correlation between patient characteristics and PI duration or a patient’s satisfaction. Results: The total PI duration was 184 (134-286) sec (median, 25-75%), and the time distributions for content of the PI were 8 (5-10) of greeting, 45 (23-70) of history taking, 15 (10-20) of physical examination, 50 (25-98) for obtainingan informed consent, 20 (10-30) of explanation for anesthetic planning, 15 (5-28) for explanation of patient controlled analgesia, and 10 (0-4) sec for questions and answers. Age, ASA physical status, and educational level were correlated with PI duration (P < 0.001). The patient’s level of satisfaction was “very satisfied” in 39%,“satisfied” in 50%, and “moderate” in 11% of interviews. The anxiety level was “decreased” in 50%, “increased” in 8%,and “not changed” in 42% of patients. Conclusions: Although the duration of a PI given by residents was a relatively short, 89% of patients of were satisfied with the interview. The PI took a longer time to complete in patients of older age, higher ASA physical status, or lower educational levels.

Effect of ketorolac on the prevention of emergence agitation in children after sevoflurane anesthesia

Deokkyu Kim,고성훈,A Ram Doo,임형선,Ji Seon Son,Jun-Rae Lee,한영진 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.64 No.3

Background: The purpose of this study was to evaluate the effects of ketorolac on the incidence and severity of emergence agitation in children recovering from sevoflurane anesthesia. Methods: Eighty-five children aged 3 to 7 years were randomly assigned to the control group or the ketorolac group (1 mg/kg ketorolac). The children were evaluated by the Pediatric Anesthesia Emergence Delirium Scale and a four-point agitation scale. Results: The median agitation scores did not differ significantly between the two groups. The overall incidence of emergence agitation was similar in the two groups (41% in the control group vs. 32% in the ketorolac group, P = 0.526). The number of children who received rescue drugs for treatment of emergence agitation was not significantly different between the two groups. Conclusions: The administration of 1 mg/kg of ketorolac is not effective in decreasing the incidence and severity of emergence agitation in children aged 3 to 7 years after sevoflurane anesthesia.

Extrinsic parameter calibration of 2D radar-camera using point matching and generative optimization

Deokkyu Kim,Sungho Kim 제어로봇시스템학회 2019 제어로봇시스템학회 국제학술대회 논문집 Vol.2019 No.10

The fusion of sensors is a task to improve the recognition performance of obstacles in an autonomous vehicle system. For the fusion of sensors, extrinsic parameter calibration with 6-dof is needed to integrate the data between the sensors. This paper proposes a method of calibration between 2D radar and camera using point matching. We use corner reflectors calibration target, which focuses the radar signal at the center of the target. Using this target, we set the center point as Ground truth, which improves the accuracy of the estimation of the calibration parameter. We simultaneously measure the target with radar and camera. After estimating the intrinsic parameters of the camera, the coordinate axes of the camera and the radar are matched based on the camera view. This paper estimates the extrinsic parameters using point matching and top-down method. The proposed method is verified through experiments and results.

Postoperative Hypothermia

Deokkyu Kim 대한중환자의학회 2019 Acute and Critical Care Vol.34 No.1

Lymphangiomyomatosis discovered by massive hemoptysis during general anesthesia -A case report-

Deokkyu Kim,Sung Nyu Lee,이상귀,Jeongwoo Lee 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.4

Lymphangiomyomatosis (LAM) is a rare lung disease that is characterized by the progressive proliferation of atypical smooth muscle-like cells, which leads to severe respiratory impairment and death. Dyspnea, cough, recurrent pneumothorax, and hemoptysis are the most common clinical symptoms of LAM. We report a 29-year-old female patient with massive hemoptysis during laparoscopic gynecologic surgery under general anesthesia, who was diagnosed with pulmonary LAM.

Rehabilitation and Intensive Care Unit

Deokkyu Kim 대한중환자의학회 2018 Acute and Critical Care Vol.33 No.1

MLP 기반의 2D LiDAR를 이용한 보행자 검출 네트워크

김덕규(Deokkyu Kim),김성호(Sungho Kim) 대한전자공학회 2019 대한전자공학회 학술대회 Vol.2019 No.6

The effects of incremental continuous positive airway pressure on arterial oxygenation and pulmonary shunt during one-lung ventilation

Yeon Dong Kim,고성훈,Deokkyu Kim,임형선,Ji Hye Lee,Min Ho Kim 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

Background: Although one lung ventilation (OLV) is frequently used for facilitating thoracic surgical procedures,arterial hypoxemia can occur while using one lung anesthesia. Continuous positive airway pressure (CPAP) in 5 or 10 cmH2O to the non-ventilating lung is commonly recommended to prevent hypoxemia. We evaluated the effects of incremental CPAP to the non-ventilating lung on arterial oxygenation and pulmonary shunt without obstruction of the surgical field during OLV. Methods: Twenty patients that were scheduled for one lung anesthesia were included in this study. Systemic and pulmonary hemodynamic data and blood gas analysis was recorded every fifteen minutes according to the patient's positions and CPAP levels. CPAP was applied from 0 cmH2O by 3 cmH2O increments until a surgeon notifies that the surgical field was obstructed by the expanded lung. Following that, pulmonary shunt fraction (QS/QT) was calculated. Results: There were no significant differences of QS/QT between supine and lateral positions with two lung ventilation (TLV). OLV significantly decreased arterial oxygen partial pressure (PaO2) and increased QS/QT compared to TLV. PaO2 and QS/QT significantly improved at 6 and 9 cmH2O of CPAP compared to 0 cmH2O. However, there were no significant differences of PaO2 and QS/QT between 6 and 9 cmH2O CPAP. In 18 patients (90%), surgical fields were obstructed at 9 cmH2O CPAP. Conclusions: This study suggests that 6 cmH2O CPAP effectively improved arterial oxygenation without interference of the surgical field during OLV when CPAP was applied from 0 cmH2O in 3 cmH2O increments. Background: Although one lung ventilation (OLV) is frequently used for facilitating thoracic surgical procedures,arterial hypoxemia can occur while using one lung anesthesia. Continuous positive airway pressure (CPAP) in 5 or 10 cmH2O to the non-ventilating lung is commonly recommended to prevent hypoxemia. We evaluated the effects of incremental CPAP to the non-ventilating lung on arterial oxygenation and pulmonary shunt without obstruction of the surgical field during OLV. Methods: Twenty patients that were scheduled for one lung anesthesia were included in this study. Systemic and pulmonary hemodynamic data and blood gas analysis was recorded every fifteen minutes according to the patient's positions and CPAP levels. CPAP was applied from 0 cmH2O by 3 cmH2O increments until a surgeon notifies that the surgical field was obstructed by the expanded lung. Following that, pulmonary shunt fraction (QS/QT) was calculated. Results: There were no significant differences of QS/QT between supine and lateral positions with two lung ventilation (TLV). OLV significantly decreased arterial oxygen partial pressure (PaO2) and increased QS/QT compared to TLV. PaO2 and QS/QT significantly improved at 6 and 9 cmH2O of CPAP compared to 0 cmH2O. However, there were no significant differences of PaO2 and QS/QT between 6 and 9 cmH2O CPAP. In 18 patients (90%), surgical fields were obstructed at 9 cmH2O CPAP. Conclusions: This study suggests that 6 cmH2O CPAP effectively improved arterial oxygenation without interference of the surgical field during OLV when CPAP was applied from 0 cmH2O in 3 cmH2O increments.

혈관종으로 안면기형이 있는 환자의 전신마취 경험 -증례보고-

김동찬 ( Dong Chan Kim ),이지혜 ( Ji Hye Lee ),김정희 ( Jung Hee Kim ),이성녀 ( Sung Nyu Lee ),김덕규 ( Deokkyu Kim ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1

기도관리의 어려움은 마취와 관련된 중요 합병증의 원인 중에 하나이다. 어려운 기도 (difficult airway)에서 기도확보가 늦어지거나 실패한다면 환자는 사망까지 초래될 수 있다. 만약 어려운 기도가 의심된다면 각성 상태 기 관내삽관이나 외과적 기도확보가 추천된다. 저자들은 고관절과 대퇴부의 농양에 대한 수 술이 필요한 52세의 남자 환자에서 안면에 심 한 변형을 유발한 혈관종 때문에 어려운 기도 관리를 경험하였기에 이를 보고하는 바이다. Difficult airway is one of the most important causes of major anesthesia-related complications. If an airway is suspected to be difficult, awake endotracheal intubation or surgical airway were recommended. We report a case that a 52-year-old male underwent a surgery for the abscess of hip and thigh, and he had facial anomaly due to no definite treatment for hemangioma, which is cause of difficult airway.

Tracheal rupture after endotracheal intubation - A report of three cases -

임형선,Jung Hee Kim,Deokkyu Kim,Jeongwoo Lee,Ji-Seon Son,Dong-Chan Kim,고성훈 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change. Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change.