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심폐기능이 정상인 중등도의 빈혈환자에서 자궁근종 수술시 술전수혈이 꼭 필요한가?
김종일,이규종,이상곤,민병우,반종석 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.5
Background: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. Method : 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8∼10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. Results : There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. Conclusion: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice. (Korean J Anesthesiol 1997;33: 923∼927)
개흉술 후 흉부 및 요부 경막외강으로 투여된 Meperidine의 진통효과 비교
김종일,이상곤,박준순,민병우,반종석 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.3
Background : Meperidine, having intermediate lipid solubility, permits postthoracotomy analgesia. The aim of this study is to compare the analgesic efficacy, side effects, and patient satisfactions of istered thoracic versus lumbar epidural route anesthesia during the first 48 hours postthoracotomy. Methods : A prospective randomized study was conducted for 48 hours after thoracotomy with ridine administered 50 mg as a bolus and continuously at 0.21 mg/kg/hr via either a thoracic (group T), or a lumbar (group L) epidural catheter at the end of the operation. Postoperative pain was assessed 2, 8, 24, 48 hours after the operation on a visual analog scale (VAS). Side effects and levels of patient ction of the epidural analgesia were assessed. Results : There were no significant intergroup differences in heart rate, blood pressure, pain score, side effects and levels of patient satisfaction with analgesia. Conclusions : We conclude that there is no difference between thoracic and lumbar epidural eridine analgesia for postthoracotomy pain relief. (Korean J Anesthesiol 1999; 37: 453∼458)
김종일,이상곤,민병우,이윤지,반종석 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.3
Background : With recently increase in geriatric population, hip surgery of the aged is increasing likewise as one of the major surgical procedures for orthopedic surgeons. It is the purpose of this paper to study the effects of combined spinal epidural anesthesia on blood pressure, heart rate, pulse oxygen saturation, level of blockade, postoperative pain control and complication in geriatric hip surgery. Methods : Combined spinal epidural anesthesia was performed with a 27G Whitacre spinal needle through a 18G Weiss epidural needle in 30 patients undergoing elective hip surgery of geriatric patients. 0.5% heavy bupivacaine 2 ml (10 mg) was injected intrathecally. Prolonged anesthesia over 2 hours of operation was accomplished by adding 0.5% bupivacaine through epidural catheter. Onset of sensory anesthesia and motor blockade were measured at frequent intervals. Blood pressure, heart rate and pulse oxygen saturation were checked in preoperative state, 1, 2, 3, 4, 5, 7, 9, 11, 13, 15 minute after injection, and then every 3 minute until the operation was finished. 0.125% bupivacaine 110 ml with morphine 3 mg was provided by Baxter infusor (Baxter Healthcare CO. Deerfield, USA) for postoperative pain control. Results : All 30 patients had adequate anesthesia. Sensory block level was at least above T10 dermatome and motor blockade of lower extremity was Bromage 3 in all patients. Systolic blood pressure and diastolic blood pressure were significantly different (P<0.05) after 3 minutes compared to preoperative state, but any patient had no specific problem. Postoperative pain control was excellent with no significant complication. Conclusions : Combined spinal epidural anesthesia provided reliable anesthesia for hip surgery of geriatric patients without significant complication. (Korean J Anesthesiol 1998; 35: 498∼503)
김종일,이상곤,민병우,정현규,반종석 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.4
It is a common knowledge to anesthesiologists that bleeding can eventually lead to shock and it is a mandatory task of anesthesiologists to monitor and prepare for postoperative bleeding. We have experienced at recovery room a case of cardiac arrest due to massive bleeding after a spinal surgery in a 62-year-old lady weighing 60 kg with no specific abnormalities in both history and physical examination. Immediate intervention with CPR, DC shock and administration of blood and fluids revived her and a subsequent surgical procedure was performed for bleeding control. The major common cause of cardiac arrest associated with operation/anesthesia are cardiovascular failure and respiratory failure. Postoperative bleeding, therefore, warrants close and careful monitoring in order that immediate and optimal care can be provided. (Korean J Anesthesiol 1998; 35: 800∼804)
Ji-Hye Seok,Eun Ju Kim,Jong Seouk Ban,Sang Gon Lee,Ji Hyang Lee,Da-Mi Seo,Kwang-Seok Shim 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.1
There are many methods for achieving one-lung ventilation (OLV) during thoracic surgery in neonates and the accuracy of OLV may affect postoperative outcome. The authors have performed OLV using a 5 Fr Arndt endobronchial blocker (AEB, Cook Inc., Bloomington, IN, USA) on a neonate diagnosed with congenital cystic adenomatoid malformation and respiratory distress syndrome (RDS) associated with marked mediastinal shift. In spite of sufficient preoxygenation, sudden and severe fall in oxygen saturation had occurred. Since neonates with RDS may develop sudden and severe desaturation, rapid intubation with anticipation of potential difficulty is necessary as well as sufficient preoxygenation.
Joon Woo Choi,Eun Ju Kim,Byung Woo Min,Jong Seouk Ban,Sang Gon Lee,Ji Hyang Lee 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.2
Prader-Willi syndrome is characterized by infantile hypotonia, childhood-onset obesity, short stature, mental retardation, hyperphagia, hypogonadism. After infantile hypotonia phase, patient is prone to morbid obesity due to hyperphagia. Complications associated with morbid obesity are recognized as the main risk factors for death the lifespan of patients with Prader-Willi syndrome. We experienced desaturation and bronchospasm during arteriovenous fistula surgery in an obese adult with Prader-Willi syndrome.
The effect of type of anesthesia on intra-and postoperative blood loss at elective cesarean section
Jeong Eun Kim,Ji Hyang Lee,Eun Ju Kim,Myung Woo Min,Jong Seouk Ban,Sang Gon Lee 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.2
Background: In cesarean section (c-sec) it is known that women receiving spinal anesthesia have decreased intraoperative blood loss compared to women receiving general anesthesia. However, we should always consider postoperative bleeding (postpartum bleeding) that may follow. The amount of postpartum bleeding can be substantial. Therefore, we sought to evaluate the effect of type of anesthesia retrospectively on intra- and postoperative blood loss by comparing the changes of postoperative Hb, Hct at c-sec. Methods: We retrospectively compared the medical records of 287 elective c-sec patients. We excluded medical and obstetric conditions that may predispose such patients to increased blood loss. Subsequent detailed record analysis included 152 patients that received spinal anesthesia (group S), and 135 patients that received sevoflurane for general anesthesia (group G). Results: In comparison with the preoperative Hb, rates of Hb in the 1st postoperative day in group S significantly decreased compared to group G, but there was no significant difference in decreasing rates of Hb in the 3rd postoperative day between groups S and G. Estimated blood loss (EBL) of the intraoperative and operative day in group S was significantly lower compared to group G, but there was no significant difference in EBL of 1st and 2nd postoperative day between groups S and G. Conclusions: We conclude that group S had a decrease in blood loss between the intraoperative and operative day and there was no significant differences in postoperative blood loss compared with group G.
Young-Lok Kim,Da-Mi Seo,Kwang-Seok Shim,Eun-Ju Kim,Ji Hyang Lee,Sang Gon Lee,Jong Seouk Ban 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.1
The I-gelTM is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gelTM supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gelTM supraglottic airway. The authors suggest that I-gelTM is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.