Effect of bleeding on the surgical field in dexmedetomidine infusion patients undergoing endoscopic sinus surgery under general anesthesia

Kwangrae Cho,Inwook Myoung 조선대학교 의학연구원 2020 The Medical Journal of Chosun University Vol.45 No.2

Background: In order to secure an ideal surgical field for endoscopic sinus surgery (ESS), it is necessary to reduce intraoperative bleeding. Intraoperative intra-nasal bleeding is influenced by various anesthetics. The present study focuses on the differences between sevoflurane/ remifentanil (SR)-based anesthesia and sevoflurane/remifentanil/dexmedetomidine (SRD)- based anesthesia in terms of surgical field conditions. Methods: American Society of Anesthesiologists physical status class I or II patients undergoing ESS were randomly assigned to the SR (n=36) or SRD (n=32) group. In order to assess the visibility of the surgical field, the level of intraoperative bleeding was rated on a 6-point numeric rating scale (NRS). Computed tomography findings were used to evaluate the extent of each preoperative surgical lesion, as high (>12) vs. low (≤12) Lund-Mackay (LM) score. A single surgeon was in charge of rating the visibility of the surgical field on an NRS every 5 minutes, and the worst NRS was used as a representative value for each group. Results: The NRS of the surgical field was not significantly different between the two groups (p=0.089). However, in the high-LM score patients, the NRS of the surgical field was significantly better in the SRD group than in the SR group (p=0.009). Conclusions: In the high- LM score patients, SRD-based anesthesia resulted in better surgical field conditions for ESS than did SR-based anesthesia. Therefore, we conclude that SRD-based anesthesia is beneficial in ESS.

Abrupt formation of a right atrium thrombus detected by transesophageal echocardiography during laparoscopic assisted vaginal hysterectomy and spontaneous resolution during thromboembolectomy -A case report-

Kwangrae Cho,Byung-Kwan Chu,Il-Yong Han,Chee-Mahn Shin,김영재,Soon Ho Cheong,이근무,Se Hun Lim,이정한,Myoung-Hun Kim,Hyo-Joong Kim 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.4

Intraoperative formation and management of a thrombus in right atrium has been reported occasionally. Nevertheless, it is rare that a right atrial thrombus with unstable hemodynamic changes detected by transesophageal echocardiography is resolved spontaneously. We report upon the 44-year-old woman, who had a right atrial thrombus detected by transesophageal echocardiography during laparoscopic assisted vaginal hysterectomy and resolved during thromboembolectomy.

Comparison of dexmedetomidine and ketamine for the analgesic effect using intravenous patient-controlled analgesia after gynecological abdominal surgery

이원진,Jung Dae Shin,Kwangrae Cho,Myoung-Hun Kim 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.6

혁신형 창업기업의 집적화를 위한 입지요인 탐색

최종민 ( Jongmin Choi ),조광래 ( Kwangrae Cho ) 전남대학교 지역개발연구소 2021 지역개발연구 Vol.53 No.3

정부는 기술 기반의 창업을 활성화하고자 다양한 지원하고 있으며, 그 중 창업기업의 비용적인 부담의 감소와 지역의 집적경제효과 발생을 위해 다양한 공간 제공 지원을 추진하고 있다. 이러한 배경에서 본 연구의 목적은 혁신형 창업기업의 집적화를 극대화하기 위한 제도적 방향을 제시하는 것에 있다. 본 연구는 250개 혁신형 창업기업을 대상으로 입지 선호요인을 조사하였고, 이를 소재지·창업기간·창업분야별로 교차분석을 실시하였다. 분석 결과 첫째, 수도권과 비수도권 여부 등의 소재지에 따라서 입지 선호 요인이 통계적으로 차이가 있는 것으로 나타났다. 둘째, 사업장 이전 기업을 대상으로 조사한 결과에서도 마찬가지로 소재지에 따라서 이전 사유에서 통계적인 차이가 존재하였다. 셋째, 집적효과를 발생시키는 데 필요한 시설과 기관이 무엇인가를 분석한 결과에서도 소재지, 창업 기간별로 차별적 요구가 존재하는 것으로 나타났다. 이를 토대로 기술 기반 혁신형 창업기업의 성공적인 집적화를 위해서는 수도권과 비수도권, 업력별로 차별화된 정책이 필요함을 확인하였다. The purpose of this study is to shed light on the institutional direction necessary to maximize the agglomeration of technology-based start-ups. This study surveyed 250 innovative start-ups to investigate location preference factors, and analyzed them by location, the founding year of start-ups, and technology field. The results reveal that, first, location preference factors of start-ups were found to be statistically different depending on the location, such as whether it was in the metropolitan area or non-metropolitan area. Second, the reasons for start-ups' relocation were different depending on the location. Third, it was found that there were differences in the facilities and institutions required for agglomeration by location and the founding year of start-ups. Customized policies suitable for start-ups according to metropolitan area and non-metropolitan area and firm age are necessary for successful agglomeration.

Analgesic effect of preoperative versus intraoperative dexamethasone after laparoscopic cholecystectomy with multimodal analgesia

임세훈,Eun Ho Jang,Myoung-Hun Kim,Kwangrae Cho,이정한,이근무,Soon Ho Cheong,김영재,Chee-Mahn Shin 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.4

Background: Pain after laparoscopy is multifactorial and different treatments have been proposed to provide pain relief. Multimodal analgesia is now recommended to prevent and treat post-laparoscopy pain. Dexamethasone is effective in reducing postoperative pain. The timing of steroid administration seems to be important. We evaluated the analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during laparoscopic cholecystectomy with multimodal analgesia. Methods: One hundred twenty patients aged 20 to 65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the group N received normal saline 1 hour before induction and after the resection of gall bladder. The patients in the group S1 received dexamethasone 8 mg 1 hour before induction and normal saline after the resection of gall bladder. The patients in the group S2 received normal saline 1 hour before induction and dexamethasone 8 mg after the resection of gall bladder. Results: VAS scores of group S1 and S2 were lower than that of group N during 48 hours after laparoscopic cholecystectomy. There were no significant differences of VAS scores between the group S1 and the group S2. The analgesic consumption of group S1 and S2 were significantly lower than that of group N. Conclusions: A single dose of dexamethasone (8 mg) intravenously given 1 hour before induction or during operation was effective in reducing postoperative pain after laparoscopic cholecystectomy with multimodal analgesia. The analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during surgery was not significantly different.

Effect of dexamethasone gargle, intravenous dexamethasone, and their combination on postoperative sore throat: a randomized controlled trial

기승희,Myoung Inwook,Cheong Soonho,임세훈,Cho Kwangrae,Kim Myoung-hun,Han Yongjae,오민경,Park Yohan,Kim Kwanghee,Lee Jeonghan 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.4

Background: Postoperative sore throat (POST) is a complication that decreases patient satisfaction and increases postoperative complaints. The present study was conducted to investigate effects of gargling with dexamethasone, intravenous dexamethasone injection and the combination of the two on the incidence and severity of POST.Methods: Study participants were 96 patients who had undergone laparoscopic cholecystectomy, randomly allocated into three groups. Group G gargled with 0.05% dexamethasone solution and were infused intravenous 0.9% normal saline before general anesthesia; group I gargled with 0.9% normal saline and were infused intravenous 0.1 mg/kg dexamethasone; group GI gargled with 0.05% dexamethasone solution and were infused intravenous 0.1 mg/kg dexamethasone. The incidence and severity of POST, hoarseness and cough were evaluated and recorded at 1, 6, and 24 h after the surgery.Results: There were no significant differences in the total incidence of POST up to 24 postoperative hours among Group G, Group I and Group GI (P = 0.367, Group G incidence = 34.38%, [95% confidence interval, 95% CI = 17.92–50.83], Group I incidence = 18.75%, [95% CI = 5.23–32.27], Group GI incidence = 28.13%, [95% CI = 12.55–43.70]). The other outcomes were comparable among the groups.Conclusions: In patients who had undergone laparoscopic cholecystectomy, gargling with 0.05% dexamethasone solution demonstrated the same POST prevention effect as intravenous injection of 0.1 mg/kg dexamethasone. The incidence and severity of POST were not significantly different between the combination of gargling with 0.05% dexamethasone solution and intravenous injection of 0.1 mg/kg dexamethasone and use of each of the preventive methods alone.

Verification of the performance of the Bispectral Index as a hypnotic depth indicator during dexmedetomidine sedation

기승희,Lee Dongeon,Lee Wonjin,Cho Kwangrae,Han Yongjae,Lee Jeonghan 대한마취통증의학회 2022 Anesthesia and pain medicine Vol.17 No.1

Background: Differences in the effects of propofol and dexmedetomidine sedation on electroencephalogram patterns have been reported previously. However, the reliability of the Bispectral Index (BIS) value for assessing the sedation caused by dexmedetomidine remains debatable. The purpose of this study is to evaluate the correlation between the BIS value and the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scale in patients sedated with dexmedetomidine. Methods: Forty-two patients (age range, 20–80 years) who were scheduled for elective surgery under spinal anesthesia were enrolled in this study. Spinal anesthesia was performed using 0.5% bupivacaine, which was followed by dexmedetomidine infusion (loading dose, 0.5–1 μg/kg for 10 min; maintenance dose, 0.3–0.6 μg/kg/h). The MOAA/S score was used to evaluate the level of sedation, and the Vital Recorder program was used to collect data (vital signs and BIS values). Results: A total of 215082 MOAA/S scores and BIS data pairs were analyzed. The baseline variability of the BIS value was 7.024%, and the decrease in the BIS value was associated with a decrease in the MOAA/S score. The correlation coefficient and prediction probability between the two measurements were 0.566 (P < 0.0001) and 0.636, respectively. The mean ± standard deviation values of the BIS were 87.22 ± 7.06, 75.85 ± 9.81, and 68.29 ± 12.65 when the MOAA/S scores were 5, 3, and 1, respectively. Furthermore, the cut-off BIS values in the receiver operating characteristic analysis at MOAA/S scores of 5, 3, and 1 were 82, 79, and 73, respectively. Conclusion: The BIS values were significantly correlated with the MOAA/S scores. Thus, the BIS along with the clinical sedation scale might prove useful in assessing the hypnotic depth of a patient during sedation with dexmedetomidine.

Epidural anesthetic management of achondroplastic parturient dwarf undergoing cesarean section -A case report-

임세훈,Chee-Mahn Shin,Young-Jae Kim,이근무,이정한,Kwangrae Cho,Myoung-Hun Kim,Shin-Hae Chang 대한마취통증의학회 2012 Anesthesia and pain medicine Vol.7 No.2

Achondroplasia is the most common non-lethal skeletal dysplasia. Underdevelopment and premature ossification of bones result in characteristic craniofacial and spinal abnormalities. Achondroplastic dwarfs have low fertility rates and require delivery by cesarean section due to their cephalo-pelvic disproportion. Controversy exists regarding the ideal anesthesia for an achondroplastic parturient dwarf for urgent cesarean section. Anesthesia, whether general or regional, presents many potential problems during cesarean section. We report the experience of the epidural anesthesia in an achondroplastic dwarf undergoing elective cesarean section.

KSR-Ⅲ 공력가열 해석 및 비행시험

김성룡(Seong-Lyong Kim),이준호(Junho Lee),김인선(Insun Kim),조광래(KwangRae Cho) 한국항공우주학회 2004 韓國航空宇宙學會誌 Vol.32 No.8

2002년 11월 28일 발사된 KSR-Ⅲ 과학로켓에서 공력가열로 인한 온도상승을 측정하였으며, 로켓 외피의 온도 및 공력가열량을 계산하였다. 계산에 사용된 소프트웨어는 이론식에 기초한 경계층을 해석하여 비행시간동안 비정상 공력가열량을 계산하는 MINIVER 코드이며, 비행체 내부로의 일차원 고체 열전도까지 고려하였다. 계산 결과 비행체 내부 페이로드 장착부분의 열전달은 대부분 복사로 이루어지고, 공력가열로 인한 KSR-Ⅲ 외피 최 고온도는 핀에서 223℃이며 최대 공력가열은 노즈캡에서 133㎾/㎡이었다. 중요부분에서 재질의 허용온도를 만족하였으며 외피 단열재 설계가 적절히 이루어졌음이 확인되었다. The inner surface temperatures of the KSR-Ⅲ Sounding Rocket launched at 29th November 2002 were measured in the flight test, and the aerodynamic heating rate and outer surface temperature were calculated. The used program is the MINIVER code, which calculate the boundary layer equation based on the theoretical analysis, and its calculation is simulated on the flight time histories. The analysis considered the inner surface heat transfer with one dimensional solid heat conduction. The results showed that the major interior heat transfer is the radiation heat transfer, and the maximum outer surface temperature due to aerodynamic heating reached to 223℃ at fin and the maximum heating rate is about 133㎾/㎡ at nose cap. The whole analysis proved that the surface temperature remained below the allowable temperature, and the KSR-Ⅲ thermal design satisfies the thermal environmental conditions.