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( Seong Hyop Kim ),( Tae Gyoon Yoon ),( Tae Yop Kim ),( Hae Kyoung Kim ),( Woo Sung Sung ) 대한마취과학회 2010 Korean Journal of Anesthesiology Vol.58 No.2
Anesthetic management for aortic arch aneurysm (AAA) surgery employing deep hypothermic circulatory arrest in a Jehovah`s Witness (JW) patient is a challenge to anesthesiologist due to its complexity of procedures and their refusal of allogeneic transfusion. Even in the strict application of intraoperative acute normovolemic hemodilution (ANH) and intraopertive cell salvage (ICS) technique, prompt timing of re-administration of salvaged blood is essential for successful operation without allogeneic transfusion or ischemic complication of major organs. Cerebral oximetery (rSO2) monitoring using near infrared spectroscopy is a useful modality for detecting cerebral ischemia during the AAA surgery requiring direct interruption of cerebral flow. The present case showed that rSO2 can be used as a trigger facilitating to find a better timing for the re-administration of salvaged blood acquired during the AAA surgery for JW patient. (Korean J Anesthesiol 2010; 58: 191-196)
Seong Hyop Kim,Seung Zhoo Yoon,Kyung Hee Koh,Jung Man Lee 조선대학교 의학연구원 2018 Medical Bilogical Science and Engineering Vol.1 No.2
Myocardial viability is one of important factors to determine clinical outcomes after off-pump coronary artery bypass grafting. We hypothesized that the revascularization of nonviable myocardium might show the different features of myocardial reperfusion postoperatively as compared with viable myocardium. Patients who underwent off-pump coronary artery bypass grafting for 2 years were retrospectively reviewed. Viable group (V group, n=159) and nonviable group (N group, n=24) were divided using preoperative single photon emissioncomputed tomography. The postoperative complication was evaluated by 1) occurrence of rhythm disturbance (atrial fibrillation/flutter or ventricular tachycardia), 2) use of continuous epinephrine, and 3) intra-aortic balloon pump insertion. Intubation time and intensive care unit (ICU) stay were also documented. Demographic data (gender, age, ejection fraction, and New York Heart Association [NYHA] classification) showed no difference. N group showed higher incidence of rhythm disturbance. Although intubation time showed no difference, ICU stay of N group was longer than V group. Revascularization of non-myocardium was associated with higher incidence of rhythm disturbance and longer ICU stay as compared with viable myocardium.
Kim, Seong-Hyop,Oh, Chung-Sik,Lee, Sun Joo Japan Society of Anesthesiology ; Springer Tokyo 2015 Journal of anesthesia Vol.29 No.4
<P>The study was designed to assess the efficacy of palonosetron and ramosetron in preventing postoperative nausea and vomiting (PONV) related to intravenous (IV) patient-controlled analgesia (PCA) with opioids after gynecological laparoscopic surgery.</P>
증례보고 : 체외순환 없는 관상동맥 우회술 도중 호기말이산화탄소분압에 의해 조기 발견된 파열된 폐 낭포
김성협 ( Seong Hyop Kim ),윤태균 ( Tae Gyoon Yoon ),강주은 ( Joo Eun Kang ),오충식 ( Chung Sik Oh ),김덕경 ( Duk Kyung Kim ),김태엽 ( Tae Yop Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Capnography is monitoring of concentration or partial pressure of CO2 in respiratory gases. It provides information about CO2 production, pulmonary perfusion, alveolar ventilation, respiratory patterns and elimination of CO2 from the anesthesia circuit and ventilator. Thus it gives us a rapid and reliable method to detect life threatening conditions such as malposition of tracheal tube, ventilatory failure, circulatory failure and defective breathing circuits. Authors experienced that change of capnogram during off pump coronary artery bypass grafting surgery helped early detecting ruptured bulla and prevented intraopertive or postoperative pneumothorax. (Korean J Anesthesiol 2009;56:83~6)
증례보고 : 모야모야병 환자에서의 심폐회로를 가동하지 않는 관상동맥우회로 이식술 중 뇌산소포화도 감시
김성협 ( Seong Hyop Kim ),김태엽 ( Tae Yop Kim ),이현하 ( Hyun Ha Lee ),윤태균 ( Tae Gyoon Yoon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4
We report a case using cerebral oxygen saturation (rCbO2) for off-pump coronary artery bypass graft (OPCAB) surgery in a patient with co-existing Moyamoya disease. The rCbO2 with the routine monitoring for OPCAB surgery were monitored intraoperatively. In spite of infusing nimodipine (0.2 μg/kg/min) and maintaining the end-tidal CO2 tension at 35-40 mmHg, a sudden reduction in the right-side rCbO2 from the base line value of 70-80%/78-83% (Left/Right) to 70-72%/65-70% was developed during the harvesting of the vascular graft. We increased the rate of phenylephrine infusion to increase systemic and cerebral perfusion pressure, and both rCbO2 values were elevated to 80%/70% within 3 minutes. However, the preferential reduction in the right-side rCbO2 compared with the left-side value was not corrected. While suspecting cerebral ischemia due to cerebral vascular spasm, we administered nimodipine 2 mg bolus and increased infusion rate to 0.5 μg/kg/min. Finally, the preferential rCbO2 reduction in the right-side was corrected and both rCbO2 reached 84%/91%. We concluded rCbO2 monitoring is useful for detecting an intraoperative episode of cerebral ischemia and maintaining the optimal cerebral perfusion during OPCAB surgery with Moyamoya disease. (Korean J Anesthesiol 2009;56:433~7)
Kim, Seong-Hyop,Oh, Chung-Sik,Yoon, Tae-Gyoon,Cho, Min Jeng,Yang, Jung-Hyun,Yi, Hye Ran Hindawi Publishing Corporation 2014 The Scientific World Journal Vol.2014 No.-
<P>The study was designed to investigate postoperative nausea and vomiting (PONV) in low- and high-dose remifentanil regimens for total intravenous anaesthesia (TIVA) in adult female patients with American Society of Anaesthesiologists physical status classification I undergoing local breast excision. Propofol and remifentanil 5 ng<I>·</I>mL<SUP>−1</SUP> (L group) or 10 ng<I>·</I>mL<SUP>−1</SUP> (H group) were administered for anaesthesia induction and maintenance. Propofol was titrated within range of 0.1 <I><I>μ</I></I>g<I>·</I>mL<SUP>−1</SUP> to maintain bispectral index (BIS) values between 40 and 60. Haemodynamic parameters during the intra- and postoperative periods and 24 h postoperative visual analogue scale (VAS) and PONV were evaluated. Each group with 63 patients was analyzed. The H group showed higher use of remifentanil and lower use of propofol, with similar recovery time. Mean systemic arterial blood pressure (MBP), heart rate, and BIS did not differ significantly before and after endotracheal intubation in the H group. However, significant increases in MBP and BIS were apparent in the L group. Postoperative VAS, PONV incidence and scale, and Rhodes index did not differ significantly between the two groups. In conclusion, TIVA with high-dose remifentanil did not aggravate PONV with similar postoperative pain, compared with low-dose remifentanil. Furthermore, high-dose remifentanil showed more haemodynamic stability after endotracheal intubation. This trial is registered with KCT0000185.</P>