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실험연구 : 말초신경손상 쥐에서 중추신경계 α2-아드레날린성 수용체 아형의 발현
최소론 ( So Ron Choi ),이형창 ( Hyung Chang Lee ),정찬종 ( Chan Jong Chung ),김해규 ( Hae Kyu Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Background: The change of expression of the α2-adrenergic receptor (α2-AR) subtypes in the thalamus and hypothalamus were investigated in a neuropathic pain rat model. Methods: The left sciatic nerve was clamped for creating a neuropathic pain model in five rats. A sham operation was done in three rats as control group. Behavioral tests for pain were conducted by using mechanical stimuli applied to the hind paws. After 7 days, the expression of α2-AR subtype mRNA in the rat thalamus and hypothalamus was measured using real time polymerase chain reaction. Results: Mechanical allodynia were developed on postoperative 1, 3, and 7 days in the neuropathic pain model. The expression of α2A-AR, α2B-AR, and α2C-AR was significantly higher in the thalamus and hypothalamus in the neuropathic pain model (P > 0.05). Conclusions: These results would suggest that the subtypes of α2-AR in thalamus and hypothalamus may contribute to produce neuropathic pain. (Korean J Anesthesiol 2006; 51: 468~75)
The effect of spectral entropy monitoring on propofol use and recovery in children
이지연,So Ron Choi,정찬종,이지현,Ji-hye Park,Chang-Yeoul Baik 대한마취통증의학회 2014 Anesthesia and pain medicine Vol.9 No.2
Background: The evaluation of anesthetic depth using electroencephalographyshowed reduction in recovery time from anesthesiaand decrease in the amount of anesthesia used. This researchcompared the dosage of propofol and the recovery characteristicswhen anesthesia was controlled using spectral entropy monitoringand when it was controlled by hemodynamic changes. Methods: Seventy children of the American Society of Anesthesiologistsphysical class I–II, ages 3–10, that were scheduled forgeneral anesthesia were randomly distributed into two groups. Thechildren were sedated with midazolam (0.15 mg/kg), and anesthesiawas induced with fentanyl (2.0 μg/kg), propofol (2.5 mg/kg), androcuronium (0.6 mg/kg). Anesthesia was maintained with propofolcontinuous IV infusion under N2O in O2. For the Entropy Group,the state entropy (SE) was maintained at 40–60, and for theStandard Group, anesthesia was maintained so that the heart rateand systolic blood pressure were at 20% of the standard value. Results: Last 10 minutes of the surgery, the SE and RE (Responseentropy) were significantly higher for the Entropy Group whencompared to the Standard Group (P < 0.05). The maintenancedose of propofol was significantly lower for the Entropy Group whencompared to the Standard Group (P < 0.05). The times takenfor recovery were all significantly shorter for the Entropy Group thanthe Standard Group (P < 0.05). Conclusions: Entropy guided anesthetic administration wasassociated with reduced propofol use and faster recovery in childrencompared to standard practice.
Byung Ju Ko,Ji Na Oh,이종환,So Ron Choi,이승철,정찬종 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.64 No.1
Background: Etomidate has a stable hemodynamic profile after induction, but hypertension and tachycardia are frequent after intubation as well as myoclonus. We compared the effects of fentanyl and remifentanil on the hemodynamic response to intubation and myoclonus during etomidate induction in elderly patients. Methods: Ninety ASA I or II patients aged over 65 were randomly assigned to 3 groups. Group C received normal saline 10 ml (n = 30), group F and R were pretreated with fentanyl 1.0 μg/kg (n = 30) or remifentanil 1.0 μg/kg with continuous infusion of 0.1 μg/kg/min (n = 30) 1 min before induction with etomidate 0.2 mg/kg. Endotracheal intubation was performed after administration of rocuronium 0.8 mg/kg. Systolic blood pressure (SBP), mean arterial pressure, diastolic blood pressure (DBP), heart rate (HR), and the incidence and intensity of myoclonus were recorded. Results: After intubation, group R showed significant decreases compared with groups C and F for all of the hemodynamic variables measured. The incidences of increases in SBP and HR of more than 30% of the baseline levels, SBP of > 200 mmHg, and HR of > 120 beats/min were significantly lower in group R (0%, 10%, 0%, and 0%, respectively) compared with groups C (83%, 83%, 30%, and 13%, respectively) and F (63%, 77%, 13%, and 7%, respectively). The frequency and intensity of myoclonus were significantly decreased in both groups F and R compared with group C. Conclusions: Pretreatment with remifentanil suppressed cardiovascular reactions to endotracheal intubation more effectively than that of fentanyl during etomidate induction. Both opioids reduced the incidence of myoclonus.