소아의 자가조절진통에서 Morphine과 Fentanyl의 비교

백승완,김해규,김경훈,백승훈,김운성 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21

Purpose: Patient controlled analgesia (PCA) of opioids is a effective analgesic technique for children. But postoperative complications prevent children fully benefiting from their peA. We have compared morphine based PCA with fentauyl based PCA during pediatric orthopedic surgery. Subject and Methods: Sixty children (5-14 years old) after orthopedic surgeries allocated into two group. Morphine group received morphine based PCA; loading dose 0.1 ㎎/㎏, continuous infusion 0.05 ㎎/㎏/hr, bolous dose 0.025 ㎎/㎏. Fentanyl group received fentanyl based PCA; loading dose 1 ㎍/㎏, continuous infusion 0.5 ㎎/㎏/hr, bolus dose 0.25 ㎍/㎏. Pain was assessed by visual analogue scale (VAS). Scores for pain, respiratory depression, sedation, prutitus, nausea, vomiting and bolus counts and PCA dose were recorded at recovery room, 12 hour, 24 hours and 48hours after surgery. Results: There were no differences in VAS score between two groups on each times. The incidences of respiratory depression, sedation, pruritus, nausea and vomiting were no differences, too. But cumulative bolus demands was significantly higher in fentanyl group on 24 hours and 48 hours after surgery (P < 0.05). Conclusions: Morphine based PCA was similar effect with fentanyl based PCA, in controlling postoperative pain. Furthermore, morphine based PCA offer cost-effectiveness over fentanyl based PCA and do not increase the incidence of side effects.

Profound Hypothermia and Circulatory Arrest for Adult PDA Surgery: Case report

Seung Hun Baek,Sang Wook Shin,Hae Kyu Kim,Seong Wan Baik,Inn Se Kim,Kyoo Sub Chung Korean Society of Critical Care Medicine 1997 Acute and Critical Care Vol.12 No.2

Correction of a calcified patent ductus arteriosus (PDA) is a difficult surgical procedure. Simple ligation or division of PDA is not possible if diffuse circumferential calcification is present. Several techniques using cardiopulmonary bypass and closure of PDA from within the aorta or pulmonary artery have been introduced. And the surgical procedure is performed under profound hypothermia and circulatory arrest. Total ischemia time should be less than 30 minutes, which is free from the organ damage by the circulatory arrest. Barbiturates, calcium channel blockers and steroids are used for brain protection. We experienced successful use of these techniques for adult female patch closure of PDA and reviewed the anesthetic considerations of the profound hypothermia and circulatory arrest for cardiac surgery.

Sevoflurane Does not Adversely Affect Myocardial Function after Ventricular Septal Defect Repair in Children

( Seung Hoon Baek ),( Jae Young Kwon ),( Seong Wan Baik ),( Hae Kyu Kim ),( Sang Min Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.3

Vecuronium 투여방법에 따른 근이완 발현시간에 대한 고찰

백승훈,백승완,신상욱,김해규,정규섭,김인세 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.1

Background : Priming significantly shortened the onset of neuromuscular blockade(NMB), but also results in a high incidence of side effects. This study was designed to determine the effect of infusion priming method on the side effects, intubation condition, and onset of NMB compared with divided priming method. Method : The effects of different priming method of vecuronium on onset time and endotracheal intubation condition were investigated. 40 patients were studied in two parts. In control part, 20 patients were allocated into two groups(n=10 in each group) receving 10, 20 g/kg vecuronium as a priming dose, followed by a intubating dose(0.1 mg/kg-priming dose) 3 min later; the other part, 20 patients were allocated into two groups(n=10 in each group) receving 0.2 mg/kg/hr vecuronium continuous intravenous infusion, followed by a intubating dose(0.1 mg/kg-total infusion dose) 3, 5 min later. Onset time is calculated by single twitch stimulation test from injection of the intubating dose to maximum depression of the single twitch. Intubatin condition was appreciated based on vocal cord reflex, coughing, and jaw relaxation and scored. Results : The times to fade out on the single twitch of the intravenous infusion priming group were shorter than control priming group. There was no difference between control priming group and infusion priming group to evaluate the intubation conditions. Side effects in the continuous infusion group were lesser than control priming group. Conclusion : This results suggest that the use of continuous infusion method is one of the promising methods to shorten the neuromuscular blockade and to provide more comfort to the patients. (Korean J Anesthesiol 1998; 35: 76∼81)

Impacts of In-canyon Vegetation and Canyon Aspect Ratio on the Thermal Environment of Street Canyons

Ju-Wan Woo,Sang-Hyun Lee,Hyunho Lee,Seung-Bu Park,Jong-Jin Baik 한국기상학회 2015 한국기상학회 학술대회 논문집 Vol.2015 No.10

둔상에 의한 쇄골하동맥과 상완신경총의 동반 손상

한승백,김준식,백광제,김아진,신동운,이용주,백완기 대한응급의학회 2001 대한응급의학회지 Vol.12 No.1

Subclavian artery(SCA) injuries are rare, accounting for only 1 to 2% of all acute vascular injuries. The majority of SCA injuries are occured by motor vehicle accident and by penetrating trauma, only 1 to 5% of all subclavian artery injuries occurred by blunt mechanisms. The incidence of brachial plexus injury is also rare and 60% of brachial plexus injuries induced by blunt injury is occurred by motor vehicle accident. Aggressive diagnostic work-up is recommended for the patients with high suspicious index and repair is essential for the successful management of these rare vascular injuries, We report the experience of one case of combined subclavian artery and brachial plexus injuries due to blunt trauma.

만성통증 환자에서 Tramadol/Acetaminophen 복합제제의 치료 효과

백승훈 ( Seung Hoon Baek ),김철홍 ( Chul Hong Kim ),김경훈 ( Kyung Hoon Kim ),신상욱 ( Sang Wook Shin ),김해규 ( Hae Kyu Kim ),백승완 ( Seong Wan Baik ) 대한통증학회 2004 The Korean Journal of Pain Vol.17 No.2

인공고관절 전치환술에서 보편적 측방 도달법과 단일 절개 최소 침습적 측방 도달법과의 비교 분석

김완림 ( Wan Lim Kim ),장작 ( Jak Jang ),강승백 ( Seung Baik Kang ),이지호 ( Ji Ho Lee ),윤강섭 ( Kang Sup Yoon ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.3

목적: 인공고관절 전치환술 시 기존의 직접 측방 절개법(15~20 cm)과 최소 침습적 측방 절개법(<8 cm)으로 시행한 술례를 비교 분석하였다. 대상 및 방법: 직접 측방 접근법으로 시행된 총 80예의 인공고관절 전치환술을 대상으로 최소 침습 절개 군과 기존의 절개 군을 40명씩 무작위으로 구분하였으며 기존 절개 군은 Hardinge 접근법을 사용하였으며 최소 침습 절개 군은 대전자부 첨단을 중심으로 전상방에서 후하방으로 8 cm 정도의 피부절개를 하였다. 결과: 피부 절개에서 봉합까지 수술 시간은 최소 침습 군이 짧았으며(p=0.03) 흡입 배액관을 통한 배액량도 최소 침습 군이 적었다(p=0.02). 실혈양, 대퇴 스템 정렬, 비구 컵 경사도, 술 후 통증과 파행, Harris Hip Score, 감염률 등에서는 차이가 없었다. 최소 침습 군에서 고관절 아탈구 1예, 비구 골절 1예 등 2예의 합병증(5.0%)이 발생되었고, 1예의 대퇴 스템 내반 삽입이 있었다. 결론: 최소 침습법은 수술 시간과 실혈량의 의미있는 감소와 같은 장점이 있지만 기존 인공 고관절 전 치환술이 장기 생존률과 안정성에서 이미 검증되었고 최소 침습법은 좁은 수술 시야로 인해 문제 발생 가능성이 있으므로 충분한 수술 술기의 숙련 후 시행하는 것이 바람직할 것으로 사료되었다. Purpose: We compared the outcomes of primary consecutive THAs performed via the direct lateral approach through minimally invasive incisions (<8 cm) and through standard incisions (15~20 cm). Materials and Methods: Eighty primary consecutive THAs were performed via direct lateral approach through minimally invasive incisions or through standard size incisions. The standard incision is Hardinges direct lateral approach. For the MIS group, an approximately 8 cm long oblique skin incision was made centered at the tip of the greater trochanter and running anterosuperiorly to posteroinferiorly. Results: The surgical time was shorter (p=0.03) and the average amount of Hemovac drainage was smaller (p =0.02) in the MIS group. Alignment of the femoral stem and acetabular cup, post-operative pain and limping, HHS, and infection rate were no different between the two groups. In the MIS group, two complications (5.0%) occurred (one lateral positioning of the acetabular cup, one intra-operative acetabular fracture), and one varus stem insertion occurred. Conclusion: Minimization of the skin incision length for primary THAs performed via the direct lateral approach appears to have benefits with regard to shortening the wound closing time and decreasing the amount of postoperative Hemovac suction drainage. However, the minimally exposed operative field raises technical problems, so sufficient surgical experience and training are required.

Propofol TCI를 이용한 전신마취시 최면상태의 판정을 위한 BIS 감시장치의 사용경험

이승준,길호영,백승완,황성미,박영주 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.4

Understanding depth of anesthesia is essential for the anesthesiologist. Although electroencephalogram (EEG) has been proposed and studied as a method of determining anesthetic depth, major limitations restrict its usefulness. For example, spectral edge frequency (SEF) dose not correlate well with the level of sedation. However, recently introduced bispectral index (BIS) which is derived from frequency, amplitude and coherence of the EEG is strongly correlated with clinical measurements of sedation and hypnosis. BIS monitoring may be used to guide the titration of anesthetic agents to achieve effective dosing without increasing the risk of awareness and to allow a better balance of hypnotic and analgesic administration. We report two cases of successful BIS monitoring for the measurement of intraoperative hypnotic state of patient during propofol target controlled infusion (TCI). (Korean J Anesthesiol 1999; 36: 729∼735)

Efficacy and Safety of Aceclofenac Controlled Release in Patients with Knee Osteoarthritis: A 4-week, Multicenter, Randomized, Comparative Clinical Study

( Young Wan Moon ),( Seung Baik Kang ),( Tae Kyun Kim ),( Myung Chul Lee ) 대한슬관절학회 2014 대한슬관절학회지 Vol.26 No.1

Purpose: To evaluate the analgesic effect, efficacy and safety of aceclofenac controlled release (CR) in patients with chronic knee osteoarthritis (OA). Materials and Methods: A total of 125 subjects with chronic knee OA were randomly divided into two groups: one group (n=62) was administered aceclofenac CR once daily and the other (n=63), aceclofenac immediate release (IR) twice a day for 4 weeks. A 100-mm visual analogue scale (VAS), Knee injury and Osteoarthritis Outcome Score (KOOS) and range of motoin (ROM) were evaluated as the outcome measures. To evaluate the safety of the drug, adverse events, vital signs, physical examination findings, clinical laboratory values and electrocardiographic findings were evaluated. Results: The VAS, KOOS and ROM were improved after 4 weeks of administration in both groups, but the differences between the two groups were not statistically significant. Significant differences between the two groups were not shown in the evaluation of the adverse events, vital sign, physical examination results, clinical laboratory values, and electrocardiography. Conclusions: The aceclofenac CR and aceclofenac IR were equally effective in patients with chronic knee OA and the clinical trial results didn`t show any significant difference in safety. The new aceclofenac CR formulation was found to be effective and safe with the practical advantage of once daily administration.