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권수아 ( Su Ah Kwon ),김은수 ( Eun Soo Kim ),박성천 ( Sung Chun Park ),김혜진 ( Hye Jin Kim ),권재영 ( Jae Young Kwon ),백승훈 ( Seung Hoon Baek ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
We report a case of unintentional intraoperative awareness during sevoflurane-remifentanil anesthesia in a 26 years old woman undergoing elective minimal invasive mitral valvuloplasty. Cardioprotective effects of sevoflurane were clinically most apparent when administered throughout the surgical procedure. Also use of sevoflurane during cardiopulmonary bypass decreases incidence of awareness. Although awareness during cardiac anesthesia has been previously described with sevoflurane, the implication of this case is that unexpected awareness can occur in patients with sevoflurane during cardiopulmonary bypass on cardiac surgery. Therefore, more attention is needed to use sevoflurane during cardiopulmonary bypass. (Korean J Anesthesiol 2009; 57: 100~3)
경동맥의 내막-중막 두께와 마취유도 시의 혈역학적 반응과의 상관관계
권수아 ( Su Ah Kwon ),김은수 ( Eun Soo Kim ),박성천 ( Sung Chun Park ),김경훈 ( Kyung Hoon Kim ),김해규 ( Hae Kyu Kim ),권재영 ( Jae Young Kwon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Background: The carotid intima-media thickness (IMT) have been known to be related to the degree of atherosclerosis and cardiovascular risk factors. The aim of this study was to elucidate the relationship of IMT and the hemodynamic changes during anesthetic induction. Methods: Two hundred fourteen patients scheduled for general anesthesia were studied. The blood pressures and heart rates during anesthetic induction and endotracheal intubation were measured. IMT was measured at right common carotid artery using M-mode ultrasonography after anesthesia, Results: Mean IMT of the patients was 0.611±0.146 (0.34-0.96) mm. IMT was significantly related with age, systolic blood pressure, the changes of blood pressure after induction, and the changes of blood pressure after intubation. IMT was not related for basal heart rate and the changes of heart rate during anesthetic induction and intubation. Conclusions: IMT is related with the magnitude of blood pressure decreasing during anesthetic induction and increasing during intubation. The further study is needed to evaluate the relationship of IMT and hemodynamic changes during other anesthetic practice. (Korean J Anesthesiol 2009;56:519~24)
백서의 척수신경결찰모델에서 Morphine의 투여가 항이질통 효과와 척수 α<sub>2</sub> 아드레날린계 수용체 아형 mRNA 발현에 미치는 영향
정규연,신상욱,권수아,김태균,백승훈,백승완,Chung, Kyu Yeon,Shin, Sang Wook,Kwon, Su Ah,Kim, Tae Kyun,Baek, Seung Hoon,Baik, Seong Wan 대한통증학회 2009 The Korean Journal of Pain Vol.22 No.1
Background: The neuropathic pain arising from nerve injury is difficult to treat and the therapeutic effects of opioid drugs remain debatable. Agonists acting at the ${\alpha}_2$ adrenergic and opioid receptors have analgesic properties and they act synergistically when co-administered in the spinal cord. The lack of subtype-selective pharmacological agents has previously impeded the synergistic effects that are mediated by the adrenergic receptor subtypes. Methods: We created neuropathic pain model by ligating the L5 spinal nerve in Sprague-Dawley rats (n = 18). We divided the rats into three groups (n = 6 for each group), and we administered intraperitoneal morphine (1 mg/kg, 3 mg/kg, 5 mg/kg) and then we measured the mechanical allodynia with using von-Frey filaments for 8 hours. We then injected morphine (5 mg/kg) intraperitoneally, twice a day for 2 weeks. We measured the tactile and cold allodynia in the morphine group (n = 9) and the saline group (n = 9). After 2 weeks, we decapitated the rats and harvested the spinal cords at the level of lumbar enlargement. We compared the ${\alpha}_2$ subtype mRNA expression with that of control group (n = 6) by performing real time polymerase chain reaction (RTPCR). Results: Intraperitoneal morphine reduced the neuropathic pain behavior in the dose-dependent manner. Chronic morphine administration showed an antiallodynic effect on the neuropathic pain rat model. The rats did not display tolerance or hyperalgesia. The expression of the mRNAs of the ${\alpha}_{2A}$, ${\alpha}_{2B}$, ${\alpha}_{2C}$ subtypes decreased, and morphine attenuated this effect. But we could not get statistically proven results. Conclusions: Systemic administration of morphine can attenuate allodynia during both the short-term and long-term time course. Morphine has an influence on the expression of ${\alpha}_2$ receptor subtype mRNA. Yet we need more research to determine the precise effect of morphine on the ${\alpha}_2$ subtype gene expression.