http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
남복희,김수진,박은지,김미운 東國大學校醫學硏究所 2007 東國醫學 Vol.14 No.1
복강경 수술은 개복술에 비하여 많은 장점이 있어 많이 시행되고는 있으나, 복강경 수술은 필수적으로 인위적 기복을 만들고, 복압이 증가하므로 이로 인해 피하기종, 종격동 기종, CO2 가스 색전증 등의 부작용이 있다. 복강경 수술 중 호기말 이사화탄소분압의 감시가 특히 유용한 지표가 될 수 있으며, 수술시간에 비례해 호기말 이산화탄소분압의 증가시 복강경 수술의 부작용을 의심하여야 한다. 저자들은 부인과 복강경 수술에서 수술 후반에 활력증후의 이상소견 없이 이산화탄소분압이 증가하고 기흉이나 종격동 기종을 동반하지 않은 단순 피하기종이 발생하였던 환자에서 과환기와 18G 바늘로 피부에 천자를 하여 치료를 한 2예를 체험하였기에 문헌고찰과 함께 보고하는 바이다. Laparoscopic surgeries have been widely performed, because of their advantages over laparotomies, however the artificial pneumoperitoneum is necessary during the laparoscopic procedure, and thus carrying some complications, such as subcutaneous emphysema, pneumomediastinum and C02 gas embolism, of increased abdominal pressure. The monitoring of end-tidal partial pressure of C02 can be an useful indicator during the laparoscopic surgeries. Whenever increased end-tidal partial pressure of C02 in respect to operative time is observed, a complication of a laparoscopic surgery should be suspected. We experienced two cases of subcutaneous emphysema unaccompanied by either pneumothorax or pneumomediastinum during laparoscopic gynecologic surgeries, more likely caused by inadvertent manipulation of Verres needle and leakage of insufflated gas into the subcutaneous tissue, in which were managed by hyperventilation and multiple punctures using 18G needle on emphysematous skin.
임상연구 : 소아에서 Sevoflurane 마취 시 Remifentanil 병용 투여가 수술 후 회복시간과 각성흥분에 미치는 영향
남복희 ( Vo Ki Nam ),김미운 ( Mi Woon Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Background: Sevoflurane anesthesia may show emergence agitation and delirium in children, compared to other inhalation agents. Therefore, we studied the effect of low dose sevoflurane on recovery time and emergence agitation in children. Methods: We studied 50 patients who were planned for surgery under general anesthesia, aged between 2 and 8 years. They were randomly divided into two groups. Patients of group S were anesthetized with sevoflurane 2.5-3 vol%, whereas those of group R were given sevoflurane 1.2-1.5 vol% and continuous intravenous infusion of remifentanil 0.1-0.2μg/kg/min. All patients received N2O:O2 50:50 during maintenance of anesthesia. After the surgery, the anesthesiologist recorded recovery time and determined agitation score using 5-point scoring scale in both groups. Agitation score, incidence of emergence agitation and recovery time were compared with each other between the two groups. Results: The agitation scores were 2.72 ± 0.98 and 2.64 ± 0.95 in S and R groups, respectively, showing statistical insignificance. The incidence of emergence agitation score 4 or 5 was not significantly different, either. The recovery time was statistically shorter in R group (P<0.05). Conclusions: Compared with sevoflurane inhalation anesthesia alone, the use of sevoflurane and remifentanil in combination provided shorter recovery time, but no effect on emergence agitation. (Korean J Anesthesiol 2007; 52: 675~80)