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갑상선 절제술을 받은 환자에서 P6 Acupressure의 술 후 오심, 구토에 대한 예방 효과
라세희 ( Se Hee Na ),김나영 ( Na Young Kim ),길혜금 ( Hae Keum Kil ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4
Background: Postoperative nausea and vomiting (PONV) is a common problem in patients recovering from anesthesia and surgery. P6 point is the acupressure point for prevention of postoperative nausea and vomiting. We evaluated the efficacy of acupressure at the P6 point in 94 patients undergoing thyroidectomy in a randomized, prospective and placebo-controlled study. Methods: Ninety-four female patients, aged 18 to 60, scheduled for elective thyroidectomy, were randomized to have either placebo band or acupressure band (Sea-Band(R) UK Ltd., Leicestershire, England, UK) applied to the P6 point of both hands before induction of anesthesia. The acupressure bands removed 24 h later. Postoperative nausea and vomiting was evaluated 1, 6 and 24 h following surgery. In addition, the need for rescue antiemetic medication during 24 h was registered. Results: The incidence of postoperative nausea was lower in acupressure group at 0-1 h (16.7% vs. 39.1%; P=0.015) and at 6-24 h (0% vs. 15.2%; P=0.05). The need for rescue antiemetic medication was also lower at 0-1 h (4.2% vs. 23.9%; P=0.006), at 1-6 h (6.2% vs. 20.9%; P=0.039) and at 6-24 h (0% vs. 13%; P=0.012). Conclusions: In patients undergoing thyroidectomy, nausea and need of rescue antiemetic medication were reduced by acupressure at the P6 point. (Korean J Anesthesiol 2009;56:413~8)
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심박변이도를 이용한 중환자실 입원 환자의 자율신경계 일중변동성에 대한 예비연구
오주영,조동래,김종인,박재섭,허재석,김재진,라세희,신증수,이보름,박진영,Oh, Jooyoung,Cho, Dongrae,Kim, Jongin,Park, Jaesub,Heo, Jaeseok,Kim, Jae-Jin,Na, Se Hee,Shin, Cheung Soo,Lee, Boreom,Park, Jin Young 대한생물정신의학회 2017 생물정신의학 Vol.24 No.1
Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.
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김창석 ( Chang Seok Kim ),곽영란 ( Young Lan Kwak ),김대희 ( Dae Hee Kim ),라세희 ( Se Hee Na ),심재광 ( Jae Kwang Shim ),방서욱 ( Sou Ouk Bang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Background: Hydroxyethyl starch (HES) effectively restores plasma volume and thereby enhances microcirculation and tissue oxygenation at the expense of coagulation impairment. These effects are related to molecular weight, substitution and C2:C6 ratio. But, most of the studies regarding coagulation impairment in cardiac surgeries were performed in patients undergoing cardiopulmonary bypass which significantly causes coagulation derangements. Therefore, we have evaluated the effects of 2 different HES solutions on tissue oxygenation and postoperative bleeding in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Methods: Forty four patients were prospectively enrolled. After the induction of anesthesia, either HES 130/0.4 (V group) or 200/0.5 (H group) were infused for fluid therapy to maintain predetermined urine output, cardiac index and filling pressure up to 16 h after the surgery. Tissue oxygenation profiles and respiratory parameters were recorded after induction of anesthesia, completion of distal anastomosis and sternum closure, upon admission at intensive care unit, and 4 h thereafter. The amounts of chest tube drainage, transfusion and fluid balance were measured up to 16 h after the surgery. Results: Patients` demographic data were similar between the groups. Tissue oxygenation profiles, respiratory parameters, hemodynamics, and time to extubate were not different between the groups. However, chest tube drainage and transfusion requirements were significantly less in the V group. Conclusions: In OPCAB, 6% HES 130/0.4 causes less postoperative bleeding and transfusion requirement and has a comparable efficacy on hemodynamic stability, pulmonary function and tissue oxygenation when compared to 6% HES 200/0.5. (Korean J Anesthesiol 2007; 52: 649~56)
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