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김주덕,손일순,권원경,성태윤,Hanafi Sidik,김가람,강현,방지연,여귀은,이동규,김태엽 대한의학회 2018 Journal of Korean medical science Vol.33 No.4
Background: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S′) in patients undergoing cardiac surgery. Methods: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S′ at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. Results: Mean S′ values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8–12.2), 9.5 (8.3–10.8), and 8.4 (7.3–9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were −1.0 (−1.6, −0.3), −1.1 (−1.7, −0.6), and −2.1 (−3.1, −1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). Conclusion: Isoflurane increments (1.0–2.0 MAC) dose-dependently reduced LV systolic long- axis performance during cardiac surgeries with a preserved preoperative systolic function.
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작은 여성에서 단일관튜브와 기관지 차단기를 사용한 일측 폐환기 -증례 보고-
서소진,임태완,손일순,김준현,홍덕만,강매화,전윤석,박재현 대한마취통증의학회 2010 Anesthesia and pain medicine Vol.5 No.2
One-lung ventilation with a double-lumen endotracheal tube or a UniventⓇ tube may be difficult or dangerous in small patients, children, and patients with anatomic abnormalities of the airway. The use of a bronchial blocker through a single-lumen endotracheal tube has been used successfully in such situations.A 69-year-old woman was scheduled for Ivor-Lewis operation and right upper lobectomy.She could not be intubated with a internal diameter 6.0 mm UniventⓇ tube owing to narrow diameter of the vocal cord. We report a successful one-lung ventilation using a UniblockerⓇ through an adult-size single-lumen endotracheal tube in a small woman, who needed postoperative ventilator care.
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전성국(Seong Gook Jeon),손정일(Chong Il Sohn),김지은(Jee Eun Kim),박기호(Ki Ho Park),황일순(Il Soon Whang),김은주(Eun Joo Kim),박창영(Chang Young Park),김병익(Byung Ik Kim),전우규(Woo Gyu Jeon),정을순(Eul Soon Chung),이풍렬(Poong Lyu 대한내과학회 2000 대한내과학회지 Vol.58 No.2
N/A Background : Gastroesophageal reflux disease (GERD) is considered to be less common in the Orient compared to the West, but epidemiological data on GERD in Korea are rare. The aim of this study was to determine the prevalence of symptoms of gastroesophageal reflux in routine check-up subjects. Methods : We analyzed 2243 subjects (male 716, female 1527; age range 20-69 yr) visited health promotion center for routine check-up. Subjects were given a validated self-reported questionnaire, which measured the presence, duration and severity of typical symptoms (heartburn, acid regurgitation); and the presence of atypical symptoms. At least weekly symptoms of heartburn and/or acid regurgitation were characterized as the definition of GERD. Results : The prevalence of heartburn for at least monthly, at least weekly and at least daily episodes was 6.2%, 3.4% and 3.1%, respectively. The corresponding figures for acid regurgitation were 6.1%, 2.1% and 0.7%. The prevalence of GERD was 8.5%, and was more common in female (p<0.01). Sixty eight percent of subjects with GERD reported the symptoms as having been present for less than 5 years. Seventy four percent of subjects with GERD reported these symptoms to be mild to moderate in severity. Heartburn and acid regurgitation were significantly associated with dyspepsia, chest pain, dysphagia and globus sensation (p<0.01), but not with hoarseness or chronic cough. Conclusion : The prevalence of heartburn and/or acid regurgitation experienced at least weekly is 8.5% in routine check-up subjects. Heartburn and acid regurgitation were associated with epigastric pain, chest pain, dysphagia and globus sensation.(Korean J Med 58:145-151, 2000)
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The effect of injection rate on etomidate-induced myoclonus
도상환,한성희,박상현,김진희,황진영,손일순,김민석 대한마취통증의학회 2008 Korean Journal of Anesthesiology Vol.53 No.3
Background: Etomidate frequently causes myoclonus. Since the myoclonus is caused by a transient disequilibrium due to etomidate exposure in the CNS, we hypothesized that a slow rate of injection of the drug may decrease the incidence of myoclonus. We conducted a prospective randomized study to compare the effect of two different types of the etomidate injection rate on the incidence and severity of myoclonus. Methods: Fifty patients were randomly assigned to the fast-injection group (group F) or slow-injection group (group S): Group F patients received etomidate (0.3 mg/kg) over ten seconds. The same dose was administered over two minutes for group S patients. The response to the injection of etomidate was graded on a four-point scale in a blinded manner. The time to loss of consciousness (LOC) was also recorded. Results: The incidence of myoclonus was significantly lower (P < 0.001) in group S patients; 84% and 28% in group F and group S patients, respectively. The myoclonus was also significantly less severe in group S patients (P < 0.001). The time to LOC was significantly longer in group S patients (106 ± 22 sec) than that of group F patients (49 ± 18 sec, P < 0.001). Conclusions: With same dose, a slower rate of injection resulted in a lower incidence of myoclonus and can effectively reduce myoclonus without the use of a pretreatment agent. Background: Etomidate frequently causes myoclonus. Since the myoclonus is caused by a transient disequilibrium due to etomidate exposure in the CNS, we hypothesized that a slow rate of injection of the drug may decrease the incidence of myoclonus. We conducted a prospective randomized study to compare the effect of two different types of the etomidate injection rate on the incidence and severity of myoclonus. Methods: Fifty patients were randomly assigned to the fast-injection group (group F) or slow-injection group (group S): Group F patients received etomidate (0.3 mg/kg) over ten seconds. The same dose was administered over two minutes for group S patients. The response to the injection of etomidate was graded on a four-point scale in a blinded manner. The time to loss of consciousness (LOC) was also recorded. Results: The incidence of myoclonus was significantly lower (P < 0.001) in group S patients; 84% and 28% in group F and group S patients, respectively. The myoclonus was also significantly less severe in group S patients (P < 0.001). The time to LOC was significantly longer in group S patients (106 ± 22 sec) than that of group F patients (49 ± 18 sec, P < 0.001). Conclusions: With same dose, a slower rate of injection resulted in a lower incidence of myoclonus and can effectively reduce myoclonus without the use of a pretreatment agent.
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