http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
항응고제 사용 환자에서 지속적 경막외 제통술후 발생한 경막외 혈종 - 증례보고 -
유경연(Kyung Yeon Yoo),임웅모(Woong Mo Im),박준서( 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1
Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at T,, interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at T, inter- space. Four days later, he died due to underlying diseases. Central neural blockade in pa- tient with anticoagulant therapy is contraindicated in most cases. If it is undertaken, close observation of patients neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.
유경연,Seong Heon Lee,김석재,최정일,정철원,정성욱,Kyung Yeon Yoo 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.6
Background: Nitrous oxide (N2O) and remifentanil both have anesthetic-reducing and antinociceptive effects. We aimed to determine the anesthetic requirements and stress hormone responses in spinal cord-injured (SCI) patients undergoing surgery under sevoflurane anesthesia with or without pharmacodynamically equivalent doses of N2O or remifentanil. Methods: Forty-five chronic, complete SCI patients undergoing surgery below the level of injury were randomly allocated to receive sevoflurane alone (control, n = 15), or in combination with 67% N2O (n = 15) or target-controlled infusion of 1.37 ng/ml remifentanil (n = 15). Sevoflurane concentrations were titrated to maintain a Bispectral Index (BIS) value between 40 and 50. Measurements included end-tidal sevoflurane concentrations, mean arterial blood pressure (MAP), heart rate (HR), and plasma catecholamine and cortisol concentrations. Results: During surgery, MAP, HR, and BIS did not differ among the groups. Sevoflurane concentrations were lower in the N2O group (0.94 ± 0.30%) and the remifentanil group (1.06 ± 0.29%) than in the control group (1.55 ± 0.34%) (P < 0.001, both). Plasma concentrations of norepinephrine remained unchanged compared to baseline values in each group, with no significant differences among groups throughout the study. Cortisol levels decreased during surgery as compared to baseline values, and returned to levels higher than baseline at 1 h after surgery (P < 0.05) without inter-group differences. Conclusions: Remifentanil (1.37 ng/ml) and N2O (67%) reduced the sevoflurane requirements similarly by 31-39%, with no significant differences in hemodynamic and neuroendocrine responses. Either remifentanil or N2O can be used as an anesthetic adjuvant during sevoflurane anesthesia in SCI patients undergoing surgery below the level of injury.
임상연구 : 제왕절개술환자에서 호기말 Sevoflurane 농도를 1%로 유지 시 수술전 분만통 유무에 따른 이중분광계수의 비교
강명우 ( Myung Yoo Kang ),유경연 ( Kyung Yeon Yoo ),김석재 ( Seok Jai Kim ),정성태 ( Sung Tae Chung ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Background: An end-tidal concentration of 1% sevoflurane with 50% nitrous oxide (N2O) during a Cesarean section resulted in bispectral index (BIS) values > 60, which are considered at risk for awareness. The present study aimed to determine whether the presence or absence of labor pain prior to the Cesarean section would affect the BIS value. Methods: Sixty women scheduled to undergo Cesarean section under general anesthesia, were allocated to three groups of 20 patients: women undergoing elective surgery without labor pain (group 1, control), or emergency surgery without (group 2) or with (group 3) active labor pain. After endotracheal intubation, anesthesia was maintained with end-tidal 1% sevoflurane and 50% N2O in oxygen throughout the surgery. The BIS value, systolic blood pressure and heart rate were measured before (baseline) and during the induction of anesthesia, intubation, skin incision, uterine incision, delivery and at 1, 3, 5 and 10 min after delivery. Neonatal effects were assessed using Apgar scores at 1 and 5 min after delivery. Results: BIS values were significantly lower in group 3 than in groups 1 and 2 throughout the study, except at baseline and induction (P < 0.05). However, the systolic blood pressure, heart rate and Apgar scores did not differ among the three groups. Conclusions: These results demonstrate that 1.0% sevoflurane combined with 50% N2O results in BIS values < 60 during Cesarean delivery in women with active labor pain but not in those without active labor pain, consistent with an adequate depth of anesthesia to prevent recall. (Korean J Anesthesiol 2007; 53: 709∼13)
전신마취하에 제왕절개술을 받는 전자간증 환자에서 마취유도 시 사용되는 Remifentanil이 산모와 신생아에 미치는 영향
박병윤 ( Byoung Yun Park ),유경연 ( Kyung Yeon Yoo ),이미경 ( Mi Kyoung Lee ),정철원 ( Cheol Won Jeong ),정성욱 ( Seong Wook Jeong ),정성수 ( Sung Su Chung ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Background: Endotracheal intubation elicits cardiovascular and arousal responses. The present study was aimed to determine whether remifentanil affects these responses in patients with preeclampsia. Methods: Thirty preeclamptic women who were scheduled to undergo cesarean delivery under general anesthesia were randomly assigned to receive either remifentanil 1 μg/kg (n=15) or saline (n=15) before induction of anesthesia. Systolic arterial pressure (SBP), heart rate (HR) and bispectral index (BIS) value as well as plasma catecholamine concentrations were measured. Neonatal effects were assessed using Apgar score and umbilical cord blood gas analysis. Results: Induction with thiopental caused a reduction in SBP and BIS (P<0.01) in both groups. Following the tracheal intubation SBP and HR increased in both groups, the magnitude of which was lower in the remifentanil group. BIS values also increased, of which magnitude did not differ between the groups. Norepinephrine concentrations increased significantly following the intubation in the control, while remained unaltered in the remifentanil group. The neonatal Apgar scores (5 min), and umbilical gas values were similar in the two groups except for higher incidence of Apgar score <7 at 1 min in the remifentanil group. Conclusions: Remifentanil 1 μg/kg effectively attenuates hemodynamic and catecholamine but not BIS responses to tracheal intubation in preeclamptic patients undergoing cesarean delivery. However, remifentanil may cause mild neonatal depression and thus should be used when adequate facilities for neonatal resuscitation are available. (Korean J Anesthesiol 2009; 57: 62~8)
백서를 이용한 포르말린 시험하에서 척수강내 Gabapentin 의 항침해작용에 대한 Serotonergic 수용체의 영향
최정일(Jeong Il Choi),유경연(Kyung Yeon Yoo),윤명하(Myung Ha Yoon) 대한통증학회 2002 The Korean Journal of Pain Vol.15 No.1
N/A Background: Spinal gabapentin actively encounters tissue-injury nociception. Serotonin is involved in the modulation of nociceptive transmission at the spinal level. Gabapentin increases the blood serotonin level. This study was designed to examine the role of spinal serotonergic receptors on the action of intrathecal gabapentin in rats. Methods: Intrathecal catheters were inserted into the lumbar enlargement. For nociceptive test, 50㎕ of 5% formalin was subcutaneously injecetd into the hind paw. The effects of intrathecal gabapentin on the formalin stimulation and of respective serotonin receptor antagonist on the action of gabapentin were examined. Results: Intrathecal gabapentin attenuated the flinching response during phase 2, but not during phase 1, of the formalin test. None of the serotonin receptor antagonists (1, 1A, 1B, 1D, 2, 2C, 3, 4) affected the antinociceptive of gabapentin. Conclusions: These results suggest that spinal serotonergic receptors are not directly involved in the antinociceptive action of intrathecal gabapentin
수술후 통증조절을 위한 경막외 차단후 발생한 고위척추차단 - 증례보고 -
정성수(Sung Su Chung),유경연(Kyung Yeon Yoo),채영 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1
High spinal block is a rare complication during epidural block, but it may result in seri- ous events. 56-year-old man with gall stones was scheduled for cholecystectomy under gen- eral anesthesia. After operation, lumbar epidural catheterization was done at T inter- space for postoperative pain control. At the recovery room, initial bolus drug(0.1% bupivacaine IOml containing fentanyl 100 μg) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia occurred. Hartman' solu- tion was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continu- ously. The location of intrathecal catheter was confirmed by cerebrospinal fluid(CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged I week later in good health.