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증례보고 : 심한 척주관 협착증 환자에서 척추 마취 후 발생된 마미 증후군
정규돈 ( Kyu Don Chung ),유승준 ( Sung Jun Yu ),이상묵 ( Sang Mook Lee ),조현숙 ( Hyun Sook Cho ),손윤숙 ( Youn Suk Son ),윤건중 ( Keon Jung Yoon ),윤은경 ( Eun Kyeung Yoon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3
Cauda equina syndrome is a well-known but rare complication of spinal anesthesia. An 80-year-old man was scheduled for both herniorrhaphy. Spinal anesthesia was performed at the L3-4 interspinous space with 0.5% hyperbaric bupivacaine 12 mg. Eight hours after anesthesia, the patient complained bilateral sensorimotor deficits of the lower extremities and peroneal region. Urinary and fecal incontinence were also observed. MRI and myelography showed severe central spinal stenosis at L3-4 and L4-5. EMG showed cauda equina syndrome. Seven weeks after the procedure, left decompressive subtotal laminectomy L2-L5 was done. The patient still complains the neuropathic pain in the both lower extremities and ambulates using a walker. The local anesthetic was injected into thecal sac between maximum stenoses, and it is likely that there was poor upward spread leading to maldistribution of local anesthetic and resultant local anesthetic toxicity. (Korean J Anesthesiol 2009;57:364∼6)
저용량의 Rocuronium을 사용한 기관내 삽관 시 사전예비정주법이 Rocuronium의 작용 발현시간과 삽관 조건에 미치는 영향
손윤숙 ( Yoon Suk Son ),정규돈 ( Kyu Don Chung ),조현숙 ( Hyun Sook Cho ),유승준 ( Sung Jun Yu ),김수화 ( Su Hwa Kim ),이상묵 ( Sang Mook Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
Background: A priming dose of rocuronium can shorten the onset time of neuromuscular blockade. The purpose of this study was to evaluate the effect of priming with rocuronium on the onset time and intubation conditions during tracheal intubation with low-dose rocuronium (0.35 mg/kg) and to compare results with those for rocuronium 0.45 mg/kg. Methods: One hundred twenty four patients were randomly allocated to three groups. Following induction of anesthesia, groups I and III received normal saline while group II received a priming dose of rocuronium (0.05 mg/kg). Three minutes after priming, groups I, II and III received, respectively, 0.45 mg/kg, 0.3 mg/kg and 0.35 mg/kg rocuronium. Intubation was performed 2 minutes after the administration of an intubating dose and intubation conditions were evaluated. Neuromuscular blockade was assessed by accelerography. Results: The proportion of cases having optimal intubation conditions in group I was higher than in groups II and III. There was no significant difference in the onset times among groups. Neuromuscular blockade at 60, 90 and 120 seconds after an intubating dose was similar among all groups except at 60 sec. Maximal blockade for group I was deep compared to groups II and III. Conclusions: Rocuronium 0.35 mg/kg does not provide satisfactory intubation conditions. There are no effects on onset time and intubation conditions due to priming during tracheal intubation with rocuronium 0.35 mg/kg. (Korean J Anesthesiol 2009;57:444∼9)
이영애,유승준,이용식,신철호,현승권 한국학교체육학회 2002 한국학교 체육학회지 Vol.12 No.2
본 연구는 청소년 볼링 선수들의 경기 대처 기술 요인의 구조를 밝히는 것으로 이를 바탕으로 볼링선수들의 성공적인 수행을 예상하여 경기력을 향상 시키는데 그 목적이 있다. 이러한 연구목적에 맞추어 본 연구는 우수선수와 비 우수선수의 심리적 기술 요인을 측정하기 위하여 Smith, Schutz, Smoll, Ptacek(1995)에 의해 개발된 선수들의 대처기술(ACSI-25: the Athletic Coping Skills Inventory-28)척도를 국내 실정에 맞게 번안하여 심리측정적 타당도를 검증한 후 사용하였다. 각 요인별 타당도와 신뢰도를 화보하기 위하여 요인분석을 실시한 결과 16문항 6요인으로 분류되었으며, 분류된 6개의 심리기술 요인을 성취욕구, 걱정, 코칭능력, 목표설정, 역경대처, 집중력으로 명명하였다. 이 후 각각의 배경변인(성별, 우수여부, 학년)에 따른 각 요인별로 three-way MANOVA분석 결과 6개 요인에 대한 배경변인의 차이는 발견되지 않았다. This study aims to provide information on how to improve bowlers capacity by examining amateur bowlers athletic coping skill factors. A test paper on the Athletic Coping Skills Inventory-28(ACSI-28) developed by Smith, Schutz, Smoll, and Ptacek(1995) is used in order to measure the athletic coping skill factors of excellent as well as mediocre players. This paper is adapted for the domestic situation, with its appropriateness for measuring the bowlers mental state verified. Crombach's α result is used in classifying 16 questions and 6 factors, with factor analysis done in order to secure the appropriateness and credibility by each factor The six factors are: accomplishment desire, worry, coaching ability, goal setting, coping with adversity, and concentration, A statistic analysis is then conducted according to environmental variables such as sex, excellence, and grade. Based on the analysis, the following conclusions are derived: The factor analysis reveals six athletic coping skill factors of bowlers, e,g,, accomplishment desire, worry, coaching ability, goal setting, coping with adversity, and concentration. A three-way MANOVA analysis per three environment variables (sex, grades, and excellency) for the six athletic coping skill factors (accomplishment desire, worry, coaching ability, goal setting, coping with adversity, and concentration) reveals that environment variables do not cause any difference in the psychological technique factors of bowlers. In order to verify the effect of a bowlers maturity on the six athletic coping skill factors (accomplishment desire, worry, coaching ability, goal setting coping with adversity, and concentration), multiple regression analysis is done with a multi-step method, using predicative variables and athletic coping skill factors as reference variables. The result shows that the bowlers level of maturity is evident in goal setting and coping with adversity.
타카야수 동맥염 환자에서 경부경막의 차단을 병용하여 시행한 마취경험 : 증례 보고 A case report
윤건중,김경희,강준구,이은경,유승준 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5
Takayasu's arteritis is a chronic and occlusive inflammatory disease of uncertain etiology affecting medium to large sized arteries. We anesthetized a patient who had Takayasu's arteritis affecting both common carotid arteries, the left anterior descending coronary artery, and the left subclavian artery. During beating heart coronary artery bypass graft and aorto-carotid bypass graft we chose a cervical epidural block combined with general anesthesia as an anesthetic technique. We managed the patient successfully with consistant hemodynamic stability. The operation was done without cardiopulmonary bypass and the patient was retuned to consciousness immediately after the end of the operation. We extubated the endotracheal tube in the operating room without pain. The patient maintained hemodynamic stability in the intensive care unit and we controlled the pain via a cervical epidural catheter with morphine and 0.1% bupivacain. (Korean J Anesthesiol 2002; 43: 673~677)