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윤준로 ( Jun Rho Yoon ),정은용 ( Eun Yong Jung ),김미정 ( Mi Jung Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Background: Advances in the field of interventional and diagnostic radiology have resulted in anesthesiologists becoming involved in angiographic suites. In the present study, we evaluated the characteristics of patients and the anesthetic management in an angiographic suite, to determine what factors influenced the patient outcome. Methods: Data pertaining to patients that were anesthetized at an angiographic suite in a university hospital between 1 January 2007 and 31 December 2007 were evaluated retrospectively. Specifically, we evaluated the patient characteristics and the types of anesthesia administered, to determine which factors were related to patient outcome. Results: Sixty-four percent of the patients enrolled in this study were women. Cases involving coiling for unruptured and ruptured aneurysm, embolization for intracranial arteriovenous malformation and fistula, pediatric diagnostic angiography, embolization for extracranial arteriovenous malformation, and implantable cardioverter-defibrillator (ICD) implantation all required the involvement of anesthesiologists. Major postoperatve complications included pneumonia, atelectasis, and hydrocephalus. In addition, GCS, net fluid balance, and anesthesia time had influence on patient outcome. Conclusions: We evaluated the characteristics of patient groups, procedures, and postoperative complications in an angiographic suite. The results of our analysis revealed that a through understanding of nervous and vascular pathology, as well as knowledge of current interventional radiology, neuroanesthesia and vascular anesthesia techniques is essential for development of safe and effective care. (Korean J Anesthesiol 2009;56:36~46)
윤준로(Jun Rho Yoon),한석호(Seok Ho Han),정은용(Eu 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2
N/A Background: Continuous epidural block is widely used for surgical operation and postoperative pain management. The potential infection due to the epidural catheter is a definite harzard of continous epi- dural block We investigated the effectiveness of bacterial filter in pmvention of infection due to the epidural catheter. Methods: Patients scheduled for transabdominal hysterectomy were assigned to two groups by simple randomization (50 patients per group). All catheters were placed in the 2nd and 3rd lumbar epidural space, using careful sterile technique. Group 1 received injections by the epidural catheter with a bacterial filter and group 2 received injections by the epidural catheter without a bacterial filter. The infection rate in the tips of epidural catheter left for 3 days were compared between the two groups. Results: There was no significant difference in the infection rate between two groups. Conclusions: A bacterial filter of the epidural catheter for surgical anesthesia and postoperative analge- sia dose not prevent all kinds of infection in continuous epidural block.
증례보고 : 뇌동맥류 색전술 중 헤파린첨가 생리식염수의 동맥 내 과다 주입으로 발생한 폐부종
윤준로 ( Jun Rho Yoon ),김태관 ( Tae Kwan Kim ),이민규 ( Min Gyu Lee ),오용주 ( Yong Ju Oh ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Here we report, along with a review of the literature, our experience with a patient suffering from a cerebral aneurysm and developed volume overloading pulmonary edema during endovascular coiling. A 51-year-old female patient who had an aneurysm in the basilar artery tip and subarachnoid hemorrhage was scheduled for endovascular embolization under general anesthesia. She developed pulmonary edema during the procedure. Coiling failed so neurosurgeon performed aneurysmal clipping under general anesthesia. The massive intraarterial infusion and flushing with heparinized saline may have triggered the pulmonary edema. We monitored diuresis and hemodynamics following surgery, as a high degree of vigilance, including monitoring of arterial blood gas and electrolyte evaluation, of patients undergoing prolonged endovascular embolization and receiving many intra-arterial fluids may help recovery. (Korean J Anesthesiol 2007; 53: 810~4)