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증례보고 : 진단받지 않은 후두개 낭종으로 인한 어려운 기관 내 삽관
이정혁 ( Jeoung Hyuk Lee ),최준권 ( Jun Gwon Choi ),윤동일 ( Dong Il Yoon ),이영민 ( Young Min Lee ),인준용 ( Jun Yong In ),정승현 ( Seung Hyun Chung ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
An epiglottic cyst is a common form of laryngeal cysts which are rare causes of upper airway obstruction. A congenital laryngeal cyst always causes neonatal respiratory distress, but an acquired cyst shows very wide spectrum of symptoms such as no specific complaints, dysphagia, respiratory difficulty, or even death according to its size, location, or age. From anesthesiologists` point of view, an asymptomatic undiagnosed laryngeal cyst is a major concern. Unexpectedly, it can cause difficult airway such as ‘cannot intubate` or `cannot intubate and cannot ventilate` situation during anesthesia. Recently we discovered an undiagnosed epiglottic cyst obscuring laryngeal inlet, leading to difficult intubation during general anesthesia for decompression and fusion of lumbar vertebrae. Fortunately, mask ventilation was possible, and after failed attempts of direct laryngoscopy, we could perform oral fiberoptic bronchoscope-aided intubation. He was discharged 10 days later with no harmful events. (Korean J Anesthesiol 2009;56:567~70)
윤탁,김용식,이남영,김세현,최준권,이정혁,정인원,Youn, Tak,Kim, Yong Sik,Lee, Nam Young,Kim, Se Hyun,Choi, Jun Gwon,Lee, Jeoung Hyuk,Chung, In Won 대한생물정신의학회 2017 생물정신의학 Vol.24 No.3
Electroconvulsive therapy (ECT) has been recognized effective as primary or secondary treatments for major psychiatric disorders including depression and schizophrenia, as well as psychiatric emergency such as suicide, food refusal and catatonia, and so on. Medicines used in anesthetic induction for ECT, cause various reactions in autonomous, hemodynamic, and neuromuscular systems. The anesthetics also affect the duration, threshold, and intensity of seizures evoked with electric stimuli, and thus modify the seizure quality in ECT. Individual characteristics of age, sex, weight, comorbid physical disorders, and medications should also be considered for optimal clinical response after ECT. When preparing for anesthesia, adequate anesthetic agents and muscle relaxants, and rapid recovery should be carefully considered. We conducted a case-series study to address practical issues that are frequently encountered during ECT anesthesia with reviews of updated journals in order to provide practical helps to clinicians who are preparing ECT for their patients.
김경옥 ( Kyoung Ok Kim ),신홍일 ( Hong Il Shin ),이정혁 ( Jeoung Hyuk Lee ),이윤석 ( Youn Suk Lee ),최준권 ( Jun Gwon Choi ),윤동일 ( Dong Il Yoon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Hysteroscopic surgery has become a routine gynecologic procedure. The advantages are associated with more accurate removal of lesion, its short operating time, rapid post-operative recovery and low morbidity. However, there are potentially serious complications which can be occured during and following hysteroscopic surgery. The complications are uterine perforation, fluid overload and electrolyte disturbance due to intravasation and absorption of uterine distention media, hemorrhage and, rarely, gas or air embolism. We experienced pulmonary edema during hysteroscopic surgery in three consecutive patients. Therefore, we report these cases of fluid overload with uterine distention media resulting acute pulmonary edema during hysteroscopic surgery. (Korean J Anesthesiol 2009; 57: 117~22)
임상연구 : 이산화탄소에 의한 복강내압 증가가 압반사 민감도에 미치는 영향
정승현 ( Seung Hyun Chung ),조헌 ( Hun Cho ),김경옥 ( Kyoung Ok Kim ),이윤석 ( Youn Suk Lee ),최준권 ( Jun Gwon Choi ),인준용 ( Jun Yong In ),최윤숙 ( Yun Suk Choe ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Background: To determine if positive pressure pneumoperitoneum has adverse effects on autonomic nervous system function, we examined baroreflex sensitivity (BRS) during carbon dioxide pneumoperitoneum in patients undergoing laparoscopic surgery. Methods: Twenty adult patients scheduled for laparoscopic gynecologic surgery were selected for the study. After general anesthesia was induced with sevoflurane, continuous electrocardiography and blood pressure were monitored. Spontaneous BRS was achieved using sequence method immediately before, and 5 minutes after, pneumoperitoneum. Heart rate variability (HRV) was also determined. Results: After pneumoperitoneum, BRS decreased from 12.9 ± 1.8 ms/mmHg to 8.1 ± 1.1 ms/mmHg (P < 0.05), and the power of the high frequency band decreased from 237.8 ms2/Hz to 49.6 ms2/Hz (P < 0.05). Conclusions: Compared to recordings obtained before pneumoperitoneum, BRS was decreased during pneumoperitoneum. This may predispose patients undergoing laparoscopic surgery to hemodynamic instability in addition to pneumoperitoneum itself. (Korean J Anesthesiol 2008; 55: 662~5)