A Comparison of Lighted Stylet (Surch-Lite™) and Direct Laryngoscopic Intubation in Patients with High Mallampati Scores :

Rhee, Ka-young,Lee, Jeong-rim,Kim, Jinhee,Park, Sanghyon,Kwon, Won-Kyong,Han, SungHee Ovid Technologies (Wolters Kluwer) - AnesthesiaAna 2009 Anesthesia and analgesia Vol.108 No.4

<P>BACKGROUND: A lighted stylet is an effective alternative to a direct laryngoscope and has been reported to be particularly useful in patients with difficult airways. A high Mallampati class indicates poor visibility of the oropharyngeal structures. Because a lighted stylet does not require direct oropharyngeal visualization, we hypothesized that the lighted stylet would be easier to use than a direct laryngoscope in patients with a high Mallampati score. To examine our hypothesis, we performed a prospective, randomized study comparing a lighted stylet (Surch-Lite) with direct laryngoscopy in patients with high Mallampati scores. Success rate, time required for intubation, and hemodynamic changes were compared. METHODS: Mallampati Class III patients were enrolled and were randomly assigned to the Surch-Lite group (Group SL) or the direct laryngoscopy group (Group DL). Patients' tracheas were intubated with the randomly selected intubation device after induction of general anesthesia. Heart rate (HR) and mean arterial blood pressure were measured immediately before and every 30 s after intubation for 5 min. The time to intubation and success rate were recorded. Postoperative pharyngolaryngeal complaints were also assessed. RESULTS: Thirty patients were enrolled in each group. The success rate on the first attempt was significantly higher in Group SL (29 of 30) than in Group DL (24 of 30). The difference between maximal HR and baseline HR was significantly higher in Group DL (25 +/- 13 bpm) than in Group SL (16 +/- 10 bpm). The change in mean arterial blood pressure was also higher in Group DL (38 +/- 14 mm Hg) than in Group SL (20 +/- 13 mm Hg). The time to intubation was significantly shorter in Group SL (12 +/- 6 s) than in Group DL (17 +/- 12 s). Postoperative pharyngolaryngeal complaints were not significantly different between the two groups. CONCLUSIONS: The Surch-Lite showed a higher success rate on the first intubation attempt and produced an attenuated hemodynamic response to endotracheal intubation of patients with high Mallampati score. Thus, the Surch-Lite is an effective alternative to direct laryngoscopy in these patients.</P>

Sedation with Propofol-Midazolam Combination versus Propofol alone during Spinal Anesthesia: Prospective, Randomized Study

Ka Young Rhee,Mi Ja Yun,Duck Kyoung Kim,Tae Kyung Seol,Kyoung Ok Kim 대한마취과학회 2005 Korean Journal of Anesthesiology Vol.49 No.6

Intratracheal Pulmonary Ventilation (ITPV)

Ka Young Rhee,Kook Hyun Lee Korean Society of Critical Care Medicine 1997 Acute and Critical Care Vol.12 No.2

No abstract available.

술 중 Clonidine 정주에 따른 척추 마취시간의 연장

이가영 ( Ka Young Rhee ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.3

남성 연소노인의 은퇴 후 적응과정과 노년기 조망에 대한 연구

이가옥(Rhee Ka-Oak),이지영(Lee Ji-Young) 한국사회복지학회 2005 한국사회복지학 Vol.57 No.1

은퇴 후 연소노인들이 어떻게 노인이 되어 가고 있으며, 앞으로의 노년기는 어떻게 조망하고 있는지에 대해서 살펴보는 것이 본 연구의 목적이다. 이 연구 목적을 달성하기 위해 10명의 연소노인을 대상으로 이들의 삶의 모습을 살펴보았다. 은퇴 후에도 연소노인들은 계속적으로 일을 하기를 원하였지만, 사회적으로 이들의 일에 대한 지향은 이루어지기 힘든 상황이었다. 이 글은 일을 중심으로 그들의 기대를 낮추는 과정이 어떻게 일어나고 있는지, 이러한 과정 속에서 앞으로의 노년기를 어떻게 조망하고 있는지를 중심으로 기술하였다. 연구 결과, 연소노인들은 끊임없이 자신의 야심 달성에 실패하면서, 그때마다 기대를 낮추도록 요구받고 있었다. 외면적으로 이들의 포부는 점점 사라지는 것처럼 보였다. 그러나 사회적 배제의 과정은 단순히 이들에게 일에 대한 포부뿐만 아니라, 자신의 미래에 대한 계획까지 빼앗고 있었다. 결과적으로, ‘젊어지려는’ 개인과 ‘조로(早老)시키려는’ 사회 사이의 커다란 괴리는 연소노인의 삶의 만족도를 떨어뜨리고 있었다. The purpose of this study is to examine how relatively young old men become old people after retirement and how they view their forthcoming old age. We interviewed the aspects of lives of the 10 relatively young old men to attain the purpose. According to the interviews, it was difficult to get a job after retirement in our society even though they wanted to do. This paper focuses on how the process of lowering their expectation to work happened, how they viewed their forthcoming old age during the process. One of the results showed that whenever they had failed to attain a job, they had been asked to lower their expectation of work. It seemed that their expectation to work became weak. But the process of exclusion of social role took away not only their expectation to work but also their plan for the future. As a result, the gap between an individual who wanted to be younger and the society which made them older made to decrease the degree of satisfaction.

임상연구 : 전신적 동맥경화성 혈관염 환자에서 동맥우회술 시 항응고 요법의 효과

이가영 ( Ka Young Rhee ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.45 No.5

Background: The administration of low dose heparin and dextran therapy in patients with arterial bypass surgery is thought to prevent thrombosis and graft occlusion. The purpose of this study was to evaluate the effectiveness of low dose heparin and dextran in atherosclerosis patients presenting hypercoagulability. Methods: Whole blood coagulation was evaluated using thrombelastography and standard coagulation testing before and a day after surgery in nine atherosclerotic patients and nine control patients. Heparin 5000 U and dextran 500 ml were administrated in atherosclerotic patients during their operations. Results: Atherosclerotic patients showed higher maximal amplitude compared to the control patients during preoperative thrombelastography. After surgery atherosclerotic patients revealed no significant change, but the control group became more hypercoagulable in status compared to the preoperative period. Conclusions: Intravenous heparin and dextran prevented postoperative change to a more hypercoagulable state than the preoperative status in atherosclerotic patients undergoing arterial bypass surgery. (Korean J Anesthesiol 2003; 45: 617∼621)

개두술에 의한 수술중 거대 뇌동정맥기형 절제후 발생한 경막외혈종

이가영,오용석,황기선 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.8

A 46 years old woman developed a sudden transcalvarial brain herniation 1 hour after removal of a huge right frontal arteriovenous malformation intraoperatively. In spite of all possible anes- thesiologic resuscitative treatments, the brain swelling was not subsided. Resuscitative resection of the frontal lobe was done. The brain CT taken immediately postoperatively showed a large unsuspected epidural hematoma over the contralateral left temporal and occipital areas. This rare complication should be remembered during brain surgery if unexpected brain swelling occurs without apparent reasons after resection of arteriovenous malformation.

척추 마취시 아트로핀의 정주가 혈역학적 지표에 미치는 효과

이가영,김용락 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.5

Background : The major complications of spinal anesthesia are hypotension and bradycardia. In normal condition, hypotension stimulates baroreceptor reflex and compensatory tachycardia is occured. But during spinal anesthesia, there is possibility of a blockade of cardiac sympathetic nerve fibers which would result in increased vagal tone and depress compensatory baroreceptor reflex which is activated during hypotension. Atropine is an anticholinergic agent whose predominant cardiovascular effect was known as increasing heart rate at clinical dose. The purpose of this study was to evaluate hemodynamic effect of atropine during spinal anesthesia. Methods : We compared heart rate, systolic, diastolic and mean arterial pressures and cardiac output in 26 patients of ASA physical status 1, 2 before and after intravenous injection of atropine sulfate 0.01 mg/Kg during spinal anesthesia. Hemodynamic parameters were measured just prior to and 1, 2, 3, 4, 5, 10 minutes after atropine sulfate intravenous injection. The data were analyzed by repeated measures ANOVA. Results: Heart rate, mean blood pressure and diastolic blood pressure after atropine sulfate injection increased with significance. Conclusion : These findings suggest that during spinal anesthesia atropine is effective to produce tachycardia with a dosage of 0.01 mg/Kg in humans. Also hypotension might be improved because atropine makes mean blood pressure and diastolic blood pressure increase. (Korean J Anesthesiol 1998; 35: 946∼951)

소아에서 하악골절 전신마취시 굴곡성 내시경과 유도선을 이용한 경비 기관내 삽관

이가영,염광원,김현정 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.1

Although the endotracheal intubation using laryngoscope can usually be performed under general anesthesia, it may be very difficult in situations such as head and neck trauma, hemorrage, or deformity. Recently we performed antegrade fiberoptic nasotracheal intubation with a guide wire. A 15-month aged female child with mandibular fracture was scheduled for open reduction and internal fixation under general anesthesia. She was anticipated difficult intubation due to displacement of the fracture site. After induction of anesthesia, we passed an adult fiberoptic bronchoscope (O.D. 3.8 mm, LF-2, Olympus optical co, Japan) to vocal cord via right nostril. Then a guidewire was inserted through the suction port of bronchoscope, and bronchoscope was removed in a state of guidewire in situ. We slid the endotracheal tube over guidewire according to Seldinger's technique. We think that nasotracheal intubation using an adult fiberoptic bronchoscope and a guidewire is good for children under 2 years old who are expected the difficult intubation. (Korean J Anesthesiol 1999; 36: 162∼164)

고령자 고용정책의 대응전략에 대한 비판과 시민권(citizenship)의 원리를 통한 대안 모색

이가옥(Rhee, Ka-Oak),이지영(Lee, Ji-Young) 한국노년학회 2005 한국노년학 Vol.25 No.2

시대적 변화의 흐름 속에서 고용자 고용을 위한 어떤 가능성을 찾아낼 수 있는가에 대해서 면밀한 검토를 해 볼 필요가 있지만, 현 고령자 고용정책은, 거세어지는 외부의 압력에 의해서 빠른 변화만을 요구받으면서, 노동만을 강조하고 있다. 이러한 흐름 속에서 현재 우리나라에서 새롭게 논의되고 있는 고령자 일자리 전략은 크게 두 가지이다. 하나는 일자리 연장 방식이며, 다른 하나는 사회적 일자리 방식이다. 일자리 연장의 방식의 경우, 유연적 삶이 노년기의 이상적 사회로 간주되면서 안정화의 필요성이 간과되는 양상을 보이고 있다. 사회적 일자리의 경우, 사회통합의 의미는 배제된 채 잔여적 복지의 일환으로 협소하게 해석되어 적용되고 있다. 이러한 고령자 고용정책의 한계는 연령차별주의와 경제우선주의가 맞물려서 이루어지고 있으며, 이 두 가지 논리에 의해서 고령자의 삶의 질은 간과되고 있다. 따라서 본 고에서는 시대변화에 따른 현 고령자고용정책의 비판을 통해, 고령자의 삶의 질 향상을 위해 강조되어야 할 것은 무엇인지를 살펴보고, 이에 따른 새로운 방향을 제시해 보고자한다. 연령 차별적 논리와 경제우선주의를 극복하고, 사회통합을 지향하는 새로운 이념적 틀로, 본 고에서는 시민권(citizenship)의 원리를 제시하였다. 노동생활의 지속성을 유지하기 위해서는 기본적으로 생존권과 건강권이, 그리고 질적인 향상을 위해서는 평생학습권의 보장이 전제되어야 할 것이다. 시민권에 대한 논의는 기존의 경제논리에 묶여 있던 고령자 고용정책에서 새로운 차원으로 전환되어야 함을 역설하고 그 정당성을 확보해 주는 데 의의가 있다. Nowadays, the employment policies for older people is requested to become the new form in the change of information, globalization, and aging. It is discussed, simultaneously, about an age integrated society as the full time jobs' continuation and social jobs after the full time jobs. The discussion of jobs' continuation include from institutional system to age integrated society. Social jobs include from public labor to social wages. jobs' continuation passes over stabilization, regarding it as ideal society. social jobs are interpreted it as residual welfare, excluding the meaning of social solidarity. In fact, most of the debates is overwhelmed by the logic of economy. And so they pass over the quality of life of individuals. Therefore, this study critics the employment policies for older people in the present situation and states a direction improving the quality of life older people.