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증례보고 : 금식되지 않은 환자에서 응급수술 후 회복실에서 인지된 흡인성 폐렴
최원준 ( Won Joon Choi ),경문기 ( Moon Ki Kyoung ),김용찬 ( Yong Chan Kim ),문성하 ( Sung Ha Moon ),김윤홍 ( Yung Hong Kim ),김현수 ( Hyun Soo Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.5
Aspiration pneumonia is considered to be a morbid complication of anesthesia, It was reported that several conditions are associated with an increased frequency of aspiration pneumonia, such as gastroenterological, neurological and, pulmonary diseases. The incidence is also higher in emergency situations than during elective surgery. We encountered aspiration pneumonia after emergency laparoscopic salpingectomy. The patient was 25 years old woman with no prior medical history but had fasted for only 5 h in the preoperative period. During the perioperative period, there were no signs of regurgitation of the gastric contents into the oral cavity. After surgery, the patient was transported to the recovery room in a fully awakened state. However, the patient became cyanotic without vomiting. After physiotherapy, a chest CT scan was performed, and she was diagnosed with aspiration pneumonia. She was admitted to intensive care. Ten days later, she was discharged in a healthy state. (Korean J Anesthesiol 2007; 52: 612~6)
임상연구 : 압축공기 분사청소가 ProSeal 후두마스크의 수술 후 잔류 단백질 제거에 미치는 효과
최원준 ( Won Joon Choi ),김윤홍 ( Yun Hong Kim ),경문기 ( Moon Ki Kyoung ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: The reusable ProSeal(TM) laryngeal mask airways (PLMA`s) have the potential to act as a vector for the transmission of prion diseases such as variant Creutzveldt-Jacob disease. This study tested the hypothesis that supplementary compressed air jet cleaning facilitates the removal of protein deposits on PLMA`s after surgery. Methods: After clinical use, thirty PLMA`s were randomly allocated to be washed by hand and with an autoclave (134℃ for 40 min) (group 1, n = 15), or by hand, autoclave and compressed air jet cleaning (1 min) (group 2, n = 15). In both groups, protein deposits were detected on PLMA`s by erythrosine staining. A staining score designated as nil, mild, moderate, and severe was given to each site (outer, inner surface and edges of the cuff, airway and drain tube, finger strap) according to the percentage of stained surface area. The severity of staining was compared for masks prior to use and after cleaning the mask. Results: Despite the cleaning of masks, the staining score worsened on the outer, inner surface and edge of PLMA`s in both groups (P<0.05); however, a similar pattern was observed on each part of a cleaned PLMA for both groups. Conclusions: We conclude that compressed air jet cleaning for 1 min did not improve the removal of protein deposits on PLMA`s after surgery. (Korean J Anesthesiol 2007; 53: 430~4)
증례보고 : 대뇌 전두엽에 재발한 악성 수막종 환자의 뇌종양 절제술 중 발생한 간대성근경력 발작
김윤홍 ( Yun Hong Kim ),이영재 ( Young Jae Yi ),경문기 ( Moon Ki Kyoung ),김현수 ( Hyun Soo Kim ),문성하 ( Sung Ha Mun ),최원준 ( Won Joon Choi ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2
Several suspected etiologies can cause seizures during the resection of a brain tumor via a craniotomy: the tumor itself, intracranial hypertension or the anesthetic agents used, etc. Generalized myoclonic seizures, during general anesthesia in a 44 year old man, who underwent a resection for a relapsed frontal meningioma, were experienced. Anesthesia was induced and maintained using propofol and remifentanil. The myoclonic seizures began 30 minutes after the induction of anesthesia. The administration of rocuronium was unable to stop the involuntary movement. Midazolam was given to cease the seizures, but they continued for a further 105 minutes. After opening the dura mater, the seizures immediately disappeared and did not recur thereafter. (Korean J Anesthesiol 2007; 52: 241~4)