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요추부 수술 후 경막외 무통방법과 지속적 정맥 주입에 의한 통증 조절의 효과 비교
오규성,신문수,길현주,허륭,최훈규,안정용,권성오,Oh, Kyu Sung,Shin, Moon Soo,Gil, Hyun Joo,Hur, Ryoong,Choi, Hun Kyu,Ahn, Jung Yong,Kwon, Seong Oh 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.12
Objective : The purpose of this non-randomized prospective study was to evaluate the safety and efficacy of continuous intravenous nalbuphine-ketorolac-droperidol(CIA) versus continuous infusion of epidural morphine-bupivacaine(CEA) for pain control after lumbar spinal surgery. Methods : Twenty-one patients who underwent spine surgery including laminectomy, fusion with fixation were assigned to receive an intravenous bolus of nalbuphine 5mg and ketorolac 15mg, followed by a continuous infusion of nalbuphine 25mg, ketorolac 105mg, and droperidol 5mg mixed with normal saline 98cc(2cc/hr). Twenty patients received a bolus infusion of morphine 2mg and 0.125% bupivacaine 8cc followed by a continuous intravenous infusion of 100cc 0.125% bupivacaine and morphine sulfate 8.0mg(2cc/hr). Pain score was measured on a visual analogue scale(VAS). It's safety and efficacies were compared with the results of continuous infusion of epidural morphine-bupivacaine, which was reported previously by same authors. A continuous infuser was used to give epidural morphine-bupivacaine and intravenous nalbuphine-ketorolac-droperidol. Results : In general, mild pain, pain less than 3 VAS scores, was observed postoperatively from 30minutes to 72hours in CEA group, and from 6 hours to 72 hours in CIA group. The early postoperative pain was controlled easily in 6 hours in CEA group, compared to CIA group(p<0.05). However, there was no statistical significance in 72 hours on pain scores between CEA and CIA groups after 6-12hours of pain managements. Pruritus, nausea and vomiting, and urinary retention were more frequent in CEA group. Conclusion : CIA and CEA are considered effective methods in postoperative pain managements. However, adequate doses in early intravenous infusion and continuous intravenous analgesia with nalbuphine-ketorolac-droperidol will be needed for better control in early postoperative pain with less side effects.
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2015 개정 통합사회 교원연수 프로그램의 특징 및 적용 가능성 분석: 교원연수 프로그램 개발의 패러다임 전환
이혁규(Lee Hyug Kyu),박윤경(Park Yun Kyoung),길현주(Gil Hyun Joo),이효인(Yi Hyo In) 한국열린교육학회 2019 열린교육연구 Vol.27 No.3
이 연구의 목적은 2015 개정 통합사회 교원연수 프로그램의 특징 및 적용 가능성을 분석함으로써, 향후 통합사회 교원연수 프로그램의 개발 방향에 대한 시사점을 도출하는 것이다. 이를 위해 통합사회 과목 도입기의 교원연수 프로그램의 개발 및 운영 과정을 분석하고, 연수 참여 교사와 연수 강사를 대상으로 설문조사와 초점 집단 면접을 수행하였다. 먼저, 연수 프로그램의 특징을 분석한 결과, 연수 개발 및 운영 과정이 실행 연구의 성격을 갖고, 연수 강사 중심의 협력적 시스템을 구축하여 표준화된 프로그램 개발을 지향한다는 점이 드러났다. 또한, 연수 내용의 차원에서는 교육과정-수업-평가의 유기적인 흐름을 강조하고, 방법 차원에서는 실습을 강조하며, 교사 전문성 제고와 관련하여 협력적 관계를 통한 집단전문성의 향상을 모색한다는 특징이 드러났다. 이와 관련하여, 연수 참여 교사들은 연수 프로그램에 대해 높은 만족도를 보였으며, 연수 참여 교사 및 연수 강사들은 흐름이 있는 내용 구성, 실습형 연수, 다른 전공 교사들과의 협력적 분임 활동, 우수한 현장 교사로 구성된 연수 강사 활용, 개별 강사가 아닌 시스템에 기반 한 연수 개발 및 운영 체제 등을 연수 프로그램의 강점으로 파악하였다. 이상의 분석 결과를 바탕으로 향후 통합사회 연수 프로그램 개발 방향에 대한 시사점을 제안하였다. The goal of this study is to analyze the characteristics and applicability of the Teacher Training Program of the 2015 Revised Integrated Social Studies Subject. Also, it is to draw implications for the future direction of teacher training program development. For this purpose, we analyzed the development and operation procedures of teacher training programs as well as conducted a survey and focus group interviews with instructors and teachers who participated the program. As a result of analyzing the characteristics of the training program, its development and operation procedures were characterized as an action research, which builds a collaborative system based on a instructor learning community and protocol-based standardized program development. In terms of the training program content, it emphasized an organic flow between national curriculum, class and evaluation. Furthermore, in terms of the training methods, it emphasized a practice while showing characteristics of finding ways to improve a collective expertise through cooperative relationships that are related to enhancing teacher professionalism. The participating teachers showed a high degree of satisfaction with the details of the program. Both the participating teachers and the instructors appointed streamlined content composition, practical training, cooperative activities with teachers of different sub-major, utilization of training instructors who are excellent on-site teachers, development and operating system of the program based on a system not an individual instructor as the strengths of the practice-based program. Based on the results of this study, we proposed implications to improve the training system development for the future integrated social studies training program.
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