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증례보고 : 승모판 치환술 후 발생한 의인성 대동맥 박리
김희주 ( Hee Zoo Kim ),임상호 ( Sang Ho Lim ),박성우 ( Sung Woo Park ),김난숙 ( Nan Suk Kim ),이미경 ( Mi Kyoung Lee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Iatrogenic aortic dissection (IAD) is a life-threatening complication that can occur during open heart surgery, therefore IAD requires early diagnosis and prompt management. We describe here a case of IAD that occurred during mitral valve replacement. The transesophageal echocardiography (TEE) evaluation revealed features indicative of acute aortic dissection and the tear was successfully repaired by interposition of a graft. (Korean J Anesthesiol 2007; 53: 524~7)
뇌성마비 환자에서 마취 유도 시 BIS와 Entropy 값의 비교
김남엽 ( Nam Yeop Kim ),이일옥 ( Il Ok Lee ),임병건 ( Byung Gun Lim ),김희주 ( Hee Zoo Kim ),공명훈 ( Myoung Hoon Kong ),이미경 ( Mi Kyoung Lee ),임상호 ( Sang Ho Lim ),김난숙 ( Nan Suk Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
Background: Demand of anesthesia for patients with cerebral palsy is more increasing. But there is still lacking in clinical research regarding how BIS and entropy reflect well on sedative and hypnotic state in patients with cerebral palsy. Methods: Fifteen patients with cerebral palsy (Group CP) and fifteen patients without cerebral palsy (Group NL) scheduled for elective orthopedic surgery were included in the study. Induction of anesthesia was done by having the patient inhale 1 vol% sevoflurane and 100% oxygen using a total fresh gas flow of 8 L/min. Simultaneously BIS, state entropy (SE), response entropy (RE), end-tidal sevoflurane concentration were recorded every 15 seconds till there was no self respiration. When end-tidal sevoflurane concentration had not risen any more for 30 seconds, we increased inhaled sevoflurane concentration in 1 vol% increments. End point of recording was when self respiration was lost or the time sevoflurane concentration reached 8 vol%. Results: No significant differences in RE, SE, BIS at baseline and end point were found between the two groups. No significant difference in the time reach end point was found between the two groups. BIS, SE and RE correlated with end-tidal sevoflurane concentration in the two groups. Conclusions: The authors found no significant difference in the entropy values between patients with CP and normal patients. Also, the entropy values could be interpreted like BIS in patients with CP. And BIS showed a stronger correlation with end tidal sevoflurane concentrations than entropy. (Korean J Anesthesiol 2009;57:422~7)
임상연구 : 복강경하에 담낭절제술을 받는 환자에서 Propofol과 Remifentanil을 이용한 전 정맥마취와 Sevoflurane과 Alfentanil을 이용한 마취의 비교
구은혜 ( Eun Hye Koo ),김현정 ( Hyun Jung Kim ),김희주 ( Hee Zoo Kim ),오혜란 ( Hye Ran Oh ),이일옥 ( Il Ok Lee ),김난숙 ( Nan Sook Kim ),이미경 ( Mi Kyung Lee ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Background: The aim of this prospective, double-blind randomized study was to compare the clinical properties of sevoflurane-alfentanil with propofol-remifentanil anesthesia in patients undergoing a laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery received total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-alfentanil. The TIVA group was induced with propofol 5μg/ml and remifentanil 4.5 ng/ml. The anesthesia was maintained with a continuous infusions of propofol 2.5μg/ml and remifentanil 3 ng/ml. The sevoflurane-alfentanil group was induced with alfentanil 15μg/kg and propofol 1.5 mg/kg IV. Maintenance was obtained with 2.0 vol% sevoflurane and a bolus of alfentanil 10μg/kg IV where needed. Results: There were no significant differences in the systolic and diastolic blood pressure and heart rate between the two groups. There were no significant differences in the time to eye opening, the time to extubation, post-anesthetic recovery room stay time and the incidence of postoperative nausea and vomiting between the two groups. Conclusions: Propofol-remifentanil (TIVA) and sevoflurane-alfentanil both provided satisfactory anesthesia for a laparoscopic cholecystectomy. (Korean J Anesthesiol 2006; 51: 24~8)
박성우 ( Sung Woo Park ),김난숙 ( Nan Suk Kim ),이미경 ( Mi Kyoung Lee ),공명훈 ( Myoung Hoon Kong ),김희주 ( Hee Zoo Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: Several survey reported that use of dietary supplements including herbal medicine was common in the preoperative period. The use of such remedies has implications for the anesthesiologists because of the potential for drug interactions and side effects. Little information is available on the frequency of use in the surgical population in Korea. This study was purposed to find out the frequency and predictors of the use of dietary supplements in presurgical patients. Methods: A questionnaire was distributed to all patients at the preoperative visit from May 2006 to August 2006. The questionnaire inquired as to basic demographics, use of dietary supplements, the name and number of dietary supplements used, reasons to take the dietary supplements, and whether the patient had informed anesthesiologist of the use. Results: A total 1,072 completed surveys showed that overall 37% of presurgical patients reported the use of dietary supplements. Less than half of the patients told their anesthesiologists that they were using dietary supplements. The most commonly used dietary supplements were ginseng, soy, glucosamine, garlic, prunus mume, mushroom, siberian ginseng, fish oils, aloe, ginger, and gingko in order of incidence. Young age was predictor associated with lower use of dietary supplements. Conclusions: Use of dietary supplements is common in the preoperative period in Korea. Documentation of the use of these products in the perioperative period is important to consider the potential interaction of dietary supplements with medical medicine or anesthetics. (Korean J Anesthesiol 2007; 53: 15~20)
증례보고 : 36년간 지속된 난치성 절단통증 환자에서 척수자극술을 이용한 통증 관리
이미금 ( Mi Geum Lee ),한성진 ( Sung Jin Han ),이미경 ( Mi Kyoung Lee ),임상호 ( Sang Ho Lim ),김희주 ( Hee Zoo Kim ),최상식 ( Sang Sik Choi ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.5
Spinal cord stimulation (SCS) is an effective therapy for chronic and intractable neuropathic pain. We present a case report of successful pain control using SCS implantation in a patient with chronic, intractable stump pain for 36 years. The patient lost his two legs under the knees during the Vietnam War and had an amputation. After that he suffered stump pain for 36 years due to recurrent neuroma even after neuroma excision was performed over 30 times. We inserted the dual percutaneous leads at the level of left T9 and right T10 in this patient and could get complete pain relief without any complications. (Korean J Anesthesiol 2008;55:648~51)
증례보고 : 중지의 복합 부위 통증 증후군 2형 환자에서 경부 척수자극술 -증례보고-
서경원 ( Kyoung Won Seo ),최상식 ( Sang Sik Choi ),이호준 ( Ho Jun Lee ),구은혜 ( Eun Hye Koo ),김희주 ( Hee Zoo Kim ),오혜란 ( Hye Ran Oh ),김난숙 ( Nan Sook Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.6
Complex regional pain syndrome (CRPS) is quite difficult to comprehend and manage, of which etiology and pathophysiological mechanisms have not been fully understood. CRPS is classified as either type 1 (without any known nerve injury) or type 2 (with apparent nerve or tissue injury). Spinal cord stimulation is a restorative therapy that currently offers the best chances of obtaining long-term pain relief in CRPS patients with pain that has not responded to other treatments such as physical therapy or analgesic medications. A 45 years old male patient referred to our pain clinic due to uncontrolled pain at the middle finger for 4 years after crushing injury. He was diagnosed with CRPS type 2 and treated with medication, stellate ganglion block, thoracic sympathetic block, and pulsed radiofrequency therapy, but their effects were transient and not satisfactory. A percutaneous spinal cord stimulation (SCS) with a single quadripolar electrode was tried and the patient`s finger pain was improved significantly (from VAS 10 to 2). SCS is an effective treatment for CRPS type 2 which results from crushing injury when alternative therapies fail. (Korean J Anesthesiol 2007; 52: 733~6)