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임상연구 : 뇌수술에 있어 핀 고정과 절개 부위에 국소 침윤한 Levobupivacaine의 혈역학 영향
신동진 ( Dong Jin Shin ),배홍범 ( Hong Beom Bae ),최정일 ( Jeong Il Choi ),윤명하 ( Myung Ha Yoon ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: Several drugs have been used to reduce the hemodynamic responses evoked by skull-pin head-holder application and skin incision in neurosurgery. This study evaluated the effects of levobupivacaine infiltration on hemodynamics followed by the skull-pin head-holder application and the skin incision. Methods: Eighty-eight patients who had been scheduled for neurosurgery under general anesthesia were randomly divided into five groups. Saline or different concentrations of levobupivacaine (1, 2.5, 5, 7.5 mg/ml) were infiltrated into skull-pin head-holder insertion sites and the skin incision sites. Systolic (SBP) and diastolic blood pressure (DBP) and heart rate were measured just before skull-pin head-holder application and 30 see, 1 min, 3 min and 5 min after skull-pin head-holder application and skin incision. Changes in hemodynamics were compared. Results: SBP, DBP and heart rate significantly increased after skull-pin head-holder application. The range of increase was diminished by local application of levobupivacaine. However, 5 mg/ml and 7.5 mg/ml levobupivacaine group decreased blood pressure or heart rate to below the baseline after skin incision. Conclusions: These results indicate that 7.5 mg/ml levobupivacaine attenuates the hemodynamic responses evoked by skull-pin head-holder application, but decreases blood pressure and heart rate after skin incision in craniotomy. Therefore, 5 mg/ml levobupivacaine was effective minimum local concentration to attenuate the change of hemodynamics by skull-pin head-holder application and skin incision in craniotomy if the level of anesthesia is maintained properly. (Korean J Anesthesiol 2006; 51: 179~84)
임상연구 : 갑상선 수술 환자에서 마취 방법에 따른 수술 후 구역과 구토의 비교
최철훈 ( Cheol Hun Choi ),정성욱 ( Seong Wook Jeong ),정성태 ( Sung Tae Chung ),배홍범 ( Hong Beom Bae ),최정일 ( Jeong Il Choi ),정성수 ( Sung Su Chung ),유경연 ( Kyung Yeon Yoo ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Background: The aim of this study was to compare the anesthetic techniques for preventing postoperative nausea and vomiting (PONV) in the patients undergoing thyroidectomy. Methods: Sixty patients of ASA status I or II, undergoing thyroidectomy were studied. Patients were allocated randomly to one of three groups. Group 1 (n = 22): anesthesia was induced by propofol (2 mg/kg) and maintained with desflurane and 50% nitrous oxide in oxygen. Group 2 (n = 22): anesthesia was induced and maintained propofol and alfentanil using a computer controlled infusion system in 60% medical air in oxygen. Group 3 (n = 16): anesthesia was induced propofol using computer controlled infusion system in combination 50% nitrous oxide in oxygen. The incidence of PONV was assessed at 6 and 24 hours after the surgery and standardized by Rhodes index of nausea, vomiting and retching (RINVR) score. Results: In group 3, the incidence of PONV within the first 6 hours after surgery, was significantly lower as P < 0.05. But, there was no statistical differences among the three groups in the 6 to 24 hours` RINVR score after surgery. Conclusions: The use of propofol for induction and maintenance with combination 50% N2O is the most effective technique at preventing PONV among the three groups within the first 6 hours after thyroidectomy. This study found no statistically significant difference between the RINVR score, using desflurane-N2O and propofol-alfentanil. (Korean J Anesthesiol 2006; 51: 449~54)
척수신경 결찰 모형에서 Morphine 내성 유도가 Gabapentin의 항이질통 효과에 미치는 영향
최금화 ( Jin Hua Cui ),이형곤 ( Hyung Gon Lee ),김웅모 ( Woong Mo Kim ),배홍범 ( Hong Beom Bae ),윤명하 ( Myung Ha Yoon ),최정일 ( Jeong Il Choi ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Background: Morphine is more effective in inflammatory or acute pain than neuropathic pain. Recently, some reports demonstrated that the development and maintenance of opioid tolerance and neuropathic pain have similar aspects. Here, we evaluated whether morphine tolerance affects the anti-allodynic effect of gabapentin in spinal-nerve ligated rat. Methods: Male Sprague-Dawley rats weighing 100-120 g received L5,6 spinal nerve ligation to induce neuropathic pain. Rats showing allodynia were implanted with intrathecal (i.t.) catheter to administer the experimental drugs into the subarachnoid space. To induce olerance to morphine, 15 μg of morphine was injected via i.t. catheter twice a day for 7 days, and the effect of i.t. gabapentin on the paw withdrawal threshold was examined using the von Frey test before and after the development of morphine tolerance. Results: Ligation of spinal nerves decreased the paw withdrawal threshold. Intrathecal morphine initially increased the paw withdrawal threshold, but this effect decreased gradually over time. However, morphine tolerance did not influence the effect of gabapentin on withdrawal threshold. Conclusions: Morphine tolerance did not affect gabapentin efficacay in a neuropathic pain model. (Korean J Anesthesiol 2009;56:74~8)
임상연구 : Doxapram Hydrochloride가 후두마스크기도를 이용한 전 정맥마취 시 환기반응에 미치는 영향
윤영철 ( Young Chul Yoon ),곽상현 ( Sang Hyun Kwak ),정성태 ( Sung Tae Jeong ),김석재 ( Seok Jai Kim ),배홍범 ( Hong Beom Bae ),정성수 ( Sung Su Chung ),정창영 ( Chang Young Jeong ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: Intravenous anesthetics causes depression of ventilatory response to hypercapnea. Doxapram stimulates ventilation via peripheral and central chemoreceptors. This study was aimed to evaluate the effect of doxapram on ventilation during total intravenous anesthesia (TIVA). Methods: 60 patients undergoing operation under spontaneous ventilation via laryngeal mask airwaywere randomly divided into 3 groups: Control group received 5% dextrous infusion, D-2 group received doxapram injection of 1 mg/kg followed by continuous infusion of 2 mg/kg/hr, and D-4 group received doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr. Anesthesia was induced and maintained with propofol and remifentanil. Respiratory rate, tidal volume (VT) and arterial carbon dioxide tension (PaCO2) were measured before and 15 min after induction of anesthesia, 0(15 min after start of operation), 1, 2, 3, 5, 15, 30, 45, and 60 min after start of doxapram infusion during TIVA. Results: VT was significantly increased 1 min after start of doxapram infusion and returned to the value of pre-doxapram infusion immediately. In D-4 group, VT was significantly (P<0.05) increased again 5 min after doxapram infusion compared with the value of pre-doxapram infusion and control group. PaCO2 was decreased 1 min after start of doxapram infusion and then increased again 2 min after doxapram infusion. In D-4 group, the degree of increase of PaCO2 was significantly (P<0.05) less than those of D-2 group. Conclusions: Doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr improved the depression of ventilatory response during TIVA. (Korean J Anesthesiol 2007; 53: 470∼6)
백서의 척수강 내로 투여한 Metabotropic Glutamate 수용체 약물의 항침해효과 및 Morphine과의 상호작용
최정일 ( Jeong Il Choi ),이형곤 ( Hyung Kon Lee ),정성태 ( Sung Tae Chung ),김창모 ( Chang Mo Kim ),배홍범 ( Hong Beom Bae ),김석재 ( Seok Jai Kim ),윤명하 ( Myung Ha Yoon ),정성수 ( Sung Su Chung ),정창영 ( Chang Young Jeong ) 대한통증학회 2005 The Korean Journal of Pain Vol.18 No.1