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실험연구 : 흰쥐 횡격막 신경근 표본에서 Ondansetron과 Granisetron이 Rocuronium의 근 이완 작용에 미치는 효과
백종화 ( Chong Wha Baek ),강현 ( Hyun Kang ),정용훈 ( Yong Hun Jung ),박정원 ( Jung Won Park ),정화성 ( Hwa Sung Jung ),이윤경 ( Yoon Kyung Lee ),양홍석 ( Hong Seuk Yang ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Background: Both ondansetron and granisetron exert their antiemetic effects via a blockade of the 5-hydroxytryptamine 3 receptor (5-HT3R). Because the 5-HT3R is a member of a superfamily of ligand-gated ion channels and has structural similarities to the nicotinic acetylcholine receptor (nAChR), a 5-HT3R antagonist may also inhibit the nAChR. This study examined the effects of 5-HT3R antagonists, ondansetron and granisetron, on rocuronium-induced neuromuscular blockade in vitro. Methods: Rat phrenic nerve-hemidiaphragm preparations were isolated and allocated randomly into seven groups (control, 1, 10, 100μg/ml of ondansetron, 0.1, 1, 10μg/ml of granisetron). Two studies were carried out using single twitch responses. In the cumulative dose-response study, rocuronium 1μg/ml and each doses of ondansetron or granisetron were administered simultaneously, and incremental 0.5μg/ml doses of rocuronium were added to obtain more than 95% neuromuscular twitch inhibition. ED5, ED50, ED90, and ED95 of rocuronium in each group were calculated using a logistic model. In the partial curarization study, the twitch heights were measured after administering ondansetron or granisetron (10 minutes after administering 3μg/ml rocuronium) and were measured 10 minutes later. The 2 twitch heights were then compared. Results: In the cumulative dose-response study, ondansetron 100μg/ml and granisetron 10μg/ml significantly reduced the ED50 of rocuronium (P < 0.05). There were no intergroup differences in the partial curarization study. Conclusions: High concentration of ondansetron and granisetron enhanced the neuromuscular blockade of rocuronium. Granisetron enhanced the neuromuscular blockade of rocuronium more potently than ondansetron. (Korean J Anesthesiol 2006; 51: 94~100)
임상연구 : 슬관절 전치환술을 받는 노인환자에서 혈역학적 변화를 최소화하기 위해 지속 정주한 Remifentanil과 Esmolol, Nicardipine의 비교
백종화 ( Chong Wha Baek ),곽미정 ( Mi Jeung Gwak ),고나영 ( Na Young Ko ),강현 ( Hyun Kang ),박정원 ( Jung Won Park ),정용훈 ( Yong Hun Jung ),우영철 ( Young Cheol Woo ),김진윤 ( Jin Yun Kim ),구길회 ( Gill Hoi Koo ),박선규 ( Sun 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: The use of tourniquet is associated with severe hemodynamic changes, particularly in elderly patients. This study examined the effects of continuously infused remifentanil or nicardipine with esmolol on the attenuation of the hemodynamic changes with enflurane inhalation during total knee arthroplasty in elderly patients. Methods: Thirty elderly female patients undergoing total knee arthroplasty were enrolled into this randomized, prospective study. Remifentanil (group R) or nicardipine with esmolol (group EN) was infused using a titration method to maintain a mean arterial pressure (MAP) of 90 mmHg to 70 mmHg during tourniquet inflation. In addition, the inhalation of enflurane was adjusted to guarantee a hypnotic state based on entropy. The hemodynamic variables, inhaled concentration of enflurane, recovery time, and postoperative pain characteristics were measured and compared. Results: Following tourniquet inflation, the MAP was increased and maintained in the target since 20 min after that in both group. Following tourniquet deflation the MAP was decreased significantly in both groups and more patients in group R required a vasopressor. Group R inhaled a lower enflurane concentration and showed more rapid recovery than group EN. There were no significant differences in the level of postoperative pain between the two groups. Conclusions: These results suggest that remifentanil is more likely to be associated with hypotension after tourniquet deflation and require more attention than nicardipine with esmolol. (Korean J Anesthesiol 2007; 53: 463~9)
실험연구 : 백서에서 산성식염수 반복주사로 유발된 이질통에 대한 Minocycline의 영향
강현 ( Hyun Kang ),우영철 ( Young Cheol Woo ),백종화 ( Chong Wha Baek ),박정원 ( Jung Won Park ),정용훈 ( Yong Hun Jung ),김진윤 ( Jin Yun Kim ),구길회 ( Gill Hoi Koo ),박선규 ( Sun Gyoo Park ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: Activation of glial cells (microglia and astroglia) has been observed in rat neuropathic pain models and they are known to play a role in inducing allodynia in these animals. Minocycline (MC), a tetracycline derivative antibiotics, displays selective inhibition of microglial activation. The author investigated antinociceptive effect of intrathecal administration of MC on muscular pain model induced by repetitive intramuscular injection of low pH saline. Methods: pH 5 saline was injected into gastrocnemius muscle of rat. Second injection of pH 5 saline was done 3 days after first injection. To study preventive effect of MC, normal saline or MC 50μg or 100μg was administered intrathecally 15 min before each low pH saline injection. To evaluate the therapeutic effect, normal saline or MC 500μg was administered intrathecally after pain model made. To quantify the mechanical allodynia, withdrawal threshold to mechanical stimuli was measured using von Frey filament. Results: Preventive administration of MC 50μg did not attenuate the mechanical allodynia, on the contrary MC 100μg administration showed pain attenuation. Therapeutic administration of MC 500μg did not show analgesic effect. Conclusions: Preventive intrathecal administration of MC 100μg attenuated mechanical allodynia, but not in preventive MC 50μg and therapeutic administration. (Korean J Anesthesiol 2007; 53: 97~103)
임상연구 : 한국 성인에서 굴곡성 기관지경으로 측정한 이중관 기관지 튜브 사용시 안전역
박정원 ( Jung Won Park ),라은길 ( Eun Gil Rah ),이보령 ( Bo Ryoung Lee ),백종화 ( Chong Wha Baek ),정용훈 ( Young Hun Jung ),오수원 ( Soo Won Oh ),우영철 ( Young Cheol Woo ),김진윤 ( Jin Yun Kim ),구길회 ( Gill Hoi Koo ),박선규 ( 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.2
임상연구 : 백내장적출술을 위한 안구후차단시 Remifentanil, Alfentanil, Fentanyl이 혈역학적 변화와 진통, 진정효과에 미치는 영향
임세근 ( Sei Keun Im ),구길회 ( Gill Hoi Koo ),강현 ( Hyun Kang ),백종화 ( Chong Wha Baek ),박정원 ( Jung Won Park ),정용훈 ( Yong Hun Jung ),우영철 ( Young Cheol Woo ),김진윤 ( Jin Yun Kim ),박선규 ( Sun Gyoo Park ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery. Methods: Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3μg/kg. Furthermore, group A received a 4.5μg/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6μg/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block. Results: The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P<0.05). Conclusions: We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery. (Korean J Anesthesiol 2007; 53: 441~7)
부인과 환자에서 정맥 내 자가통증 조절시 수술 후 오심 및 구토를 예방하기 위한 Ondansetron의 지속투여
임승모 ( Seung Mo Lim ),김진윤 ( Jin Yun Kim ),강현 ( Hyun Kang ),백종화 ( Chong Wha Baek ),박정원 ( Jung Won Park ),정용훈 ( Yong Hun Jung ),우영철 ( Young Cheol Woo ),구길회 ( Gill Hoi Koo ),박선규 ( Sun Gyoo Park ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.2