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증례보고 : Ranitidine 투여 후 수술환자 이동 중 발생한 아나필락시스
박성욱 ( Sung Wook Park ),류형석 ( Hyung Seok Yoo ),성준경 ( Joon Kyung Sung ),이재우 ( Jae Woo Yi ),김건식 ( Keon Sik Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
A 43-year-old male was admitted for reconstruction surgery to repair posterolateral rotatory instability of the knee. At the request of the surgeon, ranitidine was slowly administered intravenously immediately before the patient was transferred to the operating room to reduce the incidence of acid reflux. A few minutes later, during the transfer of the patient, anaphylaxis developed with hypotension, nausea, dyspnea, change in consciousness and urticaria. The patient had no previous history of any allergic tendency. After appropriate management, he recovered without complication. Following surgery, an allergic skin prick test was performed to determine if the patient was allergic to any of the drugs used during the surgery. According to the results, only ranitidine showed a positive reaction. (Korean J Anesthesiol 2009;56:79~82)
이시영,윤화영,성준경,박흥석,Lee. Si-Young,Yun. Hoa Young,Sung. Joon Kyung,Park. Houng Sek 한국방재학회 2012 한국방재학회논문집 Vol.12 No.2
본 연구는 1945년부터 2010년 까지 우리나라 주요 산불정책 변화 분석과 향후 정책대안을 마련하기 위하여 광복이후 산림청 발족 이전(1945~1966), 산림청 발족 이후 산림기본계획 수립이전(1967~1972), 제1차 산림기본계획기(1973~1978), 제2차 산림기본계획기(1979~1987), 제3차 산림기본계획기(1988~1997), 제4차 산림기본계획기(1998~2007), 제5차 산림기본계획기(2008~현재) 등 7단계로 나누어 분석한 결과, 1996년 4월 강원 고성산불을 계기로 산불조직, 제도 및 기술의 발전을 가져왔으며, 향후에는 보다 체계적인 지역단위 산불대응체계의 정착과 훈련이 필요하다. In this study, we studied and analyzed the change of forest fire policies in order for helping to improve a established forest fire policies. We divided into 7 periods for easier analysis. The first period was `the period of pre-establishing the Korea forest service after independence (1945-1966). And the second was `the period of pre-basic plan of forest` after establishing the Korea forest service(1967-1972). The third was `the period of the first basic plan of forest`(1973-1978). The forth was `the period of the second basic plan of forest`(1979-1987). The fifth was `the period of the third basic plan of forest`(1988-1997). The sixth was `the period of the forth basic plan of forest`(1998-2007). And the seventh was `the period of the fifth basic plan of forest`(2008-present). In the result, the fire fighting organization, system and techniques was made rapid progress after Goseong forest fire in Kangwon region in April 1996. For future large scale forest fire attacking, the establishment of more systematical regional forest fire action plan and exercise from this would be needed.
전신마취하 관절경 무릎 수술 시 지혈대 감압이 Bispectral Index에 미치는 영향
최정현 ( Jeong Hyun Choi ),성준경 ( Joon Kyung Sung ),박성욱 ( Sung Wook Park ),강화자 ( Wha Ja Kang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4
Background: Tourniquet deflation during lower extremity surgery affects the hemodynamics and metabolism of the patient, which can affect brain activity. This study examined the changes in brain activity during tourniquet deflation by measuring the bispectral index (BIS). Methods: The BIS was measured during surgery in forty patients who had received knee arthroscopic surgery under general anaesthesia. The BIS was measured 5 minutes before deflation (DB5) and 5 minutes after deflation (DA5). Results: The BIS at DB5 and DA5 was 50.2±9.9 and 44.4±10.4, respectively. The BIS of DA5 was significantly lower than that of DB5 (P<0.05). Conclusions: Tourniquet deflation during lower extremity surgery decreases the BIS associated with hemodynamic and metabolic changes. However, its clinical significance in neurologically critical patients, such as geriatric or neurologically disabled patients, remains to be clarified. (Korean J Anesthesiol 2009;56:371~4)
복강경수술 시 Esomeprazole 전처치가 위산도 변화에 미치는 영향
이승일 ( Seung Il Lee ),최영규 ( Young Kyoo Choi ),강화자 ( Wha Ja Kang ),박성욱 ( Sung Wook Park ),이재우 ( Jae Woo Yi ),성준경 ( Joon Kyung Sung ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3
Background: The use of CO2 for pneumoperitoneum during laparoscopic surgery provokes a decrement in the gastric pH. Since the incidence rate of PONV increases after laparoscopic surgery, the possibility of lung aspiration of gastric juice with a low pH during a postanesthetic emergence may increase and this could be fatal for the patient. We conducted this study to determine the effects of esomeprazole premedication on inhibiting the decrement of the gastric pH during laparoscopic surgery. Methods: 40 adult patients with no underlying diseases were chosen and 20 patients each were grouped as C (the control group) and E (the esomeprazole group). In both group, 0.2 mg glycopyrrolate was given intramuscularly 30 minutes prior to the surgery. In group E, esomeprazole was given orally 2 hours prior to the surgery. The pH, PaCO2, and P(ET)CO2 were measured via pH probe, an ABGA and an capnogram at preinsufflation and 15, 30 and 60 minutes after the CO2 insufflation and right before CO2 exhaustion (predeflation). Results: Comparing the measurements of the gastric pH between group E and group C, all the results showed a significant increase in group E (P<0.05). The difference of the PaCO2 and P(ET)CO2 in the two groups was not significance. Conclusions: In contrast to the decrease in the gastric pH as the PaCO2 and P(ET)CO2 increased in group C, the gastric pH in group E remained high until the end of the surgery despite the increase in the PaCO2 and P(ET)CO2. Esomeprazole premedication seem to have an effect for inhibiting the gastric pH decrement regardless of the increase in the PaCO2 and P(ET)CO2 during laparoscopic surgery. (Korean J Anesthesiol 2009; 56: 259~64)