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술후 통증제거를 위한 경막외강내로의 Morphine 과 Nalbuphine 의 비교
이강원,김종선,송경상,김광성,박경희 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.3
This study was performed to compare the effects of epidural morphine and nalbuphine with general anesthesia for relief of pain after abdominal surgery. Patients were devided into three groups like Group I(General anesthesia), II(Epidural mor- phine) and III(Epidural nalbuphine). Pain score, gas passing and ambulation time were checked in all groups respectively. And side effects inclduing urinary retention and respiratory changes were evaluated too. The results were as follow. 1) The effects of epidural morphine and nalbuphine on pain relief were better than general anesthesia. And the effect of epidural morphine was superior to epidural nalbuphine too. 2) Ambulation time was the shortest in epidural morphine group. 3) Urinary retention, gas pasing time and respiratory changes were similar in a11 groups.
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지주막하 마취에서 Bupivacaine 과 Tetracaine 의 비교
박경희,김효정,송경상,김광성 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.2
Background : Tetracaine has been the most commonly used long-acting spinal anesthetic agent. Recently, hyperbaric bupivacaine was introduced to be useful agent, and has been reported to produce the better quality of anesthesia. The aim of the present investigation was to compare the anesthetic effects of 0.5% hyperbaric bupivacaine and 0.5% hyperbaric tetracaine spinal anesthesia. Methods : 40 ASA Class I patients undergoing lower extremity operation were randomly distributed to two groups. Group A(n=20) received 15mg, 0.5% bupivacaine in 8% glucose, while Group B(n=20) received 15mg, 0.5% tetracaine in 10% glucose in the lateral decubitus position(L3,4 interspace). We evaluated the sensory and motor blockade, cardiovascular effects and the incidence of tourniquet pain. Results : The mean maximum cephalad spread of analgesia was higher in bupivacaine group(T5) than in tetracaine group(T6) and the spread time was more rapid in bupivacaine group(13.1±3.3min.) than in tetracaine group(15.8±4.3min.), but thereere no statistical significances. Tetracaine group was earlier onset of motor block and the duration of complete motor block in tetracaine group was significantly longer than in bupivacaine group. The mean decrease in systolic and diastolic blood pressure was 10% to 25% in both groups and more marked in tetracaine group. The incidence of tourniquet pain was greater in tetracaine group than in bupivacaine group. Conclusions : The quality of anesthesia obtained with bupivacaine may be superior to that produced by tetracaine. We concluded that 0.5% hyperbaric bupivacaine was suitable for short orthopedic or lower abdominal surgery because of less incidence of hypotension, shorter duration of motor block and lower incidence of tourniquet pain. (Korean J Anesthesiol 1997; 33: 283∼290)
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척추마취시 Midazolam 으로 진정 후 Flumazenil 의 각성효과
박경희,이강원,박미경,김종선,송경상,김광성 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.8
The effects of flumazenil, a benzodiazepine antagonist were evaluated in a clinical study in which midazolam (0.1 mg/kg) was used as a sedative agent during the spinal anesthesia. Sixty patient were divided into two groups as group F (n=30) and group S (n=30). Flumazenil 0.3 mg (3 mL) in group F and saline 3 mL in group S were administered at the end of surgery. Blood pressure, pulse rate, respiratory rate and oxygen saturation (SaO₂) were checked just before and at, 5, 15, 30, 60 and 120 minutes after the administration of flumazenil or saline. Also we evaluated the level of conciousness and orientation in time and space. The results were as follows; 1) Changes in blood pressure, pulse rate and respiratory rate were not different between two groups, exeept SaO₂ was which increased significantly in the flumazenil group. 2) The flumazenil group revealed improved level of consciousness and orientation in time and space which began 5 minutes after flumazenil and was maintained 30 minutes thereafter. 3) We could not observe the any side effects of flumazenil.
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Tetracaine 척추마취후 발생한 지속적 근간대성 발작의 증례보고
박경희,박미경,이강원,송경상,김광성 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.5
The subarachnoid injection of local anesthetics to obtain lower limbs anesthesia has been used since 1899 by first August Bier. Transient neurologic complications during and immediately after spinal anesthesia are rare ; however we recently encountered a case of CNS toxicity that was nonspecific and severe in a 30 year old man who had a hemiorrhaphy under spinal anesthesia using tetracaine with epinephrine. The exact cause of seizure attack was unknown, but we suspected it tetracaine induced CNS toxicity due to vascular absorption or cephalard movement in CSF.
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