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염종훈 ( Jong Hoon Yeom ),신우종 ( Woo Jong Shin ),김유정 ( Yu Jung Kim ),심재항 ( Jae Hang Shim ),전우재 ( Woo Jae Jeon ),조상윤 ( Sang Yun Cho ),김경헌 ( Kyoung Hun Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Background: We hypothesized that pressure control ventilation allows a more even distribution in the lung and better maintenance of the mean airway pressure than is achieved with volume control ventilation. We try to compare the effect of pressure control ventilation (PC) with that of volume control ventilation without an end-inspiratory pause (VC) during one-lung ventilation (OLV) in an anesthetized, paralyzed patient for performing thoracopic bullectomy of the lung. Methods: We ventilated 20 patients with VC and PC after the insertion of a thoracoscope in continual order for, at least for 15 minutes, for each, VC and PC procedure. At the end of VC and PC, the respiratory mechanics, gasometrics, and hemodynamic parameters were measured and collected. Results: We found no significant differences between VC and PC except for the peak inspiratory airway pressure (PIP), the mean airway pressure and the arterial oxygen partial pressure (PaO2). The PIP was significantly decreased from 27.0±6.0 cmH2O (VC) to 21.8±5.4 cmH2O (PC). The mean airway pressure was significantly increased from 8.6±1.6 cmH2O (VC) to 9.4±2.0 cmH2O (PC), and the PaO2 was significantly increased from 252.9±97.3 mmHg (VC) to 285.2±103.8 mmHg (PC). Conclusions: If PC allows mechanical ventilation with the same tidal volume and respiratory rate as VC during OLV, then PC significantly increases the PaO2 but this is not clinically significant, and the PC significantly decreases the PIP, which induces barotrauma or volutrauma when the PIP is excessively high. (Korean J Anesthesiol 2009;56:492~6)
흰쥐에서 척수강내로 투여한 AMPA 수용체 길항제, ACEA 2085 의 항통각과민 효과
전종헌(Jong Hun Jun),염종훈(Jong Hoon Yeom),김용철 대한통증학회 1999 The Korean Journal of Pain Vol.12 No.1
N/A Background: To study the role of spinal alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors in pain behaviors caused by mild bum, we examined the effect of intrathecal administered ACEA 2085, which has been recently characterized as a high potency competitive AMPA receptor antagonist, on the thermal hyperalgesia state induced by mild burn. Methods: A thermal injury was induced by applying the left hind paw to a thermal surface (52.5C) for 45 sec, Thermal escape latency of the hind paw was determined using an underglass thennal stimulus. Thirty min after thermal injury, the paw withdrawal latency (PWL) in injured paw of all groups fell from 10-12 sec to 5-7 sec. At that time, ACEA 2085 (0.01-0.1 mcg) and 6-cyano-7-nitroquin- oxalinedione (CNQX, 1-30 mcg) were injected through intrathecal catheters in rats with mild burn injury on the right hindpaw, And then, PWL were measured in the both hindpaw every 30 minutes for about three hours. Results: The intrathecal injection of ACEA 2085 produced a dose dependent reversal of the hyperalgesia in the right hindpaw and more potent than CNQX, but had no effect upon the response latency of the normal left hind paw even at the largest doses. All effects were observed at doses that had no significant effect upon motor function. Conclusions: Intrathecal ACEA 2085, highly selective AMPA receptor antagonist produce a dose- dependent reversal of the thermal hyperalgesia evoked mild burn injury. These results suggested that spinal AMPA receptor play an important role in the hyperalgesia induced by mild burn injury.
경막외 카테터의 고정방법과 수술후 카테터의 위치 변화와의 관계
신우종(Woo Jong Shin),염종훈(Jong Hoon Yeom),김희 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.1
N/A Background: Patients mover more as their post operative pain decrease. With the increase in movement there will be a tendency for the epidural catheter to migrate out of its original position. We studied 2 methods of flxation of the epidural catheter and the changes in position as related to patient movement. Methods: Patients were divided into two groups. Patients in Group A had their epidural catheter formed with a circular loop at the (skin) exit site then directed over the right shoulder. Group B had the epidural catheter flxed with Fixomull on the exit site without forming a circular loop. At the end of the operation, 3 mg of epidural morphine was injected via indwelling epidural catheter for postop- erative pain control. Epidural catheter depth was measured 24 hours later. Results: The overall rate of migration of epidural catheter was 61.9% In Group A, number of patients whose catheter migrated over 0.5 cm was 23(69.9%) with l4 inward migration and 9 outward migration. Group B had 16(53%) patients catheters migrate over 0.5 cm, with 2 patients having inward migration and 14 outward migration. Conclusions: Although the rates of migration of epidural catheter were similar for both groups, the number of inner migration of catheter, which could result serious complications, was significantly lower in Group B than Group A. Based on our results we recommend the epidural catheter be fixed without a circular loop.
김영선 ( Young Sun Kim ),신우종 ( Woo Jong Shin ),신중천 ( Joong Cheon Shin ),심재항 ( Jae Hang Shim ),전우재 ( Woo Jae Jeon ),조상윤 ( Sang Yoon Cho ),염종훈 ( Jong Hoon Yeom ),김경헌 ( Kyoung Hun Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
Background: High monitors are patients who require information on anesthesia and surgery and generally carry out active searches. These patients will benefit from more information related to surgery preoperatively whereas low monitors will benefit from less detailed information. This study examined whether or not patients` desire for information related to anesthesia and surgery differ according to their coping style classified by the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Methods: 465 patients were asked to fill out the questionnaires in APAIS, State-Trait anxiety inventory (STAI) and also to mark their perception on a 10 cm line in a visual analog scale (VAS). The APAIS with the other subjective measurements of anxiety were evaluated according to their gender, ASA class, past history of surgery and degree of education. Thirteen questionnaires were evaluated according to their coping styles. Results: High monitors wanted to know all 13 questions compared with low monitors, whereas low monitors preferred not to know (P<0.05). The APAIS has a significant relationship with the VAS and STAI (P<0.05). Women, patients with no prior history of surgery, and patients with ASA 2 were significantly more anxious than men, patients with a prior experience of surgery and ASA 1 patients, respectively (P<0.05). The VAS and APAIS were in good agreement in defining patients as anxious and there were significant correlations between the two instruments (P<0.05). Conclusions: The APAIS can be used as an efficient tool for identifying patients who are particularly anxious or require information. (Korean J Anesthesiol 2007; 53: 153~8)