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이나형,최성호,이기영,최성호 대한마취통증의학회 2009 Anesthesia and pain medicine Vol.4 No.4
Background: We investigated the effect that replacement with Ringer’s lactate (RL) for preoperative NPO deficits might have on blood glucose concentration in children undergoing strabismus surgery. Methods: Sixty children scheduled for strabismus surgery were enrolled in this study and RL was administered to all subjects for replacement of preoperative NPO deficits. Patients were randomly assigned to three groups according to the types of maintenance fluid employed during anesthesia. RL, 5% dextrose in one-fourth strength normal saline (D51/4NS), and an equal volume of D51/4NS and RL each were used as maintenance fluids for Group 1, 2, and 3, respectively. After glycopyrrolate 0.004 mg/kg IV, anesthesia was induced with propofol 3 mg/kg and rocuronium 0.6 mg/kg. After tracheal intubation, anesthesia was maintained with 2−3 vol% sevoflurane in 50% air with oxygen. Blood glucose concentrations were checked from blood samples through a 22 gauge catheter inserted into a saphenous vein at the time of induction, 30 and 60 min after induction of anesthesia. Results: There were no significant differences in baseline blood glucose levels at the time of induction of anesthesia among three groups. And the mean blood glucose concentrations remained unchanged throughout the study period in all groups. None of the patients were found to be hypoglycemic or hyperglycemic throughout the study period. Conclusions: This study shows that the replacement of preoperative NPO deficits with RL maintains the blood glucose concentration within physiological range throughout the operation and anesthetic recovery phase, regardless of the types of maintenance fluid.
최은미,최승호,이나형,민경태 대한마취통증의학회 2009 Anesthesia and pain medicine Vol.4 No.2
Background: Sympathetic stimulation associated with post-craniotomy pain might subsequently increase blood pressure resulting in postoperative complications. We studied whether scalp nerve blocks would reduce the severity of postoperative pain. Methods: Thirty-two patients undergoing craniotomy were randomly allocated to either the ropivacaine group (n = 16) or the saline group (n = 16). After the skin closure, we carried out scalp nerve blocks with ropivacaine (0.75%) or saline (0.9%). Visual analog scale scores (VAS), mean arterial pressure, and heart rate were measured at 0.5, 1, 2, 4, 6, 12, 24, and 48 h after extubation. Tramadol 50 mg iv was used as rescue analgesic. The delay before administration of the first analgesic and cumulative dose of rescue analgesic for the first 48 h postoperatively were measured. Results: The ropivacaine group had lower analgesic requirements than the saline group (P = 0.008). The delay before administration of the first analgesic was not different significantly between two groups. VAS was similar between the two groups at each time interval. Postoperative MAP and HR were not significantly different between two groups. VAS did not correlate with these hemodynamic variables. Conclusions: Although scalp nerve blocks with ropivacaine reduced the analgesic requirement, they did not provide the sufficient pain relief.