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고신옥,방은치,이세실 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.2
Background: To maintain adequate oxygen delivery and oxygen consumption is essential to care of the critically ill patients. The authors undertook this study to evaluate the patterns of oxygen delivery and oxygen consumption in hemodynamically unstable patients. Methods: Twenty hemodynamically unstable patients were studied, Pulmonary artery catheters were inserted and the hemodynamic variables including oxygen delivery and oxygen consumption were calculated immediately, and 1, 8, 24 hours, respectively after catheterization, and immediately before catheter removal. Patients were divided into survivor and nonsurvivor groups, and the hemodynamic data were compared. The same patients were divided into septic and nonseptic patient groups and same study was done. Results: There were no statistical differences in oxygen delivery and oxygen consumption between the survivors and the nonsurvivors, and the septic and the nonseptic patients. But oxygen delivery and oxygen consumption of the survivors were higher than those of the nonsurvivors. Conclusions: Although we could not find statistical significance, we concluded that supranormal level of oxygen delivery and oxygen consumption could improve the outcome of critically ill patients.
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홍정연,이명희,이세실,지영석,강진구,임웅철,강희륜 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6
Background : The pharmacologic interactions between propofol and adjuvant agents have increasingly been recognized as clinically important and the improved knowledge of these is being used to optimise the quality of total intravenous anesthesia. The aim of the present study was to investigate the effects of fentanyl, fentanyl-midazolam, and fentanyl-ketorolac as analgesic supplementations on the induction of propofol anesthesia with Diprifusor TCI. Methods : Sixty ASA 1 patients undergoing elective diagnostic laparoscopy were randomly allocated to three groups equally according to injected adjuvant agents : group F, fentanyl 1 μg/kg; group FM, fentanyl 1μg/kg-midazolam 0.05 mg/kg; group FK, fentanyl 1μg/kg-ketorolac 0.5 mg/kg IV before induction. Propofol target concentration of 4 μg/ml was preset and unconsciousness with 3 min was considered as successful. Induction dose, time, success rate of induction, calculated and effective concentration, context sensitive decrement time when awakening concentratios 1.2μg/ml, vital signs and side effects were checked. Results : Successful induction rate was 55% in the group F, 100% in the group FM, and 85% in the group FK (P< 0.05). Induction time and dose were significantly decreased in the group FM compared with the group F and FK. Calculated concentration, effective concentration, and context sensitive decrement time were significantly lower in the group FM than other groups. Injection pain score and postoperative pain score showed no differences between groups, but incidence of apnea was significantly increased in the group FM. Conclusions : Fentanyl-midazolam as a analgesic supplementation offered better quality of propofol induction using TCI, but showed increased incidence of apnea compared with fentanyl or fentanyl- ketorolac. (Korean J Anesthesiol 1999; 37: 966∼972)
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