http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례보고 : 조립 오류로 인한 자가충전호흡낭 소생기의 기능이상
김덕규 ( Deok Kyu Kim ),김유일 ( Yu Yil Kim ),이지선 ( Ji Sun Yi ),임형선 ( Hyung Sun Lim ),김동찬 ( Dong Chan Kim ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
A self-inflating bag resuscitator is universally used to ventilate patients during cardiopulmonary resuscitation and transfer. This device can be reused after sterilization and reassembly, and the mis-assembly of a resuscitator can possibly happen. We report here on a case of mis-assembly of a resuscitator valve that resulted to barotrauma and instability of a patient. (Korean J Anesthesiol 2008; 55: 731~5)
증례보고 : 어려운 기도에서 굴곡성 기관지경을 사용한 경비 기관내삽관 시 효과적인 비출혈 제거
김명환 ( Myeong Hwan Kim ),손지선 ( Ji Seon Son ),임형선 ( Hyung Sun Lim ),김덕규 ( Deok Kyu Kim ),김동찬 ( Dong Chan Kim ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.5
Nasal bleeding related to nasal trauma is the most common complication of nasotracheal intubation with a fiberoptic scope. When nasotracheal intubation with a fiberoptic scope is performed, profuse bleeding from the nasal cavity makes it difficult to handle a fiberoptic scope and may cause a hypoxemia. So when nasal bleeding occurs, it is important to suction the nasal cavity for easy handling of a fiberoptic scope. But, it may be difficult to suction in a nasal cavity with a fiberoptic suction port only. We report a patient with nasal bleeding following nasotracheal intubation with a fiberoptic scope because of articular trismus, and successful nasotracheal intubation utilizing a fiberoptic scope by suctioning with an extra suction apparatus. (Korean J Anesthesiol 2008;55:618~20)
당뇨병성 자율신경병증 환자에서 Desflurane에 의한 혈역학적 변화
김덕규 ( Deok Kyu Kim ),김은아 ( Eun Ah Kim ),서명조 ( Myung Jo Seo ),임형선 ( Hyung Sun Lim ),고성훈 ( Seong Hoon Ko ),이상귀 ( Sang Kyi Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
Background: Diabetic cardiovascular autonomic neuropathy (CAN) causes perioperative cardiovascular instability. A rapid increase in the desflurane concentration induces tachycardia and hypertension (HTN). This study examined the effects of the cardiovascular response to desflurane on patients with diabetic CAN. Methods: Forty diabetes mellitus (DM) patients with CAN were divided two groups: one with HTN (DM+HTN group, n=17) and one without HTN (DM group, n=23). The control group (n=20) was composed of healthy patients without DM or HTN. In each group, the concentration of desflurane inspired was increased abruptly to 12.0 vol% 2 minutes after a thiopental injection. The target was to produce an end-tidal concentration of desflurane of 10.0 vol%, which was maintained until the end of the study by adjusting the vaporizer dial setting. The heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were measured. Results: The HR, MAP and CI increased significantly in all three groups when compared with the baseline (P<0.05). Additionally, the HR and MAP showed did not differ among the three groups at any of sampling times. However, the CI of the DM group and the DM+HTN group differed when compared with the control group at 90 and 120 seconds after intubation (P<0.05). Conclusions: In diabetic patients with CAN, the hemodynamic responses to a rapid increase in desflurane concentration are similar to those in non-diabetic patients before endotracheal intubation. However, after endotracheal intubation, increments in CI are blunted in diabetic patients with CAN. (Korean J Anesthesiol 2009;57:560∼5)
고위 경추 손상 환자에서 전신 마취 후 발생한 음압성 폐부종
이지혜 ( Ji Hye Lee ),두아람 ( A Ram Doo ),차경남 ( Kyung Nam Cha ),임형선 ( Hyung Sun Lim ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.2
음압성 폐부종은 상기도 폐쇄가 발생한 후 흉강내 음압이 형성되어 발생하며, 근육이 잘 발달되어 있는 환자에서 보다 큰 흉강내 음압이 형성되기 때문에 음압성 폐부종이 잘 발생한다. 하지만 증례의 환자와 같이 고위 척수신경의 손상으로 인하여 사지의 근력이 저하되어 있는 경우에서도 환기능력이 유지된다면 음압성 폐부종이 발생할수 있으므로 주의해야 한다. Negative pressure pulmonary edema is also known as post obstructive pulmonary edema. This is life threatening complication of post general anesthesia. This is secondary to generating large negative intrathoracic and transpulmonary pressure. These have generally been reported to be secondary to trying to inspire against an obstructed airway. Inspiratory force needs a muscle power but a quadriplegia patient has low respiratory muscle power. We are report a negative pressure pulmonary edema in quadriplegia patient.
임상연구 : 고농도 Desflurane 흡입에 의한 심혈관계 반응의 연령에 따른 차이
김은아 ( Eun Ah Kim ),김성규 ( Seong Kyu Kim ),임형선 ( Hyung Sun Lim ),고성훈 ( Seong Hoon Ko ),한영진 ( Young Jin Han ),송희선 ( He Sun Song ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: The inhalation of high concentrations of desflurane transiently increases the cardiovascular responses. This study examined the effects of age on the cardiovascular response to desflurane. Methods: Eighty two patients were divided into one of three groups: under 3 years (Group 1), 20-50 years (Group 2), and over 65 years (Group 3). In each group, the inspired concentration of desflurane was increased abruptly to 12.0 vol% 2 minutes after a thiopental injection. The heart rate, blood pressure (BP), cardiac index (CI), End-tidal concentration of desflurane (ETdesf), and end-tidal concentration of CO2 were measured at the baseline and every 30 seconds. Results: The heart rate, BP, and CI increased transiently in the three groups compared with the baseline. The ETdesf increased more rapidly in Groups 1 and 3 than in Group 2. The ETdesf to reach the maximal mean arterial pressure (MAP) was highest in Group 3 among three groups. The relative maximal HR to the baseline value was similar in the three groups, but the relative maximal MAP to baseline value was significantly highest in the elderly patient group. The times to reach the maximal HR and BP were shortest in Group 1 among three groups. There were no significant differences in the CI between three groups. Conclusions: The inhalation of a high concentration of desflurane increases the HR, BP and CI transiently in all age groups. In pediatric patients, HR and BP increases more rapidly than in young adults and elderly patients. The relative maximal MAP to the baseline value is higher in elderly patients. (Korean J Anesthesiol 2007; 53: 435~40)
임상연구 : 고혈압 환자에서 Desflurane에 의한 혈역학적 변화
김은아 ( Eun Ah Kim ),이정우 ( Jung Woo Lee ),임형선 ( Hyung Sun Lim ),손지선 ( Ji Seon Son ),고성훈 ( Seong Hoon Ko ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.5
Background: A rapid increase in the desflurane concentration induces tachycardia and hypertension and increases the plasma catecholamine concentration. This study compared the desflurane-induced hemodynamic responses in hypertensive patients with those of normotensive patients. Methods: Sixty patients, 30 normotensive patient (group 1) and 30 hypertensive patients (group 2), were scheduled to undergo elective surgery under general anesthesia. The hypertensive patients have been taking regular antihypertensive drugs and their blood pressure and heart rate was well controlled. Thirty normotensive patients were not premedicated. The inspired concentration of desflurane through the mask was increased abruptly to 12.0 vol%. The target was to produce an end-tidal concentration of desflurane (ETdesf) of 10.0 vol% which was maintained until the end of the study by adjusting the vaporizer dial setting. The heart rate (HR), blood pressure (BP), cardiac index (CI), systemic vascular resistance (SVR), ETdesf, end-tidal concentration of carbon dioxide, and peripheral oxygen saturation were measured at the baseline and every 30 seconds for 5 minutes after inhaling of desflurane and for 2 minutes after intubation. Results: The HR, BP, and CI increased significantly in the two groups compared with the baseline. However, the HR, blood pressure, CI, SVR, and ETdesf were similar in both groups. In addition, there were no significant differences of hemodynamic changes between the β-blocker and the calcium channel blocker in the hypertensive patients. Conclusions: In patients with well-controlled hypertension, the hemodynamic responses to desflurane are similar to those in normotensive patients. (Korean J Anesthesiol 2007; 52: 516~20)
증례보고 : 경막천자 후 두통으로 오인된 자발성 두개내 저압
김덕규 ( Deok Kyu Kim ),손지선 ( Ji Seon Son ),김동찬 ( Dong Chan Kim ),이정우 ( Jeong Woo Lee ),임형선 ( Hyung Sun Lim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2
Spontaneous intracranial hypotension (SIH) occurs without any preceding events such as lumbar puncture, surgery, trauma, or medical illness. It is characterized by a postural headache that is aggravated whilst in the erect or sitting position, and is relieved in the supine position. A postural headache usually resolves either spontaneously or with conservative treatment. An epidural block is a very important treatment for lumbago and is mostly performed for pain control. However, an incidental dural puncture is possible during epidural block and anesthesiology and pain medicine doctor should be familiar with an epidural block. Radioisotope cisternography is a highly sensitive, reliable and safe technique for confirming of the presence and location of cerebrospinal fluid (CSF) leakage. We report two cases of spontaneous intracranial hypotension that was diagnosed by SIH through cisternography in a situation where the post-dural puncture headache was primarily suspected as being the cause. If a postural headache occurs after an epidural block through an epidural needle without CSF leakage, other causes e.g. dural puncture need to be identified. (Korean J Anesthesiol 2007; 52: 245~8)