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증례보고 : 회복실에서 Ketorolac 투여 후 발생한 아나필락시스
전성식 ( Sung Sik Chon ),김진호 ( Jin Ho Kim ),안은경 ( Eun Kyoung Ahn ),유은숙 ( Eun Sook Yoo ),김윤석 ( Youn Suk Kim ),박정복 ( Jung Bok Park ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Anaphylaxis is an acute onset, potentially fatal systemic allergic reaction. Multiple agents can cause anaphylaxis in the perioperative setting. Ketorolac is a potent analgesic drug and has been widely used for postoperative pain control. A 38-year-old male patient, who had surgery under general anesthesia without any problems, was scheduled for a spinal fusion. There were no problems during anesthesia. In post anesthetic care unit, he was given 30 mg of ketorolac intravenously. After the ketorolac injection, severe hypotension and tachycardia developed and delayed skin rash and wheel appeared. The patient was given epinephrine, antihistamine and steroid. The patient recovered without any significant complications. (Korean J Anesthesiol 2008; 55: 761~4)
파형도관(corrugated tube)을 부착하여 사용할 때 Laerdal 소생낭이 전달하는 산소 농도의 변화
김기준,고신옥,전성식,남용택,구민우 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.2
Background : In emergency rooms or intensive care units, we have shown delivery of higher fractions of oxygen promptly for respiratory or cardiac arrest patients by using resuscitating instmments, especially the resuscitator bag. Previously we studied the variables affecting the fraction of delivered oxygen (F_dO_2) under varying ventilating techniques and conditions. In this paper, using corrugated tubes as substitute for reservoir bag, we measured F_dO_2 and compared two. Methods : We designed a special wooden box, which held the Laerdal resuscitator bag. We measured the F_dO_2 with or without reservoir bags and corrugated tubes at various tidal volumes, respiration rates and oxygen flows. Results : With a 500 ml corrugated tube, F_dO_2 were higher than with a 250 ml corrugted tube but lower than with a reservoir bag. Conclusions : Corrugated tube is less effective to deliver high fractions of oxygen than the reservior bag, but it is acceptable to use corrugated tube as a substitute for a reservior bag than not to use it at all. (Korean J Anesthesiol 2000; 38: 327~332)
척추후측만곡을 동반한 만성폐쇄성폐질환 환자에게 Nasal Mask BiPAP을 이용한 호흡보조
고신옥,방은치,전성식,박병학,남용택,이원영 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.6
Chronic fatigue of the respiratory muscles has contributed to the decreased ventilatory capacity and reduced excercise tolerance of individuals with COPD, especially in kyphoscoliosis. Nasal mask BiPAP has been shown to be useful for the patient with nocturnal muscle fatigue and COPD. A 35-year-old man with severe kyphoscoliosis was admitted to ICU due to acute respiratory failure. He had been diagnosed of COPD and had been intubated with mechanical ventilatory support for 7 times. This time he was intubated with ventilatory support, too, in ICU and readmitted to the ICU for severe hypoxemia and hypercarbia from general ward. Thereafter he refused the intubation. Nasal mask BiPAP ventilatory support system was applied and IPAP, EPAP level being adjusted to the 12, 4 cmH2O under monitoring vital signs and arterial blood gas analysis. His condition was improved and discharged home with support of nasal mask BiPAP system after 33 day-stay in the ICU. (Korean J Anesthesiol 1997; 33: 1207∼1211)
Sufentanil 이 토끼의 심근 분리조직에 미치는 영향
김원옥,남순호,전성식 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.1
Background: The synthetic narcotic sufentanil has been used in clinical practice for anesthetic induction and maintenance. But there is little information concerning its direct effects on heart. The purpose of this study is to evaluate the direct effects of sufentanil on contracture of ventricular myocardium. Methods: Isometric contraction of isolated right ventricular papillary muscle of rabbit was measured under 0.2 Hz electrical stimulation in Krebs solution. Peak developed force(Fo), maximum rate of rise of developed force(+dF/dt_(Max)), maximum rate of fall of developed force(-dF/dt_(Max)) were analyzed. Results: There were no statistically significant differences in frequency of isometric contraction from the 100% baseline value in time-matched control group. Sufentanil, in concentration of 0.01-0.1 mM, increased F, and -dF/dt_(max) was decreased especially in concentration of 0.1 mM but not +dF/dt_(Max) Fo +dF/dt_(max) and -dF/dt_(max) were statistically different from time-matched control group in concentration of 0.1 mM. Conclusions: We conclude that sufentanil has mild contracture effect on ventricular muscle of rabbit directly.