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실험연구 : 흰쥐 횡격막신경근 표본에서 Nimodipine이 비탈분극성 근이완제의 용량반응곡선에 미치는 영향
조인해 ( In Hea Cho ),김윤진 ( Yun Jin Kim ),백희정 ( Hee Jung Baik ),김종학 ( Jong Hak Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5
Background: Interactions between nimodipine, a calcium channel blocker, used perioperatively for the treatment of subarachnoid hemorrhage, and vecuronium, rocuronium, and atracurium were studied with phrenic nerve-hemidiaphragm preparations of rats. Methods: Male 200-300 g Sprague-Dawley rats were randomly allocated into four groups (control, NMD5, NMD50 and NMD500 group, n = 10, respectively) according to the nimodipine concentration, and three groups (control, NMD2D and NMD7D, n = 10, respectively) according to the pretreatment duration. A square wave 0.1 Hz supramaximal stimuli was applied to the phrenic nerve-hemidiaphragm preparation and the twitch height response was recorded with mechanomyography. The dose-response curves were measured, and ED5, ED50, ED90, and ED95 of each vecuronium, rocuronium, and atracurium in different concentrations of nimodipine of 5, 50, and 500 ng/ml and rocuronium in pretreatment with nimodipine 2.5 mg/kg/d for 2 and 7 days were calculated using an inhibitory sigmoid Emax model. Results: The dose-response curves of rocuronium and atracurium were significantly shifted to the left in NMD500 group, and significantly shifted to the right in NMD7D group (P < 0.05). In NMD500 group, ED50, ED90, and ED95 of rocuronium and atracurium were significantly reduced, and those of rocuronium in NMD7D group were significantly increased compared with the control group (P < 0.05). Conclusions: Nimodipine 500 ng/ml in the phrenic nerve-hemidiaphragm preparation of rat increased sensitivity to rocuronium and atracurium, and the dose-response curve was significantly shifted to the left, but following pretreatment for 7 days, nimodipine decreased the potency of rocuronium, and the dose-response curve was significantly shifted to the right. (Korean J Anesthesiol 2006; 50: 572~8)
민홍기,이유미,최윤,이청,조인해,정성량,정월선 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.2
Background : Epidural pressure is reported to change in accordance with intracranial pressure (ICP). As ICP changes during general anesthesia, it is also possible that epidural pressure may change during general anesthesia. The aim of this study was to obtain trends of epidural pressure change during general anesthesia. Methods: Eighteen patients scheduled for gastrectomy were allocated for this study after obtaining informed consent. Epidural catheter was inserted at T7-8, T8-9 interspace before induction. Catheter was connected to a pressure transducer after calibration. General anesthesia was induced with thiopental sodium (5 mg/kg), succinylcholine (1 mg/kg), followed by 3% enflurane. Anesthesia was maintained with 50% N2O in oxygen and 1∼2% enflurane with vecuronium (0.1 mg/kg). Each patients was mechanically ventilated with tidal volume of 10 ml/kg at a rate of 10 bpm. Epidural pressure was measured before induction, at the time of injection of thiopental sodium, succinylcholine, laryngoscopy, intubtion, surgical incision, and 30 minutes after surgical incision. Stastical analysis was done using repeated measures of ANOVA with Helmert option (p<0.05). Results : Epidural pressure significantly changed dynamically during general anesthesia. Epidural pressures increased at intubation and at 30 minutes after surgical incision when compared with those at the time of laryngoscopy and incision, respectively (p<0.05). Conclusion : Our study indicates that epidural pressures changes dynamically during induction period of general anesthesia and also showed possibility that epidural pressure monitoring could be used instead of more invasive direct ICP monitoring. (Korean J Anesthesiol 1999; 36: 232∼238)