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기관내 삽관시 Lidocaine 정주가 혈역학적 변화에 미치는 영향
최윤,임승운,문선학 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.2
A randomised trial was conducted in 13 patients to assess the circulatory response to endotracheal intubation. None of the patient suffered from heart or lung disease, all were premedicated with lorazepam 0.4 mg/kg, glycopyrrolate 0. 004 mg/kg intramuscularly 30-60 min. beforehand. Patients received vecuronium 0.01mg/kg intravenously for precrurarization and 2 min. later 6 patients received lidocaine 2 mg/kg intravenously and 7 patients received saline 1 ml/20 kg intravenously. Blood pressure and pulse rate were measured repeatedly by an automatic recording device (Datascope 2100A) and cardiac output was measured by noninvasive cardiac output monitor with suprasternal doppler ultrasound. After laryngoscopy and intubation, systolic arterial pressure increased 19.7% mean arterial pressure 18.8% from baseline values in lidocaine group (p$lt;0.05), and systolic arterial pressure increased 21.4% mean artereal pressure 19.8% from baseline values in saline group (p$lt;0. 05). Pulse rate increased 30.9% from baseline values in lidocaine group (p$lt;0.05) and 32.5% from baseline in saline group (p$lt;0.05). But there was no intergroup difference in systolic arterial pressure, mean arterial pressure and pulse rate. Diastolic pressure of both group did not increase significantly and did not show intergroup difference. Cardiac output increased 35.3% from baseline values in lidocaine group (p$lt;0.05). We concluded that lidocaine 2 mg/kg infusion intravenously 2 min prior to laryngoscopy and intubation does not prevent hemodynamic reaction evoked by endotracheal intubation.
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Enflurane 마취시 유도저혈압을 위한 Sodium Nitroprusside 의 용량 및 심혈관계 변화
김광우,노규정,이병용,문선학,임승운,석세일 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.5
Sodium nitroprusside given by intravenous drip has been used to control hypertensive crises since 1929. Its evanescent action makes it suitable for controlled hypotension during general anesthesia with enflurane. The patients (n=10) were all undergoing Cotrel-Dubousset instrumentation for the operative treatment of scoliosis or spinal stenosis. Hemodynamic variables were obtained during administration of sodium nitroprusside. Mean arterial pressure was decreased to 50-60mmHg, while cardiac output, central venous pressure, systemic vascular resistance showed only minor changes. The average dosage of sodium nitroprusside (ug/kg/ min), plotted against age, showed a significant correlation (p$lt;0.05, r= -0.63). The amonut of whole blood transfused during operation was 5.7±2.2 units (mean±SD) and postoperative hemoglobin and hematocrit (11.19±1.21g/dl, 33.49±3.79%, respectively, mean±SD) were singificantly lowered than preoperative hemoglobin and hematocrit (12.94±1.78g/dl, 37.22±4.88%, respectively, mean±SDlobin: p$lt;0.004, hematoorit: p$lt;0.006)
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