Modified Neuroleptanesthesia with Haloperidol-Morphine-N₂O-O₂

安東愛 고려대학교 의과대학 1979 고려대학교 의과대학 잡지 Vol.16 No.1

Modified Neuroleptanesthesia with Haloperidol-Morphine-N₂O-O₂

安東愛,辛正順 고려대학교 의과대학 1979 고려대 의대 잡지 Vol.16 No.1

To obtain stable vital signs and unconsciousness during operation and rapid recovery from anesthesia, neuroleptanesthesia was performed with haloperidol in place of droperidol and morphine in place of fentanyl. We selected randomly 30 patients who had physically status 1 or 11 by the American Society of Anesthesiologist classification and the operating time was expectedly taken more than 2 hours. Then we observed blood pressure, pulse rate, electrocardiographic change, tidal volume, plasma CO₂ combing power. pest operative pain control, port operative nausea and vomiting. We classified into 2 groups. In group 1 haloperidol and morphine were injected 10-15㎎ intravenously individually. In group 11 haloperidol was injected 5-7.5㎎ and morphine 10-15㎎ intravenously. The following results were obtained. 1) In both groups, induction doses of morphine ranged from 0.17 to 0.28㎎/㎏ and of haloperidol 0.18 to 0.28㎎/㎏ in group 1 and 0.08 to 0.16㎎/㎏ in group 11. Additional doses of morphine ranged from 2.37 to 5.27㎎ and 50 minutes after induction were administrated. 2) In both groups, blood pressure and pulse rate were almost stable. 3) We observed arrythmia during induction on lead 11 by means of continous electrocardiographic monitoring. Among 24 patients, 3 cases cleveloped arrythmia. But it was not clear that arrythima was induced from haloperidol and morphine or not. 4) In every case, neostigmine and atropine were administrated from reversal of relaxants but antagonist was not used for morphine In both groups, tidal volume and plasma bicarbonate ion were not showed clinically significant changes. 5) In both groups, it was not great that difference of time and the number of cases that analgesics were administrated after operation. 6) Post operative nauea and vomiting were not found in group Ⅰ , but nausea and vomiting occured 2 cases each in group Ⅱ. 7) Extapyramidal sign was not noted in both groups. Therefore we expect that the above mentioned drugs become clinically and socioeconomically applied to our country because respiratory and cardiovascurlar system were stable and few complication was noted.

腎機能 障碍가 Gallamine triethiodide 作用時間에 미치는 영향

安東愛,辛正順 고려대학교 의과대학 1982 고려대 의대 잡지 Vol.19 No.1

It has been accepted generally that gallamine triethiodide is excreted unchanged in the urine.Furthermore, it has been assumed that the excretion of gallamine is the prime determinant of the duration of this compound and duration of action of gallamine is dose dependent. As a consequence many clinicians consider the use of gallamine in patients with established or Potential renal insufficiency or undergoing bilateral nephrectomy to be contraindicated. Prolonged, sometimes fatal, postoperative neuromuscular block has been reported after the use of gallamine in such patient. In order to study the influence of renal funtion on the neuromuscular blocking effect of largo single dose of gellamine, the duration of action was measured by single-twitch response using cat's sciatic nerve-gastrocnemius muscle preparation. Twenty-four cats were used for this study and subdivided 3 groups: group Ⅰ ; control group, group Ⅱ : unilateral renal pedicle ligation, group Ⅲ; 1) bilateral renal pedicle ligation. The animals were anesthetized with intra-muscular injection of nembutal, 60 ㎎/㎏. Following tracheostomy and intubation, the lungs were artificially ventialted with room air to deliver 40 ㎖/㎏ at a rate of 20 breaths/minute. And a stable pH, 7. 34-7.46 was maintained throughout the experiment. The body temperature was kept at 35-37℃ by thermoblanket. An infusion rate of Ringer's lactate solution was 10 drops/minute. The degree of neuromuscular block and time inteval taken to 25%(T25). 50%(T50), 75%(T75) and 90%(T90) recovery of control twitch height were measured after intravenous injection of gallamine 4㎎/㎏. Thc sciatic nerve was stimulated supramaximally by a single stimulus with square waves. (0.2msec duration, 0.1 ㎐ frequency) The results were as follows; 1) The mean time to produce 100% block was 140 sec in group Ⅰ, 128 sec in group Ⅱ, and 127 sec in group Ⅲ respectively. No significant time difference was observed between each groups. 2) The mean spontaneous recovery time to return to 90% recovery of control twitch height was 128 min. in group Ⅰ and 217 min. in group Ⅱ. Significant time difference was observed between group Ⅰ and group Ⅱ. 3) In group Ⅲ, spontaneous recovery to 25% twitch height of control twitch height was noted in 2 cases only and no recovery was noted in the order 6 cats. 4) In the absence of bilateral renal funtion, neuromuscular paresis would be occured after the use of large single dose of gallamine. The paresis may last many hours even a few day.

Lethal coronary air embolism caused by the removal of a doublelumen hemodialysis catheter -a case report-

문성하,안동애,최현정,김태희,빈정우,고동찬 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.3

Coronary air embolism is a rare event. We report a case in which an acute myocardial infarction occurred in the region supplied by the right coronary artery after the removal of a double-lumen hemodialysis catheter. Emergent coronary angiography revealed air bubbles obstructing the mid-segment of the right coronary artery with slow flow phenomenon distally. The patient expired due to myocardial infarction.

Haloperidol 전처치가 진정효과와 수술후 오심 및 구토에 미치는 영향에 관한 연구

길찬일,안동애,서충호,이경자,최세진,신정순 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.3

We used haloperidol as premedicants to be calm and reduce postoperative nausea and vomiting. From April to November, 1976, total 181 cases were evaluated. The results were as followings. 127 cases (70.2%) were indifferent to their surroundings; 22 cases (12.2%) drowsy and completely indifferent to, but, they answered questions adequately. We experienced postoperative nausea and vomiting in subjects (8.3% of all); in each analgesic and anesthetic drug; of 87 patients 5 (5.7%) in pentazocine, of 75 patients 5 (6.7%) in meperidine, no cases were found in halojhane, of 9 paitents 5 (55.6%) in diethyl-ether.

Pain clinic에서의 임상경험

김인현,안동애,임경임 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.1

Authors have expcrienccd the treatment for the uppermost frcquent cases, herpes zoster, frozen shoulder and low back pain among those who visited our pain clinic. 1. Herpes zoster The Patients who received the treatment within 4 weeks of the onset of the disease, not only healed herpes without leaving post herpetic neuralgia but also crust formation was fast. 2. Frozen shoulder Over 90% of the patients who received suprascapular nerve block accompanied with trigger points electric stimulation was very efficient prncedure, futhermore, authors felt keenly the necessity each patients co-operation and individual endurance for this treatment. 3. Low back pain An epidural steroid administration to the patients who did not have any organic disturbances was effective treatment. If this non-effective, search other cause of the disease or operation was advisable one.

지속적 미추 차단을 이용한 항문 부위 수술 후 통증 치료

이원기(Won Gi Lee),안동애(Dong Ai An) 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1

Background: Continuous caudal epidural block is a useful method in postoperative pain control after perianal surgery. But caudal epidural block has the potential of developing adverse effects such as urinary retention. The goal of this study is to evaluate the analgesic and adverse effect of bupivacaine with fentanyl through continuous caudal epidural block in relation to the concentration of bupivacaine. Methods: We divided the patients randomly into two groups. For group l(n=25) postoperative pain was controlled by continuous caudal epidural infusion at the rate of 4 ml/hr of 0.0625% bupivacaine with 3 μg/ml fentanyl: group II(n 14), 0.125% bupivacaine with 3 μg/ml fentanyl, respectively, for duration of 48 hours via epidural catheter. We evaluated pain scores with visual analogue scales at 30 mins, 6 hrs, 12 hrs, 24 hrs and 48 hrs after the operation and the incidence of adverse effect, especially urinary retention, for each group. Results: There were no significant differences in the pain score between group I and II. Urinary retention developed in 9 patients(36%) of group I, and 11 patients (78.6%) of group II. Other adverse effects such as pruritus, nausea, vomiting and respiratory depression developed in few patients. Conclusions: While performing continuous caudal epidural block with mixture of bupivacaine and fentanyl after the perianal surgery, we conclude 0.0625% bupivacaine solution is preferable to 0.125% bupivacaine solution because 0.0625% solution resulted in satisfactory analgesia with minimal incidence of adverse effect.