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이석희,정규섭,장사충 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.1
We experienced 4,945 cases of surgical operation at the Busan National University Hospital from Jan. 1966 to Dec. 1970. The cases that expired within the first 24 hours pastoperatively, were recorded as the postoperative death in this analysis. Thus, postoperative deaths were 126 cases, comprising 2,6 per cent of all the surgical operation. Emergency operation was 119 cases and neurosurgery was 90 cases among 126 cases, Above results imply that more careful attention and efforts to every emergency and neurosurgical case were needed.
제왕절개술 후 Morphine 의 지속적 경막외 주입시 Nalbuphine 첨가에 의한 부작용 감소효과
이상근,한인숙,장사충,안정찬 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.6
Background: This study was undertaken to reduce the side effects of epidural morphine through the addition of nalbuphine in 37 cesarean delivery. Methods: Forty patients were divided into 2 groups; M(control) group: bolus administration of morphine 2 mg in 0.5% bupivacaine and continuous epidural 41 hour-infusion of morphine 7mg, N(experimental) group: bolus administration of morphine 2 mg in 0.5% bupivacaine combined with nalbuphine 10mg and continuous epidural 41 hour-infusion of morphine 7mg combined with nalbuphine 10mg via the Paragon infusor. Results: During the postoperative 48 hours, their pain scores and side effects were recorded at 6, 12, 18, 24, 30, 36, 42 and 48 hours. The analgesic effects were good in two groups(mean VAS$lt;3.0) and pain scores were statistically significant at 18 and 30 hour. The incidence of pruritus, nausea, vomiting and urinary retention was decreased in group N(p$lt;0.05). Conclusions: We concluded that continuous epidural morphine combined with nalbuphine was one of recommendable methods to reduce side effects of morphine. (Korean J Anesthesiol 1996; 31: 771~776)
제왕절개술후 진통을 위한 지주막하 Neostigmine의 효과
김지수,정찬종,조상선,한인숙,장사충 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.3
Background : Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. Methods : Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5ug, or neostigmine 25ug intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500ug and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. Results : There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. Conclusions : These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects. (Korean J Anesthesiol 1998; 35: 545∼552)