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37권6호 영문부록 : 소아에서 Clonidine 직장 전투약의 효과
정찬종(Chan Jong Chung),여광환(Kwang Hwan Yeo),이수일(Soo Il Lee),진영준(Young Jhoon Chin) 대한마취과학회 1999 연수강좌 Vol.- No.-
Background : Oral clonidine has been shown to be an effective preanesthetic medication for children. Rectal administration of the premedicant would be as effective as oral administration. This study was designed to investigate the efficacy of rectal clondine as a premedicant in children. Methods : Forty-five children aged 3-6 yr undergoing elective surgery in inguinal region received midazolam 0.5 mg/kg, clonidine 2.5μg/kg, or clonidine 5μg/kg rectally 30 min before induction of anesthesia. The level of sedation, the quality of separation from the parent, and the acceptance of mask application during inhalation of halothane were noted. Anesthesia was maintained with continuous infusion of propofol and N20 66% in oxygen. The hemodynamic changes after tracheal intubation and propofol consumption were compared among the three groups. Side effects were evaluated from the premedication to 12 h after surgery. Results : The sedative effect of clonidine was dose related. The clonidine premedication at dose of 2.5μg/kg did not provide adequate preanesthetic sedation. Similar to midazolam 0.5 mg/kg, clonidine 5μg/kg provided effective preanesthetic sedation and good qualities of separation and acceptance of mask. Compared with midazolam 0.5 mg/kg, clonidine 5μg/kg attenuated the increases in blood pressure and heart rate following tracheal intubation, and decreased the maintenance dose of propofol during anesthesia. Bradycardia developed in 2 and 4 patients of the clonidine 2.5 μg/kg and clonidine 5.0μg/kg groups during surgery, respectively. No clinically significant side effects were observed at the preoperative and postoperative periods. Conclusions : These data indicate that rectal clonidine 5μg/kg would be an effective premedication in children. (Korean J Anesthesiol 1999; 37: S 10∼S 16)
임상연구 : 소아 사시 교정술에서 마취제가 각성 섬망에 미치는 영향
이승철 ( Seung Cheol Lee ),정찬종 ( Chan Jong Chung ),진영준 ( Young Jhoon Chin ),이수일 ( Soo Il Lee ),이종환 ( Jong Hwan Lee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2
Background: This study was designed to compare the effects of anesthetic methods used recently on emergence delirium in pediatric strabismus surgery. Methods: Two hundred and thirty two children, aged 2-10 years, undergoing strabismus surgery, were randomly assigned to one of eight groups; ketamine-desflurane (n = 30), ketamine-sevoflurane (n = 30), ketamine-propofol (n = 30), ketamine-remifentanil (n = 27), midazolam-desflurane (n = 28), midazolam-sevoflurane (n = 30), midazolam-propofol (n = 27), and midazolam-remifentanil (n = 30). Anesthesia was induced with ketamine 1.0 mg/kg or midazolam 0.15 mg/kg. Laryngeal mask airway (LMA) was placed with rocuronium 0.5 mg/kg. Anesthesia was maintained with desflurane 5-6 vol%, sevoflurane 2-3 vol%, propofol 7-8 mg/kg/hr, and remifentanil 0.5μg/kg/min under N2O 66% in O2. Ventilation was controlled to maintain normocapnia. The status of emergence delirium (ED) was evaluated by a blinded observer until discharge from postanesthetic care unit. Results: There was no differences in age, sex, weight, height, anesthetic time, and recovery time among the eight groups. ED occurred in 54 children (23.3%), but severe ED needed treatment was not occurred. Compared with ketamine group, midazolam group showed less incidence of ED. Propofol and remifentanil groups showed less incidence of ED compared with desflurane and sevoflurane groups. ED group was more younger and more temperamental compared with nonED group. Conclusions: Propofol or remifentanil anesthesia provided less incidence of ED compared with desflurane and sevoflurane in pediatric strabismus surgery. (Korean J Anesthesiol 2007; 52: 138~42)
임상연구 : 소아 사시수술 시 Remifentanil 마취의 혈역학적 반응과 회복 특징
정찬종 ( Chan Jong Chung ),김태균 ( Tae Gyun Kim ),이형창 ( Hyung Chang Lee ),이승철 ( Seung Cheol Lee ),진영준 ( Young Jhoon Chin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: This study evaluated the hemodynamic response and recovery profile of remifentanil-N2O anesthesia, compared with secoflurane-N2O anesthesia in pediatric surgery. Methods: Fifty-seven healthy children aged 1-9 years undergoing strabismus surgery were randomly assigned to two groups, group R or group S. None of the children was premedicated with an anticholinergic agent. Anesthesia was induced with intravenous ketamine 1.0 mg/kg. A laryngeal mask airway (LMA) was placed with rocuronium 0.4 mg/kg. Anesthesia was maintained with sevoflurane 2.0-3.0 vol% and N2O 66% in group S, and with remifentanil 0.75㎍/kg over 1 min followed by remifentanil 0.5㎍/kg/min and N2O 66% in group R. At the end of surgery, the anesthetic agents were discontinued, and the early emergence, recovery, and side effects were assessed. Results: During anesthesia, the heart rate and blood pressure were lower in group R (P < 0.05). The incidence of an oculocardiac reflex was similar in both groups. The times to spontaneous ventilation and the removal of LMA were similar in the two groups. The times from eye opening to command, orientation and full recovery were faster in group R (P < 0.05). The incidence of postoperative nausea and vomiting was similar in both groups. The incidence of coughing was lower in group R (P < 0.05). Mild pruritus developed in 17.2% of patients in group R. Conclusions: In pediatric strabismus surgery, remifentanil provided similar hemodynamic stability, and an earlier and smoother recovery, compared with sevoflurane anesthesia. (Korean J Anesthesiol 2006; 51: 174~8)