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전신마취하 환자에서 단일형 호흡회로의 사용시 혈역학반응 및 동맥혈가스분석
김용락,최윤정,염광원,박학수,전용석 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.3
Background : Most of nonrebreathing circuits were used for pediatrics, not for adults and the high flow of fresh gas and specially designed valve or lever should be needed. The current study was designed to compare between one corrugated tube(universal FTMcircuit) and two corrugated tube in patients with oral and maxillofacial surgery under general anesthesia. Methods : Twenty adults undergoing oral and maxillofacial surgery were anesthetized with enflurane- N2O-fentanyl after radial arterial cannulation. Under the condition with stable vital signs, ventilator was setted with tidal volume 10ml/kg, respiratory rate 11 breaths/min using two separate limbs(expiratory and inspiratory limbs) and one corrugated tube of anesthesia machine. Mean arterial pressure, heart rate, saturated pulse oxygen, end tidal carbon dioxide, peak inspiratory oxygen, arterial blood gas analysis were measured at 15, 30min during the use of each circuit. Results; There were no differences of mean arterial pressure, heart rate, end tidal carbon dioxide, saturated pulse oxygen. peak inspiratory presssure and arterial blood gas analysis between 2 circuits during mechanical ventilation. Conclusions: Universal FTMcircuit of single limb could substituted for the two corrugated tube, especially in patients with oral and maxiolofacial surgery. (Korean J Anesthesiol 1997; 32: 366∼369)
Lorazepam 에 의해 억제된 뇌기능 및 순환기능에 대한 Flumazenil 의 역전 효과에 관한 실험적 연구
김용락,오용석,원영천 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.5
The effects of lorazepam on cerebral function, metabolism, and hemodynamics were studied in eight dogs receiving a general anesthesia with isoflurane(0.5 vo1%)-50% nitrous oxide-oxy-gen. The effects of benzodiazepine antaronist, flumazenil, were also examined. Lorazepam(0.5 mg/kg) administration did decrease mean arterial pressure(MAP) and herat rate(HR). It did significantly decrease cerebral blood flow(CBF)(measured by posterior sagittal sinus outflow method) by 25% of control value(68±l3 vs. 51±12ml/100gm/min, meanSD) and cereberal metabolic rate for oxygen(CMRO ) by 17% (3.96±1.04 vs. 3.30±0.92ml/l00gm/min, mean±SD). Electroencephalogram(EEG) converted to high amplitude, predominantly theta and delta activity. Intracranial pressure(ICP) increased markedly. Following flumazenil(0.06 mg/kg) administration, HR recovered completely to control level but MAP increased only at 5 min. compared to pre-flumazenil value and returned to pre-flumazenil level. CBF recovered to control level for 15 min. and deereaster 30 min. compared to control level but higher than pre-flumazenil level about 9-15%. CMRO recovered completely to control leveL EEG changed to an awake pattern after fluamzenil administration. It is concluded that lorarepam decreased cerebral function and metabolism and depressed hemodynamic fuction. Benzodiazepine antag- onist, flumazenil, was effective in reversing cerebral and hemodynamic effects, may be in dose related manner.