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증례보고 : 개심술 마취 도입 중 좌측 쇄골하정맥을 이용한 중심정맥도관 삽입 후 발생한 객혈 2예
도준용 ( Jun Yong Do ),김일석 ( Il Seok Kim ),홍성준 ( Sung Jun Hong ),박준희 ( Jun Hee Park ),신근만 ( Keun Man Shin ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1
Central venous catheters allow a measurement of the hemodynamic variables that cannot be measured accurately by noninvasive means, and allow the delivery of medications and nutritional support that cannot be administered safely through peripheral venous catheters. Unfortunately, the use of central venous catheters is associated with adverse events that are hazardous to patients. Hemoptysis is a significant clinical presentation in respiratory medicine. Often a life threatening emergency, it mandates a prompt assessment and intervention. Fiberoptic bronchoscope is useful and essential for investigating the cause of hemoptysis as well as for managing airway hygiene. We report two cases of hemoptysis after left subclavian central venous catheterization along with the use of a fiberoptic bronchoscope for hemoptysis. (Korean J Anesthesiol 2007; 52: 91~4)
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동영상 촬영을 이용한 후두에서의 근이완제의 발현시간에 대한 연구
방경선,도준용,김일석,홍성준,신근만 대한마취통증의학회 2006 Korean Journal of Anesthesiology Vol.50 No.3
Background: Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare the onset of rocuronium at the adductor pollicis and the larynx and to determine the time suitable for intubation. Methods: Fifteen ASA physical status 1 and 2 adult patients were studied. Anesthesia was induced and maintained with propofol and alfentanil. The recurrent laryngeal nerve was stimulated superficially and movement of the vocal cords were recorded on video tape by using a fiberoptic bronchoscope passed via a laryngeal mask airway. Neuromuscular function was recorded at the adductor pollicis by using mechanosensor. After the administration of rocuronium 0.9 mg․kg-1, the times to loss of fourth twitch response in train -of - four stimulation at the larynx and hand were observed. Results: The times to loss of fourth twitch response in train-of-four stimulation at the larynx and hand are 47.3 ± 12.8 sec and 70 ± 13.6 sec respectively. Conclusions: Video imaging may be a useful research technique for estimating the neuromuscular blockade at the larynx and showing the onset time of rocuronium is significantly faster at the larynx than hand. (Korean J Anesthesiol 2006; 50: 262~5)
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