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이경호,안용미,박천희 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.6
Blunt tracheobronchial injuries are rare, and usually lethal without aggressive and appropriate management. Recently, the incidence of tracheobronchial injuries has been increased with the increase of traffic accident and mechanization. We report a case of complete tracheal transection combined with a longitudinal rupture of the membranous portion of the trachea extending to the right main bronchus following blunt chest trauma, and review the anesthetic management. (Korean J Anesthesiol 1998; 35: 1174∼1179)
N-아세틸시스테인 투여후 발생한 급성 무기폐 : 증례보고
이광범,안용미,이철승,최준석,박천희 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.34 No.1
Causes of atelectasis under general anesthesia are tracheal foreign body, blood clot, aspiration of bronchial secretion, one-lung ventilation and relative predominance of parasympathetic system. N-acetylcysteine is mucolytic agent which improves the capability of sputum drainage. After administration of N-acetylcysteine, an increased volume of liquified bronchial secretions may occur. When cough is inadequate, the airway must be maintained open by mechanical suction. In case that is a mechanical block due to local accumulation, the airway should be cleared by endotracheal aspiration. A 49-year-old female was admitted for bilateral laparoscopic oophorectomy due to ovarian tumors. There was not any problem during a general anesthesia induction. After instillation of N-acetylcysteine into endotracheal tube, acute atelectasis was developed in right lower lung.
이광범,김정률,안용미,최준석,박천희 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3
Perioperative cerebral infarction is rare but may be fatal. This is a case report of acute cerebral infarction following general anesthesia in geriatric patient. A 72 year old female patient was admitted for transabdominal hysterectomy and bilateral saipingooophorectomy and pelvic lymphnode dissection. Preanesthetic assessment revealed a history of hypertension and diabetes mellitus. After surgery, she was alert but she gradually appeared to have right hemiparesis and confusion. Emergency CT brain scan showed early cerebral infarction in the middle cerebral artery territory. She was transferred to the depart ment of neurology and received treatment. She was discharged at 19 days after surgery with improved symptoms.
기관지 편향을 동반한 환자에서 갑상선종양 절제술시 시행한 경부경막외마취
김원태,이철,국은영,이철승,안용미 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.1
Large thyroid tumors present distortion of the airway, endocrine disturbance and metastatic effect. It may compromise airway directly or indirectly through dysfunction of the recurrent laryngeal nerve. The management of abnormal airway structure and the potential for both difficult intubation and surgical access to the airway are based on the principle of burning no bridges. Thyroidectomy can be performed under regional anesthesia using cervical epidural anesthesia in which maintenance of the airway and monitoring of recurrent laryngeal nerve function are possible. We describe a patient in whom a large thyroid mass with marked tracheal deviation was treated successfully by cervical epidural anesthesia and spontaneous respiration. (Korean J Anesthesiol 1999; 37: 159∼163)
Eisenmenger씨 증후군을 동반한 충수돌기염 천공에 의한 복막염 환자의 마취경험 : 증례보고
천경석,박천희,이철승,이철,안용미,최준석 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3
Eisenmenger's syndrome includes any condition in which communication between the pulmonary and systemic circulation gives rise to pulmonary vascular disease causing a right to left shunt with peripheral cyanosis, It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. We report a case of a 58-year-old woman with an emergency operation for peritonitis due to appendiceal perforation and Eisenmenger's syndrome secondary to large ventricular septal defect. We carefully performed balanced anesthesia with air-O₂-desflurane-remifentanil. She was transferred to the intensive care unit in intubated state postoperatively and discharged two weeks later without any complications.
술후 제통에 사용된 Piroxicam 첩포의 선행진통효과
국은영(Eun Young Kook),안용미(Yong Mi An),이 철(Ch 대한통증학회 1999 The Korean Journal of Pain Vol.12 No.1
N/A Background: Preemptive analgesia has been suggested recently as an another technique of post- operative pain control. Combination of low dose opioid and NSAIDs was used to lessen systemic opioid side effect, however, the use of NSAIDs may hinder their side effects in perioperative period. The local application of small dose at the target site can be effective without systemic effect. The aim of this study is evaluating the additive effect and side effect of transdermal piroxicam as preemptive adjuvant to intravenous nalbuphine on pain relief after major abdominal surgery. Methods: We reviewed the records of patients received piroxicam patch for preemptive analgesia before operation and compared it with control group. Two sheets of piroxicam patch to the skin incision site for 12 hours before operation were attached (Group 1, n-20) and no patch were applied (Group 2, #n 20). Both groups were received nalbuphine continuously after operation using two days infuser (2 ml/hr) containing 80 mg (96 ml). Pain is evaluated by VAS score at each time; 30 min, 1, 6, 12, 24, 36, 48 hours after operation and side effects of NSAIDs were observed for 3days postoperatively. Results: There was no significant VAS score difference between two groups following time in progress. And no significant side effect was noted in both groups, either. Conclusion: There is no preemptive or synergistic analgesic effect of piroxicam patch attached at planned operation site before operation.
복강경하 담낭 절제술에서 Celecoxib의 수술 전 투여가 수술 후 통증에 미치는 영향
김달용 ( Dal Yong Kim ),안용미 ( Yong Mi An ),문종필 ( Jong Pil Moon ),최정기 ( Jung Gi Choi ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3
Background: For laparoscopic cholecystectomy, pain is most frequent complaint and the most common cause of delayed discharge. The aim of this study was to determine the effect of preoperative administration of celecoxib on the level of postoperative pain in patient undergoing laparoscopic cholecystectomy. Methods: We enrolled 60 patients ASA class I and II, scheduled for elective laparoscopic cholecystectomy. The patients were randomized to receive celecoxib 200 mg, celecoxib 400 mg or placebo two hour before the induction of anesthesia. The patients received the same anesthetics. The intensities of abdominal pain were assessed using VAS (visual analog scale) at 1, 2, 4, 12, 24 hours after surgery. Results: In celecoxib 200 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. In celecoxib 400 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. There was no difference between celecoxib 200 mg and celecoxib 400 mg in pain scores of somatic pain. Dosage of meperidine in two celecoxib groups after surgery were each 31 mg and 26 mg and that of control group was 72 mg. There was no difference between celecoxib groups and placebo group in pain scores of visceral pain. Conclusions: The preoperative administration of celecoxib reduces the level of postoperative pain after laparoscopic cholecystectomy without adverse effects. (Korean J Anesthesiol 2009;57:327∼30)