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- 저자 : 유승화(Seung Hwa Ryoo) (검색결과 2 건)
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만성 신부전 환자의 상완 동-정맥루 형성술식을 위한 경추 경막외마취
유승화(Seung Hwa Ryoo),김태준(Tae Joon Kim),옥시영(Si Young Ok),김상호(Sang Ho Kim),박욱(Wook Park),송단(Dan Song),문철(Chul Moon) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Purpose: Cervical epidural analgesia is used for pain control in head and neck or upper arm. But it is not commonly used for the purpose of pure regional anesthesia for upper arm surgery. Therefore, we investigated the usefulness of cervical epidural anesthesia (CEA) as a method of regional anesthesia for arteriovenous bridge graft (AVBG) for hemodialysis at upper arm and evaluated the effects of CEA on hemodynamics and respiration. Methods: One hundred-fifty chronic renal failure patients scheduled for AVBG were randomly assigned. In the sitting position, an epidural catheter was inserted at C6-7 or C7-T1 and 15 ml of 0.375% ropivacaine with fentanyl 20㎍ was injected. Analgesic level, blood pressure and heart rate were measured at 5-minute intervals after injection of the drug. Arterial blood sampling was taken for aBGA before and twenty minutes after CEA. Results: Average anesthetic dermatomalsensory levels were C3.4±1.2∼T5.7±2.8. During surgery, hypotension was noted in 49% of patients. It was treated with ephedrine or phenylephrine i.v. Baseline PaCO₂ changed from 42.4±2.9 ㎜Hg to 44.6±3.6 ㎜Hg. Conclusion: The above results suggest that CEA is suitable for AVBG at upper arm as a regional anesthesia.
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경막외강 확인법으로서 Drip infusion법의 유용성
옥시영 ( Si Young Ok ),유승화 ( Seung Hwa Ryoo ),백영희 ( Young Hee Baek ),김상호 ( Sang Ho Kim ),김순임 ( Soon Im Kim ),김선종 ( Sun Chong Kim ),박욱 ( Wook Park ),송단 ( Dan Song ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Background: Cervical epidural anesthesia (CEA) is used for pain control and surgical procedures of the head and neck or upper arm areas. However, the failure rate of CEA is reported to be high, is the failure rate being quite higher than other sites, because of the anatomical differences of the cervical spine. We hypothesized that the loss of resistance (LOR) method combined with the drip infusion method for confirmation of the cervical epidural space can reduce the failure rate. This study investigated the usefulness of the drip infusion method. Methods: One hundred chronic renal failure patients undergoing arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. In the cervical epidural puncture, we identified the cervical epidural space using a combination of the LOR method with the drip infusion method. After confirmation of the epidural space with LOR method, we decided it was the true epidural space when fluid dripping to the space was present. Otherwise, if fluid dripping was not present, we designated it was pseudo LOR, and we found the true epidural space using the drip infusion method only. Results: In all cases, the combined LOR with drip infusion method, identify the epidural space. Conclusions: Combined LOR with drip infusion method is an efficacious method for the confirmation of the cervical epidural space. (Korean J Anesthesiol 2009;57:181∼4)
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