http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례보고 : 진단받지 않은 후두개 낭종으로 인한 어려운 기관 내 삽관
이정혁 ( Jeoung Hyuk Lee ),최준권 ( Jun Gwon Choi ),윤동일 ( Dong Il Yoon ),이영민 ( Young Min Lee ),인준용 ( Jun Yong In ),정승현 ( Seung Hyun Chung ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
An epiglottic cyst is a common form of laryngeal cysts which are rare causes of upper airway obstruction. A congenital laryngeal cyst always causes neonatal respiratory distress, but an acquired cyst shows very wide spectrum of symptoms such as no specific complaints, dysphagia, respiratory difficulty, or even death according to its size, location, or age. From anesthesiologists` point of view, an asymptomatic undiagnosed laryngeal cyst is a major concern. Unexpectedly, it can cause difficult airway such as ‘cannot intubate` or `cannot intubate and cannot ventilate` situation during anesthesia. Recently we discovered an undiagnosed epiglottic cyst obscuring laryngeal inlet, leading to difficult intubation during general anesthesia for decompression and fusion of lumbar vertebrae. Fortunately, mask ventilation was possible, and after failed attempts of direct laryngoscopy, we could perform oral fiberoptic bronchoscope-aided intubation. He was discharged 10 days later with no harmful events. (Korean J Anesthesiol 2009;56:567~70)
Desflurane 폐포내농도 상승에 따른 뇌산소포화도 반응에 미치는 Remifentanil의 효과와 뇌혈관의 이산화탄소 반응성
이정혁 ( Jeoung Hyuk Lee ),이윤석 ( Youn Suk Lee ),인준용 ( Jun Yong In ),정승현 ( Seung Hyun Chung ),신홍일 ( Hong Il Shin ),이경진 ( Kyoung Jin Lee ),김경옥 ( Kyoung Ok Kim ),조헌 ( Hun Cho ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Background: It is known that sympathetic stimulation and increase in cerebral blood flow velocity can be induced by desflurane. Cerebral oxygen balance could be disturbed during desflurane induction. Aim of this study was to elucidate that cerebral oxygen imbalance induced by desflurane mask induction can be reduced by combination of remifentanil and hypocapnia. Methods: Twenty ASA 1-2 subjects were allocated randomly into 5 groups divided by concentration of remifentanil (0.0, 0.5, 1.0, 1.5, and 2.0 ng/ml). After confirmation of attaining proposed concentration of remifentanil, propofol and vecuronium were administered and mechanical ventilation was done with 8% desflurane with facial mask. Subsequently, changes in regional cerebral oxygen saturation (△rSO2), arterial blood pressure, heart rate, cardiac index, estimated alveolar concentration of desflurane (P(DESF)), and end-tidal concentration of carbon dioxide (PET(CO2)) were recorded for the following 10 minutes. According to concentration of desflurane and remifentanil, △rSO2 and hemodynamic factors were checked. Results: During desflurane induction, changes in cerebral oximetry reached up to+10% (6 [first quartile], 13 [third quartile]). Arterial blood pressure, heart rate, and cardiac index were changed within clinical ranges. The △rSO2 showed S-shaped increasing pattern according to increasing P(DESF). Hypocapnia and concentration of remifentanil reduced the maximum △rSO2 (P=0.0046, P=0.0060). Hypocapnia also shifted the curve to left (P=0.0001). Conclusions: During 8% desflurane induction, regional cerebral oxygen saturation (rSO2) increases maximum +25%. Hypocapnia and use of remifentanil can reduce the increase in regional cerebral oxygen saturation. (Korean J Anesthesiol 2009;56:543~51)
임상연구 : 이산화탄소에 의한 복강내압 증가가 압반사 민감도에 미치는 영향
정승현 ( Seung Hyun Chung ),조헌 ( Hun Cho ),김경옥 ( Kyoung Ok Kim ),이윤석 ( Youn Suk Lee ),최준권 ( Jun Gwon Choi ),인준용 ( Jun Yong In ),최윤숙 ( Yun Suk Choe ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Background: To determine if positive pressure pneumoperitoneum has adverse effects on autonomic nervous system function, we examined baroreflex sensitivity (BRS) during carbon dioxide pneumoperitoneum in patients undergoing laparoscopic surgery. Methods: Twenty adult patients scheduled for laparoscopic gynecologic surgery were selected for the study. After general anesthesia was induced with sevoflurane, continuous electrocardiography and blood pressure were monitored. Spontaneous BRS was achieved using sequence method immediately before, and 5 minutes after, pneumoperitoneum. Heart rate variability (HRV) was also determined. Results: After pneumoperitoneum, BRS decreased from 12.9 ± 1.8 ms/mmHg to 8.1 ± 1.1 ms/mmHg (P < 0.05), and the power of the high frequency band decreased from 237.8 ms2/Hz to 49.6 ms2/Hz (P < 0.05). Conclusions: Compared to recordings obtained before pneumoperitoneum, BRS was decreased during pneumoperitoneum. This may predispose patients undergoing laparoscopic surgery to hemodynamic instability in addition to pneumoperitoneum itself. (Korean J Anesthesiol 2008; 55: 662~5)
인준용,김동원,이우용,홍기혁 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1
Hyperhidrosis means excessive sweating at rest or in response to emotional stress which disturbs patient's daily activity. Main affecting sites are usually axillae, palms, soles and forehead. The cause is unknown. We met a patient who had suffered from heavy sweating on his forehead mediated with emotional stress. Additionally he complained if fatigue, nervousness, decreased libido, depressed mood, palpitation, etc. We started to block stellate ganglion with 0.5% mepivacaine 5ml. Patient's symptoms were dramatically improved after 10 stellate ganglion blocks. After then, we have done more than 30 blocks and he is very satisfied with his normalization.