• Title/Summary/Keyword: 마취합병증

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Life-threatening Airway Edema after Arthroscopic Repair of Massive Rotator Cuff Tear - A Case Report - (관절경하 광범위 회전근 개 파열 수술 후 발생한 치명적인 기도 부종 - 증례 보고 -)

  • Moon, Young-Lae;Yu, Byung-Sik;So, Keum-Young;Lim, Kyung-Joon;Kang, Jeong-Hoon
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.136-139
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    • 2007
  • Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries. To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.

The Effect of Anticholinergic Agents on Postoperative Sore Throat in Patients Undergoing Endoscopic Sinus Surgery (내시경적 부비동 수술 시 항콜린성제제 사용이 수술 후 인후통 발생에 미치는 영향)

  • Lee, Joo-Young;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.305-310
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    • 2007
  • Background : After sinus surgery, airway dryness is made worse because patients breathe by mouth. Anticholinergic agents have antisialogogue effects. The airway dryness that occurs after surgery is severe and can increase the incidence of postoperative sore throat. Materials and Methods : One-hundered patients who were scheduled for endoscopic sinus surgery(ESS) were divided into four groups. Each group was premedicated with glycopyrrolate or had no premedication and reversed with glycopyrrolate or atropine. After the surgery the patients were asked about a sore throat and hoarseness postoperatively after 1h, 6h, 12h, 24h, and 48hours, respectively. Results : The incidence of postoperative sore throat and hoarseness was not significantly different among the four groups at any time. Conclusion : The severity of complications after ESS was low and subsided within 24 hours. Therefore, the use of anticholinergic agents does not need to be limited.

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Selective Bronchial Suction Catheter after Resection Surgery of Lung -Case report- (폐절제술 후 선택적 기관지내 흡인도관 유치 -증례 보고-)

  • 조정수;김종원;김영대
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.884-887
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    • 2004
  • We applied our technique of selective bronchial suctioning (SBS) for the treatment of atelectasis after resection surgery of lung in four patients with refractory atelectasis who were treated successfully. We considered that SBS using hydro-catheter insertion under local anesthesia above fourth tracheal ring is the effective technique for the treatment of refractory atelectasis when conventional respiratory therapy is not effective and a bronchoscopist is not available.

Development of a real-time prediction model for intraoperative hypotension using Explainable AI and Transformer (Explainable AI와 Transformer를 이용한 수술 중 저혈압 실시간 예측 모델 개발)

  • EunSeo Jung;Sang-Hyun Kim;Jiyoung Woo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2024.01a
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    • pp.35-36
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    • 2024
  • 전신 마취 수술 중 저혈압의 발생은 다양한 합병증을 유발하며 이를 사전에 예측하여 대응하는 것은 매우 중요한 일이다. 따라서 본 연구에서는 SHAP 모델을 통해 변수 선택을 진행하고, Transformer 모델을 이용해 저혈압 발생 여부를 예측함으로써 임상적 의사결정을 지원한다. 또한 기존 연구들과는 달리, 수술실에서 수집되는 데이터를 기반으로 하여 높은 범용성을 가진다. 비침습적 혈압 예측에서 RMSE 9.46, MAPE 4.4%를 달성하였고, 저혈압 여부를 예측에서는 저혈압 기준 F1-Score 0.75로 우수한 결과를 얻었다.

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Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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Evaluation of diagnostic methods in children with nonpalpable undescended testis (비촉지성 정류고환의 진단 방법의 평가)

  • Seok, Noh Sung;Suh, Hong Jin;Lee, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.732-736
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    • 2006
  • Purpose : Numerous methods exist for diagnosing nonpalpable testis in treatment of cryptochidism. However, there is no clinically established data for the rational diagnostic tool of nonpalpable testis in terms of expenses. We tried to establish a current conventional diagnostic course of nonpalpable testis. We then evaluated the efficacy of ultrasonography, physical examination under general anesthesia and laparoscopy for diagnosing nonpalpable testis. Methods : Between March 2000 and February 2005, 103 boys(129 testes) with undescended testes were treated in our department. There were 31 testes(24.0%) that were not palpable at physical examination. These patients were evaluated with ultrasonography and repeated physical examination under general anesthesia. In the cases where testes could not be detected with ultrasonography and physical examination under general anesthesia, laparoscopy was performed to diagnose nonpalpable testis. Results : In 31 cases of nonpalpable testis, 13 testes were detected with ultrasonography and 15 testes became palpable with physical examination under general anesthesia. All of the remaining 16 nonpalpable testes were confirmed with laparoscopy. Conclusion : Physical examination under general anesthesia was superior to ultrasonography in making a diagnosis of nonpalpable testis. Ultrasonography and physical examination under general anesthesia could reduce the incidence of diagnostic laparoscopy. Therefore, it is recommended that ultrasonography, physical examination under general anesthesia and laparoscopy must be performed conventionally in order to diagnose nonpalpable testis.

Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

Evaluation of Neck Node Dissection for Thoracic Esophageal Carcinoma (흉부식도암 수술에서 경부림프절 절제의 의의)

  • 전상훈;박창률;이응배;박준식;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1081-1084
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    • 1998
  • Background: Esophageal surgery in esophageal cancer has low curative resection rate and its resut has not improved even after the extended lymphnode dissection. To evaluate the effectiveness of cervical lymph node dissection, we compare the node of cervical lymph node metastasis in patients esophageal cancer. Materials and methods: We studied a series of 32 patients who underwent operation for thoracic esophageal carcinoma at our institution. The 25 patient who underwent curative surgery were divided into two groups. Both groups A and B underwent transthoracic esophagectomies with mediastinal and abdominal lymphadenectomies only, but group B also underwent bilateral lower neck node dissection. Results: The rate of operative complications did not differ significantly between two groups. No operative and hospital mortalities were noted in either group. However, the mean anesthetic time was significantly longer in group B(mean: 90 minutes). Neck node metastasis was revealed in 27% of group B. Conclusions: Therfore, neck node dissection is meaningful for surgical treatment of the thoracic esophageal carcinoma. The longterm survival rate should be compared later.

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Propofol Patient-Controlled Sedation Using WalkMed (Medex Inc, USA) Infusion Pump in Dental Patients (치과 환자에서의 WalkMed사(Medex Inc, USA)의 자가통증조절기를 이용한 Prorofol 자가진정조절법)

  • Kim, Hyun-Jeong;Park, Chang-Joo;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.16-20
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    • 2001
  • 연구배경: 일반적으로 자가통증조절기가 자가진정조절을 위해 적합한 것으로 알려져 있다. 그러나 이 장치들은 몇몇 진정제 투여 시 너무 긴 최소 폐쇄간격을 가지고 있다 WalkMed사(Medex inc, USA)의 자가통증조절기는 폐쇄간격을 0으로 설정할 수 있으며 30 ml/h로 추가용량을 투여할 수 있다. 이번 연구에서는 환자 개개인의 요구에 맞추어 환자의 진정을 조절하기 위하여 위장치를 이용한 propofol 자가진정조절기의 가능성를 조사하였다. 방법: Propofol과 전산 프로그램된 WalkMed 주입장치를 이용한 자가진정조절법이 치과치료를 받는 24명의 건강한 환자에게 시행되었다. Propofol 지속 주입량은 2 mg/kg/h로, 추가용량은 5 mg으로 조절되었으며 치소 폐쇄간격은 0으로 설정하였다. Ketoloac 30 mg이 통증 조절을 위하여 진정법 시행 전에 근주되었다. 결과: 진정법 시행 동안 주입된 propofol의 평균량은 3.4 mg/kg/h이었으며 평균 추가용량은 1.6 mg/kg/h이었다. 시간 당 추가용량에는 많은 변이가 있었다(0-32). 모든 환자는 진정법 시행 동안 완전한 각성상태였으며 이러한 진정 법에 만족하였다. 진정 법과 관련된 주요한 합병증은 관찰되지 않았다. 결론: WalkMed사의 자가통증조절기를 이용한 propofol 자가진정조절법이 치과 치료를 받는 환자들에게 유용하게 사용될 수 있다.

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Surgical Invasiveness is Important for Determining Severity of Postoperative Pain after Oral & Maxillofacial Surgery (구강악안면 수술의 침습도 및 술 후 통증의 정도와의 상관성)

  • Shin, Teo-Jeon;Park, Yun-Ki;Seo, Kwang-Suk;Han, Hyo-Jo;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.9-15
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    • 2011
  • 배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.