• Title/Summary/Keyword: 수술가스

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Recovery of Pulmonary Function according to the Operative Sites after General Anesthesia (전신마취를 이용한 수술에서 수술부위에 따른 폐기능의 회복)

  • Kim, Hyeon-Tae;Lee, Sang-Moo;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.250-258
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    • 1993
  • Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.

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Ventricular Tachycardia during Arthroscopic Shoulder Surgery - A Case Report - (관절경하 견관절 수술 시 발생한 심실성 빈맥 - 증례 보고 -)

  • Jo, Seung-Hyeon;Lee, Jin-Ung;Jo, Nam-Su;Lee, Yong-Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.84-84
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    • 2008
  • 최근 견관절 질환의 상당수가 관절경 수술로 이루어지고 있다. 좌체위(beath chair position)를 이용한 관절경 수술은 시술 중 관헐적 방법으로의 전환이 용이하고 공간에 대한 orientation을 쉽게 잡을 수 있어 선호되고 있다. 또한 관절경 수술 시 시야 확보를 위해 epinephrine을 혼합한 세척액이 통상적으로 사용되고 있다. 관절경 수술 시 심부 정맥 혈전증(deep vein thrombosis), 가스 색전증, 세척액에 사용하는 epinephrine에 의한 심실성 빈맥 등과 같은 치명적인 부작용이 가끔 보고되어 있다. 관절경하 견관절 수술 도중 심실 빈맥의 발생은 매우 드문 경우이며 이에 대한 보고도 거의 없는 상태이다. 저자들은 2주의 기간 동안 좌체위로 관절경하 견관절 수술을 하는 도중 갑작스럽게 발생한 심실 빈맥 2예를 경험하였기에 원인 및 치료 과정을 보고하고자 한다. 좌체위로 인한 뇌혈류 저하, 가스 색전증 등의 증세는 없었다. 관절경술 도중 세척액에 투입된 소량의 epinephrine이 동시에 체내로 급속히 유입되어 심실 빈맥이 왔으리라 추정하고 있으며, 실험을 통해 이를 증명하고자 하였다.

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Comparative Analysis of arterial Gases and Acid-base status in Patients with Congenital and Acquired Heart Disease at Preoperative Period, During Extracorporeal Circulation. and Postoperative Period (선천성 및 후천성 심질환 환자에서 체외순환 전, 중, 후의 동맥혈 가스의 비교 분석)

  • 이동석;이봉근;김송명
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.831-842
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    • 2001
  • Background: Patients with cardiac diseases who have structural defects in their heart bring about metabolic insult such as preoperative acid-base imbalance. Cardiac operation requires many nonphysiologic procedures such as extracorporeal circulation, hypothermia, and hemodilution. We studied the acid-base status of surgical heart diseases pre-operatively, during extracorporeal circulation, and post-operatively and researched the treatment indications of acid-base disturbances. Material and Method: From January 1997 to May 1999, fifty two cases of open heart surgery were carried out under extracorporeal circulation, which divided into a set of pediatric and adult groups, congenital and acquired groups, non-cyanotic and cyanotic groups, The $\alpha$ -stat arterial blood gas analysis was done in each group during the preoperative period, during the operation with extracorporeal circulation, and during the postoperative period. Result: Before surgery, all patients present metabolic acidosis, PaO2 was low in adult group and acquired group and compensatory respiratory alkalosis was noted in cyanotic group. During extracorporeal circulation, adult group revealed alkalosis and normal in acquired group. Pediatric group presents low Pa$CO_2$, metabolic acidosis and respiratory alkalosis. Congenital group and non-cyanotic group showed non-compensatory alkalosis trend and non-compensatory respiratory acidosis were observed in cyanotic group during extracorporeal circulation. Postoperative acid-base status of adult group was recovered to normal and the standard bicarbonate was increased in the acquired group. All of the pediatric, congenital non-cyanotic, and cyanotic groups revealed the lack of buffer base.

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Application of $CO_2$ laser in Minor Surgery of Oral Soft Tissue : Case Reports (연조직 소수술에서 $CO_2$ 레이저의 적용 증례)

  • Park, Ju-Hyun;Jeon, Young-Mi;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.35 no.3
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    • pp.177-182
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    • 2010
  • Conventional surgical therapy for oral soft tissue includes the use of scalpel, diathermy, cryotherapy and electrosurgery. But, these therapies have some surgical problems. Nowadays, laser surgery can be considered as the another option for conventional surgical therapy. Compared to conventional surgical therapies, advantages of laser therapy include maintenance of sterile conditions, promotion of wound healing, reduction of bleeding, less instruments, post operative pain reduction, less scar, saving cost by using fewer materials, staff and time. Carbon dioxide ($CO_2$) laser uses gaseous medium, and has long wavelength about 10,600nm. The first advantage of $CO_2$ laser for surgical treatment of oral soft tissue is hemostasis and visibility improvement by making relatively dry field. These case reports are about cases of minor surgery of oral soft tissue using $CO_2$ laser, and emphasize advantages of laser compared to conventional surgical therapies.

Effect of Nonsolvent Additive in Casting Solutions on Polysulfone Membrane Preparation (Polysilfone 막의 제조에 있어 제막용액에 첨가된 비용매의 영향)

  • 한명진
    • Membrane Journal
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    • v.6 no.3
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    • pp.157-165
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    • 1996
  • Polysulfone(PS) membranes were prepared from homogeneous PS solutions by the phase inversion technique. When propionic acid(PA) was added into a casting solution of n-methylpyrrolidone(NMP) and PS, precipitation rate of the solution film was accelerated. This kind of acceleration was consistent, even though a precipitating nonsolvent was changed from water to isopropanol. These phenomena were caused by decrease of nonsolvent tolerance in the casting solution due to addition of PA. PS powder was prepared by precipitation of a 3wt% solution in dimethylformamide(DMF) using ethanol as nonsolvent. Gas adsorption analysis of the powder showed that the capillary condensation sites were found in the powder structure. Membranes prepared from PS solution(15wt%) in NMP had the following characteristics of gas adsorption and water permeation. In gas adsorption analysis, the membrane precipitated using isopropanol showed low uptake of nitrogen gas and the capillary condensation sites were not found. On the contrary, a significant amount of the capillary condensation sites was found in the membrane coagulated by water, which was related to increase of nitrogen uptake. tn the membrane prepared froin the solution including PA, an increase of the Henry's law sites and the Langmuir sites was not found clearly. However, the capillary condensation sites were significantly increased, and the water transport also increased.

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Finite Element Analysis on the Strength Safety of a Fuel Tank for Highly Compressed Gas Vehicle (수술실 내의 아산화질소($N_2O$) 노출평가)

  • Baek, Jong-Bae;Uhm, Min-Yong
    • Journal of the Korean Institute of Gas
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    • v.13 no.6
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    • pp.34-38
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    • 2009
  • Nitrous oxide, which is used as an anesthetic gas, has been shown to be a chronic health hazard. It is necessary to monitor and control the nitrous oxide exposure of the operating theaters staff. In this study, N2O exposure level of the operating nurses is assessed with a GC-ECD. The nitrous oxide gas is collected on a molecular sieve 5A contained in a glass tube and desorbed for 12 hours at $100^{\circ}C$ in heating block. As a result of the test using GC-ECD, calibration curve's $R^2$ of $N_2O$ is 0.9992, LOD is $0.96{\mu}g$/injection, LOQ is $3.21{\mu}g$/injection, desorption efficiency is 94.78 4.50% in average and break through is within 10% compared with the concentration. The average concentration before operation is 5.12ppm and it is 42.3ppm during operation. There are a significant difference showing that the P value is lower than 0.05. Assessing exposure level to nitrous oxide based on nurses' working positions, the exposure levels do not show significant difference( P>0.005). And $N_2O$ in active sampling method is higher than passive sampling method(P<0.05).

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Non-Robotic, Endoscopic Hemi-Thyroidectomy via Retro-auricular Single-incision Approach : A Preclinical Feasibility Study in Cadavers (후이개 절개를 이용한 내시경 갑상선 절개술-전임상 사체연구)

  • Lee, So-Yoon;Sun, Dong Il;Ahn, Su Hyun;Lee, Il Hwan;Park, Young Hak
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.10-14
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    • 2014
  • 목 적 CO2 가스 삽입 없이 내시경 보조 갑상선 절제술, 특히 액와 절개를 이용하는 경우의 대부분은 기구 사용을 용이하게 하기 위하여 흉부 또는 유륜에 절개를 넣어 시행하는 것이 대부분이다. 본 연구는 후이개 절개를 통하여 추가적 절개 없이 내시경을 이용한 갑상선 절제술 및 중심 임파선 절제술이 가능한지의 여부를 사체연구를 통하여 확인해 보고자 한다. 방 법 사체 이용 해부 및 수술 후이개 내시경 보조 갑상선 절제술이 가능한지의 확인은 수술 시야 및 접근성, 수술 완성도, 그리고 주요 구조물의 보존 여부인 3가지 항목으로 평가하였다. 결 과 수술 시야는 기구를 다루고 수술을 하기에 충분하였으며, 추가 절개 없이 수술을 완성할 수 있었다. 절제된 갑상선 조직의 피막은 손상되지 않았으며, 잔존 갑상선 조직이 없음을 수술 부위를 통하여 확인하여, 수술의 완성도 여부를 평가할 수 있었다. 모든 사체에서 되돌이 후두신경 및 상 또는 하부갑상선의 보존을 확인하였으며, 주변 구조물들의 손상이 없음을 확인하였다. 결 론 로봇이 아닌 후이개 절개를 이용한 내시경 보조 갑상선 절제술은 시행 가능한 접근법 및 수술방법이라 사료된다.

The Effects of Semi-Fowler's position on Post-Operative Recovery and Pain for Patients with Laparoscopic Abdominal Surgery (복강경 수술 후 반좌위가 수술회복성과 통증에 미치는 영향)

  • Choi, Un Jong;Ha, Tae Uk;Kang, Ji Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.412-419
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    • 2017
  • Purpose:This study was conducted to identify the effects of theSemi-Fowler's position on post-operative recovery and pain for patients with laparoscopic abdominal surgery Methods: This study utilized a non-equivalent control group non-synchronized design to validate the effects of theSemi-Fowler's position. After IRB approval, 56 patients took part in this study, 29 in the experimental group and 27 in the control group. Consent was obtained from the participants. The Semi-Folwer's position was applied to experimental group and the supine position was applied to the control group for 24 hours after surgery. All data were reviewed retrospectively from April to June 2016. Collected data, frequency, percentage, average, standard deviation, chi-squared test, independent t-test and repeated measures ANOVA were conducted using SPSS 20.0. Results: There was no significant difference between the experimental and control group with regard to recovery outcomes; however, there was a significance differencebetween groups and among check times with regard to post operational pain. Conclusion:The results of this study provide information that will be usefulto the development of strategies for improving recovery outcomes and pain for laparoscopic operation patients.

The Relationship between Arterial and End-tidal Partial Pressures of CO$_{2}$ in Halothane-anesthetized Heavy Breed Horses with respect to Operative Positions and the Modes of Ventilation (Halothane으로 마취된 거대말에서 수술자세와 호흡방법에 따른)

  • 안경아;권오경;산권명부;권구청;산안칙부
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.238-243
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    • 1997
  • 체중이 700-750kg 인 4마리의 중종마에 70분동안 마취를 실시하여 동맥혈의 이 산화탄소 분압과 호기말 가스내의 이산화탄소 분압 사이의 관계를 관찰하였다. 마취도중 자발 호흡, 인공호흡 1(흡기시간 2.0초), 인공호흡 2(흡기시간 2.5초)를 각각 30분,20분,20분씩 실시하였으며 매 10분마다 동맥혈가스분석과 호기말 가스내 이산화탄소분압 측정을 실시하 였다. 동시에 혈압, 심전도, 체온측정을 실시하여 마취된 환축의 상태를 관찰하였다. 2주후에 자세를 달리하여(앙와에서 측와로) 같은 방법으로 재 실험하였다. 호기말 이산화탄소분압은 동맥혈에서보다 평균 10 mmHg 정도 낮은 양상을 보였으나 높은 상관관계를 보였으며 자세에 따른 유의적 차이는 업었다(앙와자세; r=0.949, 측와자세; r=0.920, P<0.01). 이러한 결과를 토 대로 조직에 창상을 줄 수 있는 동맥혈 가스분석 대신 비침습적방법인 호기말 가스내 이산화 탄소 분압을 측정하는 것이 환축의 모니터링에 효과적으로 사용 가능하다는 것을 알 수 있었다.

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Evaluation of Indoor Air Quality in a Hospital Operating Room During Laparoscopic Surgery (병원 수술실에서의 복강경 수술 중 실내공기질 평가)

  • Choi, Dong Hee;Kang, Dong Hwa
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.30 no.3
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    • pp.67-74
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    • 2024
  • Purpose: The identification and quantification of indoor airborne contaminants, including bio-aerosols, particulates, and gaseous contaminants, are crucial for maintaining acceptable indoor air quality for hospital operating rooms (ORs). Laparoscopic surgery has become widely accepted for various surgical procedures due to its rapid recovery rate and the low risk associated with small incisions compared to conventional open surgery. The objective of this study is to investigate the indoor air quality in hospital ORs and to identify indoor airborne contaminants generated during laparoscopic surgery. Methods: Measurements of an indoor environment, including temperature, humidity and air quality, were performed in an OR before and during a laparoscopic surgery. Indoor airborne contaminants, including volatile organic compounds (VOCs), formaldehyde, carbon monoxide (CO), carbon dioxide (CO2), sulfur dioxide (SO2), nitrogen dioxide (NO2), suspended indoor particles, and airborne bacteria, were measured simultaneously. Results: The study determined that the concentrations of indoor air particles and airborne bacteria increased during the surgery but were within acceptable levels. However, the concentration of CO2, reached a high level of 1,791 ppm due to the CO2 gas required for maintaining the pneumoperitoneum during the surgery. Implications: The results emphasized the use of ventilation and filtration in a laparoscopic surgery room to lower the concentration of filterable and non-filterable contaminants.