• Title/Summary/Keyword: 외과마취

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Prediction of Surgical Anesthesia in Medetomidine/Tiletamine/Zolazepam Anesthetized Dogs using Electroencephalography (Medetomidine/Tiletamine/Zolazepam 마취견에서 뇌전도를 이용한 외과마취의 평가)

  • Jang, Hwan-Soo;Kim, Jung-Eun;Lim, Jae-Hyun;Kwon, Young-Sam;Lee, Maan-Gee;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.540-545
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    • 2010
  • Changes of electroencephalogram (EEG), mean arterial blood pressure (MAP) and heart rate under surgical anesthesia were investigated in medetomidine (MED) and tiletamine/zolazepam (ZT)-anesthetized dogs. To determine the level of surgical anesthesia, pedal withdrawal reflex was regularly tested after ZT injection. The first time point without pain response was regarded as the beginning of surgical anesthesia (SSA). After SSA, the first time point showing positive pain response was considered the end of surgical anesthesia (ESA). Comparing the control, an additional significant decrease of ${\delta}2$ and ${\alpha}2$ was observed at SSA. Comparing the control, ${\delta}2$ was significantly decreased at ESA. Significant reductions of MAP were observed at pre-ESA and ESA. Heart rate significantly decreased in all stages. These results suggest that ${\delta}2$ band power is a valuable parameter for correlating surgical anesthesia in dogs anesthetized with MED and ZT.

Ultrasound-Guided Regional Nerve Block in Lower Extremity (하지에서의 초음파 유도 국소 신경 차단술)

  • Kang, Chan
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.50-59
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    • 2012
  • In the domain of orthopaedic surgery, application of regional nerve block for surgery or pain control in upper and lower extremities has been increased. By performing regional block of popliteal (sciatic), femoral, proximal saphenous nerve and ankle block under guidance of ultrasound, not only the safety, but also success rate of the procedure has increased, and amount of local anesthetics could be used less, too. Since the perineural single injection or continuous catheterization of diluted local anesthetics was performed more precisely and easily by the guidance of ultrasound, postoperative pain could be controlled without complications of PCA such as nausea, vomiting, etc. We will discuss about this ultrasound guided regional nerve block.

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Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

뇌압항진 환자의 마취관리

  • Kim, Heung-Dae
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.13-24
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    • 1986
  • 마취과 의사는 신경외과수술시 뇌압이 상승되어 있는 환자의 마취를 자주 접하게 된다. 따라서 이러한 환자에서 뇌압의 상승을 억제시키고 뇌압상승 요인들을 제거하며 적당한 뇌혈류량을 유지시킴으로서 이미 손상된 뇌조직을 보호하고 더 이상의 뇌손상을 가하지 않도록 노력해야 한다. 이를 위하여 마취과적 입장에서 고려해 보아야 할 여러 문제점들, 특히 두개강내 역학 즉 뇌용적, 뇌압, 뇌혈류, 뇌산소대사율의 유기적 관계와 마취과에서 쓰여지는 여러약제 및 기타 뇌압과 관계되는 약제 및 요인들에 관하여 기술해 보았다.

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Stress Response and Wound Healing of Surgical Incisions in Far Eastern Catfish, Silurus asotus (메기, Silurus asotus의 외과적 시술시 회복 및 생리학적 반응)

  • Gi, Hyun Woo;Lee, Tae Ho;Park, In-Seok
    • Korean Journal of Ichthyology
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    • v.29 no.1
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    • pp.22-31
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    • 2017
  • To find out the stress response and wound healing of surgical incisions, we analyzed the change of stress hormone and the healing process in far eastern catfish, Silurus asotus. The survival rate of the clove oil (1,000 ppm) anesthesia group after surgery was about 90% in 3~42 days, while no anesthesia group showed about 74%. Thus, the survival rate after anesthesia group was higher than that of the no anesthesia group. The plasma cortisol concentration of the clove oil anesthesia group was higher than that of the no anesthesia group (P<0.05). In addition, the plasma glucose concentration of clove oil anesthesia group was higher than that of the no anesthesia group (P<0.05). The plasma lactic acid concentration of clove oil anesthetized group was higher than that of the not anesthetized group (P<0.05). On the 14 days and 28 days after surgery, there were still stitching fiber of suture and swimming behavior was not active. On the 35 days after surgery, trace of the suture has almost disappeared on the outside of the fish. Finally, 42 days after surgery, stitching fiber was not visible, and the sutured wounds were distinctly recovered. The results of this study showed that the anesthesia group showed higher survival rate and received less postoperative stress than that of the no anesthesia group. Surgical wound healing in the catfish of this study was shown to be successful when using anesthetics.

A CASE OF TRANSIENT RECURRENT LARYNGEAL NERVE PARALYSIS FOLLOWING ENDOTRACHEAL INTUBATION (기관내 삽관마취로 인한 일측반회 신경마비 1치험례)

  • 이강대;왕수건
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.16.2-16
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    • 1987
  • 최근 전신마취의 발달로 외과영역에서는 괄목할만한 수술적 진전을 보여 왔으나, 이에 못지 않게 전신마취에 의한 여러 가지 합병증의 보고가 늘고 있다. 특히 이비인후과영역에서는 술후 뚜렷한 원인없이 사성 및 호흡곤란 등을 호소하는 환자들을 종종 접하게 되며, 추정할 수 있는 유인으로는 대개 후두 및 기관점막의 염증, 후두결절, 후두육아종 등이 대부분이나 때로 매우 희귀하지만 원인 불명의 성대마비로 인한 경우도 있다. 저자는 최근 술전에 전혀 후두증상이 없었던 환자로서 기관내 삽관마취하 이하선 혼합종수술후에 속발한 일측성 반회신경마비례를 경험하였기에 문헌적 고찰과 함께 보고하고자 한다.

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Retrospective Analysis of Equine General Anesthesia Performed at Korea Racing Authority (한국마사회에서 실시한 말의 전신마취에 대한 후향 분석)

  • Kim, Ahrham;Yang, Youngjin;Song, Daeyoung;Kim, Jinkap;Kim, Hagi;Kwon, Cheoljae;Seo, Eugene;Jeong, Hyohoon;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.102-107
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    • 2014
  • This study was conducted to analyze the results of inhalation anesthesia performed at the equine hospital of Korea Racing Authority (KRA) and to find out the influencing factors on mortality during and/or after inhalation anesthesia. Among 585 cases of anesthesia, orthopedic surgery (410) was performed the most frequently, followed by colic surgery (85) and upper airway surgery (45). Twenty out of 585 horses were either euthanized or died during and/or after anesthesia. Among those twenty horses, fourteen horses received colic surgery, three received orthopedic surgery, and three others received upper airway surgery. The major causes of mortality were rupture of intestine in colic surgery and airway obstruction during recovery in upper airway surgery. Myopathy, refracture, laminitis were the causes of mortality in orthopedic surgery. Consequently, the horses that received colic and upper airway surgeries showed significantly high mortality rate rather than horses that received orthopedic surgery (p < 0.01). According to the results, horses that received colic surgery showed the highest mortality rate from euthanasia due to poor and grave prognosis. To reduce the perioperative mortality of horses, it is recommended to perform perioperative intensive care for colic surgery and careful monitoring for upper airway surgery during recovery.