• 제목/요약/키워드: general IV anesthesia

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신장기능(腎臟機能)에 미치는 몇가지 전신마취제(全身麻醉劑)의 영향(影響) (Effects of General Anesthetic Agents on the Renal Function of Rabbits)

  • 김선희;조경우;송희선
    • The Korean Journal of Physiology
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    • 제17권1호
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    • pp.29-35
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    • 1983
  • The most popular way to get the animal to be co-operative for the animal experimentation is by using some kinds of general anesthetic agents. One of the most important point to take care of is, however, whether the agent(s) to be used is hinder the experimentation itself. There have been many contradictory reports of the general anesthetic agents on the renal function. Moreover, little information on the changes of the renal function by anesthesia has been available. We have done experiments to clarify and compare the effects of anesthesia induced by several general anesthetic agents on renal function in unanesthetized rabbits. Nembutal anesthesia(30 mg/kg, iv.) caused a decrease in free-water clearance, and increase in sodium and chloride excretion without significance. Thiopental anesthesia$(20{\sim}30\;mg/kg,\;iv.)$ suppressed all renal parameters tested. Chloralose(50 mg/kg, iv.) and chloral hydrate(75 mg/kg, iv.) did not change renal functions except for glomerular filtration rate, which parameter was suppressed only for a short period just after agent administration. Urethane(1 g/kg), administered by the route of either subcutaneously or intraperitoneally, suppressed renal functions lasted for the duration of experimental anesthesia. The above data suggest that it is very important to chose an appropriate anesthetic agents for a given experiment, especially experiment involved with renal function, and to interprete the data obtained from the anesthetized animal model for the expected results.

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울혈성 심부전증 환자의 앉은 자세에서의 마취 유도 (Anesthetic Induction in a Sitting Position for a Patient with Congestive Heart Failure)

  • 김승동;정걸;지대림
    • Journal of Yeungnam Medical Science
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    • 제25권2호
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    • pp.150-153
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    • 2008
  • A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.

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Dental treatment in patients with severe gag reflex using propofol-remifentanil intravenous sedation

  • Shin, Sooil;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권1호
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    • pp.65-69
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    • 2017
  • Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

복강경하 담낭절제술환자에서의 마취방법에 따른 수술 후 오심과 구토의 비교 (The Comparison of the Effects of Two Anaesthetic Techniques on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy)

  • 서윤주;박효선;양인순
    • 임상간호연구
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    • 제15권2호
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    • pp.67-75
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    • 2009
  • Purpose: Postoperative nausea and vomiting(PONV) is a common problem after general anesthesia. The aim of this prospective, double-blind randomized study was to compare the effect of Propofol-Remifentanil vs. Sevoflurane inhalational anesthetics on PONV after laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery participated in the study. Twenty of them received total intravenous anesthesia (TIVA group) with Propofol-Remifentanil, and the rest were given Sevoflurane inhalational anesthetics (inhalation group). The TIVA group was induced with Propofol 5mcg/ml and Remifentanil 3~4mcg/ml. The anesthesia was maintained with the continuous infusion of Propofol 2~3mcg/ml and Remifentanil 2~3mcg/ml IV. The inhalation group was induced with Pentotal Sodium 5mg/kg and 3~4mcg/kg/hr IV Remifentanil. Maintenance was obtained with 1.5~2.0 vol% Sevoflurane. Results: The subjects in TIVA group reported less PONV than those in Sevoflurane inhalation anesthesia group. Conclusion: Propofol-Remifentanil anesthesia (TIVA group) was considered a satisfactory anesthetic technique in reducing PONV in patients with laparoscopic cholecystectomy.

소아의 편도절제술시 Nalbuphine정주가 술후 진통에 미치는 영향 (The Effects of Intravenous Nalbuphine on the Posttonsillectomy Pain in Children)

  • 조대현;박재건;김명희
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.247-252
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    • 1998
  • Background: Tonsillectomy is one of the most common operation in children. Postoperative pain and its sequelae are universal complaints of the patients. The purpose of this study was to evaluate the effects of nalbuphine on the posttonsillectomy pain in children. Methods: Fifty-four pediatric patients undergoing tonsillectomy under general anesthesia were randomly allocated to one of the 3 groups 1) control group who received no analgesics, 2) received IV nalbuphine before induction of anesthesia and 3) received IV nalbuphine after both tonsillectomy. In postanesthetic recovery room, comfort level in all patients was assessed using the objective pain scale (OPS). Systolic blood pressure, diastolic blood pressure and heart rate were measured at just before and immediately after extubation and postanesthetic recovery room. Results: The pain scale score in group 2 was significantly lower than group 1, but no significantly different with group 3. There were no significant differences in blood pressure among three groups. The heart rate in group 2 and 3 was significantly lower than group 1 only at immediately after arriving recovery room. Conclusions: Administration of nalbuphine before induction is more effective on postoperative pain control after tonsillectomy in children.

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타조에서 전위절개술을 통한 매복의 치유예 (A Case Report of Proventriculotomy for Impaction of Proventriculus in Ostrich)

  • 김남수;이종일
    • 한국임상수의학회지
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    • 제16권2호
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    • pp.469-473
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    • 1999
  • A 120 kg, 3-year-old, male ostrich (Struthio camelus) was submitted to the veterinary teaching hospital, Chonbuk national university, for chronic weight loss, anorexia, small hard fecal pellets, and lethargy. Illness was first noticed approximately 2 weeks before submission. Although the bird was able to stand, he was extremely weak and cachectic. Blood examination indicated that the bird was dehydration (PCV: 55%). Fluoroscopic and lateral abdominal radio-graphic view indicated impaction of distended proventriculus with bigger rocks than normal. Anesthesia was induced with ketamine (10 mg/kg, IV)-xylazine (1 mg/kg, IV) combination and maintained with ketamine (10 mg/kg, IV) at intervals of 8 to 15 minutes during the entire procedure. After induction of general anesthesia, the bird was positioned in dorsal recumbency. The skin was incised approximately 15cm caudal to the caudal margin of the sternum and extended 20 to 25 cm caudally. After the proventriculotomy was peformed, the impacted material that weighed 3kg contained rocks in 4 to 6cm diameter was removed. The incision of proventriculus was closed in 2 layers. Cephalothin sodium (30 mg/kg, IV, q12hrs) and dexamethazone (2 mg/kg, IM, q24hrs) was administered before and after 5 days of the operation. The bird was eating well and defecating normal feces after 3 weeks of the surgery

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Surgical Management of Rectal Prolapse in an Elk Bull

  • Hyohoon Jeong;Young-Sam Kwon
    • 한국임상수의학회지
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    • 제40권1호
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    • pp.73-77
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    • 2023
  • Rectal prolapse is encountered in all domestic animal species but clinical report regarding the condition in the elk is limited. A 10-year-old elk bull weighing 400 kg was referred to the Large Animal Hospital of Kyungpook National University with clinical signs including intermittent tenesmus related to rectal prolapse and anorexia for the previous 5 days. Type II rectal prolapse was diagnosed based on the history and clinical signs. An emergency resection and anastomosis including a purse string suture was performed under general intravenous (IV) anesthesia in field to prevent injury of the patient and the staff. The patient recovered uneventfully after the surgery without excitement. A systemic antibiotic and an anti-inflammatory drug were given to prevent postoperative complication and relieve pain. The follow up on the patient after 4 weeks of the surgery showed that the prolapse recurred due to intermittent straining after 2 weeks of the surgery. The patient was on the glucocorticoid for the following 3 days but was finally euthanized owing to the exacerbation of the prolapse 1 week after the recurrence. This report describes a rare case of rectal prolapse in an elk bull and the clinical outcome of the surgical repair in detail.

수액가온요법과 피부가온요법이 개복술 환자의 저체온 예방에 미치는 효과 비교 (A comparison of the Effects of Intravenous Fluid Warming and Skin Surface Warming on Peri-operative Body Temperature and Acid Base Balance of Elderly Patients with Abdominal Surgery)

  • 박효선;윤혜상
    • 대한간호학회지
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    • 제37권7호
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    • pp.1061-1072
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    • 2007
  • Purpose: The purpose of this study was to compare the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of abdominal surgical patients under general anesthesia. Method: Data collection was performed from January 4th, to May 31, 2004. The intravenous fluid warming(IFW) group(30 elderly patients) was warmed through an IV line by an Animec set to $37^{\circ}C$. The skin surface warming(SSW) group(30 elderly patients) was warmed by a circulating-water blanket set to $38^{\circ}C$ under the back and a 60W heating lamp 40 cm above the chest. The warming continued from induction of general anesthesia to two hours after completion of surgery. Collected data was analyzed using Repeated Measures ANOVA, and Bonferroni methods. Results: SSW was more effective than IFW in preventing hypothermia(p= .043), preventing a decrease of $HCO_3{^-}$(p= .000) and preventing base excess(p= .000) respectively. However, there was no difference in pH between the SSW and IFW(p= .401) groups. Conclusion: We conclude that skin surface warming is more effective in preventing hypothermia, and $HCO_3{^-}$ and base excess during general anesthesia, and returning to normal body temperature after surgery than intravenous fluid warming; however, skin surface warming wasn't able to sustain a normal body temperature in elderly patients undergoing abdominal surgery under general anesthesia.

부인과 수술 후 Ondansetron과 병용한 Dexamethasone의 오심, 구토 예방과 제통 효과의 비교 (Comparison of Ondansetron with Ondansetron and Dexamethasone in Preventing of PONV in Major Gynecologic Surgery)

  • 이기흥;신효상;전영훈;김시오;홍정길
    • The Korean Journal of Pain
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    • 제14권1호
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    • pp.76-82
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    • 2001
  • Background: Postoperative nausea and vomiting (PONV) are common after general anesthesia and patient controlled analgesia (PCA) using opioids. This study was designed to compare the effectiveness of ondansetron plus dexamethasone versus ondansetron alone in the prevention of PONV in a patient undergoing a PCA. Methods: We studied 166 ASA I, and II in-patients undergoing general anaesthesia for major gynecological surgery. After induction of anesthesia, Group 1 (n = 64) received intravenous (IV) dexamethasone 10 mg and Group 2 (n = 102) received IV saline 2 ml before the surgical incision. Each patient received IV meperidine 50 mg as a loading dose. Meperidine 5 mg/kg, ketorolac 3.6 mg/kg and ondansetron 8 mg diluted in 40 ml solutions were connected to PCA pump for postoperative pain control. Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 1, 4, 8, 16, 24, and 36 hours after the PCA connection. Results: For Group 1 and Group 2, respectively, the overall incidence of PONV was 12.5% and 23.5%. The pain scores were lower in patients receiving a combination of ondansetron and dexamethasone than those on ondansetron alone at 4 hr (P < 0.05), 8 hr (P < 0.05) and 16 hr (P < 0.05). Conclusions: This study suggests that the combination of ondansetron and dexamethasone is not more effective than ondansetron alone in the prevention of postoperative nausea and vomiting in women having PCA following major gynecological surgery but is more effective for pain control.

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전신마취 또는 정주진정 하 치과치료가 소아 환자의 구강 건강과 관련된 삶의 질에 미치는 영향 (Impact of Dental Treatment under General Anesthesia or Intravenous Sedation on Oral Health-related Quality of Life in Pediatric Dental Patients)

  • 송지수;김영재
    • 대한소아치과학회지
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    • 제43권1호
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    • pp.27-35
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    • 2016
  • 본 연구는 전신마취 또는 정주진정 하 치과치료가 주 양육자가 인식하는 환아의 구강 건강과 관련된 삶의 질과 환아 가족의 일상생활에 미치는 영향을 확인하기 위해 시행되었다. 10세 이하의 건강한 환아와 그 환아의 주 양육자를 대상으로 연구가 진행되었다. 환아가 전신마취 또는 정주진정 하 치과치료를 위해 내원한 당일, 치료 시작 전에 환아의 주 양육자가 설문지를 작성하고, 치료 후 6개월 이내에 동일한 주 양육자가 동일한 설문지를 다시 작성하였다. 총 43명의 환아가 연구 대상에 포함되었으며, Child Oral Health Impact Profile(COHIP)과 Family Impact Scale(FIS)의 대한민국 버전이 설문에 사용되었다. COHIP과 FIS 점수 모두 술 전에 비하여 술 후에 개선되었다. 성별은 COHIP 및 FIS 점수의 개선에 별다른 영향을 주지 않았으며, 연령은 COHIP 점수의 개선에 영향을 주지 않았다. 그러나 어린 환아의 경우 술 전 FIS 점수가 더 양호한 것으로 나타났다. 치수치료를 한 경우에는 COHIP 점수가 더 크게 개선되었으며, 구치부 기성금속관 수복을 한 경우에는 FIS 점수의 개선 정도가 적었다. 전치부 심미수복 여부와 전치부 조기 발거 여부는 COHIP 및 FIS 점수의 개선 정도에 영향을 주지 않았다. 결론적으로, 전신마취 또는 정주진정 하 치과치료는 주 양육자가 인식하는 환아의 구강 건강과 관련된 삶의 질을 개선시킨다.