• 대한수의학회지
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• 제45권2호
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• pp.263-271
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• 2005

To compare the sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam (n = 5, TZ group), xylazine-ketamine (n = 5, XK group) and propofol (n = 5, PI group), we investigated the changes of hemodynamic (heart rate, arterial pressure), $SpO_2$, rectal temperature, respiratory rate and pain score during 60 minute sedation and 40 minute recovery period in beagle dogs. The value of rectal temperature was significantly higher in PI groups (p<0.05) during recovery period. The value of heart rate was significantly lower in XK group (p<0.05) during sedation. The changes of respiratory rate were similar tendency in all groups. The change of $SpO_2$ was stable during sedation and value was significantly higher in PI group (p<0.05) during recovery period. The value of systolic arterial pressure (SAP) was significantly lower in XK group (p<0.05) than PI group during sedation and recovery period. Low analgesic effect occurred in PI group. We concluded that intravenous anesthesia by intermittent bolus injection with propofol is useful in stabilizing rectal temperature, $SpO_2$ and hemodynamic during sedation and provide fast recovery, but have low analgesic effect.

• 대한치과마취과학회지
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• 제9권2호
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• pp.98-103
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• 2009

Background: Despite increasing popularity of dental implants, there is limited information on the pain experience associated with the surgical implant placement under general anesthesia. The aim of this study was to assess the characteristics of patient-reported pain and efficacy of patient controlled analgesia after implant surgery under general anesthesia. Methods: Total 39 patients who underwent implant surgery under general aensthesia were enrolled. In PCA group (n=30), patients received patient controlled analgesia (fentanyl 700 mg and ketorolac 150 mg) set to basal rate 1 ml/h, bolus 1 ml, and lockout interval 10 min. In control group (n=9), patients received ketorolac 30 mg intravenously when they feel painful. We evaluated pain intensity using VAS score at the end and after 12 hr of the operation and recorded the number of bolus injection as a surrogate of rescue therapy. We compared the VAS data, the frequency of complication between two groups. Results: The self reported pain was highest at 1 hous after surgery in both groups. However, the intensity was not severe (PCA group = 5.7, control group = 5.6), and decreased gradually thereafter. Total demand bolus number was less than 6 in nearly 65% patients. And there was no significant difference in the frequency of complications such as nausea, vomiting and dizziness between both groups. Conclusions: The Pain following the surgical placement of dental implants was generally mild and gradually decreased with time. There was no difference in complications between control group and PCA group.

• The Korean Journal of Pain
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• 제6권1호
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• pp.32-39
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• 1993

전북대학교 병원에 입원하여 하복부 수술을 받는 미국 마취과학회 전신상태 분류상 class I, II인 환자 40명을 대상으로 수술후 morphine(1군)과 ketorolac(2군)을 지속적으로 정주한 결과 다음과 같은 결론을 얻었다. 1) 1군과 2군 모두 수술후 통증에 의의 있는 감소를 보였으며 군 간의 차이는 없었다. 2) 1군에서 2군보다 부작용의 빈도가 많았다. 이상의 결과로 수술후 통증 관리에 있어서 morphine과 ketorolac의 지속적 정맥 주입 방법은 모두 효과적이었으며, ketorolac이 morphine보다 부작용의 발현 빈도가 더 적은것으로 보아 morphine을 대신할 수 있는 유용한 약물로 사료된다.

• The Korean Journal of Pain
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• 제6권1호
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• pp.55-59
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• 1993

Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

• Journal of Pharmaceutical Investigation
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• 제29권3호
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• pp.211-216
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• 1999

To evaluate the thrombolytic activity of streptokinase-dextran conjugate, a rat model of arterial thrombosis was used. Briefly, the femoral artery was exposed and a filter paper saturated with 70% $FeCl_3$ solution was placed around the femoral artery in order to stop the blood flow. Six minutes after the stop of the blood flow in the femoral artery, streptokinase $(10000{\sim}30000\;units\;per\;rat)$ or streptokinase-dextran conjugate $(5000{\sim}17000\;units\;per\;rat)$ was administered by i.v. bolus injection through the femoral vein. Then the blood flow in the femoral artery was monitored using a Doppler laser flow meter. The i.v. bolus administration of streptokinase could not restore the blood flow in the femoral artery in the dose range of $10000{\sim}30000$ units per rat. The i.v. bolus administration of streptokinase-dextran conjugate could restore the blood flow in the femoral artery in the dose range of $5000{\sim}17000$ units per rat. A good correlation between the dose of streptokinase-dextran conjugate and the total thrombolytic effect was observed. In addition, the lag time between the injection of streptokinase-dextran conjugate and the restoring of the blood flow was decreased as the i.v. dose of streptokinase dextran conjugate increased. These results show the superior beneficial effect of streptokinase-dextran conjugate compared with the unconjugated streptokinase with respect to the elongation of thrombolytic activity, the administration method (single injection versus continuous infusion), and the reduced dose necessary for a equivalent thrombolytic effect.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1021-1030
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• 2018

Objective: We evaluated the effect of various patient characteristics and time-density curve (TDC)-factors on the test bolus-affected vessel enhancement on coronary computed tomography angiography (CCTA). We also assessed the value of generalized linear regression models (GLMs) for predicting enhancement on CCTA. Materials and Methods: We performed univariate and multivariate regression analysis to evaluate the effect of patient characteristics and to compare contrast enhancement per gram of iodine on test bolus (${\Delta}HUTEST$) and CCTA (${\Delta}HUCCTA$). We developed GLMs to predict ${\Delta}HUCCTA$. GLMs including independent variables were validated with 6-fold cross-validation using the correlation coefficient and Bland-Altman analysis. Results: In multivariate analysis, only total body weight (TBW) and ${\Delta}HUTEST$ maintained their independent predictive value (p < 0.001). In validation analysis, the highest correlation coefficient between ${\Delta}HUCCTA$ and the prediction values was seen in the GLM (r = 0.75), followed by TDC (r = 0.69) and TBW (r = 0.62). The lowest Bland-Altman limit of agreement was observed with GLM-3 (mean difference, $-0.0{\pm}5.1$ Hounsfield units/grams of iodine [HU/gI]; 95% confidence interval [CI], -10.1, 10.1), followed by ${\Delta}HUCCTA$ ($-0.0{\pm}5.9HU/gI$; 95% CI, -11.9, 11.9) and TBW ($1.1{\pm}6.2HU/gI$; 95% CI, -11.2, 13.4). Conclusion: We demonstrated that the patient's TBW and ${\Delta}HUTEST$ significantly affected contrast enhancement on CCTA images and that the combined use of clinical information and test bolus results is useful for predicting aortic enhancement.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.129-143
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• 2022

Background: Patient-controlled analgesia (PCA) has been widely used as an effective medical treatment for pain and for postoperative analgesia. However, improper dose errors in intravenous (IV) administration of narcotic analgesics from a PCA infusion pump can cause patient harm. Furthermore, opioid overdose is considered one of the highest risk factors for patients receiving pain medications. Therefore, accurate delivery of opioid analgesics is a critical function of PCA infusion pumps. Methods: We designed a microbalance method that consisted of a closed acrylic chamber containing a layer and an oil layer with an electronic balance. A commercially available infusion analyzer (IDA-5, Fluke Co., Everett, WA, USA) was used to measure the accuracy of the infusion flow rate from a commercially available smart PCA infusion pump (PS-1000, UNIMEDICS, Co., Ltd., Seoul, Korea) and compared with the results of the microbalance method. We evaluated the uncertainty of the flow rate measurement using the ISO guide (GUM:1995 part3). The battery life, delay time of the occlusion alarm, and bolus function of the PCA pump were also tested. Results: The microbalance method was good in the short-term 2 h measurement, and IDA-5 was good in the long-term 24 h measurement. The two measurement systems can complement each other in the case of the measurement time. Regarding battery performance, PS-1000 lasted approximately 5 days in a 1 ml/hr flow rate condition without recharging the battery. The occlusion pressure alarm delays of PS-1000 satisfied the conventional alarm threshold of occlusion pressure (300-800 mmHg). Average accuracy bolus volume was measured as 63%, 95%, and 98.5% with 0.1 ml, 1 ml, and 2 ml bolus volume presets, respectively. A 1 ml/hr flow rate measurement was evaluated as 2.08% of expanded uncertainty, with a 95% confidence level. Conclusion: PS-1000 showed a flow accuracy to be within the infusion pump standard, which is ± 5% of flow accuracy. Occlusion alarm of PS-1000 was quickly transmitted, resulting in better safety for patients receiving IV infusion of opioids. PS-1000 is sufficient for a portable smart PCA infusion pump.

• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.289-295
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• 2017

본 연구는 유방암 방사선치료 시 반대편 유방의 피부선량을 경감시키기 위해 Radon phantom을 이용하여 조직등가물질인 볼루스 5 mm, 10 mm를 적용해 종속조사면 병합치료방법(FIF)과 쐐기접선조사(Wedge 15, 30) 그리고 세기조절방사선치료계획(IMRT)을 이용하여 선량비교평가를 시행하고자 하였으며, 치료처방으로 50.4 Gy로 시행하였다. 선량비교평가 방법으로 광자극발광선량계를 이용하여 치료 부위 반대편 유방의 8곳에 부착하여 각각의 치료 계획별로 선량을 측정하였다. 연구에 이용된 광자극발광선량계 중 재현성은 3% 이내인 25개를 사용하였다. 연구 결과, FIF 치료계획에서는 볼루스 없이 측정된 결과 대비 5 mm와 10 mm 평균 감소율은 각각 37.23 cGy와 41.77 cGy이었으며, Wedge $15^{\circ}$를 이용한 치료계획에서 평균 감소율은 각각 70.69 cGy, 87.57 cGy였다. 또한 IMRT에서는 각각 67.37 cGy와 83.17 cGy의 감소율을 보여주었다. 볼루스를 이용한 결과는 모든 치료계획에서 볼루스의 두께가 증가할수록 선량 감소폭이 커지는 결과를 보여주었다.

• 한국의학물리학회지:의학물리
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• 제27권2호
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• pp.93-97
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• 2016

유방암 환자에 대한 세기조절방사선치료(IMRT)를 수행함에 있어서 환자의 호흡이 계획표적부피(PTV) 내의 선량분포에 미치는 영향을 평가하고 그 영향을 감소시킬 수 있는 방안에 대해 연구를 수행하였다. 이에 따라 호흡위상별 전산화단층 촬영술(4DCT) 영상을 획득하여 IMRT 치료계획에 적용하고 호흡위상 30%와 60%, 90%에서 PTV에 조사된 선량분포와 선량균질지수(HI), 덮힘율지수(CVI), 처방선량지수(CI)를 선량-부피히스토그램(DVH)을 이용하여 비교하였다. 또한 치료 부위의 피부에 조직보상체와 가상계획표적부피 설정을 통하여 유방암 IMRT중에 발생할 수 있는 호흡운동에 의한 부작용 감소 효과를 평가해 보았다. 조직보상체를 사용하지 않는 경우에 HI가 2배 증가하고 CVI는 상대적으로 감소하였으나 조직 보상체와 가상계획표적부피를 사용한 경우에는 환자의 호흡에 따른 표적부피 선량 변화가 상대적으로 크지 않게 평가되었다. 따라서 유방암 환자의 대한 IMRT 치료에서의 정밀도 향상을 위하여 조직보상체 및 가상계획표적부피 사용이 한가지 방안이 될 수 있을 것으로 사료된다.

• 한국자기학회지
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• 제26권3호
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• pp.99-104
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• 2016

항암요법과 방사선치료를 병행하여 두경부암을 치료하는 환자의 경우 항암요법과 방사선치료를 거듭할수록 구토, 메스꺼움, 식욕부진 등의 이유로 환자의 체중 감소가 생기게 된다. 체중 감소는 목의 두께 변화로 나타날 수 있으며 이로 인해 치료하고자 하는 t 타겟과 주위 정상조직의 선량 전달에도 영향을 미치며 방사선이 전달되는 방향에 위치한 피부선량의 변화가 나타날 것으로 사료된다. 특히 비인두암 환자의 경우 비인두 구조가 다른 장기보다 복잡한 구조를 지니고 있고 치료방법인 토모테라피는 수 mm 차이로 급격한 선량 변화가 발생하므로 이러한 체중 감소의 변화에 주의 깊은 관찰이 필요하다. 현재 토모테라피의 경우 매 회 치료 전 정확한 자세 재현을 위한 영상 검증을 통해 이러한 움직임을 확인하고 그 값을 보정하여 치료를 수행한다. 그러나 환자의 체중 감소로 인하여 피부선량에 전달되는 선량 변화의 검증은 되지 않고 있다. 환자의 피부선량이 증가함으로써 나타나는 부작용은 환자의 삶의 질에 영향을 미칠 뿐 만 아니라 2차 암 발생률을 높일 수 있다. 이에 환자의 체중 감소로 인하여 나타나는 환자의 목 두께를 휴먼 팬톰에 볼루스를 올리고 두께를 조절해가며 변화시켜 필름을 이용하여 피부선량의 변화가 어떻게 나타나는지 분석해보고자 한다.