• 대한의용생체공학회:의공학회지
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• 제11권2호
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• pp.257-268
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• 1990

A system has been developed for monitoring the effect of neuromuscular blocking frugs and the neuromuscular function during anesthesia and surgery. This system is composed of software and hardware, the latter are nerve stimulator, force transducer, interface board(preamplifier, filter, peripheral input/output) and personal computer (apple ll) , the former are programmed in ASSEMBLY and BASIC language. The nerve stimulator which is controlled by personal computer is capable of delivering single shocks at o.)Hz, train of four at 2Hz and tetanic stimulation at 30, 100, 200Hz. The response, adduction of the thumb, is sensed by the force transducer. The output of the force transducer Is amplified, filtered, converted digital signal and then processed by the per- sonal computer. The personal computer quantia4es twitch and traln of four tesponse and calculates the 74 ratio (Ta/Tl )between the first and fourth response of train of four. This ratio is used to estimate the level of the neuromuscular block. This system has reaserch potential for determining the effect of newer neuromuscular blocking drugs for comparlsion with presently used drugs of alternatively, for delerminig the effects of blocking drugs in altered physilogical states.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.173-178
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• 2020

We experienced a case of induction of general anesthesia without using neuromuscular blocking agents (NMBAs) in a 40-year-old woman with a history of anaphylaxis immediately after the administration of anesthetics lidocaine, propofol, and rocuronium to perform endoscopic sinus surgery 2 years before. The skin test showed a positive reaction to rocuronium and cis-atracurium. We induced general anesthesia without using NMBAs after inducing airway anesthesia with lidocaine (transtracheal injection and superior laryngeal nerve block). Deep general anesthesia was maintained with end-tidal 4 vol% sevoflurane. Hypotension was treated with phenylephrine infusion. The operation condition was excellent, and patient recovered without complications after surgery. Airway anesthesia with local anesthetics may be helpful when we cannot use NMBAs for any reason, including hypersensitivity to NMBA and surgery that needs neuromuscular monitoring.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.98-105
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• 2018

Objective: To evaluate whether the increase of the amplitude of motor evoked potentials (MEPs) during surgery can imply favorable prognosis postoperatively in spinal cord tumor surgery. Method: MEPs were monitored in patients who underwent spinal cord tumor surgery between March 2016 and March 2018. Amplitude changes at the end of monitoring compared to the baselines in limb muscle were analyzed. Minimum and maximum changes were set to $MEP_{min}$ (%) and $MEP_{max}$ (%). Strengths of bilateral 10 key muscles which were documented a day before ($Motor_{pre}$), 48 h ($Motor_{48h}$) and 4 weeks ($Motor_{4wk}$) after the surgery were reviewed. Results: Difference of $Motor_{48h}$ from $Motor_{pre}$ ($Motor_{48h-pre}$) and $Motor_{4wk}$ from $Motor_{pre}$ ($Motor_{4wk-pre}$) positively correlated with $MEP_{min}$, suggesting that smaller the difference of MEPs amplitude, less recovery of muscle strength. There was a negative correlation between the amount of bleeding and $MEP_{min}$, indicating that the greater the amount of bleeding, the smaller the $MEP_{min}$, implying that MEPs amplitude is less likely to improve when the amount of bleeding is large. It also showed significant difference between patients with improved or no change of motor status and patients with motor deterioration after surgery according to anatomical tumor types. Conclusion: Improve of muscle strength was less when the increase of MEPs amplitude was small, and improvement of MEPs amplitude was less when the amount of bleeding was large. Correlation between changes of status of muscle strength after surgery and tumor types was observed. With amplitude increase in MEPs monitoring, restoration of muscle strength can be expected.

• 구강회복응용과학지
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• 제22권1호
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• pp.89-100
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• 2006

Traditionally, goals of orthodontic treatment fall into four categories: good tooth alignment, improvement of skeletal profile and good soft tissue, and rehabilitation of the normal function. Electromyography (EMG) has proven as useful tool in evaluating masticatory function among the maxillomandibular relationship and could be useful in accompanying orthodontic treatment objectives. But in pursuit of clinical application, it is necceassry to systemize clinical guideline for diagnosis by EMG records in evaluating the effects of orthodontic, orthopedic, or surgical treatment. This study present 3 orthodontic cases, which treatment results, ie neuromuscular balances of masticatory muscle, could be moitered by EMG procedure.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.233-237
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• 2022

Postpolio syndrome (PPS) is widely known to manifest as muscle weakness in patients affected by poliomyelitis in early childhood. This is caused by the long-term overwork of motor nerves regenerated from surviving nerve cells. We report a characteristic delay in recovery from muscle relaxation after administering rocuronium to a patient with PPS under general anesthesia with desflurane. A 59-year-old woman was scheduled to undergo surgical debridement for jaw osteonecrosis. She had a history of poliomyelitis at the age of 2 years, and was diagnosed with PPS at the age of 51 years. General anesthesia was induced with 80 mg propofol, 50 ㎍ fentanyl, and 30 mg (0.69 mg/kg) rocuronium, and maintained with desflurane and remifentanil. The durations of train-of-four (TOF) count 0 and 1 were 96 and 37 min, respectively. Five minutes after discontinuing desflurane, the TOF count was 4. Three minutes after administering 200 mg sugammadex, the TOF ratio was 0.83, and the tracheal tube was subsequently removed. In summary, the effect of a single dose of rocuronium on twitch in TOF monitoring was significantly prolonged in a patient with PPS, which may have been exacerbated by desflurane.

• The Korean Journal of Physiology and Pharmacology
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• 제18권6호
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• pp.461-467
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• 2014

The hypothesis of this study was that diabetes-induced desensitization of rat soleus (SOL) and extensor digitorum longus (EDL) to non-depolarizing muscle relaxants (NDMRs) depends on the stage of diabetes and on the kind of NDMRs. We tested the different magnitude of resistance to vecuronium, cisatracurium, and rocuronium at different stages of streptozotocin (STZ)-induced diabetes by the EDL sciatic nerve-muscle preparations, and the SOL sciatic nerve-muscle preparations from rats after 4 and 16 weeks of STZ treatment. The concentration-twitch tension curves were significantly shifted from those of the control group to the right in the diabetic groups. Concentration giving 50% of maximal inhibition ($IC_{50}$) was larger in the diabetic groups for all the NDMRs. For rocuronium and cisatracurium in both SOL and EDL, $IC_{50}$ was significantly larger in diabetic 16 weeks group than those in the diabetic 4 weeks group. For SOL/EDL, the $IC_{50}$ ratios were significantly largest in the diabetic 16 weeks group, second largest in the diabetic 4 weeks group, and smallest for the control group. Diabetes-induced desensitization to NDMRs depended on the stage of diabetes and on the different kind of muscles observed while was independent on different kind of NDMRs. The resistance to NDMRs was stronger in the later stage of diabetes (16 versus 4 weeks after STZ treatment). Additionally, when monitoring in SOL, diabetes attenuated the actions of neuromuscular blockade more intensely than that in EDL. Nonetheless, the hyposensitivity to NDMRs in diabetes was not relevant for the kind of NDMRs.

• 대한임상검사과학회지
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• 제52권4호
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• pp.317-326
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• 2020

마취는 의식의 차단 역할을 하는 주 마취제와 감각, 운동, 반사의 차단을 하는 부 마취제인 근이완제로 구분된다. 깊은 의식의 차단만으로는 심한 자극에 대한 반응을 막을 수 없고, 다량의 진통제만으로는 무의식을 보장할 수 없다. 그러므로 마취는 동시에 두 가지를 모두 만족시켜야 한다. 근 이완제는 흡입 또는 정맥마취제의 투여 용량을 감소시키면서 기관지내 삽입관, 수술 시야 및 수술적 환경(operating conditions)을 향상시킬 수 있으며, 수술 중 기계적 조절 환기(controlled mechanical ventilation) 시 호흡 관리를 위하여 매우 중요하다. 이러한 근이완제는 투여 용량이 과다하면 수술 중 신경 검사가 안 되는 영향을 줄 수 있고, 투여 용량이 부족하게 되면 환자가 수술 중 움직일 수 있어서 근 이완 마취 심도와 수술 중 감시 검사는 밀접한 관계가 있다. 근 이완제를 많이 사용하면, 수술 중 신경생리학적 검사가 원활하게 되지 않는 단점과 수술 이후에 완전히 근 이완효과를 제거하기 어렵다는 단점도 갖고 있다. 수술 중 감시 검사를 하는 수술에서 마취과에서는 어떠한 기준으로 근 이완제를 투여하며 유지하는지에 대하여 국내뿐만 아니라 전 세계적인 동향을 살펴 봄으로써 보다 원활한 수술 중 신경 검사가 되길 바란다.

• 한국임상수의학회지
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• 제39권5호
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• pp.226-234
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• 2022

To evaluate butorphanol and tramadol as adjuvants to lidocaine in dogs undergoing mandibular nerve block. Fifteen beagles were allocated to groups based on the following treatments: lidocaine alone (L group), lidocaine + butorphanol (LB group), or lidocaine + tramadol (LT group). After mandibular nerve block with opioids as an adjunct to local anesthetics, the onset time, duration of action, and depth of anesthesia were evaluated using a quantitative method through neuromuscular blockades (NMBs) monitoring. The onset time of nerve block was 4.60 ± 2.06 min, 2.00 ± 0.00 min, and 2.60 ± 1.62 min in the L, LB, and LT groups, respectively; however, there was no statistically significant difference. The duration of nerve block was 111.88 ± 34.78 min, 302.00 ± 76.72 min, and 260.40 ± 49.88 min in the L, LB, and LT groups, respectively, with a significant difference between L and LB groups. The LB group demonstrated a more profound depth of anesthesia compared to the L and LT groups. In this study, using a quantitative method through NMBs monitoring, it was demonstrated that lidocaine and butorphanol in combination can increase the duration of nerve block and more profound the depth of anesthesia rather than lidocaine alone. Additionally, the combined use of lidocaine and opioids presented an objective indicator that could provide a more clinically stable nerve block.

• Ocean and Polar Research
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• 제30권1호
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• pp.109-117
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• 2008

해양환경 건강성 평가에서 바이오마커의 적용은 상대적으로 새로운 분야이다. 국립학술원 및 세계보건기구에 따르면 바이오마커는 노출바이오마커, 영향바이오마커 및 민감바이오마커 등 3가지로 나누어진다. 해양생태계에 대한 환경오염물질의 노출 및 영향을 평가하기 위하여 다음과 같은 바이오마커들이 시험되고 있다: 해독, 산화스트레스, 분해산물, 스트레스 반응, 세포사멸, 물질대사, 신경반응, 생식, 스테로이드 호르몬, 항산화물질, 유전적 변형. 1990년대 초부터 여러 바이오마커 연구그룹들은 해양생물의 건강지수를 개발하여 해양환경의 상태를 평가하기 위한 수단으로 활용해 왔다. 바이오마커 지수는 생물학적 효과에 대한 모니터링활동으로부터 얻어진 자료의 해석에 사용될 수 있다. 본 총설에서는 이제까지 보고된 바이오마커 지수 관련 연구 중 대표적인 건강평가지수(Health assessment Index), 바이오마커 지수(Biomarker Index), 생물영향평가지수(Bioeffect Assessment Index) 및 일반화된 선형모델(Generalized Linear Model) 등의 연구를 요약하였다. 오염된 지역에 서식하는 해양생물의 바이오마커 반응 측정 및 바이오마커 지수 개발은 다양한 측면의 해양생태계 위해성 평가를 위해 고안된 환경모니터링 프로그램에 공헌할 수 있는 정보를 제공해 줄 수 있을 것이다.