61 results on '"Ka-Young Rhee"'
Search Results
2. Comparison emergence of sedation, using dexmedetomidine and remimazolam, in spinal anaesthesia -- double blinded randomized controlled trial.
- Author
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Seung-Wan Hong, Jun-Young Park, Ka-Young Rhee, and Seong-Hyop Kim
- Published
- 2024
- Full Text
- View/download PDF
3. Effect of muscle relaxation on the oxygenation of human skeletal muscle: a prospective in-vivo experiment using an isolated forearm technique
- Author
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Ka Young Rhee, Tae-Yop Kim, In Su Oh, Seoung Joon Lee, and Thomas Ledowski
- Subjects
neuromuscular blockade ,near-infrared spectrometry ,skeletal muscles ,tourniquets ,Anesthesiology ,RD78.3-87.3 - Abstract
BackgroundTotal oxygen consumption has been found to be reduced under deep neuromuscular blockade due to a lower rate of metabolism of skeletal muscles. However, the magnitude of this effect in individual muscles has not been investigated. Thus the aim of this study was to compare the oxygenation of paralyzed versus non-paralyzed forearm muscle under tourniquet-provoked ischemia.MethodsAfter ethics approval and written informed consent, 30 patients scheduled for elective hand and wrist surgery were included. Ischemia was provoked by inflation of bilateral upper arm tourniquets and muscle relaxation was achieved via intravenous administration of rocuronium 0.9 mg/kg. Bilateral tourniquets were applied to both upper arms before induction of anesthesia and near infrared spectrometry (NIRS) electrodes applied on both forearms. Muscular ischemia in an isolated (= non-paralyzed, NP) as well as a paralyzed forearm (P) was created by sequential inflation of both tourniquets before and after intravenous administration of rocuronium. Muscle oxygen saturations (SmO2) of NIRS in both forearms and their changes were determined and compared.ResultsData of 30 patients (15 male, 15 female; 41.8 ± 14.7 years) were analyzed. The speed of SmO2 decrease (50% decrease of SmO2 from baseline (median [percentiles]: NP 210 s [180/480s] vs. P 180 [180/300]) as well as the maximum decrease in SmO2 (minimum SmO2 in % (median [percentiles]: NP 20 [19/24] vs. P 21 [19/28]) were not significantly affected by neuromuscular paralysis.ConclusionsNo significant effect of muscle relaxation on NIRS-assessed muscle oxygenation under tourniquet-induced ischemia was found in human forearm muscles.
- Published
- 2015
- Full Text
- View/download PDF
4. A heated humidifier does not reduce laryngopharyngeal complaints after brief laryngeal mask anesthesia
- Author
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Duk-Kyung Kim, Ka-Young Rhee, Won-Kyoung Kwon, Tae-Yop Kim, and Joo-Eun Kang
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- 2007
- Full Text
- View/download PDF
5. Impact of Anesthetic Agents on Endothelial Glycocalyx Injury during Total Knee Arthroplasty: Desflurane- vs. Propofol-Based Anesthesia-A Prospective Randomized Controlled Trial
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Hyun-Jun Park, Liyun Piao, Seong-Hyop Kim, Eun Hi Park, Ji Min Choi, Chung-Sik Oh, and Ka Young Rhee
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Male ,Article Subject ,Remifentanil ,Glycocalyx ,General Biochemistry, Genetics and Molecular Biology ,law.invention ,03 medical and health sciences ,Desflurane ,0302 clinical medicine ,Randomized controlled trial ,030202 anesthesiology ,law ,medicine ,Humans ,Prospective Studies ,Arthroplasty, Replacement, Knee ,Propofol ,Aged ,Anesthetics ,Tourniquet ,General Immunology and Microbiology ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Oxygenation ,Anesthesia ,Anesthetic ,Arterial line ,Medicine ,Female ,business ,Anesthetics, Intravenous ,medicine.drug ,Research Article - Abstract
Background. Ischemia-reperfusion injury and inflammation after tourniquet deflation in total knee arthroplasty are known to be associated with endothelial glycocalyx (EG) injury. This study is aimed at comparing EG injury between desflurane- and propofol-based anesthesia in patients undergoing total knee arthroplasty. Materials and Methods. Patients were allocated to the desflurane group or propofol group. The opioid remifentanil was administered intraoperatively in both groups. Blood samples were obtained from the arterial line preoperatively, immediately before and 5 min after tourniquet deflation, and at 1, 6, and 24 h, postoperatively. Serum syndecan-1, cytokines (interleukin-1β, 6, 10, and tumour necrosis factor-α), and other laboratory values were investigated. Results. Eighty patients were included in the final analysis. The change in syndecan-1 did not significantly differ between the desflurane and propofol groups (peak median level of syndecan-1; 754.5 pg/ml vs. 780.3 pg/ml, respectively, P = 0.512 ). Laboratory values (serum cytokines, creatinine phosphokinase, lactate dehydrogenase, and lactate levels) were also similar between the two groups. Pulmonary oxygenation was briefly improved after tourniquet deflation in the desflurane group but was similar between the two groups begging at 1 h, postoperatively. Conclusions. The effect of desflurane was not superior to that of propofol in protecting the EG from ischemia-reperfusion injury during total knee arthroplasty. This trial is registered with Trial Registry Number NCT02756715 (http://clinicaltrials.gov).
- Published
- 2020
6. High-dose ulinastatin improves postoperative oxygenation in patients undergoing aortic valve surgery with cardiopulmonary bypass: A retrospective study
- Author
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Ju Deok Kim, Ka Young Rhee, Nazri Mohamad, Tae-Yop Kim, Tae-Yun Sung, and Hyun Kang
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Male ,Medicine (General) ,aortic valve surgery ,030204 cardiovascular system & hematology ,Biochemistry ,intensive care unit ,law.invention ,chemistry.chemical_compound ,0302 clinical medicine ,Postoperative Complications ,law ,Hypothermia, Induced ,Medicine ,Postoperative Period ,Lung ,ulinastatin ,Cardiopulmonary Bypass ,General Medicine ,Middle Aged ,Intensive care unit ,Intensive Care Units ,surgical procedures, operative ,Anesthesia ,Aortic Valve ,Female ,Trypsin Inhibitors ,circulatory and respiratory physiology ,Adult ,Acute Lung Injury ,Aortic Valve Insufficiency ,Clinical Reports ,03 medical and health sciences ,R5-920 ,Cardiopulmonary bypass ,Humans ,In patient ,Aged ,Glycoproteins ,Retrospective Studies ,business.industry ,Biochemistry (medical) ,Retrospective cohort study ,Cell Biology ,Oxygenation ,pulmonary oxygenation ,Ulinastatin ,respiratory tract diseases ,Oxygen ,030228 respiratory system ,chemistry ,Aortic valve surgery ,business - Abstract
Objective To determine whether pre-treatment with high-dose ulinastatin provides enhanced postoperative oxygenation in patients who have undergone aortic valve surgery with moderate hypothermic cardiopulmonary bypass (CPB). Methods Patients who underwent aortic valve surgery with moderate hypothermic CPB were retrospectively evaluated. In total, 94 of 146 patients were included. The patients were classified into one of two groups: patients in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered during CPB (Group U, n = 38) and patients in whom ulinastatin was not administered (Group C, n = 56). The PaO2/FiO2 ratio was calculated at the following time points: before CPB (pre-CPB), 2 h after weaning from CPB (post-CPB), and 6 h after arrival to the intensive care unit (ICU-6). The incidence of a low PaO2/FiO2 ratio was also compared among the time points. Results Group U showed a significantly higher PaO2/FiO2 ratio (F(4, 89.0) = 657.339) and a lower incidence of lung injury (PaO2/FiO2 ratio Conclusion High-dose ulinastatin improved pulmonary oxygenation after CPB and in the early stages of the ICU stay in patients undergoing aortic valve surgery with CPB.
- Published
- 2018
7. Corrigendum: Effect of muscle relaxation on the oxygenation of human skeletal muscle: a prospective in-vivo experiment using an isolated forearm technique
- Author
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Ka Young Rhee, Tae-Yop Kim, In Su Oh, Seoung Joon Lee, and Thomas Ledowski
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Anesthesiology ,RD78.3-87.3 - Published
- 2015
- Full Text
- View/download PDF
8. Assessment of thrombosis in right internal jugular vein after percutaneous superior vena cava catheter insertion during cardiovascular surgery with cardiopulmonary bypass
- Author
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Ka Young Rhee, Seong-Hyop Kim, Chung-Sik Oh, and Tae-Gyoon Yoon
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Catheterization, Central Venous ,medicine.medical_specialty ,Vena Cava, Superior ,Percutaneous ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Superior vena cava ,medicine ,Humans ,cardiovascular diseases ,Internal jugular vein ,Aged ,Ultrasonography ,Cardiopulmonary Bypass ,Catheter insertion ,business.industry ,Incidence ,Central venous pressure ,Thrombosis ,Middle Aged ,medicine.disease ,Surgery ,Catheter ,030220 oncology & carcinogenesis ,cardiovascular system ,Female ,Radiology ,Jugular Veins ,Cardiology and Cardiovascular Medicine ,business ,Central venous catheter - Abstract
We evaluated the incidence of percutaneous superior vena cava catheter-related thrombosis and identified risk factors for developing the condition in patients undergoing cardiovascular surgery with cardiopulmonary bypass.A total of 121 patients were evaluated. A percutaneous superior vena cava catheter was inserted into the right internal jugular vein during cardiovascular surgery with cardiopulmonary bypass. The right internal jugular vein was evaluated using ultrasonography, including cross-sectional area and velocity just before insertion of the percutaneous superior vena cava catheter (preoperative) and 24 hours and 48 hours after its insertion. If an echogenic mass was detected in the right internal jugular vein, the size was measured.The incidence of thrombosis in the right internal jugular vein was 56.2%. Change in the right internal jugular vein cross-sectional area and velocity had no clinical implications. Multiple logistic regression analysis identified age (odds ratio, 1.061; 95% confidence interval, 1.022-1.101; P = .002), superior vena cava catheter indwelling duration (odds ratio, 1.015; 95% confidence interval, 1.008-1.023; P .001), and amount of transfusion platelet concentrate (odds ratio, 1.155; 95% confidence interval, 1.030-1.295; P = .013) as risk factors for percutaneous superior vena cava catheter-related thrombosis in the right internal jugular vein.The incidence of percutaneous superior vena cava catheter-related thrombosis was higher than conventional central venous catheter-related thrombosis. Risk factors were age, superior vena cava catheter indwelling duration, and amount of transfusion platelet concentrate.
- Published
- 2016
9. Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery
- Author
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Ka Young Rhee, Seong-Hyop Kim, Woon-Seok Kang, Chung-Sik Oh, Yun Gu Lee, Won-Kyoung Kwon, Suk Ha Lee, and Tae-Hoon Kim
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Mechanical ventilation ,medicine.medical_specialty ,Supine position ,business.industry ,medicine.medical_treatment ,Hemodynamics ,030208 emergency & critical care medicine ,Lumbar vertebrae ,Surgery ,law.invention ,03 medical and health sciences ,Prone position ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Randomized controlled trial ,030202 anesthesiology ,law ,Spinal fusion ,Anesthesia ,Breathing ,medicine ,business - Abstract
Background The aim of study was to evaluate the effect of mechanical ventilation mode type, pressure-controlled ventilation (PCV), or volume-controlled ventilation (VCV) on intra- and postoperative surgical bleeding in patients undergoing posterior lumbar interbody fusion (PLIF) surgery. Methods This was a prospective, randomized, single-blinded, and parallel study that included 56 patients undergoing PLIF and who were mechanically ventilated using PCV or VCV. A permuted block randomization was used with a computer-generated list. The hemodynamic and respiratory parameters were measured after anesthesia induction in supine position, 5 min after patients were changed from supine to prone position, at the time of skin closure, and 5 min after the patients were changed from prone to supine position. The amount of intraoperative surgical bleeding, fluid administration, urine output, and transfusion requirement were measured at the end of surgery. The amount of postoperative bleeding and transfusion requirement were recorded every 24 h for 72 h. Results The primary outcome was the amount of intraoperative surgical bleeding, and 56 patients were analyzed. The amount of intraoperative surgical bleeding was significantly less in the PCV group than that in the VCV group (median, 253.0 [interquartile range, 179.0 to 316.5] ml in PCV group vs. 382.5 [328.0 to 489.5] ml in VCV group; P < 0.001). Comparing other parameters between groups, only peak inspiratory pressure at each measurement point in PCV group was significantly lower than that in VCV group. No harmful events were recorded. Conclusion Intraoperative PCV decreased intraoperative surgical bleeding in patients undergoing PLIF, which may be related to lower intraoperative peak inspiratory pressure.
- Published
- 2016
10. Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management
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Bo Kyung Cheon, Jeong Ae Lim, Nam Sik Woo, Min Hye Kang, Ka Young Rhee, Cho Long Kim, Ka Ram Kim, Hae Kyoung Kim, and Jae Hun Kim
- Subjects
Ionizing radiation ,medicine.medical_specialty ,Review Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,fashion ,medicine ,Fluoroscopy ,Intensive care medicine ,Protective devices ,Radiation protection ,Thyroid gland ,medicine.diagnostic_test ,business.industry ,Radiation exposure ,Thyroid ,Pain management ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,fashion.garment ,Lead apron ,Interventional pain management ,business ,030217 neurology & neurosurgery - Abstract
C-arm fluoroscopy is useful equipment in interventional pain management because it helps to guide correct needle targeting for the accurate injection and drug delivery. However, due to increased use of C-arm fluoroscopy in various pain procedures, the risk of radiation exposure is a significant concern for pain physicians. The harmful biological effects of ionizing radiation on the human body are well known. It is therefore necessary to strive to reduce radiation exposure. Lead aprons with thyroid shields are the most fundamental radiation protective devices for interventional procedures, and are very effective. However, the operator's radiation safety cannot be guaranteed because pain physicians seem to lack sufficient interest, knowledge, and awareness about radiation safety. Also, inappropriate care and use of radiation protective devices may result in a higher risk of radiation exposure. The purpose of this article was to review the literature on radiation safety with a focus on lead aprons and thyroid shields and present recommendations related to those devices during C-arm fluoroscopic-guided interventions by pain physicians.
- Published
- 2018
11. Preoperative FIBTEM Predicts Postoperative Hemorrhage in Total Knee Arthroplasty
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Se Won Park, Ka Young Rhee, Seong-Hyop Kim, Tae-Hoon Kim, and Chung-Sik Oh
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Erythrocyte Indices ,Male ,Fluid administration ,medicine.medical_treatment ,Total knee arthroplasty ,030204 cardiovascular system & hematology ,Postoperative Hemorrhage ,Fibrin ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Predictive Value of Tests ,Fibrinolysis ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Anesthesia induction ,Arthroplasty, Replacement, Knee ,Blood Coagulation ,Aged ,Retrospective Studies ,biology ,business.industry ,Middle Aged ,Thrombelastography ,Clotting time ,Anesthesia ,biology.protein ,Surgery ,Suction drainage ,Female ,Blood Coagulation Tests ,Maximum clot firmness ,business - Abstract
FIBTEM parameters might predict the amount of postoperative hemorrhage following total knee arthroplasty (TKA), because fibrin polymerization and fibrinolysis have a central role in postoperative hemorrhage following TKA. This study retrospectively evaluated 54 patients who had undergone unilateral primary TKA. Laboratory coagulation parameters, including FIBTEM, were recorded before anesthesia induction and after admission to the postanesthetic care unit. The decrease in hemoglobin (Hb), amount of hemorrhage via closed suction drainage, fluid administration, and amount transfused were reviewed postoperatively. The preoperative FIBTEM amplitudes 10 (A10) and 20 (A20) minutes after clotting time and maximum clot firmness (MCF) had the highest correlations with the postoperative decrease in Hb (p = 0.001, p = 0.002, and p = 0.003, respectively). The preoperative FIBTEM A10 3.0 g/dL postoperative Hb decrement from the postanesthetic Hb value (p = 0.004, p = 0.007, and p = 0.012, respectively). Preoperative FIBTEM can predict the amount of postoperative hemorrhage following TKA.
- Published
- 2018
12. Effect of muscle relaxation on the oxygenation of human skeletal muscle: a prospective in-vivo experiment using an isolated forearm technique
- Author
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In Su Oh, Ka Young Rhee, Seoung Joon Lee, Thomas Ledowski, and Tae-Yop Kim
- Subjects
medicine.medical_specialty ,Pathology ,Clinical Research Article ,tourniquets ,business.industry ,Pain medicine ,Skeletal muscle ,Near-Infrared Spectrometry ,near-infrared spectrometry ,body regions ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,Muscle relaxation ,medicine.anatomical_structure ,neuromuscular blockade ,Forearm ,lcsh:Anesthesiology ,Physical therapy ,Medicine ,University medical ,In vivo experiment ,Corrigendum ,business ,skeletal muscles - Abstract
Background Total oxygen consumption has been found to be reduced under deep neuromuscular blockade due to a lower rate of metabolism of skeletal muscles. However, the magnitude of this effect in individual muscles has not been investigated. Thus the aim of this study was to compare the oxygenation of paralyzed versus non-paralyzed forearm muscle under tourniquet-provoked ischemia. Methods After ethics approval and written informed consent, 30 patients scheduled for elective hand and wrist surgery were included. Ischemia was provoked by inflation of bilateral upper arm tourniquets and muscle relaxation was achieved via intravenous administration of rocuronium 0.9 mg/kg. Bilateral tourniquets were applied to both upper arms before induction of anesthesia and near infrared spectrometry (NIRS) electrodes applied on both forearms. Muscular ischemia in an isolated (= non-paralyzed, NP) as well as a paralyzed forearm (P) was created by sequential inflation of both tourniquets before and after intravenous administration of rocuronium. Muscle oxygen saturations (SmO2) of NIRS in both forearms and their changes were determined and compared. Results Data of 30 patients (15 male, 15 female; 41.8 ± 14.7 years) were analyzed. The speed of SmO2 decrease (50% decrease of SmO2 from baseline (median [percentiles]: NP 210 s [180/480s] vs. P 180 [180/300]) as well as the maximum decrease in SmO2 (minimum SmO2 in % (median [percentiles]: NP 20 [19/24] vs. P 21 [19/28]) were not significantly affected by neuromuscular paralysis. Conclusions No significant effect of muscle relaxation on NIRS-assessed muscle oxygenation under tourniquet-induced ischemia was found in human forearm muscles.
- Published
- 2015
13. Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty
- Author
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Jaemoon Lee, Chung-Sik Oh, Seong-Hyop Kim, and Ka Young Rhee
- Subjects
Male ,Ischaemic reperfusion injury ,Total knee arthroplasty ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Postoperative Complications ,Cerebral oxygenation ,Lactate dehydrogenase ,Medicine ,Arterial blood gas analysis ,Humans ,Arthroplasty, Replacement, Knee ,Ischemic Preconditioning ,Remote ischaemic preconditioning ,Aged ,Tourniquet ,business.industry ,Hemodynamics ,General Medicine ,Oxygenation ,Middle Aged ,Serum cytokine ,chemistry ,Anesthesia ,Female ,business ,030217 neurology & neurosurgery ,Research Paper - Abstract
Background: Ischaemic reperfusion injury (IRI) after tourniquet release during total knee arthroplasty (TKR) is related to postoperative cerebral complications. Remote ischaemic preconditioning (RIPC) is known to minimise IRI in previous studies. Thus, we evaluated the effect of RIPC on regional cerebral oxygenation after tourniquet release during TKR. Methods: Patients undergoing TKR were randomly allocated to not receive RIPC (control group) and to receive RIPC (RIPC group). Regional cerebral oxygenation and pulmonary oxygenation were assessed up to 24 h postoperatively. The changes in serum cytokine and lactate dehydrogenase (LDH) levels were assessed and arterial blood gas analysis was performed. Total transfusion amounts and postoperative bleeding were also examined. Results: In total, 72 patients were included in the final analysis. Regional cerebral oxygenation (P < 0.001 in the left side, P = 0.003 in the right side) with pulmonary oxygenation (P = 0.001) was significantly higher in the RIPC group. The serum LDH was significantly lower in the RIPC group at 1 h and 24 h postoperatively (P < 0.001). The 24 h postoperative transfusion (P = 0.002) and bleeding amount (P < 0.001) were significantly lower in the RIPC group. Conclusions: RIPC increased cerebral oxygenation after tourniquet release during TKR by improving pulmonary oxygenation. Additionally, RIPC decreased the transfusion and bleeding amount with the serum LDH level.
- Published
- 2016
14. Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery: A Randomized Controlled Trial
- Author
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Woon-Seok, Kang, Chung-Sik, Oh, Won-Kyoung, Kwon, Ka Young, Rhee, Yun Gu, Lee, Tae-Hoon, Kim, Suk Ha, Lee, and Seong-Hyop, Kim
- Subjects
Male ,Lumbar Vertebrae ,Blood Loss, Surgical ,Hemodynamics ,Peak Expiratory Flow Rate ,Middle Aged ,Postoperative Hemorrhage ,Respiration, Artificial ,Urodynamics ,Spinal Fusion ,Prone Position ,Respiratory Mechanics ,Supine Position ,Fluid Therapy ,Humans ,Anesthesia ,Blood Transfusion ,Female ,Single-Blind Method ,Prospective Studies ,Aged - Abstract
The aim of study was to evaluate the effect of mechanical ventilation mode type, pressure-controlled ventilation (PCV), or volume-controlled ventilation (VCV) on intra- and postoperative surgical bleeding in patients undergoing posterior lumbar interbody fusion (PLIF) surgery.This was a prospective, randomized, single-blinded, and parallel study that included 56 patients undergoing PLIF and who were mechanically ventilated using PCV or VCV. A permuted block randomization was used with a computer-generated list. The hemodynamic and respiratory parameters were measured after anesthesia induction in supine position, 5 min after patients were changed from supine to prone position, at the time of skin closure, and 5 min after the patients were changed from prone to supine position. The amount of intraoperative surgical bleeding, fluid administration, urine output, and transfusion requirement were measured at the end of surgery. The amount of postoperative bleeding and transfusion requirement were recorded every 24 h for 72 h.The primary outcome was the amount of intraoperative surgical bleeding, and 56 patients were analyzed. The amount of intraoperative surgical bleeding was significantly less in the PCV group than that in the VCV group (median, 253.0 [interquartile range, 179.0 to 316.5] ml in PCV group vs. 382.5 [328.0 to 489.5] ml in VCV group; P0.001). Comparing other parameters between groups, only peak inspiratory pressure at each measurement point in PCV group was significantly lower than that in VCV group. No harmful events were recorded.Intraoperative PCV decreased intraoperative surgical bleeding in patients undergoing PLIF, which may be related to lower intraoperative peak inspiratory pressure.
- Published
- 2016
15. Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study
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Seong-Hyop Kim, Chung-Sik Oh, Seung Wan Hong, Nam-Sik Woo, Ka Young Rhee, and Tae-Gyoon Yoon
- Subjects
medicine.medical_specialty ,Article Subject ,lcsh:Medicine ,Hip fracture surgery ,Sugammadex ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,030202 anesthesiology ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Cholinesterase ,Aged, 80 and over ,General Immunology and Microbiology ,biology ,Hip Fractures ,business.industry ,Incidence ,Medical record ,lcsh:R ,Delirium ,Retrospective cohort study ,General Medicine ,Perioperative ,Hypoxia (medical) ,Surgery ,Clinical trial ,Anesthesia ,Clinical Study ,biology.protein ,medicine.symptom ,business ,gamma-Cyclodextrins ,medicine.drug - Abstract
Background.Residual neuromuscular block (NMB) after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD). We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery.Methods.Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor.Results.The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.;P=0.750). Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min;P<0.001) and the frequency of postoperative hypoxia were significantly lower (23% versus 43%;P=0.010) in the sugammadex group than in the conventional cholinesterase inhibitor group.Conclusion.Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia.
- Published
- 2016
- Full Text
- View/download PDF
16. Methods of endotracheal tube placement in patients undergoing pelviscopic surgery
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Jihyeung Kim, Ka Young Rhee, S.-H. Han, Ye-Soo Park, and Jin Young Hwang
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,Suprasternal notch ,medicine.medical_treatment ,Trendelenburg position ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Gynecologic Surgical Procedures ,0302 clinical medicine ,Pneumoperitoneum ,Intubation, Intratracheal ,medicine ,Anesthesia, Obstetrical ,Humans ,Intubation ,030212 general & internal medicine ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,030208 emergency & critical care medicine ,Middle Aged ,medicine.disease ,Surgery ,Anesthesiology and Pain Medicine ,Ceiling balloon ,medicine.anatomical_structure ,Anesthesia ,Cuff ,Female ,business - Abstract
Accidental endobronchial intubation is reported frequently during laparoscopic gynaecological surgery. We performed a prospective randomised study to compare three different methods of endotracheal tube placement in terms of susceptibility of accidental endobronchial intubation in patients undergoing laparoscopic gynaecologic surgery.The endotracheal tube was positioned by one of three methods: it was secured by palpating at the suprasternal notch while holding the pilot balloon (Group); by placing the 21 cm mark at the upper incisors (Group21cm); or by placing a guide mark, which was made on the surface of the tube 2 cm above the proximal end of the cuff, at the level of the vocal cords (GroupVC). The distance from the tip of endotracheal tube to the carina was measured with the patient in a neutral position (DTC0) and after the formation of pneumoperitoneum in the Trendelenburg position (DTC1).Eighty-eight patients were enrolled. Pneumoperitoneum and Trendelenburg position caused inward movement of the endotracheal tube toward the carina in 99%. In each group, the mean value of DTC1was significantly shorter than DTC0(GroupCuff3.0 ± 1.1 vs. 1.7 ± 1.0, Group21cm2.5 ± 0.8 vs. 1.1 ± 0.9, Groupvc3.5 ± 0.7 vs. 2.3 ± 0.8, DTc0vs. DTC1respectively)(all P vc(2.6 %, P 21cm, although this was not significantly (P=0.09) different from GroupCuff(26.7% vs. 10.0%).The incidence of endobronchial intubation was lowest in Groupvcbut endobrochial intubation could not be avoided using any of these methods.
- Published
- 2007
17. Continuous intra-lesional Infusion Combined with Interscalene Block for Effective Postoperative Analgesia after Arthroscopic Shoulder Surgery
- Author
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Joo-Han Oh, Hyun-Sik Gong, Ka Young Rhee, Sang-Gee Kim, Tae-Yune Kim, Jae-Yoon Kim, Woo Sung Kim, and Jae Kwang Kim
- Subjects
medicine.medical_specialty ,Shoulder surgery ,medicine.diagnostic_test ,Interscalene brachial plexus block ,business.industry ,medicine.medical_treatment ,Postoperative pain ,Analgesic ,Arthroscopy ,Surgery ,Anesthesia ,medicine ,business ,Interscalene block - Abstract
Purpose: The purpose of this study was to compare the effectiveness of postoperative pain control by intravenous patient-controlled analgesia (IV) to the effectiveness of postoperative pain control by continuous intra-lesional infusion of local anesthetics (IL) with or without an interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Materials and Methods: We designed this prospective randomized case-controlled double-blind study, and allocated 84 consecutive patients to four groups according to postoperative analgesic method, i.e., Group IV, Group ISBIV, Group IL, and Group ISB-IL after arthroscopic shoulder surgery. Postoperative pain, side effects and supplemental analgesics were recorded at 1 hour and then at every 8 hours for 2 days. Result: The demographic and clinical characteristics of four groups were identical statistically. Interscalene block (Group ISB-IV, Group ISB-IL) was found to be effective at relieving pain and at reducing supplemental analgesic amounts at 1 and 8 hours postoperatively (p
- Published
- 2005
18. Effects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial
- Author
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Young-Tae Jeon, Jong Man Kang, Jin-Young Hwang, Ka Young Rhee, Sung Hee Han, and Yong Seok Oh
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Adult ,Nausea ,Narcotic Antagonists ,law.invention ,Bolus (medicine) ,Double-Blind Method ,Randomized controlled trial ,Pregnancy ,law ,medicine ,Humans ,Bupivacaine ,Morphine ,Naloxone ,business.industry ,Incidence ,Pruritus ,Antagonist ,Obstetrics and Gynecology ,Analgesia, Epidural ,Anesthesiology and Pain Medicine ,Anesthesia ,Postoperative Nausea and Vomiting ,Vomiting ,Female ,medicine.symptom ,business ,Postoperative nausea and vomiting ,medicine.drug - Abstract
Background: Epidural morphine produces prolonged analgesia but has many side effects including pruritus. Naloxone is an antagonist that can reverse the side effects of morphine. Method: We studied the effects of continuously administered epidural naloxone mixed with morphine on side effects and analgesia in a randomized, double blind, two-armed study. Fifty-eight pregnant women undergoing cesarean section were enrolled. All patients received a 4-mg epidural bolus of morphine in the post-anesthetic care unit. After this, patients in group M (n=28) received continuous epidural morphine (6 mg over 48 h) in 0.1% bupivacaine; patients in group N (n=30) received an epidural infusion containing naloxone (1.2 mg over 48 h) and morphine (6 mg over 48 h) in 0.1% bupivacaine. The infusion rate was 2 mL/h. Results: The incidence (82% versus 47%) and severity of pruritus were lower in group N than group M ( P =0.001). There were no significant differences in pain score or in the incidence of nausea, vomiting or urinary disturbance between groups. Conclusion: Continuous epidural infusion of naloxone combined with morphine is effective in reducing the incidence and severity of pruritus induced by epidural morphine.
- Published
- 2005
19. The Relationship Between Plasma Inflammatory Cytokines and Labor Pain
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Pamela Flood, Laura Goetzl, Ka Young Rhee, Ramsey Unal, and Jill Cierny
- Subjects
Adult ,Labor Pain ,Pregnancy ,Labor, Obstetric ,Adolescent ,business.industry ,Term pregnancy ,Labor pain ,Maternal blood ,medicine.disease ,Proinflammatory cytokine ,Cohort Studies ,Young Adult ,Anesthesiology and Pain Medicine ,Anesthesia ,Immunology ,medicine ,Cytokines ,Humans ,Female ,Inflammation Mediators ,Young adult ,business ,Biomarkers - Abstract
Proinflammatory cytokines are increased in maternal blood at term pregnancy and are associated with cervical ripening and the initiation of labor. We hypothesize that maternal plasma cytokines also affect the sensitivity to labor pain.By using a previously validated model describing labor pain, we used a deidentified database derived from healthy nulliparous parturients who delivered singleton pregnancies at term. Numerical rating scores for pain were recorded after the onset of regular contractions using an 11-point scale. Maternal blood was drawn for the measurement of interleukin (IL)-1β, IL-4, IL-6, IL-8, and IL-10; interferon-γ; and tumor necrosis factor-α on admission or at the onset of painful contractions, whichever occurred later. Individual demographic, physiognomic, and cytokine variables that significantly affected labor pain at P0.05 were reported and included stepwise into a multivariable model.One hundred sixty parturients provided 411 numerical analog scores for pain that were evaluated with our model. The relationship between numerical analog scores and cervical dilation was significantly affected by the type of membrane rupture, membrane status, induction, oxytocin administration, maternal race, and plasma IL-1β concentration as individual variables. Only the association between the highest IL-1β quartile and slower acceleration of pain during labor remained significant in the multivariate model (P = 0.0003). Women with IL-1β concentration in the highest quartile arrived at the labor room with a more dilated cervix than those with lower plasma concentrations of IL-1β (5.1 ± 3.0 vs 4.1 ± 2.6 cm; P0.02) and had faster labor progress.Inflammatory cytokines including IL-1β play a role in cervical ripening. High maternal plasma concentrations of IL-1β may serve as a marker of advanced cervical ripening and readiness for labor that proceeds with less pain.
- Published
- 2016
20. Intravenous clonidine prolongs bupivacaine spinal anesthesia
- Author
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Jin-Tae Kim, Ka Young Rhee, Young-Tae Jeon, and Keon Wook Kang
- Subjects
Bupivacaine ,medicine.medical_specialty ,business.industry ,Local anesthetic ,medicine.drug_class ,medicine.medical_treatment ,General Medicine ,Clonidine ,Surgery ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Dermatome ,Anesthesia ,Heart rate ,Medicine ,Premedication ,business ,Prospective cohort study ,Saline ,medicine.drug - Abstract
Background: Prolongation of spinal anesthesia by oral clonidine premedication has been known. We hypothesized that intravenous clonidine administered after the spinal block may prolong spinal anesthesia. Methods: To assess the prolongation of spinal anesthesia by intravenous clonidine, we designed a double-blind, placebo-controlled, prospective study. Patients scheduled for orthopedic surgery received 12 mg of 0.5% hyperbaric bupivacaine and were randomly divided into three groups (n = 26 in each group). In the clonidine 10-min group, 3 µg kg−1 of clonidine was administered for 10 min immediately after the spinal block. In the clonidine 60-min group, 3 µg kg−1 of clonidine was administered for 10 min, 50 min after the spinal block. The control group received normal saline. Sensory block was evaluated by pinprick and the duration was defined as the time for sensory block to regress to L1 dermatome. Duration of motor block was defined as the time required for the patient to flex his or her knee. Results: The duration of sensory block was longer in both the clonidine 10-min and clonidine 60-min groups compared with the control group (196 ± 42 min, 179 ± 41 min vs. 125 ± 25 min, P
- Published
- 2003
21. Continuous mixed venous oxygen saturation, not mean blood pressure, is associated with early bupivacaine cardiotoxicity in dogs
- Author
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Jin-Tae Kim, Hong Ko, Kook Hyun Lee, Ka Young Rhee, Jae-Hyon Bahk, Young Jin Lim, and S. H. Do
- Subjects
Male ,Cardiac output ,Time Factors ,medicine.drug_class ,medicine.medical_treatment ,Cardiac Output, Low ,Blood Pressure ,Electrocardiography ,Electrolytes ,Dogs ,Oxygen Consumption ,medicine ,Animals ,Anesthetics, Local ,Bupivacaine ,biology ,Local anesthetic ,business.industry ,Fissipedia ,Hemodynamics ,Pulmonary artery catheter ,Heart ,General Medicine ,biology.organism_classification ,Oxygen ,Anesthesiology and Pain Medicine ,Blood pressure ,Mean blood pressure ,Anesthesia ,Arterial blood ,Blood Gas Analysis ,business ,medicine.drug - Abstract
Purpose: To investigate changes of continuous mixed venous oxygen saturation (cSvO 2 ) and mean arterial blood pressure (MBP) in dogs with bupivacaine-induced cardiac depression. Methods: Bupivacaine was infused into pentobarbital-anesthetized mongrel dogs (n = 8) at a rate of 0.5 mg·kg –1 ·min –1 until the MBP was 40 mmHg or less (end of bupivacaine infusion; BIE). The infusion time was divided into the early period, first 30 min of bupivacaine infusion and the late period, which was from 30 min of bupivacaine infusion until BIE. cSvO 2 was monitored using a fibreoptic pulmonary artery catheter, and MBP and cardiac output (CO) were measured every ten minutes after the initiation of bupivacaine infusion. Arterial blood gas, serum electrolyte and bupivacaine concentration were measured simultaneously. The relationships between CO and cSvO 2 , and of CO vs MBP were compared by regression analysis in the early and late periods. Results: The Pearson’s correlation coefficients between CO and cSvO 2 were 0.782 (P = 2.1 × 10 –7 ) in the early period and 0.824 (P = 1.3 × 10 –6 ) in the late period. The correlation coefficients between CO and MBP were 0.019 (P = 0.921) in the early period and 0.799 (P = 4.8 × 10 –6 ) in the late period. Conclusions: cSvO 2 , but not MBP, is associated with CO changes in bupivacaine-induced cardiac depression during the early period of bupivacaine intoxication. Decrease of MBP with low cSvO 2 observed during the late period might imply severe cardiac depression induced by bupivacaine infusion.
- Published
- 2003
22. A comparison of lighted stylet (Surch-Lite) and direct laryngoscopic intubation in patients with high Mallampati scores
- Author
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Jeong-Rim Lee, Sung Hee Han, Ka Young Rhee, Sang Hyun Park, Jin Hee Kim, and Won Kyong Kwon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Light ,Haemodynamic response ,medicine.medical_treatment ,Laryngoscopy ,Hemodynamics ,Oropharynx ,Blood Pressure ,Anesthesia, General ,Laryngoscopes ,Laryngeal Diseases ,Heart Rate ,Heart rate ,Abdomen ,medicine ,Intubation, Intratracheal ,Intubation ,Humans ,Prospective Studies ,Prospective cohort study ,medicine.diagnostic_test ,business.industry ,Equipment Design ,Pharyngeal Diseases ,Middle Aged ,Surgery ,Anesthesiology and Pain Medicine ,Blood pressure ,Anesthesia ,Female ,business ,Mallampati score - Abstract
Background A lighted stylet is an effective alternative to a direct laryngoscope and has been reported to be particularly useful in patients with difficult airways. A high Mallampati class indicates poor visibility of the oropharyngeal structures. Because a lighted stylet does not require direct oropharyngeal visualization, we hypothesized that the lighted stylet would be easier to use than a direct laryngoscope in patients with a high Mallampati score. To examine our hypothesis, we performed a prospective, randomized study comparing a lighted stylet (Surch-Lite) with direct laryngoscopy in patients with high Mallampati scores. Success rate, time required for intubation, and hemodynamic changes were compared. Methods Mallampati Class III patients were enrolled and were randomly assigned to the Surch-Lite group (Group SL) or the direct laryngoscopy group (Group DL). Patients' tracheas were intubated with the randomly selected intubation device after induction of general anesthesia. Heart rate (HR) and mean arterial blood pressure were measured immediately before and every 30 s after intubation for 5 min. The time to intubation and success rate were recorded. Postoperative pharyngolaryngeal complaints were also assessed. Results Thirty patients were enrolled in each group. The success rate on the first attempt was significantly higher in Group SL (29 of 30) than in Group DL (24 of 30). The difference between maximal HR and baseline HR was significantly higher in Group DL (25 +/- 13 bpm) than in Group SL (16 +/- 10 bpm). The change in mean arterial blood pressure was also higher in Group DL (38 +/- 14 mm Hg) than in Group SL (20 +/- 13 mm Hg). The time to intubation was significantly shorter in Group SL (12 +/- 6 s) than in Group DL (17 +/- 12 s). Postoperative pharyngolaryngeal complaints were not significantly different between the two groups. Conclusions The Surch-Lite showed a higher success rate on the first intubation attempt and produced an attenuated hemodynamic response to endotracheal intubation of patients with high Mallampati score. Thus, the Surch-Lite is an effective alternative to direct laryngoscopy in these patients.
- Published
- 2009
23. Prophylactic dexamethasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double-lumen endobronchial tube
- Author
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Sung Hee Han, Sang Hyun Park, Ka Young Rhee, Jung Won Kim, Jin Hee Kim, and S. H. Do
- Subjects
Adult ,Male ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Dexamethasone ,Double-Blind Method ,otorhinolaryngologic diseases ,medicine ,Sore throat ,Intubation, Intratracheal ,Intubation ,Humans ,Prospective Studies ,Aged ,Hoarseness ,business.industry ,Tracheal intubation ,Pharyngitis ,Middle Aged ,Double-lumen endobronchial tube ,Surgery ,stomatognathic diseases ,Anesthesiology and Pain Medicine ,Cardiothoracic surgery ,Anesthesia ,Female ,medicine.symptom ,Complication ,business - Abstract
BACKGROUND: Postoperative sore throat and hoarseness are common complications after tracheal intubation, particularly after using a double-lumen endobronchial tube (DLT). We conducted a prospective, randomized, double-blind, placebocontrolled study to evaluate the efficacy of dexamethasone for reducing the incidence and severity of postoperative sore throat and hoarseness. METHODS: One hundred sixty-six patients (aged 18–75 yr) scheduled for thoracic surgery with a DLT were enrolled. Before induction of general anesthesia, 0.1 mg/kg dexamethasone (Group D1), 0.2 mg/kg dexamethasone (Group D2), or a placebo (Group P) were infused IV in a double-blind and prospectively randomized manner. Glottic exposure as defined by Cormack and Lehane score, resistance to DLT insertion, number of intubation attempts, time to achieve intubation, and the duration of tracheal intubation were recorded. At 1 h and 24 h after tracheal extubation, the patients were evaluated for sore throat and hoarseness using a visual analog scale (VAS; where 0 no pain and 100 worst pain imaginable). RESULTS: One hour after tracheal extubation, the incidence of postoperative sore throat and hoarseness, along with the severity of sore throat were lower in Group D1 (31%, P 0.021; 11%, P 0.003; and VAS 12.4, P 0.001, respectively) and D2 (11%, P 0.001; 4%, P 0.001; and VAS 6.6, P 0.001, respectively) compared with Group P (53%, 36% and VAS 30.9, respectively). Twenty-four hours after tracheal extubation, the incidence of postoperative sore throat, hoarseness, and the severity of sore throat were significantly lower in Group D2 (27%, P 0.002; 15%, P 0.001; and VAS 29.9, P 0.002, respectively) compared with Group D1 (47%, 31%, and VAS 43.9, respectively) and Group P (57%, 45%, and VAS 51.3, respectively). There was no complication associated with the dexamethasone administration. CONCLUSION: The prophylactic use of 0.2 mg/kg of dexamethasone significantly decreases the incidence and severity of sore throat and hoarseness 1 h and 24 h after tracheal extubation of a DLT.
- Published
- 2008
24. A heated humidifier does not reduce laryngo- pharyngeal complaints after brief laryngeal mask anesthesia
- Author
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Ka Young Rhee, Duk-Kyung Kim, Won-Kyoung Kwon, Joo-Eun Kang, and Tae-Yop Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hot Temperature ,Mascara ,Laryngeal Masks ,Standard care ,Laryngeal mask airway ,Anesthesiology ,medicine ,Humans ,In patient ,Postoperative Period ,Prospective Studies ,Mask anesthesia ,Voice Disorders ,business.industry ,Humidity ,Pharyngitis ,General Medicine ,Laryngeal mask airway insertion ,Surgery ,Anesthesiology and Pain Medicine ,Elective Surgical Procedures ,Anesthesia ,Female ,business ,Anesthesia, Inhalation ,Deglutition Disorders - Abstract
Warming and humidification of inspired gases is standard care for intubated patients whose lungs are ventilated mechanically for prolonged periods. We examined whether active humidification of inspired gases might reduce laryngo-pharyngeal discomfort in patients undergoing brief laryngeal mask airway (LMA) anesthesia.In a prospective trial, 200 adult patients undergoing elective surgery under general anesthesia were randomly assigned to receive ventilation without airway warming and exogenous humidification (Group C-control), or active warming and humidification of inspired gases (Group HUM-humidified), using a humidifier with a heated wire circuit. Inhalational anesthesia was maintained via a circle system. The temperatures and relative humidities of inspired gases were monitored continuously throughout surgery. Postoperative sore throat, dysphonia, and dysphagia were assessed one and 24 hr after anesthesia. Whenever symptoms were present, their severities were graded using a 101-point numerical rating scale.The mean temperature and relative humidity of the inspired gases in Group HUM were greater compared to Group C (36.1+/-0.4 degrees C and 99.5+/-0.5% vs 26.9+/-0.8 degrees C and 76.4+/-10.9%, respectively). Postoperatively, the overall frequencies of laryngeal and pharyngeal discomfort were similar in the two groups (53.8% and 54.9% in Group C vs 51.6% and 41.9% in Group HUM at one and 24 hr respectively, P0.05). The groups were also similar with respect to the severity scores of laryngo-pharyngeal discomfort.Active warming and humidification of inspired gases has no clinically appreciable effect in reducing the incidence and severity of laryngo-pharyngeal complaints after brief (two hours) LMA anesthesia.
- Published
- 2007
25. Continuous intralesional infusion combined with interscalene block was effective for postoperative analgesia after arthroscopic shoulder surgery
- Author
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Hyun Sik Gong, Joo Han Oh, Ka Young Rhee, Woo Sung Kim, and Jae Yoon Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Shoulder surgery ,medicine.drug_class ,Postoperative pain ,medicine.medical_treatment ,Analgesic ,Injections, Intra-Articular ,Arthroscopy ,Reference Values ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Anesthetics, Local ,Aged ,Pain Measurement ,Probability ,Pain, Postoperative ,medicine.diagnostic_test ,Local anesthetic ,business.industry ,Shoulder Joint ,Analgesia, Patient-Controlled ,Nerve Block ,General Medicine ,Middle Aged ,Combined Modality Therapy ,Surgery ,Endoscopy ,Treatment Outcome ,Anesthesia ,Female ,Shoulder Injuries ,business ,Interscalene block ,Follow-Up Studies - Abstract
The purpose of this study was to compare the efficacy of postoperative pain control by intravenous patient-controlled analgesia (IV) and by continuous intralesional infusion of a local anesthetic (IL) with or without an interscalene block (ISB) after arthroscopic shoulder surgery. We allocated 84 patients to 4 groups according to analgesic method: IV, ISB-IV, IL, and ISB-IL. Postoperative pain, side effects, and supplementary analgesics were recorded at 1 hour and then every 8 hours for 48 hours. The interscalene block (groups ISB-IV and ISB-IL) was found to be effective at relieving pain and at reducing supplementary analgesic amounts at 1 and 8 hours postoperatively (P.05). Patients in group ISB-IL had less pain at 16 and 48 hours postoperatively than those in the other groups (P.05). Continuous intralesional infusion (groups IL and ISB-IL) was superior in reducing analgesic-related side effects (P.05). This study suggests that a combination of an interscalene block and continuous intralesional infusion of a local anesthetic is an effective and safe method of postoperative pain control after arthroscopic shoulder surgery.
- Published
- 2005
26. Maternal inflammatory markers and term labor performance
- Author
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Jill Cierny, Allison Praktish, E. Ramsey Unal, Pamela Flood, Laura Goetzl, Tara Hudak Olson, and Ka Young Rhee
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,Cervical dilation ,Inflammation ,Proinflammatory cytokine ,Young Adult ,Pregnancy ,medicine ,Humans ,reproductive and urinary physiology ,Labor, Obstetric ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Interleukin ,Quartile ,Anesthesia ,Labor induction ,Cohort ,Cytokines ,Female ,medicine.symptom ,business ,Biomarkers ,Interleukin-1 ,Cohort study - Abstract
Objective We sought to examine the relationship between maternal markers of inflammation and labor performance. Study Design A nested cohort study was performed utilizing an established cohort of term nulliparous patients. Maternal blood was collected at the onset of regular, painful contractions in patients undergoing labor induction or at admission in patients with spontaneous labor. Levels of cytokines including interleukin (IL)-1, IL-6, and tumor necrosis factor-α were determined using standard multiplex methodology. Maternal demographic data were collected prospectively. Detailed retrospective chart review was performed to extract data on cervical dilation, effacement, and station during labor. Subjects were excluded if they failed to achieve complete dilation. Mixed effects modeling was used to examine the association between serum cytokine quartiles and labor progress in the latent and active phases. Results In all, 334 women were included in our analysis. The lowest quartile of IL-6 was associated with slower latent labor ( P = .001). In contrast, the highest quartiles of IL-1 and tumor necrosis factor-α were associated with slower active labor ( P = .03 and .0002, respectively). Conclusion Proinflammatory activation is important in labor initiation. However, once active labor is established, excess inflammation can be detrimental to efficient labor progress. These data may explain, in part, the known associations among clinical chorioamnionitis, cesarean delivery, and postpartum hemorrhage.
- Published
- 2014
27. 322: Inflammatory cytokines, fever and term labor performance
- Author
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Allison Praktish, Ka Young Rhee, Laura Goetzl, Jill Cierny, Ramsey Unal, Pamela Flood, and Tara Hudak Olson
- Subjects
Preterm labor ,business.industry ,Immunology ,Obstetrics and Gynecology ,Medicine ,business ,Proinflammatory cytokine - Published
- 2013
28. Comparison of Analgesic Efficacy between Single Interscalene Block Combined with a Continuous Intra-bursal Infusion of Ropivacaine and Continuous Interscalene Block after Arthroscopic Rotator Cuff Repair
- Author
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Pyung Bok Lee, Sae Hoon Kim, Joo Han Oh, Seok Jae Lee, Joon Woo Lee, and Ka Young Rhee
- Subjects
Adult ,Male ,Shoulder ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Analgesic ,Rotator cuff tear ,Arthroscopy ,Rotator Cuff ,medicine ,Humans ,Ropivacaine ,Orthopedics and Sports Medicine ,Rotator cuff ,Prospective Studies ,Anesthetics, Local ,Aged ,Pain Measurement ,Infusions, Intralesional ,Pain, Postoperative ,Postoperative pain control ,medicine.diagnostic_test ,Shoulder Joint ,business.industry ,Nerve Block ,Bursa, Synovial ,Middle Aged ,Amides ,Surgery ,Single interscalene block with intra-bursal infusion ,Arthroscopic rotator cuff repair ,Catheter ,medicine.anatomical_structure ,Case-Control Studies ,Anesthesia ,Nerve block ,Original Article ,Continuous interscalene block ,Female ,Shoulder joint ,Analgesia ,business ,medicine.drug - Abstract
†‡ Background: This study evaluated the effectiveness of a continuous interscalene block (CISB) by comparing it with that of a single interscalene block combined with a continuous intra-bursal infusion of ropivacaine (ISB-IB) after arthroscopic rotator cuff repair. Methods: Patients who had undergone CISB (CISB group; n = 25) were compared with those who had undergone ISB-IB (ISBIB group; n = 25) for more than 48 hours after surgery. The visual analog scale (VAS) for pain, motor and/or sensory deficit, supplementary analgesics and adverse effects were recorded. Results: There were no significant differences between the postoperative VAS of the CISB and ISB-IB groups, except at 1 hour after surgery. Their supplementary analgesics of the two groups were similar. Transient motor weakness (52%) and sensory disturbance (40%) of the affected arm were observed in patients in the CISB group. The catheters came out accidentally in 22% of the CISB group but in only 4% of the ISB-IB group. Conclusions: ISB-IB provides similar analgesia to CISB. However, the ISB-IB group had a lower incidence of neurological deficits and better catheter retention.
- Published
- 2009
29. The Relationship Between Plasma Inflammatory Cytokines and Labor Pain.
- Author
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Ka Young Rhee, Goetzl, Laura, Unal, Ramsey, Cierny, Jill, and Flood, Pamela
- Published
- 2015
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30. Anesthetic Management of Embolization for a Cerebral Aneurysm in Patient with Portal-systemic Encephalopathy - A case report
- Author
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Won Kyoung Kwon, Ka Young Rhee, Duck Kyoung Kim, and Jin Young Hwang
- Subjects
medicine.medical_specialty ,Guglielmi detachable coil ,business.industry ,medicine.medical_treatment ,Encephalopathy ,Hyperammonemia ,medicine.disease ,Surgery ,Liver disease ,Anesthesiology and Pain Medicine ,Aneurysm ,Acute hyperammonemia ,medicine.artery ,Anesthesia ,Medicine ,Embolization ,Internal carotid artery ,business - Abstract
The clinical syndrome of hyperammonemic encephalopathy is often encountered in the context of decompensated liver disease. Although it is rare in patients without hepatic disease, non-hepatic causes cannot be excluded. Anesthesiologists should be careful in choosing the anesthetic agent and perioperative management for hyperammonemic patients in order to avoid acute hyperammonemia and encephalopathy. We report successful general anesthesia during GDC (Guglielmi detachable coil) embolization for a large unruptured aneurysm in the right distal internal carotid artery in a female patient with hyperammonemic encephalopathy that was caused by a portal-systemic shunt. (Korean J Anesthesiol 2007; 53: 419~22)
- Published
- 2007
31. Airway Management in a Patient with Focal Dermal Hypoplasia
- Author
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Rong-Min Baek, Ka Young Rhee, and Kyu-Joong Ahn
- Subjects
Pathology ,medicine.medical_specialty ,Anesthesiology and Pain Medicine ,Text mining ,business.industry ,medicine.medical_treatment ,medicine ,Airway management ,medicine.disease ,business ,Focal dermal hypoplasia - Published
- 2006
32. The Preventive Effect of Propofol on Postoperative Nausea and Vomiting (PONV) in Oral and Maxillofacial Surgical Patients
- Author
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Ka-young Rhee, Pil-Young Yun, and Young-Kyun Kim
- Subjects
business.industry ,Anesthesia ,Sedation ,medicine ,Retching ,medicine.symptom ,Propofol ,business ,Postoperative nausea and vomiting ,medicine.drug ,Surgical patients - Published
- 2006
33. Sedation with Propofol-Midazolam Combination versus Propofol alone during Spinal Anesthesia: Prospective, Randomized Study
- Author
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Ka Young Rhee, Mi ja Yun, Kyoung Ok Kim, Duck Kyoung Kim, and Tae Kyung Seol
- Subjects
Anesthesiology and Pain Medicine ,business.industry ,Sedation ,Anesthesia ,medicine ,Midazolam ,Spinal anesthesia ,Prospective randomized study ,medicine.symptom ,Propofol ,business ,Propofol sedation ,medicine.drug - Published
- 2005
34. A Comparison of Manual and Mechanical Ventilation in Terms of the Adequacy of Ventilation during Intrahospital Transport of Neurosurgical Patients in the Immediate Postoperative Period
- Author
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Jung-Won Hwang, Ka Young Rhee, Young Tae Jeon, Sung Hee Han, Hee Pyoung Park, and Yong Seok Oh
- Subjects
Mechanical ventilation ,Resuscitator ,business.industry ,medicine.medical_treatment ,Hemodynamics ,law.invention ,Anesthesiology and Pain Medicine ,Blood pressure ,law ,Anesthesia ,Ventilation (architecture) ,medicine ,Arterial blood ,Respiratory system ,business ,Tidal volume - Abstract
Background: Ambu-bags and portable ventilators can provide intubated patients with ventilation during intrahospital transport, where it is desirable to maintain normocarbia. This study was designed to compare the amount of variation in ventilation that occur during the intrahospital transport of neurosurgical patients ventilated either manually or with a portable ventilator. Methods: 40 patients were randomized to receive either manual ventilation (Group A, n = 20) during transport or ventilation by a portable ventilator (Group P, n = 20) during the immediate postoperative period. In group A, an adult laerdal resuscitator bag with a reservoir bag (2,600 ) was used and oxygen (15 L/min) was supplied from a portable oxygen tank. In group P, a portable ventilator was set to controlled mechanical ventilation or synchronized intermittent mandatory ventilation mode, 8.5-10 /kg of tidal volume, 1:2 of inspiratory to expiratory ratio, and 100% oxygen concentration. Respiratory rates were adjusted to maintain normocarbia. Hemodynamic parameters were recorded before and during transport. Arterial blood gas levels were also obtained before and during transport. Results: during transport was significantly lower in Group A than in Group P (P < 0.05). Manually ventilated patients showed greater deviations from normocarbia (35-45 mmHg) than mechanically ventilated patients (P < 0.01). during transport was no different in the two groups. Blood pressure and heart rates during transport increased significantly in both groups versus before transport (P < 0.01). Conclusions: The use of a portable ventilator can effectively maintain normocarbia and produce the stable ventilatory pattern during the intrahospital transport of neurosurgical patients during immediate postoperative period.
- Published
- 2005
35. Factors Influencing Postoperative Urinary Retention in Female Patients Undergoing Total Knee Replacements
- Author
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Jung-Won Hwang, Jong Man Kang, Sung Hee Han, Yong Seok Oh, and Ka Young Rhee
- Subjects
Bupivacaine ,medicine.medical_specialty ,Urinary retention ,business.industry ,Total knee replacement ,Urology ,Spinal anesthesia ,Multiple linear regression model ,Logistic regression ,Anesthesiology and Pain Medicine ,Outcome variable ,Anesthesia ,Micturition problems ,medicine ,medicine.symptom ,business ,medicine.drug - Abstract
Background: Postoperative urinary retention is defined as the inability to void with a full bladder during the postoperative period. It affects both sexes in all ages following all types of operation, including patients who previously had no micturition problems. We investigated the incidence and risk factors of urinary retention following long spinal anesthesia for total knee replacement. Methods: We retrospectively studied a number of factors that may be associated with urinary retention in 98 women. The outcome variable of logistic regression models are urinary retention and severe urinary retention. The potential explanatory variables are age, height, weight, history of hypertension, DM and abnormal urology, heavy bupivacaine dose, types of patient-controlled analgesia, time to regression of spinal block to sacral segments (Tregression), amount of fluid and duration of surgery. We constructed a multiple linear regression model of the time from subarachnoid injection to spontaneous voiding (Tvoiding) in relation to above variables. Results: The overall rate of urinary retention and severe retention were 57.1% and 30.6%. Tregression was identified as significant explanator of an increased probability for urinary retention (P = 0.002), Tregression and DM for severe urinary retention (P
- Published
- 2005
36. Unilateral Spinal Anesthesia Using a 26-gauge Quincke Spinal Needle
- Author
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Seung Whan Kang, Yong Seok Oh, Ka Young Rhee, Dong Sup Whang, and M. J. Yun
- Subjects
medicine.medical_specialty ,Local anesthetic ,medicine.drug_class ,business.industry ,Spinal anesthesia ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Anesthesia ,Orthopedic surgery ,medicine ,Lateral Decubitus Position ,Ligament ,Asymmetric distribution ,Hemodynamic stability ,Quincke spinal needle ,business - Abstract
Asymmetric distribution of spinal block toward the surgical side is advantageous for minimizing cardiovascular effects of spinal block. Most of the studies about unilateral anesthesia used pencilpoint needle. The tip of the common Quincke needle have long bevel that incorporate a terminal orifice and is more easy to differentiate bone from ligament than pencil point needle in clinical bases. Unlike pencil point injections, however, injection through a Quincke needle does not make streaming and directional flow in the direction of the needle hole, which minimizes the mixing of hyperbaric bupivacaine with the CSF and improves the unilateral distribution of spinal anesthesia. There have been no attempts that compared the adequacy or hemodynamic effects of unilateral spinal anesthesia with the conventional anesthesia using a Quincke needle. A few of the studies that used a Quincke needle investigated the optimal duration of the lateral decubitus position and the dose of local anesthetic solution to perform unilateral spinal anesthesia. This study was undertaken to evaluate whether the unilateral spinal anesthesia using a 26-gauge Quincke needle provides any advantages in terms of adequacy or hemodynamic stability than the conventional spinal anesthesia in orthopedic patients. Unilateral Spinal Anesthesia Using a 26-gauge Quincke Spinal Needle
- Published
- 2004
37. Perioperative Coagulation Responses to Heparin and Dextran Following Arterial Bypass in Patients with Arteriosclerosis Obliterans
- Author
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Ka Young Rhee
- Subjects
Arteriosclerosis obliterans ,medicine.medical_specialty ,business.industry ,Perioperative ,Heparin ,medicine.disease ,Thrombosis ,Anesthesiology and Pain Medicine ,Bypass surgery ,Anesthesiology ,Anesthesia ,Coagulation testing ,Medicine ,Thrombelastography ,business ,medicine.drug - Abstract
Background: The administration of low dose heparin and dextran therapy in patients with arterial bypass surgery is thought to prevent thrombosis and graft occlusion. The purpose of this study was to evaluate the effectiveness of low dose heparin and dextran in atherosclerosis patients presenting hypercoagulability. Methods: Whole blood coagulation was evaluated using thrombelastography and standard coagulation testing before and a day after surgery in nine atherosclerotic patients and nine control patients. Heparin 5000 U and dextran 500 ml were administrated in atherosclerotic patients during their operations. Results: Atherosclerotic patients showed higher maximal amplitude compared to the control patients during preoperative thrombelastography. After surgery atherosclerotic patients revealed no significant change, but the control group became more hypercoagulable in status compared to the preoperative period. Conclusions: Intravenous heparin and dextran prevented postoperative change to a more hypercoagulable state than the preoperative status in atherosclerotic patients undergoing arterial bypass surgery.
- Published
- 2003
38. Intravenous Clonidine Prolongs Spinal Anesthesia after Hyperbaric Bupivacaine
- Author
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Ka Young Rhee
- Subjects
Bupivacaine ,medicine.medical_specialty ,business.industry ,Clonidine ,Surgery ,Anesthesiology and Pain Medicine ,Mean blood pressure ,medicine.anatomical_structure ,Dermatome ,Anesthesia ,Orthopedic surgery ,Heart rate ,medicine ,Premedication ,business ,Prospective cohort study ,medicine.drug - Abstract
Background: The prolonging effects of oral clonidine premedication on spinal anesthesia are known. We hypothesized that intravenous clonidine might have the same effect even if administered after an intrathecal local anesthetics injection. Methods: To assess the prolonging effect of intravenous clonidine on spinal anesthesia, we designed a double-blinded, placebo-controlled, prospective study. Patients scheduled for orthopedic surgery were studied. All patients received 12 mg of hyperbaric bupivacaine intrathecally and were allocated to three groups. Group 1 (n = 26) was the control. Group 2 (n = 26) and Group 3 (n = 26) received 3/kg intravenous clonidine at the same time and 50 minutes after intrathecal hyperbaric bupivacaine injection. Sensory block was evaluated by pinprick and the duration was defined as the time needed for regression to L1 dermatome. Duration of motor blockade was defined as the time needed for recovery of knee flexion. Results: The duration of sensory block was longer in Group 2 (196 42 minutes) and 3 (179 41 minutes) than Group 1 (125 25 minutes). The Duration of motor blockade was longer in Group 2 (153 26 minutes) than Group 1 (131 29 minutes). The lowest heart rate and mean blood pressure were not different among the groups. Conclusions: Intravenous clonidine after an intrathecal hyperbaric bupivacaine injection prolonged spinal anesthesia without added complications.
- Published
- 2003
39. A Study on the Monitoring of Bupivacaine-induced Cardiac Depression in Dogs: A Comparison between Continuous Mixed Venous Oxygen Saturation and Mean Arterial Blood Pressure
- Author
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Jie Ae Kim, Hyun Sung Cho, Jin-Tae Kim, Kook Hyun Lee, and Ka Young Rhee
- Subjects
Bupivacaine ,Cardiac output ,Mongrel dogs ,business.industry ,medicine.medical_treatment ,Pulmonary artery catheter ,Anesthesiology and Pain Medicine ,Blood pressure ,Late period ,Anesthesia ,Medicine ,Gas analysis ,business ,Depression (differential diagnoses) ,medicine.drug - Abstract
Background: Bupivacaine induces cardiac depression, which is resistant to treatment. Therefore early recognition of its development is important so that the injection of bupivacaine can be discontinued promptly. We compared the efficacy of continuous mixed venous oxygen saturation (cSvO2) monitoring with that of the mean arterial blood pressure (MBP) monitoring in terms of the prediction of cardiac output (CO) changes in anesthetized dogs with bupivacaine-induced cardiovascular depression. Methods: Bupivacaine was infused to pentobarbital-anesthetized mongrel dogs (n = 8) at a rate of 0.5 mg/kg/min until the MBP decreased to 40 mmHg or less (end of bupivacaine infusion; BIE). We defined the early period as the interval from baseline till 30 minutes after the bupivacaine infusion and the late period as that after the 30 minutes till BIE. We monitored cSv with a fiberoptic pulmonary artery catheter. The MBP and CO were measured every ten minutes after the initiation of the bupivacaine infusion. Arterial blood gas analysis, mixed venous gas analysis, measurement of serum electrolyte concentrations and serum bupivacaine concentrations were performed simultaneously. The relationship between CO versus cSvO2 or versus MBP was compared retrospectively by regression analysis. Results: The Pearson's correlation coefficients between CO and cSvO2 were 0.782 ( = 0.6111, P 0.01) in the early period and 0.824 ( = 0.6790, P 0.01) in the late period. The correlation coefficients between CO and MBP were 0.019 (r2 = 0.0003, P 0.05) in the early period and 0.799 ( 0.01) = 0.6381, P 0.01) in the late period. Conclusions: cSvO2 is superior to MBP for the prediction of CO changes in bupivacaine-induced cardiac depression in dogs, especially in the early period. We might expect a profound reduction of CO when MBP begins to decrease in the late period.
- Published
- 2002
40. Effect of Saline-Filled or Viscous Lidocaine-Filled Cuff on the Laser-Induced Polyvinyl Chloride Endotracheal Tube Fires and Tidal Volume
- Author
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Byung Moon Ham, Chong Sung Kim, Kwang Woo Kim, Sang Chul Lee, Hea Jo Yoon, Ka Young Rhee, and Jae Hyun Bahk
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Laser ,Viscous lidocaine ,law.invention ,Surgery ,Polyvinyl chloride ,chemistry.chemical_compound ,Anesthesiology and Pain Medicine ,chemistry ,law ,Anesthesia ,Cuff ,medicine ,business ,Saline ,Tidal volume ,Endotracheal tube - Published
- 1999
41. Attenuating Effect of cAMP on Hypoxic Pulmonary Vasoconstriction in the Isolated Perfused Rat Lungs
- Author
-
Ka Young Rhee, Yong Lak Kim, Ji Hee Kim, Young Jin Ro, Seong Deok Kim, Chong Doo Park, and Seong Won Min
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,business.industry ,Hypoxic pulmonary vasoconstriction ,Internal medicine ,medicine ,Cardiology ,business - Published
- 1999
42. Nasotracheal Intubation Using Fiberoptic Bronchoscope and Guidewire in a Pediatric Mandibular Fracture Patient: A case report
- Author
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Hyun Jeong Kim, Kwang Won Yum, and Ka Young Rhee
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,Nasotracheal intubation ,business.industry ,Mandibular fracture ,Fiberoptic bronchoscope ,Medicine ,business ,medicine.disease ,Surgery - Published
- 1999
43. The Effect of Atropine on Hemodynamics during Spinal Anesthesia
- Author
-
Yong Lak Kim and Ka Young Rhee
- Subjects
Bradycardia ,Tachycardia ,Baroreceptor ,business.industry ,Hemodynamics ,Atropine ,Anesthesiology and Pain Medicine ,Mean blood pressure ,Blood pressure ,Anesthesia ,Heart rate ,medicine ,medicine.symptom ,business ,medicine.drug - Abstract
Background : The major complications of spinal anesthesia are hypotension and bradycardia. In normal condition, hypotension stimulates baroreceptor reflex and compensatory tachycardia is occured. But during spinal anesthesia, there is possibility of a blockade of cardiac sympathetic nerve fibers which would result in increased vagal tone and depress compensatory baroreceptor reflex which is activated during hypotension. Atropine is an anticholinergic agent whose predominant cardiovascular effect was known as increasing heart rate at clinical dose. The purpose of this study was to evaluate hemodynamic effect of atropine during spinal anesthesia. Methods : We compared heart rate, systolic, diastolic and mean arterial pressures and cardiac output in 26 patients of ASA physical status 1, 2 before and after intravenous injection of atropine sulfate 0.01 mg/Kg during spinal anesthesia. Hemodynamic parameters were measured just prior to and 1, 2, 3, 4, 5, 10 minutes after atropine sulfate intravenous injection. The data were analyzed by repeated measures ANOVA. Results: Heart rate, mean blood pressure and diastolic blood pressure after atropine sulfate injection increased with significance. Conclusion : These findings suggest that during spinal anesthesia atropine is effective to produce tachycardia with a dosage of 0.01 mg/Kg in humans. Also hypotension might be improved because atropine makes mean blood pressure and diastolic blood pressure increase. (Korean J Anesthesiol 1998; 35: 946∼951)
- Published
- 1998
44. Usefulness of PAR Score and Modified PADSS as Patient Discharge Criteria in Ambulatory Surgery
- Author
-
Kwang Woo Kim, Ka Young Rhee, Yun Sang Kwan, Ik Hyun Choi, Yun Seok Jeon, Woo Sik Um, and Yu Hong Kim
- Subjects
Patient discharge ,medicine.medical_specialty ,Anesthesiology and Pain Medicine ,Scoring system ,business.industry ,Ambulatory ,medicine ,Postoperative complication ,After discharge ,Complication ,business ,Surgery - Abstract
Background : Although an ambulatory surgical practice continues to increase, there is a few data exist about patient discharge criteria. This study was undertaken to evaluate the usefulness and safety of Aldrete PAR (postanesthetic recovery) score and modified PADSS (modified postaneathesia discharge scoring system) on ambulatory surgery patients for recovery in Korea. Methods : Demographic, anesthetic data, Aldrete PAR score and modified PADSS on 279 patients were recorded. The time to dicharge, from recovery room and postoperative complications were evaluated, also. Results : PAR score and modified PADSS are correlated to length of stay in ambulatory surgery center. 24hr after discharge, 16% patients complained postoperative complications. Pain was most frequent postoperative complication. The PAR score was correlated with the occurrence of the complication. Conclusion : PAR score and modified PADSS are useful scoring systems to evaluate patients and make a decision to discharge the patients from ambulatory surgery center in safe. (Korean J Anesthesiol 1998; 35: 983∼987)
- Published
- 1998
45. A Comparison of Pressure Controlled Ventilation and Hybrid Ventilation in Rabbits
- Author
-
Kook Hyun Lee, Ka Young Rhee, and Sang Chul Lee
- Subjects
Anesthesiology and Pain Medicine ,Hybrid ventilation ,business.industry ,Anesthesia ,Lung mechanics ,Pressure controlled ventilation ,Medicine ,Peak inspiratory pressure ,business - Published
- 1998
46. Anesthetic Management in a Patient with Anaphylaxis to Thiopental: A case report
- Author
-
Seong Deok Kim, Ka Young Rhee, Kook Hyun Lee, and Kyoung Ok Kim
- Subjects
Anesthesiology and Pain Medicine ,business.industry ,Anesthesia ,Medicine ,Anesthetic management ,business ,medicine.disease ,Anaphylaxis - Published
- 1998
47. The Effect of Intratracheal Pulmonary Ventilation on Dead Space and Airway Pressures in Rabbits with Acute Respiratory Failure Induced by Oleic Acid Injection
- Author
-
Ka Young Rhee, Kook Hyun Lee, Yang Ja Kang, Kwang Woo Kim, and Sung Lyang Chung
- Subjects
Mechanical ventilation ,Respiratory rate ,Pressure control ,business.industry ,Dead space ,medicine.medical_treatment ,Peak inspiratory pressure ,Anesthesiology and Pain Medicine ,Anesthesia ,Breathing ,medicine ,Respiratory system ,business ,Tidal volume - Abstract
Background : Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. To reduce anatomic dead space, a reverse thrust catheter (RTC) is introduced into an endotracheal tube (ETT) through an adapter and positioned just above the carina inside the ETT. ITPV can be combined with pressure control mode of mechanical ventilation to make hybrid ventilation(HV). The effect of HV on the reduction of dead space was compared with that of conventional mechanical ventilation(CMV) in rabbits with acute respiratory failure. Methods : Oleic acid of 0.06 ml/kg was injected to induce acute respiratory failure in 7 rabbits. PaO2 and PaCO2 were measured 30 minutes after the injection. Oleic acid was injected in another 7 rabbits to compare CMV with HV while increasing the respiratory rate(RR). Tidal volume, dead space(VD) and peak inspiratory pressure(PIP) were measured at the same RR. Results : PaO2 decreased significantly from 467± 68 mmHg to 156 ±26 mmHg at FIO2 1.0 after the injection of oleic acid. In another 7 rabbits, the VD''s of CMV were 34± 10 ml, 27 ±10 ml, 20± 6 ml, and 18± 3 ml at respiratory rate of 20/min, 40/min, 80/min and 120/min, respectively. The VD''s of HV were 28 ±11 ml, 16± 8 ml, 9± 4 ml, and 7± 3 ml at the same respiratory rates as in CMV. The VD''s of HV were lower than those of CMV. The PIP''s were lower in HV than in CMV. Conclusion: We conclude that HV, as the modification of ITPV, can be applied to acute respiratory failure to minimize the airway pressures and dead space of CMV. (Korean J Anesthesiol 1997; 32: 360∼365)
- Published
- 1997
48. A comparison of arterial blood gas values depending on the use of endotracheal tube cuff in postanesthetic patients
- Author
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Ka Young Rhee and Kook Hyun Lee
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,Airway resistance ,business.industry ,Postoperative hypoxemia ,Anesthesia ,medicine ,Arterial blood ,Endotracheal tube cuff ,business ,Surgery - Published
- 1995
49. Intraoperative Contralateral Epidural Hematoma Following Removal of Cerebral Arteriovenous Malformation
- Author
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Gi Sun Hwang, Ka Young Rhee, and Yong Seok Oh
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,Epidural hematoma ,business.industry ,medicine.medical_treatment ,medicine ,Arteriovenous malformation ,medicine.disease ,business ,Craniotomy ,Surgery - Published
- 1994
50. The Relationship Between Plasma Inflammatory Cytokines and Labor Pain.
- Author
-
Ka Young Rhee, Goetzl, Laura, Unal, Ramsey, Cierny, Jill, Flood, Pamela, and Gaiser, Robert
- Published
- 2016
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