Desflurane을 이용한 전신마취 하 소아의 안과 수술시 투여한 ketamine의 술 후 각성흥분의 발생빈도에 대한 효과
The effect of ketamine on the incidence of emergence agitation in children undergoing brief ophthalmic surgery under desflurane general anesthesia.
- 주제(키워드) Brief ophthalmic surgery , Desflurane , Emergence agitation , Ketamine , Separation anxiety
- 발행기관 고려대학교 대학원
- 지도교수 김운영
- 발행년도 2011
- 학위수여년월 2011. 8
- 학위구분 석사
- 학과 일반대학원 의학과
- 세부전공 마취통증의학전공
- 원문페이지 20 p
- 실제URI http://www.dcollection.net/handler/korea/000000026909
- 본문언어 한국어
- 제출원본 000045667855
초록/요약
- Abstract - The effect of ketamine on the incidence of emergence agitation in children undergoing brief ophthalmic surgery under desflurane general anesthesia. Won Ju Jeong, M.D. Major in Anesthesiology, Department of Medical Science, Graduate School, Korea University, Seoul, Korea (Director: Prof. Woon Young, Kim, M.D., Ph.D.) Background: Emergence agitation frequently occurs after desflurane anesthesia in children. Ketamine, because of its sedative and analgesic properties, might be useful for the management of this side effect. We investigated the effect of ketamine on separation anxiety and emergence agitation after desflurane anesthesia in children for brief ophthalmic surgery. Methods: We evaluated the effects of added intravenous ketamine in 60 children, 2-8 years old, undergoing brief ophthalmic surgery (strabismus and entropion surgery). Patients were randomly allocated to one of three groups receiving either normal saline (group C), ketamine 0.5 mg/kg (group K0.5) or ketamine 1.0 mg/kg (group K1.0). Anesthesia was induced with dose of 5 mg/kg of thiopental, nitrous oxide, oxygen and desflurane 4-6 vol%. Intubation was facilitated with dose of 0.6 mg/kg of rocuronium. Before induction, the separation anxiety score was evaluated. Children in group K1.0 received ketamine 1.0 mg/kg intravenously before entering the operating room and children in group K0.5 recieved ketamine 0.5 mg/kg 10 minutes before the end of the surgery. The recovery characteristics including time to extubation, delivery time from recovery room to ward, postoperative nausea and vomiting, agitation and pain were assessed. Result: There were no significant differences in delivery time and postoperative nausea and vomiting among the three groups. Extubation time in group K0.5 was significantly prolonged compared with group K1.0 and group C. The group K1.0 had the lower separation anxiety score compared with group K0.5 and group C. The incidence of emergence agitation and the modified CHEOPS were significantly lower in group K1.0 and group K0.5 compared to group C and there was no significant difference between group K1.0 and group K0.5. Conclusion: In children undergoing brief ophthalmic surgery with desflurane anesthesia, ketamine 1.0 mg/kg administered before entering the operating room reduced separation anxiety, pain in recovery room and incidence of emergence agitation without delaying discharge from recovery room.
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I. 서 론 ·············································· 1
II. 대상 및 방법 ···································· 2
III. 결 과 ············································ 4
IV. 고 찰 ············································ 5
V. 결론 ·············································· 8
VI. 참고 문헌 ······································· 9
