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소아 사시 교정술에서 마취약제에 따른 안구심반사와 술 후 회복의 평가

Other Titles
 Oculocardiac Reflex and Postoperative Recovery in Pediatric Strabismus Surgery: A Randomized Trial Comparing Four Anesthetic Techniques. 
 홍정연  ;  길혜금 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.37(6) : 1046-1053, 1999 
Journal Title
 Journal of Korean Society of Anesthesiologist (대한마취과학회지) 
Issue Date
Anesthetics ; intravenous: fentanyl ; propofol ; volatile: enflurane ; Complication: oculocardiac reflex ; vomiting ; Surgery ; strabismus ; intravenous ; fentanyl ; volatile ; enflurane ; Complication ; oculocardiac reflex
Background: Oculocardiac reflex (OCR) and postoperative nausea/vomiting are major complications of pediatric strabismus surgery. The aim of the study was to assess, in children undergoing strabismus surgery, the incidence of OCR and postoperative emesis with a inhalational and a intravenous technique. Methods: 44 healthy children undergoing elective strabismus surgery as inpatients were randomly allocated to four anesthetic techniques: (1) induction with propofol, maintenance with propofol infusion and 50% N2O-O2 (propofol-N2O); (2) induction with propofol and fentanyl 1μg/kg bolus, maintenance with propofol infusion and 50% air-O2 (propofol-fentnyl-air); (3) induction with thiopental, maintenance with enflurane and 50% N2O-O2 (enflurane-N2O); (4) induction with thiopental and fentanyl 1μg/kg, maintenance with enflurane and 50% air-O2 (enflurane-fentanyl-air). Results: The incidence of an OCR significantly increased in the propofol-fentanyl-air group as compared to the enflurane-N2O or enflurane-fentanyl-air groups. Times to extubation were shorter in the propofol- N2O group than in the propofol-fentanyl-air or enflurane-fentanyl-air groups. Alertness scores were lower in the propofol-N2O group than in the enflurane-N2O or enflurane-fentanyl-air groups. Postanesthetic recovery scores and nausea/vomiting during the 24 hr after the operation did not show any differences among the groups. Conclusions: We concluded that children undergoing strabismus surgery anesthetized with propofolfentanyl-air had more episodes of OCR, propofol-N2O had shorter times to extubation and higher alertness scores, and the addition of N2O or fentanyl to anesthetic regimen was not associated with nausea and vomiting.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
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