소아에서 세보플루란을 이용한 마취 시 레미펜타닐의 추가 사용이 마취유도와 회복에 미치는 영향 -무작위배정비교임상시험의 메타분석-

학위논문 (석사)-- 서울대학교 대학원 : 임상의과학과, 2016. 2. 서정화.Background: Although sevoflurane is widely used in pediatric anesthesa, its single use may be insufficient to prevent noxious stimuli induced by tracheal intubation or cause emergence agitation during recovery. Therefore, this meta-analysis was performed to determine whether administration of remifentanil may improve induction and recovery profiles during sevoflurane anesthesia in children. Methods: A comprehensive literature search was conducted to identify randomized controlled trials involving children < 18 years of age who received sevoflurane anesthesia combined with or without intravenous remifentanil. Two authors independently assessed study quality and extracted data from included studies. Random-effects models were applied to calculate pooled risk ratios (RRs) for dichotomous data and standardized mean differences (SMDs) for continuous data with the corresponding 95% confidence intervals (CIs). The primary outcomes were hemodynamic changes during tracheal intubation and the incidence of emergence agitation during recovery. Results: Out of 1920 studies screened, 13 studies involving 1237 children were included in the analysis. The use of remifentanil reduced changes of blood pressure [SMD (95% CI) -1.33 (-1.89, -0.77), P < 0.001, I2 = 87%] and heart rate [SMD (95% CI) -1.21 (-1.81, -0.61), P < 0.001, I2 = 89%] during tracheal intubation. The incidence of emergence agitation decreased when remifentanil was co-administered with sevoflurane during intraoperative period [SMD (95% CI) -1.21 (-1.81, -0.61), P < 0.001, I2 = 89%] as compared with the use of placebo. Conclusion: This meta-analysis showed that the use of remifentanil attenuated hemodynamic fluctuation during tracheal intubation and decreased emergence agitation under sevoflurane anesthesia in children. ------------------------------------- Keywords: Pediatrics, Anesthesia, Intubation, Blood Pressure, Heart Rate, Postoperative Complications.INTRODUCTION 1 METHODS 2 Study eligibility 2 Outcomes 2 Study selection 3 Quality assessment and data collection 4 Data synthesis 4 Heterogeneity 5 Sensitivity analysis 5 Publication bias 5 RESULTS 7 Search results 7 Assessment of risk of bias 7 Change in hemodynamics during tracheal intubation 7 Incidence of emergence agitation 8 Secondary outcomes 8 DISCUSSION 20 APPENDICIES 22 REFERENCES 23 국문 초록 28Maste

미세유체소자 내 액체금속거울을 이용한 분광학적 분석

학위논문(석사) - 한국과학기술원 : 바이오및뇌공학과, 2010.2, [ viii, 54 p. ]This paper presents a new absorbance measurement device using multiple internal reflections and a new novel spectrometer for both of them using fluidic mirrors filled with liquid metal. Liquid metal mirrors reflect and gather light from LED with high reflectivity and small sample volume. Optical path length has been extended with various incident angles of 20$\deg$, 30$\deg$, 40$\deg$ and 50$\deg$. We demonstrated the enhancements of the sensitivity and limit of detection (LOD) compared to the air mirrors and linear channel. As incident angle lowers, optical path length extension becomes more effective without trade-offs of sensitivity and LOD. This device with incident angle of 50$\deg$ has a 84 nM of LOD and 3.62 x $10^{-4}$ of sensitivity for absorbance measurement of fluorecein diluted in deionized water. The spectrometer is suitable for direct spectral analysis in the sample channel plane using fluidic slit and mirror filled with liquid metal. Solutions of phenol red and trypan blue which are used widely for biomolecular detection are measured for spectrometric analysis. This platform can be simply adapted to the applications using the fiber optics integration. The measurements of phenol red and trypan blue result 212 nM, 154 nM of LOD and 1.09 x $10^{-3}$, 8.10 x $10^{-4}$ of sensitivity respectively.한국과학기술원 : 바이오및뇌공학과