안와골절정복술 시 사용된 에피네프린이 동공크기에 미치는 영향에 대한 고찰
Effect of Epinephrine in Reconstruction of an Orbital Wall Fracture
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목적: 안와골절정복술 시 사용된 에피네프린이 동공크기에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 2009년 1월부터 7월까지 안와골절정복술을 시행 받은 환자 중 27명 27안을 대상으로 에피네프린주사액 사용군과 미사용군으로 나누어 수술 전, 후의 동공크기, 수술시간, 에피네프린 사용량 등을 조사하였다. 결과: 에피네프린사용군의 수술 전 동공크기는 1.80 ± 0.37 mm에서 수술 후 1.97 ± 0.43 mm (p=0.042)로, 대조군은 수술 전 1.74± 0.36 mm에서 수술 후 2.18 ± 0.52 mm (p=0.003)로 두 군 모두 수술 후 동공크기가 증가하였으며 이는 통계학적으로 유의하였다. 그러나, 에피네프린사용군의 수술 전, 후 동공크기변화량과 대조군의 수술 전, 후 동공크기변화량은 유의한 차이를 보이지 않았다(p=0.258). 에피네프린사용군에서 수술시간에 따른 동공크기의 변화는 유의한 상관관계를 보이지 않았으며(p=0.228), 주사량에 따른 동공크기의 변화 역시 통계학적으로 유의한 상관관계를 보이지 않았다(p=0.922). 결론: 안와골절정복술 시 출혈예방, 수술시야 확보 등을 위한 에피네프린주사액 사용은 효과적이라 생각한다.
Abstract
Purpose: To evaluate the effect of epinephrine on pupil size in reconstruction of an orbital wall fracture. Methods: The authors of the present study describe 27 patients (27 eyes) who had reconstruction of an orbital wall fracture from January to July of 2009. Patients were divided into two groups according to the use of epinephrine during surgery. Preoperative and postoperative pupil sizes, operation times, and epinephrine dosages were collected. Results: Preoperative pupil sizes were 1.80 ± 0.37 mm, 1.74 ± 0.36 mm and postoperative pupil sizes were 1.97 ± 0.43mm (p = 0.042), 2.18 ± 0.52 mm (p = 0.003) in the group with of epinephrine and the group without epinephrine, respectively. Postoperative pupil size significantly increased in all groups. However, no significant difference was found regarding change in pupil size after surgery (p = 0.258). In the group with epinephrine, change in pupil size did not show a significant association with operation time (p = 0.228), nor did change in pupil size and epinephrine dosage (p = 0.922). Conclusions: The use of epinephrine is an effective modality for bleeding control and securing a clear view in orbital wall fracture reconstruction.
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