The Korean Journal of Pain

  • 제19권2호
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  • Pages.181-186
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  • 2006
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  • 2005-9159(pISSN)
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  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
권호 표지

경부경막외차단 시 약물의 용량에 따른 약물 분포 범위: 5 ml와 10 ml 주입량에 대한 비교 연구

Vertebral Spreading Segments of Cervical Epidural Injection: a Comparative Study with 5 ml and 10 ml of Injected Volume

  • 이상은 (아주대학교 의과대학 아주대학교병원 마취통증의학과) ;
  • 한경림 (아주대학교 의과대학 아주대학교병원 마취통증의학과) ;
  • 김찬 (아주대학교 의과대학 아주대학교병원 마취통증의학과) ;
  • 채윤정 (아주대학교 의과대학 아주대학교병원 마취통증의학과) ;
  • 유지영 (아주대학교 의과대학 아주대학교병원 마취통증의학과)
  • Lee, Sang Eun (Pain Clinic, Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Ajou University School of Medicine) ;
  • Han, Kyung Ream (Pain Clinic, Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Ajou University School of Medicine) ;
  • Kim, Chan (Pain Clinic, Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Ajou University School of Medicine) ;
  • Chae, Yun Jeong (Pain Clinic, Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Ajou University School of Medicine) ;
  • Yoo, Ji Young (Pain Clinic, Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Ajou University School of Medicine)
  • 투고 : 2006.10.09
  • 심사 : 2006.12.01
  • 발행 : 2006.12.30
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초록

Background: Although cervical epidural block can be a useful therapeutic treatment for head, neck and upper extremities pain, there is no consensus regarding the volume of injection required for pain management. Herein, the spreading in the vertebral segments after a cervical epidural injection of either a 5 or 10 ml volume was studied. Methods: A total of 78 patients, suffering from head, neck and upper extremity pain, were selected. Cervical epidural blocks were performed consecutively with 5 ml (n = 42) and 10 ml (n = 36) of 0.4% mepivacaine and 222 mg I/ml iopamidol at the C7⁣-T1 levels. Both anteroposterior (AP) and lateral radiographs were obtained under fluoroscopy, and the upper and lower epidural spreading of the contrast media in relation to the vertebral level was evaluated. Results: The cervical epidural blocks were performed without complications. The rostral spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.6{\pm}1.1$ and $6.1{\pm}1.1$, respectively. The caudal spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.4{\pm}3.4$ and $7.2{\pm}3.9$, respectively. The total numbers of segments with vertebral spreading of the contrast media in both directions showed significant differences between the two groups. The numbers of patients who showed spreading of the contrast media up to C2 vertebral segment showed no significant differences between the two groups. Conclusions: 5 and 10 ml epidural injection volumes may be adequate for the spread of contrast media to the entire cervical spine. A 5 ml epidural injection volume, compared to a 10 ml volume, may be ample when considering the possibility of unnecessary caudal spreading of drugs and volume related complications in the management of head, neck and upper extremity pain.

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