• Title/Summary/Keyword: 신경 차단

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Analgesic Effect of Botulinum Toxin on Neuropathic Pain after Trigeminal Nerve Injury (삼차신경 손상에 의한 신경병증성 통증에서 보툴리눔 독소의 진통 효과)

  • Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.171-178
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    • 2012
  • Botulinum toxin type A (BoNT-A) has been applied successfully to treat chronic migraine, dystonia, spasticity and temporomandubular disorders(TMDs) as well as frontal wrinkle and glabella wrinkle. Recently it has been reported that BoNT-A, reversibly blocks presynaptic acetylcholine release, also inhibits the release of substance P, CGRP(calcitonin gene related peptide) and glutamate related to peripheral sensitization and neurogenic inflammation in sensory nerve, In this study we reviewed animal nerve injury model such as rat and rabbit and identify the analgesic effect and mechanism of nerve injury pain after dental treatment.

Ultrastructural and Neurophysiological Changes Observed Following Injection of Morphine, Meperidine and Pentazocine in the Sciatic Nerves of Rabbits (가토의 좌골신경에 Morphine, Meperidine, Pentazocine을 주사한 후 미세형태학적 및 신경생리학적 변화)

  • Cheun, Jae-Kyu;Kim, Sae-Yune;Bae, Jung-In
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.213-220
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    • 1992
  • The sciatic nerves of anesthetized rabbits were exposed and stimulated by a nerve stimulator in order to observe the myoneural response. These rabbits were divided into three groups and respectively injected with morphine (Group 1), meperidine(Group 2) and pentazocine (Group 3). The sciatic nerves were stimulated periodically and gait changes were observed to see the myoneural activity after the injections. When the distal part of the sciatic nerves were stimulated by the nerve stimulator after the respective drug injections, the normal muscle twitch responses were observed in all the progressional stages of Group 1. However, in Group 2 and 3, the muscle twitch responses decreased gradually, finally disappearing after approximately 10 minutes in these two groups. Complete motor paralysis continued for about 60 minutes. The muscle reactions returned to normal approximately 90 minutes after injection. Specimens drug-injected tissues were severed 4 hours, 24 hours and 1 week after injection respectively. These tissue were investigated under light as well as electron microscopy. The tissue revealed rare to moderate vacuolizations scattered in the axons of the myelinated and unmyelinated nerves of some of the specimens; however, there were no significant pathologic lesions. These results provide evidence that neurophysiologically, meperidine and pentazocine have a local anesthetic-like effect such as motor paralysis, but morphine does not. In addition, the results indicated that neurohistologically, the three narcotics have no significant toxic effects on the nerve tissue.

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Electrophysiological Features of Diabetic Polyneuropathy: Motor Nerve Conduction Studies (당뇨병성다발신경병증의 전기생리학적 특징: 운동신경전도검사)

  • Kang, Ji-Hyuk;Lee, Yun-Seob
    • The Journal of the Korea Contents Association
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    • v.10 no.10
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    • pp.237-245
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    • 2010
  • Nerve conduction studies (NCS) are the most objective measure of nerve function and essential for the diagnosis of sub-clinical neuropathy in diabetes mellitus and diabetic polyneuropathy (DPN). This study evaluates the characteristic of electrophysiological abnormalities in DPN. Electrodiagnostic data from 120 patients with diabetic polyneuropathies and 77 control subjects were reviewed. Motor nerve conduction velocities (MNCV), distal motor latencies (DML), compound muscle action potential (CMAP) amplitudes, No potential frequency and conduction block were analyzed. Data were normalized based on normative reference values, and the proportion of nerves with abnormal values in the lower and upper limbs were evaluated. DPN was systemic demyelinating peripheral polyneuropathy and more severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in peroneal nerve. It was no statistically significant difference of conduction block in control and DPN group. Our findings suggest that DPN had more common and severe peroneal nerve involvement in the motor nerve conduction studies (MNCS). These findings have important implications for the electrophysiological evaluation of DPN.

The Effectiveness of Ultrasonography-guided Suprascapular Nerve Block in Patients treated with Arthroscopic Rotator Cuff Repair (관절경하 회전근개 봉합술을 시행한 환자에 대한 초음파 유도하 상견갑 신경차단술의 효과)

  • Moon, Young Lae;Kang, Jeong Hoon;Kim, Hyun Hak
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.84-88
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    • 2014
  • Purpose: The purpose of this study was to analyze the effectiveness of suprascapular nerve block using platelet-rich-plasma (PRP) under ultrasonographic guidance in patients treated with arthroscopic rotator cuff repair. Material and Methods: 50 cases of patients, from March 2013 to March 2014, treated with arthroscopic rotator cuff repair were retrospectively analyzed. We performed ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) to these patients in the outpatient clinics at the 6 weeks follow-up after operation. We evalulated results for visual analogue score (VAS) for pain, range of motion (ROM), Constant Shoulder Score (CSS) for these patients before arthroscopic operation, following 6 weeks and 3 months after operation. Results: There was clinically significant improvement in VAS, ROM, CSS after ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP). Conclusion: Ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) is an effective treatment method not only for around shoulder pain but also postoperative residual shoulder pain and limitation of shoulder motion.

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Norepinephrine과 Angiotensin II의 혈압상승작용에 대한 Diltiazem의 영향

  • 고석태;임동윤;유강준;최홍석;심기정
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.298-298
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    • 1994
  • Norepinephrine이나 angotensin II가 그 작용을 나타내는데 $Ca^{+2}$의 세포내 유입 또는 유출과 밀접한 관련이 있다는 관점에서 $Ca^{+2}$ -channel차단제중 benzothiazenpine계인 diltiazem의 norepinephrine과 angiotensin II의 혈압상승작용에 대한 영향을 가토에서 관찰하였다. Norepinephrine과 angiotensin II의 혈압상승작용에 대한 diltiazem의 영향을 관찰하는 경우는 diltiazem을 투여한 일정시간후에 norepinephrine이나 angiotensin II을 투여하여 나타나는 혈압변화를 diltiazem투여전의 norepinephrine이나 angiotensin II의 혈압상승치와 비교 검토하였다. Diltiazem은 norepinephrine과 angiotensin II의 혈압상승작용을 억재하였으나 그 억제 시간은 지속적이지 않았다. 이와는 달리 diltiazem투여 30-40분에는 norepinephrine의 혈압상승작용의 강화현상이 나타났다. Diltiazem은 교감신경말단차단제인 bethanidine이나 신경절 차단제인 chlorisondamine 처리 가토에서도 norepinephrine이나 angiotensin II의 혈압상승작용을 억제하였다.

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특집 : 미세혈관 합병증 - 말초혈관에 의한 족부병변 - 당뇨발 괴사의 진단과 치료

  • Han, Seung-Hwan
    • The Monthly Diabetes
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    • s.259
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    • pp.22-25
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    • 2011
  • 당뇨발의 발생원인으로 신경병증 및 혈관병증이 있다. 신경병증의 경우 발의 자기 방어기전의 소실로 족부에 궤양이 유발되나, 혈관병증에 의한 혈액순환 장애는 궤양의 발생뿐 아니라, 산소 및 영양공급을 차단 시켜 궤양의 치료까지 어렵게 만들어 발이 까맣게 썩어가는 괴사까지 초래하게 된다.

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Clinical Results Following T3, 4 vs T3 Thoracoscopic Sympathicotomy in 30 Axillary Hyperhidrosis Patients (겨드랑이 다한증 환자에서 흉부교감신경의 차단부위(T3-4와 T4)에 따른 임상결과)

  • Choi, Soon-Ho;Lee, Sam-Youn;Lee, Mi-Kyung;Cha, Byoung-Ki
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.469-475
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    • 2008
  • Background: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. Material and Method: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. Result: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was $38.7{\pm}2.3$ months, and the mean follow-up for the T4 group was $18.7{\pm}3.6$ months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. Conclusion: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.

Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.