• 제목/요약/키워드: Anesthetic method

검색결과 141건 처리시간 0.022초

산모의 요추부 경막외강 깊이에 대한 고찰 (A Study on the Depth of the Lumbar Epidural Space from the Skin in Parturients)

  • 박찬흠;송필오;신명근;김인규;이성호
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.73-76
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    • 1997
  • Background : Epidural anesthesia is now accepted as a popular technique for pain relief and anesthesia. However, accidental dural puncture may occur during placement of the epidural needle. This study was undertaken to evaluate difference of the epidural depth between parturients and non-parturients. Method : Eighty non-parturients receiving epidural anesthesia were assigned to group I, and eighty parturients whose body weight had not yet increased over 15 kg from pregnancy were assigned to group II. With patients in lateral decubitus position, 18 guage Tuohy needle was punctured by approaching at $L_{3-4}$ interspace. Epidural space was identified using loss-of-resistance to air technique. Result : Epidural depth was 4.18 cm and 4.25 cm in group I and group II respectively. There was no significant statistical difference in body mass index(BMI) and ponderal index(PI) (p<0.05), nor in epidural depth between the two groups. Conclusion : Epidural needle need not be placed deeper in parturients than in nonparturients.

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자발성 두개내 저압환자에서의 경막외 혈액봉합술 (Epidural Blood Patch to Treat Spontaneous Intracranial Hypotension)

  • 이청;송준걸;박재홍;신진우;최윤;윤창섭
    • The Korean Journal of Pain
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    • 제13권1호
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    • pp.79-83
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    • 2000
  • Background: Spontaneous intracranial hypotension is a syndrome characterized by postural headache without trauma, spinal anesthesia or other medical history. The purpose of this study is to analyze the effect of epidural blood patch in spontaneous intracranial hypotension. Methods: The spontaneous intracranial hypotension patients treated with epidural blood patch were analyzed on the symptoms, radiologic images and methods of epidural blood patch retrospectively by the medical records. Results: Patients had postural headache (15 patients) including nausea/vomiting (10 patients), tinnitus (2 patients), neck stiffness (13 patients), vertigo (3 patients) and occular pain (1 patient). Brain CT and MRI showed diffuse enhancement of the pachymeninges (9 patients) and radionuclide cisternography demonstrated direct evidence of leakage (11 patients). With epidural blood patch, the symptoms were promptly relieved in 11 patients. Conclusions: We concluded that epidural blood patch is a good treatment of method in spontaneous intracranial hypotension patients.

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지주막하강내 약물투여에 의한 말기암 환자의 통증관리 -증례 보고- (Pain Management of Terminal Cancer Patients by Intrathecal Injection of Local Anesthetics, Opioid and Adjuvants -A report of two cases-)

  • 이선화;김종일;이상곤;반종석;민병우
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.259-262
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    • 2000
  • There are many difficulties in the management of terminal cancer pain. We often encounter difficulties when nerve blocks or epidural injection of drugs do not produce good results. Local anesthetics, opioids and adjunctives, were administered to two patients intrathecally. The results were very satisfactory. It has complications such as hypotension or infection due to intrathecal route. In the first case, the pancreatic cancer patient complicated with severe epigastic pain but unfortunately no management was effective in pain control. Intrathecal injection of bupivacaine and morphine mixture was successful even if syncope which was relieved by bed rest. In the second case, the patient complicated with lower abdominal pain due to ovarian cancer who very well controlled by epidural injection of morphine and clonidine mixture but morphine demand was greatly increased. Intrathecal injection of morphine and ketamine were tried. The patient had comportable analgesic effect. CSF leakage to subcutaneous occurred but resolved by change of the catheter position or retunnelling. There were no significant complications reported in two cases.

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경막외차단을 시행 받은 질식분만 산모들의 인식 조사 (Survey of Recognition in Parturients for Vaginal Delivery Controlled by Epidural Block)

  • 장영호;박은지;김애라;전재규
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.96-100
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    • 1998
  • Bakground: At our institution, We have controlled pain during vaginal delivery with epidural block since 1986. We designed a questionaire for parturients to analyze the degree of satisfaction of epidural block. Method: The self-questionaire were sent to parturients(N=200), who had epidural block to control labor pain during vaginal delivery. The questionaire covered topics dealing with motivation, fear, satisfaction and complications, of epidural block. Results: Motivation by an experienced person was 72.5%(145 parturients), fear of epidural block was 66%(132 parturients), and satisfactory response was 84%(168 parturients). Parturients who knew the role of anesthesiologist numbered 105(52.5%). Scarcely, 46 parturients displayed confidence for safety of fetus; 111 parturients experienced more than one complications. But special therapy for complications were not necessary. Conclusions: Publicity through mass-media and direct contact will improve the recognition and merit of epidural block by parturients as well as the role of the department of anesthesiology.

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암성 통증 조절을 위한 자가통증조절장치를 이용한 몰핀의 지속적 피하투여 -증례 보고- (Continuous Subcutaneous Administration of Morphine Using Patient Controlled Analgesia Device for Control of Cancer Pain)

  • 이경호;이철;김원태
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.321-325
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    • 1998
  • Most of the patients with pain resulting from advanced cancer need opioid for adequate analgesia. Various Methods of drug administration to control the pain have been developed. One of them, continuous administration of intravenous morphine is used for more effective pain control in the patient with severe pain that cannot be satisfactorily controlled by other Methods of morphine administration. But this is not a suitable method at home because of the possibility of serious infectious complications and the difficulty in managing intravenous access by untrained personnel. Continuous subcutaneous adminstration of drugs can not only overcome such disadvantages of continuous intravenous infusion but also get almost the same effect of pain control as continuous intravenous infusion, and allows opportunity to move freely and return home, improving quality of life. We used continuous subcutaneous morphine and metoclopramide in the patients with cancer pain via a portable PCA device, and accomplished satisfactory pain relief without significant side effect.

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신생아 통증완화 중재 관련 국내 연구분석 (Analysis of Research Related to the Neonatal Pain Relief Intervention in Korea)

  • 오진아;노인숙
    • 부모자녀건강학회지
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    • 제12권2호
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    • pp.160-176
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    • 2009
  • Purpose: The purpose of this study was to identify patterns and trends of studies, analyze the research, and improve direction of nursing research related to the neonatal pain relief intervention in Korea. Method: The studies were selected from dissertation, nursing journals and others in Korea. Result: Until 1995, there were no studies related to the neonatal pain relief intervention. The most studies have been increased rapidly after 2005. Pure of true experimental design of research design was used 5, Quasi experimental design was 7, preexperimental design was 7. Participants were preterm baby was 8, full-term baby was 9, and preterm and full-term baby was 2. Utilization of instruments as follows: NIPS, PIPP, ABSS, NFCS, pulse oximeter, EKG monitoring, and stethoscope. Contents of the research studies were classified 4 different types, such as studies of about the effect of auditory stimulation, taste stimulation, tactile stimulation, and topical anesthetic cream. The results of 25 studies were effective for the neonatal pain relief, but the results of 5 studies weren't. Conclusion: In the future studies need to develop the various instrument which is assessment of neonatal pain. It is important to the integrated by meta analysis. Additionally, we should develop protocol nursing intervention for the effective pain release.

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다한증 환자에서 흉부 교감신경절 차단과 인지 체온 변화와의 관계 (Changes of Index Finger Temperature as Indices of Success of Thoracic Sympathetic Ganglion Block)

  • 이효근;윤경봉;서영선;김찬
    • The Korean Journal of Pain
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    • 제7권2호
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    • pp.217-221
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    • 1994
  • Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed in 40 patients by simultaneously injecting 3 ml of pure alcohol into the T2 and T3 levels after 3 ml of injection of local anesthetic agent on the same sites. Using a skin temperature probe, finger tip temperatures were measured on the index finger ipsilateral to the nerve block before block, 15 and 30 minutes after test block, and 30 minutes after alcohol block. Alcohol block was performed immediately after 30 minutes test block. Finger tip temperatures obtained at 30 minutes post alcohol block and test block and the differences in the temperatures measured before and 30 minutes after alcohol block were shown to be statistically important as potential indicators for prediciting long term outcome of therapy for palmar hyperhidrosis using this technique. These results demonstrate that the palmar temperature monitoring method is sufficiently sensitive to predict the outcome of nerve block during and after thoracic sympathetic ganglion block.

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경막외강 유착제거술후 발생한 $S_2$ 피부분절부위의 감각변화 -증례 보고- (The Sensory Change on the $S_2$ Area after Epidural Adhesiolysis -A case report-)

  • 이상철;조대현;윤태균;이병건
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.256-259
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    • 1996
  • Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.

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치과용 국소마취 주사시 압력조절형 주사장치 사용의 효과에 대한 연구 (Study on Effect of Pressure-Controlled Injection System in Dental Local Anesthesia)

  • 윤필영;김영균
    • 대한치과마취과학회지
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    • 제6권2호
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    • pp.98-102
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    • 2006
  • The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

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Development of TEM Coil for Animal Experiments at 3T MRI System

  • Chu, Myung-Ja;Choe, Bo-Young;Kim, Kyung-Nam;Chung, Sung-Taek;Oh, Chang-Hyun;Lee, Hyoung-Koo;Suh, Tae-Suk
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2002년도 제7차 학술대회 초록집
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    • pp.78-78
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    • 2002
  • Purpose: The purpose of this study is to describe a distributed circuit approach to high frequency volume coil design illustrated with specific coils built accordingly and results obtained from animal studies at 3.0 tesla. Method: All experiments were conducted on 3T MRI system (Medinus Co., Ltd. Korea). The tuned TEM resonator measures 15cm outer diameter. by 10cm inside diameter by 30cm in length. The inside diameter and length were determined by animals body or head size (eg. rats or small dogs, etc.) while the outer diameter was chosen for compactness with some sacrifice of the optimal coil Q predicted for a larger cavity. A spin echo sequence with a TR/TE/flip angle=500/12.4ms/$75^{\circ}$was used to check image qualities with phantom. The breed of rat which used for animal images was Sprague-dawley(SD) and was anesthetic using ketamin hydrochloride 75mg/kg.

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