• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.153-156
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• 2015

A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

• The Korean Journal of Pain
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• 제9권2호
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• pp.344-348
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• 1996

Continuous epidural block can be useful in the management of acute and chronic pain. For the most effective analgesia, it is important to localize the tip of epidural catheter and the spread of radiopaque dye. Epidural catheterization was performed in 12 patients on the sitting position. Catheters were advanced by 10 cm cephalad in the cervical epidural space by median approach and radiopaque dye 3 ml was injected through the catheters. The position of cervical epidural catheters and the spread of dye was confirmed by radiography. The course of epidural catheter were: coiled 3/12 (25%), loop 2/12 (16.7%), straight 2/12 (16.7%). In 8 cases, the tip of epidural catheters were located within one vertebral segment from the level of insertion site. Radiopaque dye spreaded average 3.68 vertebral segment to cranially and 1.67 vertebral segment to caudally from the insertion site.

• The Korean Journal of Pain
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• 제12권2호
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• pp.235-237
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• 1999

Meniere's disease is a disorder of the membranous labyrinth that is characterized by vertigo, hearing loss, tinnitus and ear fullness. The etiology of Meniere's disease is yet to be described and the management is also very difficult. Fifty-one years old female patient had paroxysm of severe tinnitus and dizziness after medical therapy and surgical intervention during several years. Patient received stellate ganglion block (SGB) and her symptoms were completely relieved. Therefore, SGB could be considered another therapeutic modality for Meniere's disease.

• The Korean Journal of Pain
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• 제11권1호
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• pp.130-133
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• 1998

We present our failed case of celiac plexus block using the anterior approach under CT guidance in patient with intolerable abdominal pain originating from pancreatic cancer with celiac invasion. In spite of the proper position of needle, the contrast material was not spread due to the tumoral invasion.

• Journal of Chest Surgery
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• 제27권4호
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• pp.324-327
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• 1994

Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

• The Korean Journal of Pain
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• 제9권1호
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• pp.264-267
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• 1996

Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidural block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paralysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block which may affect responses of circulatory and ventilatory systems. Accordingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.

• 대한수의학회지
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• 제39권1호
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• pp.240-246
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• 1999

forty-five claw lamed cows with pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa were treated surgically through resection of necrotic tissues, currettage, antibiotics application, and compressive bandage, under retrograde intravenous regional anesthesia of claw. At 7 days postoperation were showed lameness score 0, absense of swelling of extremitis, without fistulation and purulent exudate in wound. Mean duration time of action of local anesthetic drug was 75 minutes and mean operation time for treatment of pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa was 35 minutes, 20 minutes, and 21 minutes, respectively.

• The Korean Journal of Pain
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• 제10권2호
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• pp.291-295
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• 1997

Technique of epidural analgesia is generally regarded a safe procedures which is widely applied in postoperative and chronic pain control. Incidence of neurologic complications following epidural analgesia are rare; however, increasing number of published reports describing transient or permanent neurologic complications following such procedures have been appearing more frequently. We report two cases of neurologic complications following epidural analgesia as we believe it is important to draw the attention of other anesthesiologist to the possibility of existence of other complications of significant medicolegal consequences.

• The Korean Journal of Pain
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• 제10권2호
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• pp.296-300
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• 1997

Continuous epidural analgesia has been used widely for treatment of acute abdominal postoperative pain. Neurologic complications related to epidural analgesia occur infrequently but may be caused by various chemical, mechanical, ischemic or idiopathic factors. We report a case of abdominal hysterectomy in which unilateral lower extremity paralysis occurred after continuous epidural analgesia.

• The Korean Journal of Pain
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• 제2권2호
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• pp.167-173
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• 1989

Inadequate pain relief after upper abdominal surgery increases the incidence of pulmonary complications due to the difficulty in coughing and deep breathing. Kvalheim and Reiestad (1984) introduced intrapleural administration of local anesthetic solutions to produce analgesia following cholecystectomy performed through a subcostal incision, unilateral breast surgery and renal surgery. We studied continuous intrapleural administration of bupivacaine and epinephrine, and its effect in controlling pain after cholecystectomy. In 9 patients, an intermittent dosage technique was used. An intrapleural catheter was inserted and 20 ml of 0.5% bupivacaine and 1:100,000 epinephrine was administered. Results were as following: 1) Mean analgesic duration from the initial intrapleural injection to secondary administration of supplementary bupivacaine was 13.5 hours. 2) No specific changes were noted on vital signs and arterial blood gases. 3) Effective analgesia, produced by intrapleural bupivacaine resulted in significant improvement in tidal volume as measured by spirometry. 4) No signs of systemic toxicity and complications were encountered. 5) Intrapleural administration of a local anesthetics after cholecystectomy provides a satisfactory duration of analgesia.