• The Korean Journal of Pain
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• 제11권2호
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• pp.343-345
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• 1998

Stellate ganglion block and cervical epidural nerve block are frequently practiced in pain clinics because of simple procedure and good effect. Nerve block at head and neck may produce serious complication such as loss of consciousness and cardiac arrest. Blood supply is rich in neck and inadvertent arterial injection of local anesthetics may enter directly into brain. We experienced convulsion and respiratory arrest during SGB and cervical epidural block. The patients were resuscitated successfully and recovered without any adverse effects.

• The Korean Journal of Pain
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• 제8권2호
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• pp.386-389
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• 1995

Combined infusion of local anesthetics and opioids has been a common method for providing postoperative analgesia. Complications that can occur with this method include pruritus, nausea and vomiting, urinary retention, hypotension, and both early and late respiratory depression. Late respiratory depression is a rare but feared complication to epidural opioid therapy. We experienced a case of respiratory arrest during epidural infusion of bupivacaine and morphine.

• 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.

• Journal of Chest Surgery
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• 제17권2호
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• pp.189-196
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• 1984

Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

• The Korean Journal of Pain
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• 제10권1호
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• pp.138-141
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• 1997

Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.

• The Korean Journal of Pain
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• 제9권1호
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• pp.260-263
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• 1996

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

• Journal of Chest Surgery
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• 제31권5호
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• pp.536-539
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• 1998

기관무명동맥루는 기관절개술후 드믈게 발생하는 합병증으로 사망률이 높은 질환이며, 치료는 신속한 외과적 처치가 관건이 된다. 환자는 과거력상 30년전에 폐결핵으로 좌측전폐절제술을 시행받았으며 그 동안 경과 양호하였으나 최근 2개월간 급성호흡부전으로 기관절개술을 시행받고 호전되어 11 mm 실리콘 Montgomery T-tube로 교환 후, 3일째 발생한 기관무명동맥루에 의한 절개창주위의 다량의 출혈과 기도폐쇄에 의한 심정지를 일으켰다. 기관무명동맥루에서 Utley maneuver와 무명동맥을 절단봉합하여 지혈에 성공하였고, 이에 지혈방법, 수술수기에 관하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제31권5호
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• pp.494-501
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• 1998

저자들은 1993년 5월부터 1995년 5월까지 인공심폐기를 사용한 개심술을 받은 211명을 대상으로 후향적 조사를 하였다. 우리는 술후 새로이 발생한 급성 신부전에 초점을 두었기에 술전 creatinine 수치가 1.5 mg/dL이하였던 환자를 다변수 통계를 이용하여 조사하였다. 술전 신기능이 정상이었던 환자는 198명(74%)이었는데 이중 27명(14%)이 술후 신장 합병증을 보였다. 20명(10%)은 신기능 이상상태(1.5$\leq$serum creatinine level < 2.5 mg/dL)였고, 7명(4%)은 급성 신부전(serum creatinine level$\geq$2.5mg/dL) 상태였다. 수술 사망률은 정상에서는 5.8%, 신기능 이상 환자에서는 5%, 급성 신부전 환자에서는 43%였다(p=0.036). 술후 급성 신부전은 심혈관 합병증, 호흡기 합병증과 함께 수술 사망의 독립적인 위험인자로 밝혀졌고, 다변수 분석에서 술후 급성 신부전 발생 위험인자는 고령, 응급수술, 저심박출증 등이었다. 술전 신부전을 보였던 13명에서 정상이었던 환자보다 술후 유병률과 사망률이 높았다. 결론적으로 술전 신기능 이상을 보이지 않았던 환자에서 술후 급성 신부전의 발생률은 낮았으나, 신부전과 동반된 사망률은 여전히 높았다. 그러므로 술전, 술중, 술후 신부전 발생에 영향을 주는 혈류역학 인자들의 세심한 관찰이 요구된다.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.753-756
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• 2005

In the cases of severe arrythmia and conduction failure, a permanent implanted pacemaker is considered an essential treatment modality with less complication rate, broad indications and low morbidity. However, some pacemakers needs to be removed or replaced due to infection, in need of a lead upgrade, elective replacement, conduction failure or insulation failure. The most common indication for pacemaker extraction is infection. Conservative treatments such as administration of intravenous antibiotics and limitation of debridement are not effective and the removal of the entire pacing system is considered to be the best approach to pacemaker pocket infection. Although a locking stylet, a laser sheath and other newer methods of transvenous lead extraction have been proven to be effective, all leads cannot be removed. Moreover, major complications such as, cardiac tamponade and respiratory arrest during leads extraction procedure should not be ignored. We experienced two cases of exposed pacemakers in the subclavicular region. After removing the pacemaker body, exposed proximal lead was pulled out and cut off. The end of remnant external insulation tube was tied to prevent infection propagation between external insulation tube and inner metalic coil. Wounds were covered by local flap coverage. No other problems were detected during the one-year follow-up. Since there are few reports on lead-preserving method of treating limited infection of exposed pacemakers, we would like to present our new method for treating exposed pacemakers.

• 대한임상독성학회지
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• 제8권2호
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• pp.122-124
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• 2010

$Basagran^{(R)}$ is a herbicide that is widely used in the field and it acts by interfering with photosynthesis in plants. It consists of bentazone, 2-methyl-4-chlorophenoxyacetic acid (MCPA) and surfactants. Bentazone is commonly used, but poisoning due to Bentazone has not been previously reported in Korea. The patients with toxic effects of bentazone show mild to severe symptoms and various complications. We report here on a case of a woman who intentionally ingested 500 ml of $Basagran^{(R)}$ and she was discharged without complication. As soon as the patient visited the emergency department, we started to treat her as if she had organophosphate intoxication because of the cholinergic symptoms. We could not detect the bentazone in her serum and urine, and we could confirm $Basagran^{(R)}$ ingestion only after getting information from her husband. Bentazone poisoning may induce harmful complications like muscle rigidity, rhabdomyolysis, respiratory failure and cardiac arrest. A detailed history taking, an accurate analysis method and early conservative management will be helpful for patients with acute bentazone poisoning.