• 제목/요약/키워드: Local Anesthesia

검색결과 629건 처리시간 0.024초

기관지성 낭종(2례수술보고) (Bronchogenic Cyst (Two Case Report))

  • 김형묵;김영철;최인환
    • Journal of Chest Surgery
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    • 제7권1호
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    • pp.9-12
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    • 1974
  • Bronchogenic cysts, though known as a relatively common malformation of the mediastinum, were rarely discussed in Korean literatures. Since the surgical removal of asymptomatic lesions was adopted as the reasonable therapeutic principle, the incidence of bronchogenic cysts were found to be higher than previously expected. Two cases of bronchogenic cysts operated on in The Dept. of Thoracic Surgery, Korea University Woo Sok Hospital were reported and related literatures were reviewed. Case 1. 5 year old boy with chief complaints of bulging cystic mass on left supraclavicular region during straining or coughing since his age of 2 was admitted, and cystogram with Lipiodol revealed hen-egg sized mass in the left antero-superior mediastinum without any communication with bronchus or esophagus. Cyst was successfully removed under general anesthesia thru left supraclavicular incision, and pathological examination of the cyst revealed thin cystic wall lined with stratified columnar epithelium and it`s content was milky white mucoid fluid devoid of any bacterial growth. Case 2. 15 year old school girl has been noted slowly growing walnut-sized mass on anterolateral side of the neck for 4 months without any subjective symptom except cosmetic problem... Mass was aspirated to find milky white mucoid fluid in some loculation and yellowish turbid fluid in other part due to chronic infection. Cystic tumor was removed under local anesthesia, which was loculated in between the trachea and esophagus without any communication, and pathological diagnosis of the cyst was bronchogenic cyst with columnar epithelial cell lining with moderate chronic inflammatory cell infiltrations. Postoperative conditions of the two cases were all excellent with normal life.

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Intraosseous hemangioma of the orbit

  • Choi, June Seok;Bae, Yong Chan;Kang, Gyu Bin;Choi, Kyung-Un
    • 대한두개안면성형외과학회지
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    • 제19권1호
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    • pp.68-71
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    • 2018
  • Intraosseous hemangioma is an extremely rare tumor that accounts for 1% or fewer of all osseous tumors. The most common sites of its occurrence are the vertebral column and calvaria. Occurrence in a facial bone is very rare. The authors aim to report a case of the surgical treatment of intraosseous hemangioma occurring in the periorbital region, which is a very rare site of occurrence and to introduce our own experiences with the diagnosis and treatment of this condition along with a literature review. A 73-year-old male patient visited our hospital with the chief complaint of a mass touching the left orbital rim. A biopsy was performed by applying a direct incision after local anesthesia. Eventually, intraosseous hemangioma was diagnosed histologically. To fully resect the mass, the orbital floor and zygoma were exposed through a subciliary incision under general anesthesia, and then the tumor was completely eliminated. Bony defect was reconstructed by performing a seventh rib bone graft. Follow-up observation has so far been conducted for 10 months after surgery without recurrence or symptoms.

경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례 (A Case Report of Injection Laryngoplasty Who have Difficulty in Neck Extension Using, an I-Gel Laryngeal Mask Airway)

  • 조광희;정찬민;장철호;최홍식
    • 대한후두음성언어의학회지
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    • 제25권2호
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    • pp.96-98
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    • 2014
  • Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

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Anaphylactic Shock Caused by the Epidurally-Administered Hyalurinidase

  • Lee, Hae-Kwang;Choi, Eun-Joo;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • 제24권4호
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    • pp.221-225
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    • 2011
  • Hyaluronidase is an enzyme that has temporary and reversible enzymatic effects on the matrix of connective tissue. When added to local anesthetics in pain treatments, it enhances their infiltration and dispersal into tissues. It is widely used in anesthesia for ocular, dental, and plastic surgery. Reports of drug hypersensitivity to hyaluronidase are rare and are usually confined to peribulbar or retrobulbar anesthesia during ophthalmic surgery. However, few reports exist on adverse drug reaction after epidural injection. We have observed two patients experiencing anaphylactic shock caused by hyaluronidase following epidural injection. Most of the patients with a hypersensitivity to hyaluronidase had one previous uneventful injection containing hyaluronidase, implying that sensitization had taken place. However, hypersensitivity occurring at the first administration is possible. A positive skin test can help establish the diagnosis. Although rare, the possibility of an allergic reaction to hyaluronidase should be considered even in patients with no known previous exposure.

전국 치과대학, 치의학대학원의 치과마취과학 교육의 현황 (Current Status of Dental Anesthesiology Education in Korean Dental Colleges and Schools)

  • 서광석;김현정
    • 대한치과마취과학회지
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    • 제13권3호
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    • pp.111-116
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    • 2013
  • Background: The purpose of this study was to evaluate the current state of dental anesthesiology education in Korea. Methods: We evaluated the curriculums of education, and class syllabus of subject which is related with dental anesthesiology education in 9 dental colleges and schools among total 11 in Korea. We investigated the subject name, numbers of teacher, lecture time, credit, and lecture content. Results: All the nine dental schools and colleges have dental anesthesiology in undergraduate education curriculum. The curriculum of dental anesthesiology was divided into two subjects (local anesthesia area and general anesthesia area) in 5 dental colleges and schools. The average credit was 1.78, and average lecture time was 30.5 hours/4 year (16-82 hours). Seven schools and colleges had lectures about dental sedation, and three had lectures about pain treatment in dental anesthesiology subject. But, there was only one school which had clinical practice curriculum in the Hospital. Conclusions: In Korean dental undergraduate education, dental anesthesiology was mostly conducted by lectures, and clinical teaching programs were not well organized.

Effect of relative head position on the anesthetic efficacy of inferior alveolar nerve block during endodontic treatment of patients with irreversible pulpitis

  • Aggarwal, Vivek;Singla, Mamta;Miglani, Sanjay
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권1호
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    • pp.41-46
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    • 2018
  • Background: The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods: Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results: The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions: Relative head position has no effect on the anesthetic success rate of IANB.

Sinus Tract Formation with Chronic Inflammatory Cystic Mass after Beta Tricalcium Phosphate Insertion

  • Kim, Hong Jin;Na, Woong Gyu;Jung, Sung Won;Koh, Sung Hoon;Lim, Hyoseob
    • 대한두개안면성형외과학회지
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    • 제18권4호
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    • pp.282-286
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    • 2017
  • Beta tricalcium phosphate (${\beta}-TCP$) is one of allogenic bone substitute which is known to have interconnected pores that draws cell and nutrients for bone generation. It has been resulted in good outcomes for bone defect coverage or augmentation. However, several studies have also reported negative outcomes and associated complications including unexpected formation of cystic mass, continuous pain and secretion. We present the case of a 36-year-old man with a right cheek cystic mass who had a history of right zygomaticomaxillary (ZM) complex fracture and surgical correction with ${\beta}-TCP$ powder insertion to ZM bone defect. Excisional biopsy under local anesthesia revealed calcified mass in a sinus tract which was found to be connected to the ZM bone defect site in postoperative computed tomography image. Further excision under general anesthesia was performed to remove the sinus tract and fine granules which filled the original defect site. Pathologic report revealed bony spicules and calcification materials with chronic foreign body reaction. Postoperative complications and recurrence were not reported.

흉부둔상에 의한 긴장성 심막기종 1예 체험 (A Case Report of Tension Pneumopericardium Following Blunt Chest Trauma)

  • 손상태;김응수;강종렬;송동섭
    • Journal of Chest Surgery
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    • 제42권6호
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    • pp.803-806
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    • 2009
  • 남자 49세 환자는 낙상으로 흉부 둔상을 당해 본원 응급센터로 내원한 분으로 단순 흉부 사진상 종격동 기종 및 심낭기종 소견을 보였다. 이에 흉부 컴퓨터 단층 촬영을 하였으며 타 장기 손상이 없는 심낭기종 소견과, 심장을 압박하는 양상이었다. 또한 좌측에 경도의 기흉 소견이 보였다. 국소 마취하에 좌측 폐쇄 흉강 삽관술을 시행하였으며, 전신 마취하에 소절개하여 개방성 심낭막개창술 및 삽관술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다.

Percutaneous osteoplasty for painful bony lesions: a technical survey

  • Kim, Won-Sung;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.375-393
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    • 2021
  • Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

악관절의 비정복성관절원판변위의 수조작 정복에 대한 이개측두신경 전달마취의 효과 (Effect of Auriculotemporal Nerve Block Anesthesia on Manual Reduction of Disc Displacement without Reduction of the Temporomandibular Joint)

  • 김숙영;김지연;홍수민;김병국;박병주;임영관
    • Journal of Oral Medicine and Pain
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    • 제36권1호
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    • pp.71-79
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    • 2011
  • 공률이 낮은 것으로 알려져 있다. 본 연구의 목적은 이개측두신경을 전달마취하여 수조작할 경우 변위된 관절원판의 정복에 영향이 있는지 여부 및 그 결과에 영향을 미치는 인자들을 조사하는 것이다. 비정복성관절원판변위로 진단된 112명의 환자들에 대해 수조작정복술을 시도하였으며, 그 중 35명의 환자들에서 관절원판 변위가 해소되었다. 관절원판 재위치에 실패한 77명의 환자들 가운데 이개측두신경의 전달마취 시술에 동의하는 49명(평균 연령 $34.3\;{\pm}\; 15.1$, 남자 24명, 여자 25명)에 대해 마취시술 후 수조작 정복술을 다시 시행하였다. 연령, 발병후 경과시간, 술전 능동적개구량을 포함한 요인들과 국소마취 후 수조작 정복 성공률과의 관련성을 분석하였다. 수조작만으로 정복이 되지 않았던 49명 환자 중, 이개측두신경 전달마취 후 19명(38.8%)에서 성공적으로 정복이 되었다. 국소마취 전 49명의 최대 능동적 절치간 개구량은 $25.7\;{\pm}\;6.0$ mm로서 개구가 상당히 제한된 상태였으나, 국소마취 및 수조작 후 관절원판이 성공적으로 재위치된 19명의 개구량은 $46.1\;{\pm}\;4.5$ mm로서 정상범위로 회복되었다. 연령, 발병후 경과시간, 술전 능동적개구량 인자들과 국소마취 후 수조작 정복 성공률과는 유의한 관련성이 없었다. 결론적으로 이개측두신경 전달마취는 수조작정복술과 함께 시행할 경우 비정복성관절원판변위의 정복 성공률을 향상시 키므로, 비정복성관절원판변위의 일차적인 치료 단계에서 적극적으로 활용하는 것이 권장된다.