• 제목/요약/키워드: Pain shock

검색결과 173건 처리시간 0.03초

Management of a trauma patient with alcohol withdrawal who developed neuroleptic malignant syndrome in Korea: a case report

  • Byungchul Yu;Ji Yeon Lee;Yong Beom Kim;Hee Yeon Park;Junsu Jung;Youn Yi Jo
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.249-252
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    • 2023
  • Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7℃ after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.

전자기식 체외충격파쇄석술시 하부요관 결석 환자에 대해 적합한 충격강도와 C-arm 총 가동시간 (The Optimal Shock Intensity and C-arm Total Running Time in Patients with Inferior Ureter Stones during Electromagnetic of ESWL)

  • 박정규;조의현
    • 한국방사선학회논문지
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    • 제8권7호
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    • pp.461-466
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    • 2014
  • 체외 충격파 쇄석술시 쇄석기종에 따라 각각 장단점이 있으며, 전 처치로 인한 여러 가지 부작용이 보고되고 있다. 이에 전자기식 ESWL시 하부결석환자에서 적합한 충격파의 강도를 찾아보고, C-arm의 총 가동시간을 측정해 보았다. 본 연구는 2014년 1월부터 6월까지 경북지역 일개시의 C대학병원에서 전 처치를 시행하지 않고 ESWL을 받은 65명의 환자를 대상으로 하였다. 성비는 남자가 48명, 여자가 17명으로 남자가 더 많았으며, 연령은 50대가 가장 많았다. 하부요로결석의 발생은 왼쪽이 더 많았으며, 결석의 크기는 5mm 이하가 39명으로 가장 많았다. 적합한 충격강도는 1의 강도이며 통증을 호소하는 경우 C의 강도로 전환하여 충격을 가할 수 있다. 또한 C-arm의 총 가동시간은 $241.73{\pm}30.37$초로 나타났으며, 이것은 하부요로결석의 크기와 유의한 차이를 보였다(p<0.05). 따라서, ESWL시 전처치를 시행하지 않고 시술을 할 경우 요관 결석의 부위에 따라 적합한 충격강도와 충격빈도의 기준이 필요로 하며, C-arm 총 가동시간도 요관 결석의 발생부위에 따라 방사선으로 인한 피폭을 최소화하기 위한 총 가동시간에 대한 기준이 필요할 것으로 사료된다.

안정화 운동, 체외충격파, 테이핑이 상승모근 근막통증 증후군에 미치는 효과 비교 (Comparing the Effects of Stability Exercise, ESWT, and Taping for Patients with Myofascial Pain Syndrome of Upper Trapezius)

  • 이중호;황경옥;박영한
    • The Journal of Korean Physical Therapy
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    • 제24권2호
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    • pp.82-89
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    • 2012
  • Purpose: In this study, the effects of stability exercise, extracorporeal shock wave therapy, and taping on pain and function in patients with myofascial pain syndrome of upper trapezius were compared. Methods: The subjects were divided into the stability exercise, ESWT and the taping treatment group and the clinical outcomes were evaluated by visual analog scale (VAS), pressure pain threshold (PPT) and a constant-murley scale (CMS) at pre-treatment and post-treatment. Paired t-test and ANOVA was used for statistical analysis. Results: All groups were statistical significance in the change in visual analog scale (p<0.05). The difference between the ESWT group and taping group was statistical significance in the change in pressure pain threshold (p<0.05) except for the taping group. Using the constant-murley scale, the stability exercise group showed a significant decrease in pain, and a significant increase in ROM, ADL, strength, total score of shoulder (p<0.05); however, the ESWT group showed no difference on ADL. In addition, there was no difference in strength for the taping group. The comparison of the effect between the stability exercise group, ESWT group and taping group in CMS showed a statistical significant difference in pain, ADL and ROM (p<0.05). Conclusion: These results indicate that stability exercise, ESWT and taping could be considered an effective and efficient treatment modality for myofascial pain syndrome of upper trapezius.

무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향 (A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty)

  • 최윤숙;윤소희;조승연;송승은;김상림
    • Journal of Medicine and Life Science
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    • 제18권1호
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    • pp.11-15
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    • 2021
  • In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

터널발파작업에 따른 방음시설의 설치시기와 방법에 대한 고찰. (A Study on the installation time and method of soundproofing facilities according to a Tunnel blasting work.)

  • 원연호;손영복;정재형
    • 대한화약발파공학회:학술대회논문집
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    • 대한화약발파공학회 2006년도 추계학술발표회 논문집
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    • pp.119-140
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    • 2006
  • 발파를 통한 암반 굴착작업은 폭약의 폭발 시 발생하는 충격압과 가스압을 이용하여 암석을 파괴하며, 폭원으로 부터 3차원적으로 전파되어온 충격압에 의한 충격파는 발파에 의한 에너지의 $0.5{\sim}20%$가 탄성파의 형태로 균열대 외부의 지반속으로 전파되면서 공기매체를 타고 전달되는 것이 발파소음이다. 발파소음은 공기의 진동에 의한 음파 가운데 가청범위 ($20{\sim}20000Hz$)의 주파수를 갖는 충격성 소음으로 인체 감응에 의해 영향이 제기되는 것으로, 정신적 고통에 의한 민원발생으로 공사정지, 발파규모 축소 등으로 발파작업에 지장을 주고 있다. 본 연구는 터널발파작업에 따른 발파소음 저감을 위해 현장마다 설치하고 있는 방음시설의 설치시기와 설치방법 그리고 재질에 대하여 현장시공 사례를 통하여 고찰하였다.

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경혈 경락 이론에 근거하여 사용된 체외 충격파 문헌 검색 및 활용 가능성 연구 (Literature Review and Applicability of Extracorporeal Shock Wave with Meridian and Acupoint Theory)

  • 정종혁;김윤아;이상현;김병준;황의형
    • 동의생리병리학회지
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    • 제36권6호
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    • pp.213-220
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    • 2022
  • We investigated the current status of research using extracorporeal shock waves on the basis of meridian and acupoint theory. By March 2022, five foreign databases (CAJ, Pubmed, Web of Science, EMBASE, Cochrane Library) and six Korean databases (Dbpia, RISS, KMBASE, scienceON, KISS, NDSL) were searched with the terms using 'Extracorporeal shock wave' and '(Acupoint or Acupuncture point)'. The search terms were adapted according to the language of the database. There were no restrictions on the study design. As a result of the search, twenty-seven papers were selected for analysis. One study was searched in English database, and the remaining twenty-six studies were searched in Chinese database. There were nineteen pain-related diseases, four obsterics and gynecology diseases, two bone-related diseases, and two other diseases. The most frequently used acupoints were GB34, ST36, and KI3. A total of six adverse events were reported in five papers. The use of extracorporeal shock wave on the basis of meridian and acupoint theory is considered to have sufficient meaning in Korean Medicine. It is expected to use extracorporeal shock wave as a new treatment method for Korean Medicine doctors in the near future.

우측 어깨의 충격증후군을 동반한 뇌졸중 후 중추성 통증 환자 치험 1례 (Case Report of Treatment with Korean Medicine on a Central Post-Stroke Pain Patient who had Impingement Syndrome of the Right Shoulder)

  • 임현찬;김태련;이혜인;김은지;이다은;전상윤
    • 대한한방내과학회지
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    • 제38권6호
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    • pp.1060-1067
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    • 2017
  • Objectives: This case study examined the effects of treatment with traditional Korean medicine on a central post-stroke pain patient, who had impingement syndrome of the right shoulder. Methods: The patient received traditional Korean medical treatments, including acupuncture, warm-needling, moxibustion, and cupping, throughout the treatment period, and extracorporeal shock-wave therapy and physical therapy for part of the treatment period. The effects of treatments were measured with a manual muscle test (MMT), numerical rating scale (NRS), range of motion (ROM), and gait staging index (self-invented). Results: The clinical symptoms of the patient were improved considerably after the complete treatment. Conclusions: Traditional Korean medicine may be effective for treatment of central post-stroke pain in patients with impingement syndrome.

테니스팔꿉증에 대한 문헌 고찰 (Literature Studies for Tennis Elbow)

  • 문달주;강태성
    • 대한통합의학회지
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    • 제3권2호
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    • pp.1-8
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    • 2015
  • Purpose: This study was conducted to know the evidence case to assessment about literatures of extensor carpi radialis therapeutic strategy of tennis elbow about dysfunction wrist extension with anatomy, biomechanic and function. Method: Patient was received the physical therapy program with medication for two weeks. Physical therapy program consists of strengthening exercise, stretching exercise and extracopereal shock wave therapy. Results: Patients could do computer and house works at three weeks significant with improved pain. The amounts used repetitive muscle was reduced slowly over a period of a day or two days for wrist moving. Wrist flexor strengthening exercise and could reduced the wrist extensor injury. Conclusion: Clinicians certainly realized biomechanic effects and anatomy of extensor carpiradialis and elbow joint.

4절링크의 전달각에 기초한 충격흡수식 안전 메커니즘 (Shock Absorbing Safe Mechanism Based on Transmission Angle of a 4-bar Linkage)

  • 박정준;김병상;송재복
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2004년도 추계학술대회 논문집
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    • pp.180-185
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    • 2004
  • Unlike industrial manipulators, the manipulators mounted on the service robots are interacting with humans in various aspects. Therefore, safety has been the important design issue. Many compliant robot arm designs have been introduced for safety. It is known that passive compliance method has faster response and higher reliability than active ones. In this paper, a new safe mechanism based on passive compliance has been proposed. Passive mechanical elements, specifically transmission angle of the 4-bar linkage, springs and shock absorbing modules are incorporated into this safe mechanism. This mechanism works only when the robot arm exerts contact force much more than the human pain tolerance. Validity of the safe mechanism is verified by simulations and experiments. In this research, it is shown that the manipulator using this mechanism provides higher performance and safety than those using other passive compliance mechanisms.

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4절링크의 전달각에 기초한 충격흡수식 안전기구 (Shock-Absorbing Safety Mechanism Based on Transmission Angle of a 4-Bar Linkage)

  • 박정준;김병상;송재복
    • 대한기계학회논문집A
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    • 제29권11호
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    • pp.1534-1541
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    • 2005
  • Unlike industrial manipulators, the manipulators mounted on service robots are interacting with humans in various aspects. Therefore, safety has been one of the most important design issues. Many compliant robot arms have been introduced for safety. It is known that passive compliance method has faster response and higher reliability than active ones. In this paper, a new safety mechanism based on passive compliance is proposed. Passive mechanical elements, specifically transmission angle of the 4-bar linkage, springs and shock absorbing modules are incorporated into this safety mechanism. This mechanism works only when the robot arm exerts contact force much more than the human pain tolerance. Validity of this mechanism is verified by simulations and experiments. It is shown that the manipulator using this mechanism provides higher performance and safety than those using other passive compliance mechanisms or active methods.