• Title/Summary/Keyword: Spinal Anesthesia

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Herbal Acupuncture of Nidus Vespae Suppresses c-Fos Expression by TNBS Induced Colitis in Rats (TNBS로 유도된 흰쥐의 대장염(大腸炎)에 대한 노봉방(露蜂房) 약침(藥鍼)의 효과)

  • Song, Jeong-Bang;Kim, Jae-Hyo;Kim, Yu-Lee;Park, Yu-Ree;Ahn, Seong-Hun;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.26 no.4
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    • pp.195-209
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    • 2009
  • Objectives : Transient inflammation has been demonstrated to alter visceral sensory function in animal models and acute mucosal inflammation may precede the manifestation of visceral hyperalgesia. Thus in this study we compared effects of herbal acupuncture of Nidus Vespae (NV) applied to the different acupoints in the acute colitis induced by trinitrobenzenesulphonic acid (TNBS) intracolonic injection in rats. Methods : In Male Sprague-Dawley rats, weighing 250 ~ 400 g, TNBS (5 mg/kg) was infused intrarectally through a silicon rubber catheter into the anus under isoflurane anaesthesia. Under general anesthesia, acupoints of LI4 (Hapkok), SI25 (Cheonchu), ST36 (Joksamni), BL25 (Daejangsu) were intramuscularly injected by NV. Expressions of cFos protein in the periaqueductal gray (PAG), locus coeruleus (LC), nucleus of solitary tract (Sol), and the 6th lumbar spinal cord (L6 s.c.) were observed at 24 hrs after TNBS induced colitis by immunohistochemistry. Results : The expression of c-Fos protein in L6 s.c., Sol, LC and PAG increased 24 hrs after TNBS injection into colorectum as compared to normal group. NV herbal acupuncture also inhibited the expression of c-Fos protein in Sol but not L6 s.c., LC, and PAG. NV to ST36 inhibited significantly the c-Fos expression in Sol and PAG. NV to ST25 inhibited the c-Fos protein expression all over the observation area. NV to BL25 showed the inhibitory effects in the areas except LC. Whether or not a role of endogenous opioids, intrathecal injection of naltrexone (30 ug / 30 ul) was applied before the 2nd herbal acupuncture treatment 24 hrs after TNBS-induced colitis in rat. Naltrexone reversed the inhibition of c-Fos protein expression in the spinal cord and brainstem under different conditions such as type of herbal acupuncture compound and choice of acupoint. Conclusions : In summary, these data show that herbal acupuncture of NV inhibits signal pathways such as spinal cord and brain stem ascending hypersensitivity of colorectum after TNBS induced colitis. This effect may be mediated by acupoints through the endogenous opioid system involving the pain modulation.

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Effects of a Paternal Participation Program during Cesarean Section on Paternal Infant Attachment (아버지의 제왕절개 분만 참여 프로그램이 부아애착에 미치는 효과)

  • Choi, Mi Ran;Kim, Hyun Kyoung
    • Women's Health Nursing
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    • v.19 no.2
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    • pp.75-87
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    • 2013
  • Purpose: In this study effects of a paternal participation program during cesarean section on paternal infant attachment were investigate. The experimental treatment was an integrative nursing intervention to promote father to infant attachment. Methods: Study design was a non-equivalent control group posttest design. The program consisted of emotional support to spouse and father towards infant attachment immediately following cesarean birth. Participants were 66 men, partners of women with normal full term pregnancy having a cesarean section with spinal or epidural anesthesia, (experimental group, 34; control group, 32). The experiment was carried out from August 1 to October 30, 2010. Control group data were obtained from May 1 to June 30, 2012. Posttest was performed 72 hours after cesarean birth. A self-report questionnaire including a paternal attachment instrument was used. Data were analyzed using t-test, propensity score matching, and analysis of covariance with the SPSS/WIN 18.0 program. Results: Total score for paternal infant attachment in the experimental group was significantly higher than the control group (p<.001). After matching, significant differences were found between the two groups through all subcategories. Adjusted mean score for paternal infant attachment verified experimental effects. Conclusion: Results indicate that this paternal participation program during cesarean section is effective in improving paternal infant attachment.

Effect of MeOH Extract of Cibotium barometz for Repair and Regeneration of Nogo A-injuried Neuroblastoma Cells (구척(狗脊) 메탄올추출액이 신경세포의 재생 및 회복효과에 미치는 영향)

  • Kim, Sang-Tae;Kim, Jeong-Do;Kim, Young-Kyoon
    • Korean Journal of Pharmacognosy
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    • v.35 no.2 s.137
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    • pp.105-109
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    • 2004
  • The effect of MeOH extract of Cibotium barometz (or Cibaro) on nogo-A expression was studied by neurite cone collapse and neurite outgrowth assay. The degrees of mRNA expression of BDNF, GDNF, and Caspase-3 in nogo-A were also examined with SK-N-SH cell lines using RT-PCR and confocal microscopy methods. We have shown that Cibaro treatment inhibits nogo-A activation in SK-N-SH cell lines. It has been shown that Cibaro increases the expression rates of neurofilament and enhances neurite outgrowth in neuroblastoma cells as increasing the amount of Cibaro. It has been also shown that Cibaro increases the expression rates of BDNF, GDNF mRNA in neuroblastoma cells as increasing the amount of Cibaro. These results suggest that Cibaro induces neutrite outgrowth by nogo-A inactivation and is, therefore, crucial for the treatments against anaplastic disc and spinal neuronal anesthesia.

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

  • Lee, Cheong;Song, Jun-Gol;Park, Jae-Hong;Shin, Jin-Woo;Choi, Yoon;Yun, Chang-Seob
    • The Korean Journal of Pain
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    • v.13 no.1
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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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Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

  • Lim, Jae-Bum;Park, Joung-Soo;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.386-389
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    • 2009
  • On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.

Analgesic Effect of Intraarticular Morphine or Ketorolac Injection after Arthroscopic ACL Reconstruction (관절경을 이용한 전 십자 인대 성형술 후 관절강내로 투여한 Morphine과 Ketorolac의 진통효과)

  • Lyu, Suk Joo;Kwon, Soon Haeng
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.119-123
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    • 1998
  • In order to obtain a good result in Arthroscopic ACL Reconstruction by immediate postoperative physical therapy, sufficient analgesia was needed. This study analyzes the analgesic effect of the intra-articular injection with ketorolac, Morphine together with bupivacaine in 80 male patients who had Arthroscopic ACL Reconstruction. On completion of the surgery under spinal anesthesia, the knee was injected with 30ml of 0.25% bupivacaine. Each of the study group received ketorolac and/or morphine, either through parenteral or intra-articular. Total amount of the drug used by Patient Controlled Analgesia(PCA) and Visual Analgesia Scale(VAS) for pain were measured and analyzed. The group which received intra-articular ketorolac or Morphine had a better analgesic effect than other group which received none. The group which received both did not do better in analgesic effect. Intra-articular infusion with either ketorolac or Morphine improved postoperative analgesia in Arthroscopic ACL Reconstruction surgery. However, combined injection did not offer more advantage.

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Effects of Acupuncture Stimulation at Different Acupoints on Formalin-Induced Pain in Rats

  • Chang, Kyung Ha;Bai, Sun Joon;Lee, Hyejung;Lee, Bae Hwan
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.2
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    • pp.121-127
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    • 2014
  • Acupuncture is the process of stimulating skin regions called meridians or acupoints and has been used to treat pain-related symptoms. However, the pain-relieving effects of acupuncture may be different depending on acupoints. In the present study, the effects of acupuncture on behavioral responses and c-Fos expression were evaluated using a formalin test in male Sprague-Dawley rats in order to clarify the analgesic effects of three different acupoints. Each rat received manual acupuncture at the ST36 (Zusanli), SP9 (Yinlingquan) or BL60 (Kunlun) acupoint before formalin injection. Flinching and licking behaviors were counted by two blinded investigators. Fos-like immunoreactivity was examined by immunohistochemistry in the rat spinal cord. Manual acupuncture treatment at BL60 acupoint showed significant inhibition in flinching behavior but not in licking. Manual acupuncture at ST36 or SP9 tended to inhibit flinching and licking behaviors but the effects were not statistically significant. The acupuncture at ST36, SP9, or BL60 reduced c-Fos expression as compared with the control group. These results suggest that acupuncture especially at the BL60 acupoint is more effective in relieving inflammatory pain than other acupoints.

The Effects of Systemic Morphine to Analgesic Level in Spinal Anesthesia (Morphine 정주가 척추마취의 레벨에 미치는 영향)

  • Lee, Kang-Chang;Kim, Tai-Yo;Yun, Jae-Seung;Lee, Eui-Sang
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.51-54
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    • 1995
  • 척추마취는 국소마취제를 지주막하강에 주입하여 척수신경 전근과 후근을 차단하는 방법으로 하복부나 하지 수술 뿐 아니라 만성 통증과 암성 통증의 치료에도 이용되고 있는데 마취시간이나 제통시간의 연장 및 적절한 피부분절의 마취나 진통의 달성은 척추마취에서 중요한 사항이다. 본 연구에서는 morphine정주가 척추마취에 어떤 영향을 주는지 알아보기 위해 척추마취하에서 하지 수술을 받은 40명의 환자를 대상으로 척추마취를 시행한 80분에 척추마취 레벨, 수축기 및 이완기 혈압, 맥박 그리고 호흡수를 조사한후 morphine 10 mg을 정맥내로 주사후 20분후에 척추마취 레벨과 혈압, 맥박, 호흡수를 조사하여 다음과 같은 결과를 얻었다. 1) 척추마취 레벨은 morphine 투여진 $T_{7.5{\pm}0.32}$에 비해 morphine 투여 20분후에 $T_{6.0{\pm}0.31}$로 의의있게 상승하였다 (p<0.005). 2) 수축기 및 이완기 혈압과 맥박수는 morphine투여전과 투여후에 의의있는 변화가 없었다. 3) 호흡수는 morphine 투여전에 비해 투여후 감소가 있었다(p<0.005). 이상의 결과로 척추마취하에서 수술을 시행할 때나 통증치료시 전신적으로 morphne을 투여하여 마취와 진통부위를 넓일 수 있을 것으로 사료된다.

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Caudal Morphine for Postoperative Pain Control after Abdominal Surgery (천골강내로 주입한 Morphine에 의한 상.하복부 수술후 진통효과)

  • Woo, Nam-Sick;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.74-79
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    • 1988
  • Caudal narcotic analgesia was assesses after the injection of 3mg morphine diluted in 30ml (physiologic) saline into the sacral canal in 15 Patients after upper abdominal surgery, in 20 patients after lower abdominal surgery under general anesthesia, and in 20 patients after perianal surgery under caudal block. Pain relief was evaluated by the subsequent need for systemic analgesics. All eases had considerable relief from pain an4 the morphine was effective for 12 or more hours. There were no significant differances between pain relief of the upper abdominal and lower abdominal surgery group, upper abdominal and perianal surgery group, and lower abdominal and perianal surgery group (p>0.05, p>0.05, p>0.05). It is suggested that the morphine, which was administered into the sacral, cannal, reached the subarachnoid space and produced it's effect by direct action on the specific opiate receptors in the substantia gelatinosa of th.8 posterior horn cell of the spinal cord. Consequently, whether analgesia from epidural narcotics appears to be segmental in distribution or not is still in controversy.

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A Clinical Study on Pruritus Due to Intrathecal Morphine (지주막하강에 투여한 Morphine으로 인한 소양감에 대한 임상적 고찰)

  • Jeong, Chan-Jong;Baik, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.91-97
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    • 1988
  • Herein is a review of eigthy six surgical cases from March to August, 1986 which recieved tetracaine hydrochloride spinal anesthesia. In an attempt to relieve postoperative pain, 0.5 mg morphine sulfate was administrated into the lumbar subarachnoid space. Pruritus, a side effect of intraspinal morphine, was explored in detail. The results were as follows : 1) The incidence of pruritus was 67.4%, 65.5% in man and 71.0% in woman. 2) The time of onset of pruritus was between 30 and 120 minutes with an average of 79.1 minutes. 3) Pruritus primary occurred on the face(87.9%), especially on the nasal, perinasal and periocular areas. Other sites included the scalp, neck, chest, abdomen, shoulder, hip, thigh, flank, and whole body. 4) The severity of pruritus was classified as mild and moderate, but 4 cases(6.9%) were regarded as severe and were treated with naloxone. 5) The duration of pruritus was from 15 minutes to 19 hours with an average of 4.7 hours. 6) There was no significant difference in the prevention of pruritus between the group recieving diphenhydramine and the one which received normal saline.

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