• Journal of Trauma and Injury
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• 제28권3호
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• pp.87-90
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• 2015

Purpose: We evaluated the efficacy of ultrasound-guided lower extremity nerve block in trauma patients. Methods: From July 2013 to April 2014, 17 patients with multiple trauma had lower extremity nerve block for immediate management of open wound in the lower extremity. We evaluated the patient satisfaction of the anesthesia and any complications related to the block. Results: During the lower extremity nerve block, incomplete nerve block occurred in one patient. This is the second case, the reason for this was the lack of technique. There was no anesthetic complications. Conclusion: Ultrasound-guided lower extremity nerve block in trauma patients is an effective anesthesia technique in the immediate management of open wound in lower extremities.

• 대한족부족관절학회지
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• 제14권1호
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• pp.90-96
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• 2010

Purpose: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. Materials and Methods: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. Results: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. Conclusion: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.67-75
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• 2014

견관절 수술을 위한 마취와 수술 후 통증 조절을 위해 적용될 수 있는 국소 신경 차단술에는 사각근간 신경 차단술, 상견갑 신경 차단술, 5번 경추 신경근 차단술 및 액와 신경 차단술 등이 있을 수 있다. 국소 신경 차단술은 통증 조절 효과는 뛰어난 것으로 보고되고 있으나 횡격 신경 마비, 기흉, 신경 손상 등의 부작용이 다수 보고되며 그 실패율도 상당하여, 부작용을 최소화하고 성공률을 높이기 위한 노력으로 초음파 유도하 중재술이 사용되고 있다. 저자들은 이와 관련된 해부학적 기초와 초음파를 이용한 국소 신경 차단 술기 등에 대하여 기술하고자 한다.

• The Korean Journal of Pain
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• 제29권3호
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• The Korean Journal of Pain
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• 제22권2호
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• pp.186-190
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• 2009

Sciatic nerve block is frequently used for anesthesia or analgesia during lower leg surgery or chronic lower leg pain syndrome. Recently, a lot of ultrasound-guided peripheral nerve block has been reported because there are several benefits compared to blind technique. We performed ultrasound-guided right sciatic nerve block successfully to the patient who has been suffering from right buttock pain after previous radiation therapy.

• 대한정형외과 초음파학회지
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• 제3권2호
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• pp.74-78
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• 2010

정형외과 영역에서 근골격계 초음파의 활용 범위가 넓어짐에 따라 슬와부 신경 차단(좌골 신경 차단)이나 대퇴 신경 차단(또는 복재 신경 차단)이 초음파를 이용하여 신경 손상이나 불완전 마취에 대한 걱정없이 쉽고, 안전하게 시행될 수 있게 되었다. 그로 인하여 족부 수술 뿐만 아니라 족관절 및 하퇴부의 정형외과적 수술이 전신 마취나 척추 마취의 부담없이 시행될 수 있게 되었다. 이러한 초음파 유도 대퇴좌골 신경 차단에 대한 자세한 술기를 120예 이상의 경험을 바탕으로 보고하고자 한다.

• 대한정형외과 초음파학회지
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• 제5권1호
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• pp.50-59
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• 2012

정형외과 영역에서 상지와 하지의 수술을 위한 부위 마취나 통증 조절을 목적으로 한 신경 차단술에서도 근골격계 초음파의 활용도가 증가하고 있다. 하지에서 슬관절 원위부의 수술을 위해 시행하던 기존의 슬와 신경 차단술, 대퇴 신경 차단술, 근위 복재 신경 차단술, 족관절 차단술 등의 부위 마취를 초음파 유도 하에 시행함으로서 시술의 안전성뿐만 아니라 국소 마취의 성공률을 높일 수 있게 되었고, 또한 사용되는 국소 마취제의 용량도 줄일 수 있게 되었다. 수술 후 통증조절을 목적으로 한 단발적인 국소 마취 희석액 신경 주위 주사나 카테터 삽입을 통한 지속적인 국소 마취 희석액 신경주위 주사도 초음파를 이용하여 정확하게 시행할 수 있어 PCA에서 나타나는 오심, 구토 등의 부작용 없이 통증 조절을 이룰 수 있게 되었다. 이러한 초음파 유도 국소 신경 차단술에 대하여 알아보고자 한다.

• The Korean Journal of Pain
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• 제28권4호
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• pp.287-289
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• 2015

Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim$^{(R)}$.

• 대한족부족관절학회지
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• 제20권3호
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• pp.135-139
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• 2016

Purpose: Modified Mau and Akin osteotomy for hallux valgus is followed by moderate to severe postoperative pain. Ultrasound-guided sciatic nerve block can be an effective option for pain control. We attempted to evaluate the efficacy of the ultrasound-guided sciatic nerve block in controlling postoperative pain. Materials and Methods: The charts of 59 consecutive patients were retrospectively reviewed between December 2014 and August 2015. Twenty-eight patients (the patient group) has received the ultrasound-guided sciatic nerve block after surgery, and 31 patients (the control group) has not received such procedure. The primary outcome was the satisfaction scale for postoperative pain control and postoperative visual analogue scale (VAS) score. Results: The VAS score at postoperative day one was significantly lower in the patient group than in the control group. The satisfaction scale for pain control for postoperative 1 day was significantly different between the two groups. In patient group, most patients have rated positively ('strongly agree' 42.9%, 'agree' 42.9%); however, in the control group, the rating scales were distributed relatively negatively ('strongly agree' 9.7%, 'agree' 22.6%, 'neutral' 29.0%, 'disagree' 25.8%, 'strongly disagree' 12.9%). The number of postoperative rescue analgesics injection was significantly lower in the patient group than in the control group. Conclusion: Postoperative ultrasound-guided sciatic nerve block was effective for pain relief after hallux valgus surgery.

• 대한족부족관절학회지
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• 제18권3호
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• pp.133-136
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• 2014

Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.