• Title/Summary/Keyword: block scale

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Is It Useful and Safe to Maintain the Sitting Position During Only One Minute before Position Change to the Jack-knife Position?

  • Park, Soo-Young;Park, Jong-Cook;Park, Sang-Hyun
    • The Korean Journal of Pain
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    • v.23 no.3
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    • pp.190-197
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    • 2010
  • Background: Conventional spinal saddle block is performed with the patient in a sitting position, keeping the patient sitting for between 3 to 10 min after injection of a drug. This amount of time, however, is long enough to cause prolonged postoperative urinary retention. The trend in this block is to lower the dose of local anesthetics, providing a selective segmental block; however, an optimal dose and method are needed for adequate anesthesia in variable situations. Therefore, in this study, we evaluated the question of whether only 1 min of sitting after drug injection would be sufficient and safe for minor anorectal surgery. Methods: Two hundred and sixteen patients undergoing minor anorectal surgery under spinal anesthesia remained sitting for 1 min after completion of subarachnoid administration of 1 ml of a 0.5% hyperbaric bupivacaine solution (5 mg). They were then placed in the jack-knife position. After surgery, analgesia levels were assessed using loss of cold sensation in the supine position. The next day, urination and 11-point numeric rating scale (NRS) for postoperative pain were assessed. Results: None of the patients required additional analgesics during surgical manipulation. Postoperative sensory levels were T10 [T8-T12] in patients, and no significant differences were observed between sex (P = 0.857), height (P = 0.065), obesity (P = 0.873), or age (P = 0.138). Urinary retention developed in only 7 patients (3.2%). In this group, NRS was $5.0{\pm}2.4$ (P = 0.014). Conclusions: The one-minute sitting position for spinal saddle block before the jack-knife position is a safe method for use with minor anorectal surgery and can reduce development of postoperative urinary retention.

The Effects of Postoperative Brachial Plexus Block Using $MgSO_4$ on the Postoperative Pain after Upper Extremity Surgery

  • Choi, In-Gyu;Choi, Young-Soon;Kim, Yong-Ho;Min, Jin-Hye;Chae, Young-Keun;Lee, Yong-Kyung;Ahn, So-Woon;Kim, Young-Shin;Lee, Aerena
    • The Korean Journal of Pain
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    • v.24 no.3
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    • pp.158-163
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    • 2011
  • Background: Although a brachial plexus block can be used to provide anesthesia and analgesia for upper extremity surgery, its effects using $MgSO_4$ on postoperative pain management have not been reported. The aim of this study was to evaluate brachial plexus block using $MgSO_4$ on postoperative analgesia. Methods: Thirty-eight patients who were scheduled to undergo upper extremity surgery were randomly allocated into two groups: patients receiving axillary brachial plexus block with 0.2% ropivacaine 20 ml and normal saline 2 ml (group S) or 0.2% ropivacaine 20 ml and $MgSO_4$ 200 mg (group M). Before extubation, the blocks were done and patient controlled analgesia was started, and then, the patients were transported to a postanesthetic care unit. The postoperative visual analogue scale (VAS), opioid consumption, and side effects were recorded. Results: The two groups were similar regarding the demographic variables and the duration of the surgery. No differences in VAS scores were observed between the two groups. There was no statistically significant difference in opioid consumption between the two groups. Nausea was observed in three patients for each group. Conclusions: Axillary brachial plexus block using $MgSO_4$ did not reduce the level of postoperative pain and opioid consumption.

Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment

  • Kim, Ji-Eun;Mah, Su-Jung;Kim, Tae-Woo;Kim, Su-Jung;Park, Ki-Ho;Kang, Yoon-Goo
    • The korean journal of orthodontics
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    • v.48 no.1
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    • pp.11-22
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    • 2018
  • Objective: The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Methods: Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. Results: An independent t-test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Conclusions: Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

A Clinical Case of Oriental Medical Treatment for the Paraplegia after Lumbar Epidural Nerve Block (요추 경막외 차단술 후 발생한 하지마비의 한의학적인 치료 효과 - 증례 보고 -)

  • Yu, Deok-Seon;Kim, So-Yeon;Kim, Dong-Eun;Jung, Il-Min;Yeom, Seung-Ryong;Kwon, Young-Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.219-228
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    • 2009
  • Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.

Evaluation on the Performance of Power Generation of Energy Harvesting Blocks for Urban and Housing Application (도시·주택 적용 미관용 에너지 블록의 발전성능 평가)

  • Noh, Myung-Hyun;Kim, Hyo-Jin;Park, Ji-Young;Lee, Sang-Youl;Cho, Young-Bong
    • Land and Housing Review
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    • v.3 no.2
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    • pp.187-193
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    • 2012
  • A technology that newly attract attention in the area of energy-related study is the energy harvesting(or scavenging) technology. In this paper, the performance of power generation for the energy harvesting block with a combination of piezoelectric technology and electromagnetic technology among various energy harvesting technologies was investigated. The goal of this study is to evaluate on the applicability of our developed energy harvesting block into the field of urban & housing. First, we evaluated the performance of power generation for the multi-layer energy harvester at laboratory scale. Second, we described the features of our developed prototype module that includes amplification technologies to improve power density per module and evaluated the performance of power generation for the energy harvesting block in a variety of ways. From the test results, the developed product increased the performance of power generation up to 255% or 505% compared to the existing product and its superiority were shown. Finally, we suggested the direction for the improvement of the energy harvesting block module.

Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

  • Ghai, Babita;Kumar, Muthu;Makkar, Jeetinder Kaur;Goni, Vijay
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.183-190
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    • 2022
  • Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

A Case Report of Complete Atrioventricular Block Treatment with Samulanshin-tang-gamibang and Acupuncture (사물안신탕가미방과 침 치료로 임상 증상에 호전을 보인 완전방실차단 환자 치험 1례)

  • Lee, Young-ung;Kim, Kwangho;Kang, Geonhui;Kang, Sunny;Song, Juhwan;Ji, Sangho;Lee, Sangkwan;Kim, Cheol-hyun
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.274-282
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    • 2022
  • Introduction: This study reports the effect of herbal medicine (Samulanshin-tang-gamibang) and acupuncture on complete atrioventricular (AV) block. Case presentation: A 63-year-old female with complete AV block was experiencing dyspnea, palpitation, dizziness, headache, bradycardia, and insomnia, and she was treated with Samulanshin-tang-gamibang and acupuncture for 12 days. To evaluate the treatment, a numeric rating scale (NRS) and the New York Heart Association (NYHA) functional classification was used. The patient's NRS scores decreased from 6 to 2 for dyspnea and palpitation and from 5 to 1 for dizziness and headache. Her NYHA Class improved from Class II to Class I. No side effects were observed during treatment. Conclusion: This study suggests that herbal medicine and acupuncture may be effective in relieving symptoms caused by complete AV block. However, the long-term effects of the treatment were not observed, and so further studies are still needed.

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

  • Mardani-Kivi, Mohsen;Nabi, Bahram Naderi;Mousavi, Mir-Hashem;Shirangi, Ardeshir;Leili, Ehsan Kazemnejad;Ghadim-Limudahi, Zahra Haghparast
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.129-139
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    • 2022
  • Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). Conclusions: Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

Comparison of Analgesic Efficacy and Shortening of Labor Duration between $L_{1-2}$ and $L_{3-4}$ Epidural Blocks in Nulliparous Normal Vaginal Delivery (초산모에서 경막외 $L_{1-2}$$L_{3-4}$ 차단 시 제통효과와 분만기간의 비교)

  • Kang, Kyu-Sik;Lee, Sang-Yoon;Kim, Jung-Soon;Nam, Kae-Hyun;Park, Wook
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.61-67
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    • 2001
  • Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

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Assessment of Scale Effects on Dynamics of Water Quality and Quantity for Sustainable Paddy Field Agriculture

  • Kim, Min-Young;Kim, Min-Kyeong;Lee, Sang-Bong;Jeon, Jong-Gil
    • Environmental Engineering Research
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    • v.15 no.2
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    • pp.123-126
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    • 2010
  • Modeling non-point pollution across multiple scales has become an important environmental issue. As a more representative and practical approach in quantifying and qualifying surface water, a modular neural network (MNN) was implemented in this study. Two different site-scales ($1.5\;{\times}\;10^5$ and $1.62\;{\times}\;10^6\;m^2$) with the same plants, soils, and paddy field management practices, were selected. Hydrologic data (rainfall, irrigation and surface discharge) and water quality data (time-series nutrient loadings) were continuously monitored and then used for the verification of MNN performance. Correlation coefficients (R) for the results predicted from the networks versus measured values were within the range of 0.41 to 0.95. The small block could be extrapolated to the large field for the rainfall-surface drainage process. Nutrient prediction produced less favorable results due to the complex phenomena of nutrients in the drainage water. However, the feasibility of using MNN to generate improved prediction accuracy was demonstrated if more hydrologic and environmental data are provided. The study findings confirmed the estimation accuracy of the upscaling from a small-segment block to large-scale paddy field, thereby contributing to the establishment of water quality management for sustainable agriculture.