• 제목/요약/키워드: nerve block

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하지에서의 초음파 유도 국소 신경 차단술 (Ultrasound-Guided Regional Nerve Block in Lower Extremity)

  • 강찬
    • 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.

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경부에서의 신경차단시 발생한 경련과 의식소실 및 호흡정지 -증례 보고- (Convulsion, Loss of Consciousness and Respiratory Arrest during Nerve Block at Neck -Two case reports-)

  • 최승택
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.343-345
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    • 1998
  • Stellate ganglion block and cervical epidural nerve block are frequently practiced in pain clinics because of simple procedure and good effect. Nerve block at head and neck may produce serious complication such as loss of consciousness and cardiac arrest. Blood supply is rich in neck and inadvertent arterial injection of local anesthetics may enter directly into brain. We experienced convulsion and respiratory arrest during SGB and cervical epidural block. The patients were resuscitated successfully and recovered without any adverse effects.

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삼차신경통 환자의 알코올 신경차단 효과 (Alcohol Block in the Treatment of Trigeminal Neuralgia: A Retrospective Study to Assess its Efficacy)

  • 김찬;이효근;양승곤;이희전;이영철;김성모
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.83-88
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    • 1996
  • This is a retrospective analysis of 158 patients who visted our Neuro-Pain clinic, April 1992 to March 1996, suffering from trigeminal neuralgia. Most patients received nerve blocks in its triggering peripheral branches of pain. All patients experienced pain relief for 3 months after initial successful nerve block. Twenty two patients complained of recurring pain within 4 to 32 months. Mean duration of pain relief was as follows: infraorbital nerve block 15.2 months, maxillary nerve block 16.8 months, and mandibular nerve block 23.4 months. Demographic and clinical characteristics of all patients were also evaluated. This study demonstrates that alcohol block is a safe and effective method of treating trigeminal neuralgia.

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김 찬 신경통증클리닉 환자의 통계고찰 (A Clinical Review of the Patients in the Kim Chan Pain Clinic)

  • 한경림;박원봉;김욱성;이재철;이경진;김찬
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.101-104
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    • 1998
  • Backgrouds: Twent five years have passed since the opening of the first pain clinic in korea, in 1973 at Yonsei University Hospital. The number of pain clinics are gradually increasing in recent times. It is important to plan for future pain clinics with emphasis on improving the quality of pain management. Therefore we reviewed the patients in our hospital to help us in planning for the future of our pain clinic. Methods: We analyzed 2656 patients who had visited our Kim Chan Pain Clinic, accordance to age, sex, disease, and type of treatment block, from July 1996 to August 1997. Results: The prevalent age group was in the fifties, 27.3%, seventy years and older compromised 9.2%. The most common disease were as follows: lower back pain(46.2%); cervical and upper extremities pain(23.1%); trigeminal neuralgia(7.2%); and hyperhydrosis(5.8%) Both nerve blocks and medication were prescribed as treatment. Lumbar epidural block(16.3%) and stellate ganglion block(15.6%) were the most frequent blocks performed among various nerve blocks. Among nerve block under C-arm guidance, lumbar facet joint block(24.4%) and lumbar root block(22.5%) were performed most frequently. Trigeminal nerve block(18.4%), thoracic(17.0%) and lumbar sympathetic ganglion block(11.4%) were next most prevalent blocks performed frequent block. Conclusions: Treatments at our hospital were focused on nerve blocks and medications prescriptions. Nerve blocks are of particular importance in the diagnosis and treatment of chronic pain. However in future, to raise the quality of pain management, we need to fucus on a multidisciplinary/interdisciplinary team approach.

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척추 신경 차단술 환자 특성이 주사시술의 공포감과 방사선의 위험 인식에 미치는 영향 (Effect on Fear of Injection Procedures and Radiation Risk Recognition on Patients Characteristics Undergo Spinal Nerve Block)

  • 차진영;성열훈
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권2호
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    • pp.171-177
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    • 2022
  • The purpose of this study was to investigate the effect of the characteristics of patients who underwent spinal nerve block on the fear of injection and the risk of radiation. Subjects were 137 patients (67 males, 70 females) who visited the Department of Anesthesiology and Pain Medicine in Cheongju. The method was conducted as a research study using a total of 28 questionnaires consisting of patient characteristics, experience characteristics of nerve block surgery, nerve block fear scale, and radiation risk perception scale. The reliability of the questionnaire response was secured with a Cronbach's alpha coefficient of 0.6 or higher. For statistical analysis, correlation was tested by descriptive statistics, frequency analysis, independent sample T-test, and Pearson and Spearman correlation coefficients by measurement scale and factor. As a result, the fear scale of nerve block was significantly higher in women than in men (p<0.05). The fear scale of nerve block injection was significantly higher in the first-visit patients than in the second-visited patients (p<0.05). However, there was no significant difference among all variables in radiation risk perception. In conclusion, patients undergoing spinal nerve block were more aware of the fear of injection than the risk of radiation exposure during the procedure.

Effectiveness of Tramadol and Butorphanol as an Adjuvant to Local Anesthetic in Mandibular Nerve Block in Beagle Dogs

  • Jang, Sang Seon;Kim, Hyeonjo;Kwon, Dae Hyun;Yoon, Eunchae;Lee, Dongbin;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제39권5호
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    • pp.226-234
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    • 2022
  • To evaluate butorphanol and tramadol as adjuvants to lidocaine in dogs undergoing mandibular nerve block. Fifteen beagles were allocated to groups based on the following treatments: lidocaine alone (L group), lidocaine + butorphanol (LB group), or lidocaine + tramadol (LT group). After mandibular nerve block with opioids as an adjunct to local anesthetics, the onset time, duration of action, and depth of anesthesia were evaluated using a quantitative method through neuromuscular blockades (NMBs) monitoring. The onset time of nerve block was 4.60 ± 2.06 min, 2.00 ± 0.00 min, and 2.60 ± 1.62 min in the L, LB, and LT groups, respectively; however, there was no statistically significant difference. The duration of nerve block was 111.88 ± 34.78 min, 302.00 ± 76.72 min, and 260.40 ± 49.88 min in the L, LB, and LT groups, respectively, with a significant difference between L and LB groups. The LB group demonstrated a more profound depth of anesthesia compared to the L and LT groups. In this study, using a quantitative method through NMBs monitoring, it was demonstrated that lidocaine and butorphanol in combination can increase the duration of nerve block and more profound the depth of anesthesia rather than lidocaine alone. Additionally, the combined use of lidocaine and opioids presented an objective indicator that could provide a more clinically stable nerve block.

Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery

  • Park, Sun Kyung;Sung, Min Ha;Suh, Hae Jin;Choi, Yun Suk
    • The Korean Journal of Pain
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    • 제29권1호
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    • pp.18-22
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    • 2016
  • Background: The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be $2.8{\pm}2.6$ and $1.1{\pm}1.8$, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.

경추 신경 손상에 의한 하지 강직 치료 시 초음파를 이용한 양측폐쇄신경차단술 -증례보고- (Ultrasound Guided both Obturator Nerve Block for Patient with Adductor Thigh Muscle Spasm -A case report-)

  • 권태명;김현주;문지연;서정훈;이평복
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.78-82
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    • 2009
  • Obturator nerve block has been used for analgesia of hip pain, relaxation of adductor muscle spasm related to cerebral palsy or paraplegia and in urologic surgery to prevent inadvertent obturator activity during lateral wall cystoscopy. Recently, ultrasound guidance has gained popularity in the field of peripheral nerve block and have been reported in some benefits. We describe here successfully performed both obturator nerve block under ultrasound guidance.

경부 경막외 차단을 이용한 연속성 딸꾹질의 치험 3예 -증례 보고- (Persistent Hiccups Treatment with Cervical Epidural Block -Case reports-)

  • 이지향;김종일;민병우
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.241-245
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    • 1997
  • Persistent hiccup is defined as duration lasting longer than 48 hours. Reflex arc of hiccup is divided into three parts : afferent, central, efferent. Afferent portion of the neural pathway of hiccup formation is composed of vagus nerve, phrenic nerve, and sympathetic chain arising from T6 to T12. Efferent limb is phrenic nerve. Hiccup center is located in brain stem, midbrain, reticular system and hypothalamus. Persistent hiccup is very difficult to treat by conventional methods. We performed cervical epidural block of the phrenic nerve root for three patients suffering from persistent hiccup. The therapeutic effect was perfect. The mechanism of the cervical epidural block is not yet defined however it is thought to block the efferent nerve fibers and suppress the reflex arc of hiccup. We conclude cervical epidural block is relatively safe and very effective for treating persistent hiccup.

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방사선치료 후 발생한 좌골신경염에 대한 초음파 유도하 좌골 신경차단 -증례보고- (Ultrasound-Guided Sciatic Nerve Block for the Treatment of Radiation Therapy Induced Sciatic Neuritis -A case report-)

  • 김준우;이평복;박찬도;최성주;최종범;문지연
    • 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.