• The Korean Journal of Pain
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• 제3권2호
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• pp.172-176
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• 1990

In Incheon Severance Hospital, a secondary delivery hospital, anesthesiologists have treated cancer pain in the operation room when referred from other department. Intrathecal neurolytic block is a valuable means of producing high quality pain relief in any hospital. It is simple to carry out, requires brief hospitalization, can be used in elderly or severely ill patients, can be repeated with the block wears off and its duration is sufficient for the terminal cancer patients. We reviewed the clinical charateristics of the intrathecal alcohol and phenol-glycerine used in two cases of cancer with pain.

• The Korean Journal of Pain
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• 제1권1호
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• pp.47-52
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• 1988

Since 1979 forty-three cancer patients have been given intrathecal block at the pain clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most of them were in the 4th and 5th decades of age. In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in 7 cases, bladder cancer in 4 cases and colon cancer in 3 cases. Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine block and rest of them had only test block. Fourteen patients whose pain sites were lumbar or lumbar and upper sacral dermatomes were put into the lateral recumbent position on the fluoroscopic table. The spinal puncture was performed as close to the spinal roots to be impregnated as possible. In 22 patients the pain sites were covered by the sacral dermatomes and so the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the affected site. Fifty one blocks were performed and their results are classified into three categories: good, fair antral poor. We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in 2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94.2% of patients. After intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7, defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present in 3 patients. The mean duration of pain relief was 2.5 months and longer than the mean survival time of 2.25 months. When patients are selected carefully and tile block is performed with great caution and good technique, the risk is minimal and a long lasting relief of intractable cancer pain achieves a painless life until death.

• The Korean Journal of Pain
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• 제1권2호
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• pp.177-180
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• 1988

Transsacral neurolytic block with 2.5ml of phenol in glycerine or bupivacaine was performed in 6 patients with malignant diseases and a patient with sphincter spasm of bladder due to spinal cord injury. Pain relief was satisfactory in all patints except one patient with very low pain threshold. In one patient, second transsacral neurolytic block alone was not sufficient because of widespread pain along distant metastasis of the malignant disease, although the first block was satisfactory. The complications include transient motor weakness(4), voiding difficulty(1), subarachnoid puncture(1), and epidural venous puncture(1), but they were all spontaneously recovered within a sbort period of time and did not give any limitation to the block.

• Advances in pediatric surgery
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• 제1권2호
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• pp.133-139
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• 1995

어린이 탈직장 11례 중 7례에서 5% 페놀을 포함한 글리세린액 직장점막하주사법을 이용한 경화요법을 시행하고 그 시술방법과 치료결과를 보고하였다. 이 방법은 간단하며, 단 1회 시술 후 6례에서 완치되어 치료율도 높았다. 시술 후 합병증이 없었다는 점과 실험적 조직소견으로 보아 본 치료법이 안전한 방법이며, 경화제에 의한 점막하층의 섬유화유발이 치료기전일 가능성의 증거도 제시되었다. 외래 혹은 입원상태에서의 국소요법 혹은 전신마취하 시술 등 상황에 따라 시술법도 자유롭게 선택할 수 있으나 시술 전 장청소과정과 시술 중 좌인지감각에 의한 주의깊은 점막하층 접근은 합병증을 피하기 위하여 반드시 지켜져야할 중요한 점으로 강조되어야 하겠다. 어린이의 탈직장에 대한 치료는 성인환자들과는 반드시 구분되어야 하며, 경화요법은 안전하고 편리하며 효과적인 우선적 치료법이라고 판단된다.