• Title/Summary/Keyword: regional: epidural

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The Effect of Epidural Ketamine in Complex Regional Pain Syndrome Occuring after Lumbar Epidural Block -A case report- (요부경막외차단술 후 발생한 복합부위 통증증후군에서의 경막외 Ketamine의 효과 -증례 보고-)

  • Ock, Kyung-Jong;Han, Kyung-Rim;Kim, Jin-Soo;Kim, Chan;Kim, Eun-Young
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.251-254
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    • 2000
  • A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

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Epidural analgesia using xylazine in swine (돼지에서 xylazine에 의한 경막외마취)

  • Cheong, Jong-tae
    • Korean Journal of Veterinary Research
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    • v.31 no.4
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    • pp.519-522
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    • 1991
  • Pain reflex and anesthetic state in swine with xylazine epidural anesthesia were observed. In xylazine epidural anesthesia, dosages of 0.50mg/kg BW for analgesia of perineal region and 0.7550mg/kg for analgesia of low abdominal wall were required. Regional anesthesia was induced 5~20 min after epidural injection of xylazine and recovered 90~120 min after administration. The results indicated that xylazine as an epidural local anesthetic was useful in swine.

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A Case of CRPS Treated with Implantable Port System -A case report- (Implantable Port System을 이용한 복합부위통증증후군 치험 1예 -증례 보고-)

  • Shin, Sung-Shick;Kim, Tae-Sam;Yang, In-Sook
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.274-277
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    • 1997
  • The complex regional pain syndrome(CRPS) exhibit symptoms such as: abnormal skin color, temperature change, abnormal pseudomotor activity, edema. If CRPS is not treated appropriately at acute stage, then the affected extremity may become a useless, painful appendage. Treatment of CRPS by sympathetic blockade may be achieved by repeated intravenous regional guanethidine blocks, repeated anesthetic sympathetic blocks, surgical sympathectomy or oral sympatholytic therapy. We treated 29-year-old male patient with CRPS of left upper extremity by continuous cervical epidural blockade. Due to wound infection and dislocation of the epidural catheter, we inserted an implantable port system to inject the mixture of local anesthetics and small amount of morphine. After 10 months of treatment, patient was cured of symptoms and signs of CRPS and was able to resume a normal life.

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Unilateral Horner's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient (산모에서 요부 경막외 차단후 발생한 편측 호너 증후군과 상지마비 -증례 보고-)

  • Jang, Yeon;Cho, Eun-Chung;Kim, Jung-Tae;Park, Soo-Seog;Lee, Jae-Hee
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.285-290
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    • 1997
  • Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

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Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report- (복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고-)

  • Yoon, Keon-Jung;Kim, Jong-Lul
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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Neurologic Complications following Epidural Analgesia -Two case reports- (경막외 차단 후 발생한 신경계 합병증 -증례보고-)

  • Moon, Dong-Eon;Shim, Jae-Yong;Lim, Yong-Gul;Kim, Yee-Suk;Kim, Byung-Chan;Kim, Sung-Nyeon
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.291-295
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    • 1997
  • Technique of epidural analgesia is generally regarded a safe procedures which is widely applied in postoperative and chronic pain control. Incidence of neurologic complications following epidural analgesia are rare; however, increasing number of published reports describing transient or permanent neurologic complications following such procedures have been appearing more frequently. We report two cases of neurologic complications following epidural analgesia as we believe it is important to draw the attention of other anesthesiologist to the possibility of existence of other complications of significant medicolegal consequences.

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Caudal and epidural blocks in infants and small children: historical perspective and ultrasound-guided approaches

  • Kil, Hae Keum
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.430-439
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    • 2018
  • In infants and small children, ultrasound (US) guidance provides ample anatomical information to perform neuraxial blocks. We can measure the distance from the skin to the epidural space in the US image and can refer to it during needle insertion. We may also visualize the needle or a catheter during real-time US-guided epidural catheterization. In cases where direct needle or catheter visualization is difficult, US allows predicting successful puncture and catheterization using surrogate markers, such as dura mater displacement, epidural space widening due to drug injection, or mass movement of the drug within the caudal space. Although many experienced anesthesiologists still prefer to use conventional techniques, prospective randomized controlled trials using US guidance are providing increasing evidence of its advantages. The use of US-guided regional block will gradually become widespread in infants and children.

Unilateral Paraparesis after Cesarean Section under Epidural Anesthesia -A case report- (경막외 마취하 제왕절개술 후에 발견한 일측 부전마비 -증례 보고-)

  • Lee, Jeong-Min;Lee, Gwan-Woo;Kang, Bong-Jin;Kim, Dong-Hee
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.253-256
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    • 2001
  • One of the most serious complications of regional anesthesia is a neurological deficit. Although such a problem is very rare, obstetric patients may develop paresthesia and motor dysfuntion during the postoperative period in association with number of other factors, including direct nerve trauma, equipment problems, adhesive arachnoiditis, anterior spinal artery syndrome, epidural hematoma or abscess and adverse drug effect. We experienced a case of unilateral paraparesis following epidural anesthesia with 20 ml of 0.75% ropivacaine and $25{\mu}g$ of fentanyl in an obstetric patient.

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The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019

  • Kayir, Selcuk;Kisa, Alperen
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.82-93
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    • 2021
  • Background: This study used bibliometric analysis of articles published about the topic of regional anesthesia from 1980-2019 with the aim of determining which countries, organizations, and authors were effective, engaged in international cooperation, and had the most cited articles and journals. Methods: All articles published from 1980-2019 included in the Web of Science database and found using the keywords regional anesthesia/anaesthesia, spinal anesthesia/anaesthesia, epidural anesthesia/anaesthesia, neuraxial anesthesia/anaesthesia, combined spinal-epidural, and peripheral nerve block in the title section had bibliometric analysis performed. Correlations between the number of publications from a country with gross domestic product (GDP), gross domestic product (at purchasing power parity) per capita (GDP PPP), and human development index (HDI) values were investigated with the Spearman correlation coefficient. The number of articles that will be published in the future was estimated with linear regression analysis. Results: Literature screening found 11,156 publications. Of these publications, 6,452 were articles. The top 4 countries producing articles were United States of America (n = 1,583), Germany (585), United Kingdom (510), and Turkey (386). There was a significant positive correlation found between the GDP, GDP PPP, and HDI markers for global countries with publication productivity (r = 0.644, P < 0.001; r = 0.623, P < 0.001, r = 0.542, P < 0.001). The most productive organizations were Harvard University and the University of Toronto. Conclusions: This comprehensive study presenting a holistic summary and evaluation of 6,452 articles about this topic may direct anesthesiologists, doctors, academics, and students interested in this topic.