• The Korean Journal of Pain
• /
• 제2권1호
• /
• pp.97-99
• /
• 1989

Epidural block is used extensively in each of the fields of surgical anesthesia, obstetric anesthesia, and diagnosis and management of acute and chronic pain. New developments in the understanding of pain conduction have extended the use of continuous epidural blockade to the administration of drugs that selectively block pain conduction while leaving sensation and motor power essentially unchanged. The safety and the reliability of spinal epidural catheter techniques have permitted relief of acute and chronic pain. However, one of the important aspects of the management of the epidural catheter is the possibility of epidural infection. We have experienced a case of epidural infection during control of post-herpetic neuralgia and discuss management of the epidural catheter in this article.

• 대한유전성대사질환학회지
• /
• 제18권3호
• /
• pp.69-77
• /
• 2018

Pregnancy and delivery pose a high risk of developing metabolic decompensation in women with defects of ketone body metabolism. In this review, the available reported cases in pregnancy are summarized. It is very important to properly manage women with defects of ketone body metabolism during pregnancy, especially nausea and vomiting in the first trimester of pregnancy, and during labor and delivery. Pregnant women with deficiencies of HMG-CoA lyase or succinyl-CoA:3-ketoacid CoA transferase (SCOT) often experience metabolic decompensations with nausea and vomiting of pregnancy, often requiring hospitalization. For successful delivery and to reduce stresses, vaginal delivery with epidural anesthesia or elective cesarean delivery with epidural or spinal anesthesia are recommended for women with HMG-CoA lyase and SCOT deficiency. In beta-ketothiolase deficiency, four pregnancies in three patients had favorable outcomes without severe metabolic problems.

• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.97-101
• /
• 2011

Intravenous Patient Controlled Analgesia (IV PCA0 after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.

• 대한치과마취과학회지
• /
• 제10권2호
• /
• pp.197-202
• /
• 2010

Multiple sclerosis is a degenerative disease prevalent in northern climates, and its cause is unknown. The histopathological lesion in multiple sclerosis is the sclerotic "plague", a discrete focus of myelin loss with maintenance of axon segments and glial proliferation. The plaques may be seen in widely different brain and spinal tissues. The common causes of low back pain are psychosomatic disorder, myofascial pain dysfunction syndrome and herniation of nucleus pulposus. Local anesthetics cross the blood-brain barrier and the signs of CNS toxicity appear at a level between 4.5 and $7.0\;{\mu}g/ml$. This is a case report of acute back pain care after mandibular block anesthesia for the surgical extraction of mandibular root rests in an old aged woman with multiple sclerosis.

• 대한장애인치과학회지
• /
• 제7권2호
• /
• pp.119-122
• /
• 2011

연골무형성증 환아는 작은 키, 짧은 사지, 척추 측만, 아데노이드와 편도 비대 등의 특징적인 소견으로 인해 치과치료시 많은 주의를 요한다. 대부분의 환자들이 구호흡을 하기 때문에 치과 시술시 호흡이 어려우며, 척추 이상으로 인해 체어에 오래 누워있기 힘든 경우가 많아 이번 증례와 같이 다발성 우식증을 치료하기 위해서는 전신마취 하 시술이 필요한 경우도 있다. 연골무형성증 환아의 치과 진료시에는 타과와의 긴밀한 협조 하에 이러한 전신적인 특징을 이해하고 접근해야 할 것이다.

• The Korean Journal of Pain
• /
• 제20권1호
• /
• pp.8-14
• /
• 2007

Background: Anticonvulsants and antidepressants are adjuvant analgesic drugs that are used widely for treating chronic neuropathic pain syndromes. The combined analgesic effect of gabapentin and milnacipran was investigated with a rat neuropathic pain model. Methods: The rat neuropathic pain model was made by ligating the spinal nerves (L5 and L6). An intrathecal catheter was inserted into the subarachnoid space. Tactile allodynia was tested with the up-down method using von Frey hair. We determined the antiallodynic effect of intraperitoneal (I.P.) and intrathecal (I.T.) gabapentin. The combined effect of I.P. gabapentin (50 mg/kg) and milnacipran (0, 10 and 30 mg/kg) was investigated. Results: Intraperitoneal and intrathecal administration of gabapentin increased the threshold for tactile allodynia (the ED50 was 60.6 mg/kg and $45.5{\mu}g$, respectively). Co-administration of I.P. milnacipran increased the antiallodynic effect of I.P. gabapentin in a dose-dependent fashion. Conclusion: The combined administration of milnacipran and gabapentin may increase the total analgesic effect during treatment of neuropathic pain.

• Journal of Korean Neurosurgical Society
• /
• 제46권6호
• /
• pp.581-583
• /
• 2009

Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

• 동의생리병리학회지
• /
• 제32권1호
• /
• pp.30-34
• /
• 2018

This research was practiced to comparative investigate the distribution of sensory and motor neuron linkaged with Yangji(TE4) by using neural-tracer technology. A total 16 S-D rats were used in the present research. After anesthesia, the rats received micro-injection of $6{\mu}{\ell}$ of cholera toxin B subunit(CTB) into the relation positions of the Yangji(TE4), in the human body for observing the distribution of the linkaged sensory neurons in dorsal root ganglia(DRGs) and motor neurons in the spinal cord(C3~T4) and sympathetic ganglia. 3 days after the micro injection, the rats were anesthetized and transcardially perfused saline and 4% paraformaldehyde, followed by routine section of the DRGs, sympathetic chain ganglia(SCGs) and spinal cord. Marked neurons and nerve fibers were detected by immunohistochemical method and observed by light microscope. The marked neurons were recorded and counted. From this study the distribution of primary sensory and motor neurons linkaged with Yangji(TE4) were concluded as follows. Yangji(TE4) dominated by spinal segments of C5~T1, C6~T4, individually.

• The Korean Journal of Pain
• /
• 제9권1호
• /
• pp.260-263
• /
• 1996

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

• The Korean Journal of Pain
• /
• 제23권4호
• /
• pp.266-269
• /
• 2010

Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity, During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.