The Korean Journal of Pain
- 제1권1호
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- Pages.34-46
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- 1988
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- 2005-9159(pISSN)
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- 2093-0569(eISSN)
내장신경차단에 관한 임상적 연구
A Clinical Evaluation of Splanchnic Nerve Block
- 김수연 (연세대학교 외과대학 마취과학교실) ;
- 오흥근 (연세대학교 외과대학 마취과학교실) ;
- 윤덕미 (연세대학교 외과대학 마취과학교실) ;
- 신양식 (연세대학교 외과대학 마취과학교실) ;
- 이윤우 (연세대학교 외과대학 마취과학교실) ;
- 김종래 (연세대학교 외과대학 마취과학교실)
- Kim, Soo-Yeoun (Department of Anesthesiology, Yonsei University College of Medicine) ;
- Oh, Hung-Kun (Department of Anesthesiology, Yonsei University College of Medicine) ;
- Yoon, Duek-Mi (Department of Anesthesiology, Yonsei University College of Medicine) ;
- Shin, Yang-Sik (Department of Anesthesiology, Yonsei University College of Medicine) ;
- Lee, Youn-Woo (Department of Anesthesiology, Yonsei University College of Medicine) ;
- Kim, Jong-Rae (Department of Anesthesiology, Yonsei University College of Medicine)
- 발행 : 1988.06.30
초록
Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was
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