• Title/Summary/Keyword: 경막외마취

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Effect of Epidural Block under General Anesthesia on Pulse Transit Time (전신마취시 경막외 차단술 병용이 맥파전달시간에 미치는 영향)

  • Choi, Byeong-Cheol;Kim, Seong-Min;Jung, Dong-Keun;Kim, Gi-Ryon;Lee, He-Jeong;Jeon, Gey-Rock
    • Journal of the Korean Society for Nondestructive Testing
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    • v.25 no.4
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    • pp.262-267
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    • 2005
  • Epidural block under general anesthesia has been widely used to control postoperative pain. In this anesthetic state many hemodynamic parameters are changed. Moreover pulse transit time is influenced by this memodynamic change. m change in the finger and the toe due to relaxation of arterial wall muscle after general anesthesia and epidural block under general anesthesia. This study, in the both general anesthesia and epidural block under general anesthesia, ${\Delta}PTT$ of the toe and of the finger are measured. In addition, ${\Delta}PTT$(toe-finger) of the epidural block under general anesthesia and of the general anesthesia were compared.

Epidural Space Identification Device Using Air-filled Catheter (공기도관을 사용하는 경막외강 자동탐지기구)

  • 강재환;김현식;김경아;김상태;배진호;임승운;차은종
    • Journal of Biomedical Engineering Research
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    • v.24 no.1
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    • pp.9-13
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    • 2003
  • An assist device was developed to identify the epidural space by continously monitoring the air-filled catheter pressure. The pressure signal appropriately amplified and filtered enabled to alarm the needle introduction into the epidural space by thresholding detection. Ten LEDs provided a visual change of catheter pressure before alarming for user convenience. Clinical trials were performed in 30 patients with 83% success rate at the first trial. When failed, the second trial was enough for successful anesthesia. The air volume introduced during each anesthesia was less than 1ml, causing side effects. Air filling of the catheter could also minimize infection possibility. Therefore, the present device guarantees safe anesthesia with user convenience.

The Effect of Ipidural Pain Block After Thoracotomy (개흉술후 지속적 경막외마취가 통증감소에 미치는 영향)

  • 최덕영;원경준
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.809-814
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    • 1997
  • Continuous epidural pain block with a local anesthetic agents is a commonly employed technique for pain relief after thoracotomy. In this study, we evaluated the effectiveness of the continuous epidural pain block in 19 patients undergoing elective lateral or posterolatrral thoracotomy with control group(n=19) from November 1994 to July 1995, Epidural lidocaine and morphine mixtures were injected via an epidural catheter as a bolus after operation, and then bupivacaine and morphine mixtures were injected continuously following 5 or 6 days. The pain score, upper arm elevation(ROM score), and respiratory rate were significantly changed(P<0.05) from 30min after injection. The CO2 tension of arterial blood was decreased significantly(P<0.05) from 2hr after injection. The postoperative hospital days were decreased significantly(P<0.05). Side effects of the epidural pain block were urinary retention(n= 10), urticaria(n=2) and a case of headache. There was no postoperative lung atelectasis. We conclude that the continuous epidural pain block is good for prevention of the postoperative lung complication and early recovery after thoracotomy.

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Video-assisted Thoracioscopic Surgery under Epidural Anesthesia in the High-Risk Patients with Secondary Spontaneous Pneumothorax (고위험인자를 가진 이차성 자연 기흉환자의 경막외마취를 이용한 흉강경 수술)

  • 김영대;박준호;양승인
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.678-682
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    • 2003
  • Video-assisted thoracoscopic surgery is good indication of secondary spontaneous pneumothorax. This method usually required general anesthesia and single-lung ventilation with collapse of other lung. But, risks of general anesthesia and single-lung ventilation must be considered in high-risk patients. Material and Method: Between September f999 and August 2001, 15 high-risk patients were treated by video-assisted thoracoscopic surgery under epidural anesthesia. Result: Video assisted thoracoscopic surgery was successfully performed in 15 patients. Duration of postoperative air-leakage was 4.3days, Significance of complication was none, No recurrence of pneumothorax was encountered. Conclusion: Video-assisted thoracoscopic surgery can be performed safely under epidural anesthesia for treatment of secondary spontaneous pneumothorax in high-risk patients.

Pneumocephalus Developed during Epidural Anesthesia for Combined Spinal-Epidural Anesthesia (척추경막외병용마취를 위한 경막외마취 중 발생한 기뇌증)

  • Kim, Youn Jin;Baik, Hee Jung;Kim, Jong Hak;Jun, Joo Hyun
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.163-166
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    • 2009
  • The superiority of air versus saline for identifying the epidural space remains unestablished. Epidural anesthesia using a loss of resistance technique (LORT) with air is associated with increasing complications of dural puncture-induced headaches and neurological and hemodynamic changes. Here, we described a case of pneumocephalus with a large amount of air that was accompanied by severe headache and nuchal and chest pain occurring after epidural block using LORT with air for combined spinal-epidural anesthesia.

Development of a VR based epidural anesthesia trainer using a robotic device (로봇을 이용한 경막외마취 훈련기의 개발)

  • Kim J.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.135-138
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    • 2005
  • Robotic devices have been widely used in many medical applications due to their accuracy and programming ability. One of the applications is a virtual reality medical simulator, which trains medical personnel in a computer generated environment. In this paper, we are going to present an application, an epidural anesthesia trainer. Because performing epidural injections is a delicate task, it demands a high level of skill and precision from the physician. This trainer uses a robotic device and computer controlled solenoid valve to recreate interaction forces between the needle and the various layers of tissues around the spinal cord. The robotic device is responsible for generation of interaction forces in real time and can be used to be haptic guidance that allows the user to follow a previous recorded expert procedure and feel the encountered forces.

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Awake OPCAB: Initial Experience (의식 있는 상태에서 경막외 마취를 이용한 심박동하 관상동맥우회술: 초기 경험)

  • Son Kuk-Hui;Cho Kwang-Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.598-603
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    • 2006
  • Background: High thoracic epidural anesthesia allows awake coronary artery bypass grafting, avoiding the drawbacks of mechanical ventilation and general anesthesia. Materian and Method: From April, 2005 to September, 2005, 12 patients were underwent awake coronary artery bypass grafting using high thoracic epidural anesthesia. There were 1 female and 11 male patients, with a mean age of $66{\pm}6$ years. Off pump coronary artery. bypass grafting was performed through a median sternotomy using arterial grafts. Result: There were no mortality. Pneumothorax was developed during surgery in 8 patients. Five patients required secondary intubation because of pneumothorax (n=3), bowel herniation (n=1), and hemothorax after chest tube insertion (n=1). Postoperative coronary angiography was performed before discharge in all patients and all the grafts were patent. Conclusion: Our intial experience demonstrated the feasibility of awake off-pump coronary artery bypass grafting. Further study is required to define the indications, advantages and limitations of this strategy.

Epidural Administration of Local Anesthetics and Steroids for Low Back Pain Management (요통 치료를 위한 경막외 국소마취제 및 스테로이드 주입 -제 2 보-)

  • Roh, Seon-Ju;Goh, Joon-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.157-161
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    • 1991
  • Low back pain and/or lumbosacral radiculopathy have become one of the most common pain problems in our pain clinic center. There are several kinds of conservative management for low back pain and/or lumbosacral radiculopathy. We as pain clinicans, focused on epidural administration of local anesthetics and steroids. The rationale for epidural steroid administration is to reduce inflammation and to inhibit the action of nociceptive agents. Eighty mg of methylprednisolone acetate in 10 ml of 0.25% bupivacaine was infected, into epidural space 3 times at one week intervals for 1 year, to 921 patients(male: 422, female: 499) seen in the period between March 1986 and December 1989. The effectiveness was evaluated a month after the final injection. The results were as follows: Excellent pain relieved group 122 patients(13.25%) Good pain relieved group: 485 patients(52.66%) Fair pain relieved group: 184 patients(19.98%) No effect group: 130 patients(14.11%) We recommend the epidural steroid inject to the patients following failure of conservative management of discogenic pain.

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