• Title/Summary/Keyword: 경막외마취

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Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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Electromyographical Studies on Experimental Hypocalcemia in Goats (산양(山羊)의 저(低)Ca 혈증(血症)에 관한 근전도학적연구(筋電圖學的硏究))

  • Kang, Chung Boo
    • Korean Journal of Veterinary Research
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    • v.19 no.2
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    • pp.161-167
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    • 1979
  • 저(低)Ca혈증(血症)의 주징(主徵)인 기립불능(起立不能)의 발현원인(發現原因)의 추구를 위해 실험적(實驗的) 저(低) Ca혈증(血症)에서 기립불능(起立不能) 나아가 심장운동정지(心臟運動停止)에 이르기까지의 과정을 근전도학적(筋電圖學的)으로 실시한 결과의 내용을 요약하면 다음과 같다. EDTA 주입전(注入前)의 정상기립시(正常起立時)에는 항중력근(抗重力筋)에만 tonic discharge가 얻어졌으나 혈정(血中) Ca 농도(濃度)의 저하정도에 따라 근방전(筋放電)이 달라져 6mg/100ml 전후에서 항중력근(抗重力筋) 및 그의 길항근(拮抗筋)에도 phasic discharge를 수반한 tonic discharge가 동기적(同期的)으로 나타나 이의 현상은 후구탈력(後軀脫力)에 의해 주저앉을 때에도 마찬가지였다. 기립불능(起立不能)의 상태에선 clonic convulsion양(樣)의 근방전(筋放電)이 폐사시까지 계속되었다. 경막외마취(硬膜外痲醉)에 의한 근전도(筋電圖)에선 근방전(筋放電)은 항시 상반적(相反的)이었고 후구마비(後軀痲痺)에 의한 횡와위(橫臥位) 상태에선 어떤 근방전(筋放電)도 얻어지지 않아 EDTA 주입(注入)에 의한 저(低) Ca혈증시(血症時)와 경막외마취시(硬膜外痲醉時)의 기립불능(起立不能)의 본질(本質)은 상위(相違)한 것으로 판명되었다. 또한 저(低)Ca혈증시(血症時)에 수반되는 각종 반사 및 임상증상의 추이(推移)로 저(低)Ca혈증시(血症時)에 수반되는 기립불능은 말초신경계 및 신경일근접합부(神經一筋接合部) 및 근(筋) 자체의 기능저하보다는 중추신경계의 기능저하에 의한 가능성을 크게 시사하는 것으로 보아진다.

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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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Clinical Use of Xylazine Epidural Anesthesia in Holstein Cows (소에서 Xylazine에 의한 경막외마취의 임상응용)

  • Chang Kwang-Ho;Cheong Jong-Tae;Nam Tchi-Chou
    • Journal of the korean veterinary medical association
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    • v.27 no.11
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    • pp.675-677
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    • 1991
  • This study was designed to examine the effect of xylazine (0.07mg/kg suspended in 5ml saline) given into the epidural space in 11 Holstein cows. Analgesic state was induced at the perineal region within 10 min after administration of xylazine and at the u

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Inadvertent Dural Puncture during Epidural Block (경막외 차단시의 경막천자)

  • Kang, Keum-Ye;Min, Ki-Chul;Kim, Dong-Chan;Choe, Huhn
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.203-206
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    • 1988
  • Evaluation of inadvertent dural puncture occuring among 308 epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1.6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspiration of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.

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The Effect of Epidural Dexamethasone after Lumbar Epidural Anesthesia (요부 경막외마취 후 경막외강으로 투여한 Dexamethasone의 효과)

  • Kim, Dong-Hee;Kim, Tae-Jin
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.65-68
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    • 1998
  • Background: Epidural steroid injection(ESI) is often adminstered to treat lower back pain, but its effect iveness on postepidural backache have not yet been determined. Methods: Sixty patients scheduled for cesarean section under epidural anesthesia were randomly assigned to receive, 1 ml of normal saline(Group 1), or 5 mg of dexamethasone (Group 2), epidurally via indwelling catheter after delivery. Results: The incidences of postepidural backache occured significantly more often in Group 1(56.7%) than in Group 2(26.7%)(P<0.05). There was a significant association between postepidural backache and multiple attempts at epidural needle placement. Conclusion: Epidural dexamethasone has a preventive effect on postepidural backache.

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Nursing Needs for Elderly Patients with Regional Anesthesia during Operation (부위마취 수술 노인환자의 수술 중 간호요구)

  • Eom, Hea-Kyoung;Ko, Sung-Hee;Lee, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.16 no.5
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    • pp.351-360
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    • 2016
  • Purpose: The purpose of this study was to identify the nursing needs of elderly patients who got a surgical operation under regional anesthesia(spinal, epidural, nerve block). Methods: The participants were 126 elderly patients who completed a questionnaire. The data were collected October 1 and October 31, 2012, and analyzed using descriptive statistics, t-test and ANOVA, $Scheff{\acute{e}}$ test. Results: The mean score for the nursing needs of elderly patients administered regional anesthesia during surgery was $3.08{\pm}0.38$, The scores for specific nursing needs were as follows: educational needs ($3.47{\pm}0.50$), spiritual needs ($3.37{\pm}0.78$), physical needs ($3.31{\pm}0.46$), emotional needs ($2.72{\pm}0.50$), and environmental needs ($2.51{\pm}0.47$). There were significant differences in nursing needs relative to gender, religion, and spouse status. Additionally, there were significant differences in nursing needs according to surgery department, the length of time the surgery, and the ASA(American Society of Anesthesiologists) physical classification. of the operation-related characteristics. Conclusion: When caring for elderly patients during the surgery, nurses must provide adequate information about the surgery and anesthesia. Further studies are needed to develop and evaluate nursing interventions to provide quality surgical care for the elderly patients.

The Effects of the Closed and Open Musical Therapies to the Patients with Spinal and Epidural Anesthesia Operation (척추 및 경막외마취 수술환자에게 시행한 개방적 및 폐쇄적 음악요법의 효과)

  • Kim, Keun-Suk;Kim, Joo-Hyun;Kim, Sung-Jae
    • Journal of Korean Biological Nursing Science
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    • v.10 no.2
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    • pp.154-161
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    • 2008
  • Purpose: The purpose of this research was to examine the effects of musical therapy and the differences of two different ways of musical therapy: the closed musical therapy using a headset and the open musical therapy using cassette player. Methods: his study was designed with the non-equivalent control group pretest-posttest design. The research cases were 60 spinal and epidural anesthesia surgery patients at K University Hospital in C city from January 3, to March 31, 2005. We measured trait & state anxiety, blood sugar level, vital signs. The group was divided into two: experimental and control group. Results: 1) There are no significant differences between an experimental group and a control group in homogeneity test. 2) We can see that musical therapy during operations stabilizes blood pressure, and reduces sugar level in blood, and decreases psychological anxiety. 3) And the closed musical therapy has more obvious and significant effects than the open musical therapy. Conclusion: We could conclude our study here saying musical therapy during operations is necessary in easing patients' anxieties. More advanced researches on the subject are required to prove validity of the findings in our pilot study.

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