• Journal of Yeungnam Medical Science
• /
• 제33권2호
• /
• pp.90-97
• /
• 2016

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

• The Korean Journal of Pain
• /
• 제11권1호
• /
• pp.109-112
• /
• 1998

The sympathetic nervous system has been implicated as an important factor contributing to causalgia. Basis on reports of presence of opioid receptors in sympathetic autonomic ganglia, including human stellate ganglion, we administered morphine in stellate ganglion block for a patient with causalgia. The patient suffering from brachial plexus injury treated with stellate ganglion block in conjunction with physical therapy. Stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine, or 0.25% bupivacaine 8 ml, with morpine 1 mg. Patient's symptoms were dramatically improved after 13 stellate ganglion blocks.

• The Korean Journal of Pain
• /
• 제3권1호
• /
• pp.44-50
• /
• 1990

Epidural injection of narcotics for postoperative pain relief has been well reported. Caudal nalbuphine was assessed as a postoperative analgesic in a randomized double blind study of 80 patients after perianal surgery. Caudal block was carried out with 1.5% lidocaine 25 ml (Group 1) in 20 patients, and mixed with nalbuphine 3 mg (Group 2) in 20 patients, nalbuphine 5 mg (Group 3) in 20 patients, and nalbuphine 10 mg (Group 4) in 20 patients. Pain relief was evaluated by the subsquent need for systemic analgesics (Pethidine). In group 4, the use of systemic analgesics was significantly reduced for the first 24 hours postoperatively. Urinary retention was not correlated with nalbuphin dose.

• The Korean Journal of Pain
• /
• 제10권2호
• /
• pp.220-224
• /
• 1997

Background: The incidence of pain on injection of propofol varies between 30 and 100%. A variety of pretreatments have been tried to alleviate this problem such as a local anesthetics, cooling and opioids. However, none of these pharmacological maneuvers were satisfactory yet. In a recent study, subhypnotic doses of both thiopental sodium and propofol decrease the acute pain. We report a comparison of thiopental sodium, lidocaine and placebo on the incidence and severity of pain on injection of propofol. Method: A controlled, double-blind study was performed to compare the prior administration of intravenous saline 2 ml(n=30, group S), lidocaine 20 mg(n=30, group L) and thiopental sodium 50 mg(n=30, group T) in alleviating the pain by propofol. Injection pain was assessed with the four-point verbal categorical scoring system. Result: The incidence of injection pain during induction was lower in group L(30%) and T(17%) than group S(77%). The incidence of injection pain was lower in group T(17%) than group L(30%), but not significant statistically. The pain scores for recall of pain in the recovery room was simlar to those pain during propofol induction. Conclusion: The pretreatment of thiopental sodium can be effective in reducing both incidence and severity of propofol injection pain and has similar effect to lidocaine to prevent propofol injection pain.

• The Korean Journal of Pain
• /
• 제11권1호
• /
• pp.91-95
• /
• 1998

Background: Quality of postoperative care may be improved by management of postoperative pain. Epidural anesthesia and analgesia have several advantages over general anesthesia and parenteral analgesics in managing the postoperative pain. We retrospectively reviewed records of obstetrical patients who underwent the cesarean sections under epidural anesthesia to evaluate perioperative analgesic use, side effects, and complications. Methods: All patients received epidural anesthesia consisting of 0.25% bupivacaine, 2% lidocaine and 100 ${\mu}g$ fentanyl, followed by epidural analgesia with 0.1% bupivacaine and 12.5 ${\mu}g$/ml fentanyl at rate of 2 ml/hr for 48 hours. Patients' records were reviewed for: medications administered for pain relief, incidence of nausea and vomiting and pruritus, and presence of respiratory or cardiovascular depression. Results: Over 18 months, 1,054 patients' records were reviewed. Average age was 27.8 years (18~43 years). 768 patients (72.9%) received no additional drugs for the pain relief. Intramuscular analgesics, ketoprofens, were one time administered to 247 patients (23.4%), 39 patients (3.7%) received two more dosages. The time of administration was $8.3{\pm}4.3$ hours postoperatively. Antiemetics, for example, low-dose droperidol, were administerd one time for 160 patients (15.2%), 5 patients (0.5%) received two or more administrations. The medication was administered $5.1{\pm}4.2$ hours postoperatively. Drugs for relief of pruritus, low-dose naloxone, were administered one time for 108 patients (10.2%), 10 patients (0.9%) received 2 or more dosages. The time of administration was $6.3{\pm}4.2$ hours postoperatively. None of the patients experienced cardiovascular nor respiratory (<8 breath/min) depression. Conclusions: Postoperative continuous epidural analgesia in combination with bupivacaine and fentanyl is an effective method of providing postoperative analgesia with low incidence of side effects.

• Tuberculosis and Respiratory Diseases
• /
• 제46권2호
• /
• pp.251-259
• /
• 1999

연구배경: 기관지경검사로 인한 합병증의 빈도는 비교적 낮으나 생명을 위협하는 중요한 합병증의 약 50% 가 전처치 약제에 의한 것으로 보고되고 있다. 전처치의 효과와 필요성에 관한 연구들은 비교적 단편적이고 그 결과도 다양하다. 저자들은 수행상태가 양호하며 비교적 간단한 검사를 필요로 하는 외래환자에서 기관지경겹사시 전처치의 필요성 유무를 조사하고자 본 연구를 시행하였다. 방 법: 80명의 환자들을 4군으로 분류하여 I 군은 위약(생리식염수), II 군은 atropine 단독, III 군은 atropine과 midazolam, IV 군은 atropine과 meperidine을 시술 30분 전에 근육주사하였다. 국소마취는 4% lidocaine 5ml를 분무기를 통해 흡입시키고, 10% lidocaine 3-4회 분무하였으며 검사를 시행하는 동안에는 2 % lidocaine을 기도내로 투여하였다. 본 조사는 전향적 무작위 이중 맹검법으로 실시하였고, 검사후 검사자와 피검자에게 설문조사를 실시하였다. 결 과: 각 군의 평균연령, 성별, 흡연력, 폐기능검사 성적, 시술전 혈역학적 지수(분당 맥박수와 산소포화도) 등의 임상적 특징은 차이가 없었다. 시술중에 투여한 2% lidocaine의 용량과 검사에 소요된 시간, 시술 후 환자가 검사실에서 퇴실하기 까지의 시간, 검사직 후와 검사 후 2 분에 측정한 혈역학적 지수는 각 군간에 유의한 차이가 없었다. 검사자는 시술의 용이성, 기침의 정도, 분비물의 정도와 검사에 대한 전반적인 느낌에 대하여 4등급으로 답하였는데, 분비물의 정도는 atropine을 사용한 군과 사용하지 않은 군사이에 유의한 차이가 있었고 검사에 대한 전반적인 느낌은 midazolam을 사용한 III 군에서 더 좋지 않았다. 피검자가 느낀 검사자체의 힘든 정도와 재검사에 대한 의향은 각 군간에 유의한 차이가 없었다. 결 론: 이상의 결과로 수행상태가 양호하고 간단한 시술이 필요한 외래환자에서 기관지경검사시 전처치는 재고되어야 할 것으로 생각되나 향후 보다 효과적인 전처치 방법에 관한 연구가 필요할 것으로 생각된다.

• 대한수의학회지
• /
• 제48권1호
• /
• pp.125-130
• /
• 2008

Mesenteric torsion was diagnosed in a 2-year-old, spayed female Miniature Schnauzer. The patient was presented with acute depression, vomiting, lethargy and hematochezia. On physical examination, severe dehydration, tachycardia, tachypnea, weak femoral pulse, delayed capillary refill time and pale mucous membrane were found and the dog was in shock. Radiography and ultrasonography revealed intestines distended with gas, ascites and the "C" shaped distended intestine. Medical treatments including fluid therapy, analgesics, antibiotics and lidocaine for reducing reperfusion injury were applied. And then, the mesenteric torsion was definitively diagnosed through exploratory laparotomy and intestinal resection and anastomosis were performed. The dog made an uneventful recovery and was free of clinical sign one week after surgery. Mesenteric torsion is an unusual and life-threatening disease in dogs. It has usually been described in the middle and large breed dogs, especially German Shepherds. However, the mesenteric torsion should be included in the differential diagnostic lists for acute abdomen even in small breed dog. The mortality rate of mesenteric torsion can be reduced through prompt diagnosis, proper preventive therapy for shock and reperfusion injury and emergency surgery.

• The Korean Journal of Pain
• /
• 제12권2호
• /
• pp.217-220
• /
• 1999

Background: Transcutaneous Electrical Nerve Stimulation (TENS) has been widely used for pain relief after surgery instead of opioid analgesics therapy. This study was designed to study the effectiveness of TENS on perianal pain after anal surgery. Methods: Forty-eight patients who underwent anal surgery were evaluated in this suudy. Caudal anesthesia with 1.5% lidocaine 30 ml mixture 1：200,000 epinephrine was performed. TENS was done at 100 Hz for 25 min. duration, postoperatively at 4 hrs and 24 hrs. Pain was also measured at the 4 hrs and 24 hrs postoperatively by visual analogue scale (VAS). VAS value were compared before and after TENS application. Results: Values of VAS after TENS were significantly lower compared to those before TENS. Conclusions: From these results, we concluded, TENS may be effective for postoperative perianal pain relief after anal surgery.

• Clinics in Shoulder and Elbow
• /
• 제22권4호
• /
• pp.227-234
• /
• 2019

Lateral epicondylitis, also known as 'tennis elbow', is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.

• 한방안이비인후피부과학회지
• /
• 제13권2호
• /
• pp.112-139
• /
• 2000

I examined and referred to literatures of every generations on the nicknames, causes, herb medications and acupucture treatments of ptosis(上胞下垂). And then the results were obtained as follows. We've compared and analyzed Occidental and Oriental medical causes, symptoms and treatments of Primary trigeminal neuralgia and wanted to get better effects by a cooperative analysis. So the examination and analysis of the recent treatment tendency and reference bibliography show the following results. 1. Trigeminal neuralgia is nerve systematic disease appearing in the distribution scope of trigeminal nerve. It's characterized by extreme pain accompanying with a repeated and simultaneous fit from several seconds to 1-2 minutes. 2. Though there are many hypothesis on the trigeminal neuralgia, but now many doctors agree that when trigeminal nerve is under the local out of sheath conditions resulting from receiving a chronic stimulus, and the nucleus of trigeminal nerve fire, owing to decrease of pain control function and abnormal occurrence of action potential, it would be appeared. 3. The Oriental medical name of trigeminal neuralgia is generally Dootong, Doopoong, Myuntong, Pyundootong, Pyundoopoong, and Myuntong is the nearest in Occidental medicine. 4. The Oriental medical cause of trigeminal neuralgia is usually divided into Wekam and Naesang. The first one is caused by Poonghan, Poongyul, Damhwa and wicked energy enter into the body, the mechanical energy is obstructed and can't move any more, so the pain appears by them. The other cause is the hurt by emotion. And it would be loss of the transportain of liver and obstructed, so result into Kanwulhwahwa, Kanpoongnaedong and the pain appears. 5. There are two methods of curing trigeminal neuralgia. As a medication, primary method is prescribing Carbamazepine and the second is using Phenytoin or Baclofen. And as a operation, Drug injection of trigeminal nerve, Amputation of branches of trigeminal nerve, Retrogasserian glycerol rhizotomy, Radiofrequency gangliolysis, Neurovascular decompression can be used. 6. There are several herb medicines for Trigeminal neuralgia. First, Chungung is good for Hwaejeetong, Keopoongjedam, Hwalhyuljeetong. Second, Jeongal, Jiryong, Okong is used for Sikpoonghekyung, Tongkyungjeetong. Third, Baekjee, Sesin, Cheonma, Manhyungja is efficacious in Sinonhepyo. Sanpoongjeetong. Fourth, for falling of liver's Wulhwa, Yongdamcho, Hyungge, Kukwha can be used. And also Saengjihwang, Hwangkm is good for going down the fever of Yangmyungwiyul and finally, Baekkangjam. Moryu can be effective for Jaumjamyang, Haekyungjitong. The other medicines can be used as assistant analgesics, and it also efficacious. 7. Generally the points of pain on the face and the points of Soyangkyung and Yangmyungkyung is used for Acupuntual therapy, because the two meridians passed on the face. Hakwan. Sabaek, Kwanryo, Keoryo, Hyubkeo, Taeyang, Jeechang, Younghyang, Eoyo, Chanjuk. Yangbaek. Sajukkong. Dooyoo, Kwangsangjum, Sengjang, Poongjee is used for taking near point and Joksamlee, Naejung, Habkok is used for taking distant point. 8. Dansam or Danggui injection which have a effect for Hwalhyulhwaeo, Sokyunghwalak and Vit B1, Vit B2, Vit B12, $2\%$ Hydrochloroprocaine, $1\%$ Lidocaine injection to pain point for local analgesics had so good effect. And external application and moxibustion are used for another treatment. 9. It proved that through mouse model, both Herb medication group and Drug medication group are efficacious for trigeminal neuralgia similarly and also the cooperative medication group shows more effective result than the only drug medication group.