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요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과
신문수,이병희,최훈규,노재섭,안정용,신승훈,이병희,정봉섭,Shin, Moon Soo,Lee, Byung Hee,Choi, Hun Kyu,Noh, Jae Sub,Ahn, Jung Young,Sheen, Seung Hun,Lee, Byung Hee,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5
Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.
소뇌교각 거미막낭에 대한 수술로 회복된 일측성 돌발성 난청
성한경(Han Kyung Sung),고범준(Bum Jun Ko),신승훈(Seung-Hun Sheen),박세라(Se Ra Park) 대한두개저학회 2017 대한두개저학회지 Vol.12 No.1
Sudden sensorineural hearing loss(SSNHL) is a common clinical disease in otolaryngology. In many cases, the causes of sudden hearing loss cannot be determined, but a cerebello-pontine angle (CPA) mass, such as an arachnoid cyst, is one of them. Arachnoid cysts are usually asymptomaic; however, when they have mass-effect, they may present with symptoms such as dizziness, tinnitus and hearing loss. The authors report a case of a 63 year-old male who presented with sudden hearing loss linked to a CPA arachnoid cyst. The patient underwent a retromastoid suboccipital craniotomy with fenestration of the arachnoid cyst to get rid of his neurological symptoms and hearing loss which did not respond to medical treatments. After the surgery the patient s hearing was recovered and other symptoms disappeared.
측두골 골절후 발생한 안면마비 환자의 안면신경감압술: 25명 환자들의 증례분석
남한가위 ( Han Ga Wi Nam ),황형식 ( Hyung Sik Hwang ),문승명 ( Seung Myung Moon ),신일영 ( Il Young Shin ),신승훈 ( Seung Hun Sheen ),정제훈 ( Je Hoon Jeong ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3
Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.