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안면신경마비 환자에서 마비점수표와 성상신경절 차단의 치료효과
구길회 중앙대학교 의과대학 의과학연구소 1994 中央醫大誌 Vol.19 No.4
Bell's palsy(idiopathic facial paralysis) is characterized by the sudden onest of facial muscle weakness or paralysis without specific causes. Bell's palsy is usually innocuous and spontaneous recovery within about 12 weeks but ofter the duration of recovery of facial muscle function is very long, and it is very serious condition to patients bacause of cosmetic problems and psychological distress. In 1952, Dr. Swan reported the treatment of the facial palsy with stellate ganglion block. And Dr. Brackman(1974) also reported the therapeutic effects of stellate gagnlision block in patients with Bell's palsy. In 1973, Dr. Wakasugi introduce the "Facial Palsy Score" and classified the degree of paralysis of facial muscle. I investigate the effects of stellate ganalion block in 66 Bell's palsy patients with the "Facial Palsy Score" from September 1993 to march 1994 at pain clinics of Chung-Ang University Yong-San Hospital. Results are follows 1. Sexual difference in incidence of facial palsy was not noted. 2. In age, the onset of facial palsy was noted in all age groups, but 6th decades of age group were high incidence and 7th decade and 5th decades were followed. 3. There was no difference of incidence of facial palsy in right and left side of face. 4. Prodromal symptom of facial palsy were noted in 25.5% of patients, the symptom were periauricular pain, dizziness, hearing difficulty, visual difficulty, and nausea. 5. The mean durations from the time of development of facial palsy to came the pain clinics were about 3 1/2 months. 6. At first time to visit to the pain clinics, lower than 30 of Facial Palsy Score was noted in 84.8% of patients, but after the 5 times of stellate ganglion block it was decreased to 66.7%, and after 30 times of SGB only 15.4% of patients were below than 30.
구길회,조형상 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.1
Sudden obstructive changes in diameter of upper respiratory tract may affect the usual process of gas exchanges in the pulmonary system with mild to severe changes in arterial blood gases and the another organ functions. Therefore immediate restoration of an adequate airway in these patients may be lifesaving. It is possible to measure regional tissue oxygen and carbon dioxide tension, and other gas tensions simultaneously and continuously because mass spectrometer has been applied to the measurement of gas tension in tissue recently. So we can understand the organ perfusion status and metabolism better than before. Eight mongrel dogs were ventilated with 100% of oxygen by volume ventilator through inlet diameter 9㎜, 4.5㎜, 3㎜ and 1.8㎜ endotracheal tubes and physiologic responses were examined. The following results were obtained. 1. Blood gas determinations showed the animal to be adequately ventilated even in narrow constriction to 1/3 of normal airway size(9㎜). 2. Controlled values of intracerebral oxygen and carbon dioxide tension were 39.50±3.97(34∼45)mmHg and 58.38±5.21(39∼62)mmHg, and those of intramyocardial were 79.38±7.02(68∼90)mmHg and 49.38±8.46(39∼74)mmHg respectively. 3. There was no statistically significant changes in intracerebral and intramyocardial gas tensions with 1/2 and 1/3 size of normal airway.
천골강내(薦骨腔內)에 투여된 Pentazocine 의 진통효과
구길회 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.5
In relief of postoperative pain, the value of epidural or subdural injection of opioids including morphine, methadone, petidine and fentanyl is now well established. The advantages of epidural or subdural over parenteral opioids is prolonged duration of analgesia, which last from several hours to several days, without sympathetic and motor blockade. But undesirable side effects include pruritus, urinary retention, delayed onset of somnolence, and cardiovascular and respiratory depression. To reduce postoperative pain, we evaluated the effects of caudal pentazocine 0.2-0.4 mg/kg with lidocaine 1.5% 400 mg for perianal surgery in 36 cases. The results were as follows: 1) There was no difference in analgesic onset between the Control Group (used lidocaine only) and Group A and B (mixed use of lidocaine and pentazocine: Group A, 0.2 mg/kg pentazocine; Group B, 0.4 mg/kg) 2) Mean duration of analgesia following caudal pentazocine and lidocaine injection was over 12 hours, but was less than 5 hours in the used lidocaine only. 3) Urinary retention was observed in all groups; 3 case in the Control group, and 4 cases in Group A and B. 4) In Group A and B, 6 cases had not used analgesics within 24 hours after caudal anesthesia. 5) No specific clinical changes were noted in the vital signs in all groups.