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나애자(Ae Ja Na),문동언(Dong Eon Moon),서재현(Jae 대한통증학회 1993 The Korean Journal of Pain Vol.6 No.1
Paraplegia complicating a block of the celiac plexus with alcohol for recurrent stomach can- cer is described. A 33 year old male patient was admitted to control for severe epigastric pain. With the patient in prone position, the needle was advanced further than 2 cm on the anteri- or margin of L1 vertebral body under fluoroscopy. 3 ml of 1% lidocaine and 5 ml of conray were injected through each needle, and the diffusion of the contrast medium was checked, This was followed by 7 ml of pure alcohol and 8 ml of 50% alcohol for each needle. At that time, the pa- tient was very satisfied with loss of abdominal pain. About 30 minutes after injection of alcohol, suddenly patient complained of severe burning pain on back and both extremities. Thereafter, loss of sensation and paralysis in both extremities were developed slowly. The senstivity to cold recovered 3 days after block. By the 33rd day after the block, sensation had recovered in both extremities, the bladder and rectum. Movement of the right ankle joint and left great toe was also possible.
양측 상박 신경총 침범으로 불인성 통증을 동반한 폐암환자의 통증치료 경험
나애자(Ae Ja Na),서재현(Jae Hyun Suh),김성년(Sung 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1
Severe intractable pain with paresthesia and severe dyspnea produced by lung cancer involv- ing both brachial plexuses, refractory to ordinary pharmacologic approaches, was managed by epidural morphine and bupivacaine administration with the continuous Baxter infusion system. Chest pain, which is somatic pain in character, was well managed with the epidural morphine and bupivacaine administrations. However paresthesia and tingling sensation of the hand and forearm were poorly controlled by epidural morphine, and were finally managed by bolus epidural injections of bupivacaine. Supportive therapy included epidural steroid injection and TENS, but the effect was not satis- factory. Severe dyspnea seemed to aggrevate cancer related pain.