신경통증클리닉 환자의 1년간 통계 고찰

양승곤(Seung Ko Yang),이성연(Seong Yeon Lee),채동 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.2

N/A l,666 patients treated by nerve block from September 1994 to August 1995 we statistical- ly analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Dis- eases and ailments were as follows. low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7/, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trig- ger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows- facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic gan- glion block 15.4%.

경막외 카테터의 장기간 거치시 말단부의 감염 조사

양승곤(Seung Ko Yang),이희전(Hee Jeon Lee),김승희( 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.2

N/A The incidence of contamination of epidural catheters used for pain control was investi- gated. To prevent epidural infection, all patients with epidural catheters had taken amoxacillin 1.5gm/day orally. Of the cultures of catheters catched from 303 patients undergoing contin- uous epidural catheterization, 5 catheters(1.7%) were found to be contaminated; cervical 1/ 86(l.2%), thoracic l/27(3.7%), and lumbar 3/190(l.6%). Staphylococcus epidermidis was the most common etiologic agent(60%). To prevent epidural infection, sterilization of the skin around the epidural catheter and prophylactic use of broad-spectrum antibiotics are thought to be beneficial.

교감신경절 차단에 의한 동상합병증 환자의 치료 경험 - 증례보고 -

양승곤(Seung Ko Yang),이희전(Hee Jeon Lee),황현정( 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

Frostbite involves freezing of tissues and usually affects the distal aspects of the ex- tremities or exposed parts of the face, such as the ears, nose, chin, and cheeks. It pro- duces tissue injury by ice crystal formation between the cells, cellular dehydration, and microvascular occulsion. There are four degrees of frostbite. First degree is accompanied by erythema and edema, second degree, by vesiculation, blistering, and eschar formation, third degree, by hemorrhagic blistering and bluish gray discoloration, and fourth degree, by injury to subcutaneous tissue, muscle, tendon, and bone leading to mottled, dry, black, and necrotic changes We succesafelly treated 2. patients suffering from frostbite by per- forming sympathetic ganglion block with pure alcohol We concluded sympathetic ganglion block is one of the most effective treatments for frostbite.

좌측 하지의 관절구축을 동반한 작열통의 치험

양승곤(Seung Ko Yang),윤덕미(Duck Mi Yoon),오흥근( 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.1

Causalgia is a symptom complex usually consisting of burning pain, hyperesthesia and atro- phy of the involved extremity. The pain may be aggravated by contact, motion of extremity or emotional excitement. It occurs following incomplete nerve injury. The patient was a 58-year-old male with a 3-year history of causalgic pain of left lower ex- tremity. He had multiple fractures with degloving injury of left lower extremity in an automo- bile accident. The pain was exacerbated by movement, and he experienced knee joint and ankle joint contracture. The patients pain decreased after continuous epidural block with 1% lidocaine and 0.25% bupivacaine. He also received lumbar sympathetic ganglion alcohol block resulting in much im-provement of level of pain and walking disturbance.

흉부 교감신경절 차단 후 발생한 편측 하지마비 - 증례보고 -

김성모(Sung Mo Kim),양승곤(Seung Ko Yang),이효근(H 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

We treated a patient who experienced motor weakness and sensory change on left lower ex- tremity after thoracic sympathetic ganglion block with pure alcohol. The following factors were suspected of contributing to neurologic complication: ischemia of spinal cord, ­ infec- tion, ® re-expression and aggravation of pre-existing neurologic disease, ? improper position. Patient spontaneously recovered from neurologic complication with conservative therapy.

소아에서 사시 교정 수술후 구역 구토의 예방

김종래,길혜금,방은치,양승곤 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.4

Nausea and vomiting are common problems after strabismus surgery in pediatric patients. We compared the effects of droperidol and ephedrine with conventional regimen consisting of halothane-N_2O to the effects of conventional regimen itself. 69 children, ASA physical status 1, aged 1-12yrs, were studied. Each child was randomly assigned to receive droperidol 0.04 mg/kg, ephedrine 0.5 mg/kg or normal saline 2ml intramuscularly, 10 minutes before the end of surgery. The incidence of postanesthetic nausea and vomiting was 17% in the droperidol group(p<0.05), 13% in the ephedrine group(p<0.05), which were significantly less than the control group(43%). But there was no significant difference between droperidol group and ephedrine group. We concluded that droperidol and ephedrine have significant postoperative antiemetic effect in patients undergoing strabismus surgery.

지속적 경부 경막외 차단 중 발생한 경막외 농양에 의한 사지마비 - 증례보고 -

이효근(Hyo Keun Lee),양승곤(Seung Ko Yang),김지영( 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper ex- tremities were developed. On admission, his temperature was 38.3 ℃ and showed progres- sive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 leveL Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus ob- tained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibi- otics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

외톨이 교감신경절 차단을 이용한 항문 주위 다한증의 치험

이효근(Hyo Keun Lee),양승곤(Seung Ko Yang),이희전( 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.2

Blockade of the ganglion impar was performed as an alternertive means of managing in- tractable neoplastic perineal pain of sympathetic origin. We successively treated a patient who had suffered from excessive perianal sweating with ganglion impar block using pure alcohol. Eight months after block, the patient has no complaint of perianal sweating. Ganglion impar block is an effective method in the treatment of excessive perianai sweating as well as perineal pain of sympathetic origin.

안면경련 환자에서 안면신경 차단의 추적조사

김 찬(Chan Kim),양승곤(Seung Ko Yang),이효근(Hyo K 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

N/A Hemifacial spasm commonly occurs in muscles about the eye, but may also involve or spread to the entire side of the face. One hundred and seventy eight patients with hemifacial spasm visited our Neuro-Pain clinic from January 1992 to April 1996. There were l2l female and 57 male patients, a 2.1: I ratio respectively. Largest percent- ages of patients were in the 50 year old range. Among them, 96 patients were treated by facial nerve block or OBrien block. In most cases, induced facial palsy disappeared within one or two months. Among the 96 patients who received nerve block, 46 patients received a second block within 5 to 25 months. The average interval from first and second nerve block was 11.5 months. After nerve block, all patients were free from spasm for 1 to 2l months. We conclude that facial nerve block is a satisfactory and reliable method for the treatment of facial spasm.

쥐에서 Phenytoin 의 단회 및 장기 투여가 Vecuronium 의 근이와작용에 미치는 영향

신양식,김종래,이종석,김진수,박광원,양승곤 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.4

The effects of phenytoin on the neuromuscular blockades(NMBs) appear to be different according to the time intervals between their administration. In general, single injection of phenytoin immediately prior to NMB may produce the augmentation of NMBs, while long-term phenytoin therapy on the neuromuscular blocking actions of vecuronium were investigated in rats using the sciatic nerve-anterior tibialis muscle preparation. Eighteen male rats were divided randomly into three groups; Group I(without phenytoin), II (single phenytoin 40 mg/kg I.V. just prior to vecuronium administration), III(phenytoin 40 mg/ kg administered intraperitoneally twice daily for 14 days). In all the groups, vecuronium with the cumulative dose-response technique of ED was administered intravenously. The results are as follows; 1) The ED of vecuronium was significantly higher in Group III(162.3±12.4 ㎍/kg) than in Group I or II(135.7±11.0 or 126.77 ±16.66 ㎍/kg, respectively), and also the ED did so(218.1 ±28.3 or respectively). 2)e cumulative dose-response curves with vecuronium, the slope of Group III was significantly lower than that of Group I or IL 3) The plasma concentrations of phenytoin in Group II and III were 60.9±15.1 ㎍/ml and 9.0±2.3 ㎍/ml, respectively. 4) The duration of vecuronium was significantly shorter in Group III(22.3±5.2 sec) than in Group I or II(34.7±5.7, 44.3±8.7 sec, respectively), and also the recovery index did so(36.8±4.4, 43.8±5.6 and 27.7±5.7 sec in Group I, II and III, respectively). 5) There was no statistically significant difference of mean arterial pressure, heart rate, body temperature, acid-base status and electrolytes among groups. In conclusion, pheytoin with long-term therapy may induce the resistance to vecuronium and shorten its recovery. However, there is no effect in the single injection of phenytoin on the vecuronium-induced neuromuscular block.