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암성 통증 조절을 위한 자가통증조절장치를 이용한 몰핀의 지속적 피하투여
이경호(Kyong Ho Lee),이 철(Cheng Lee),김원태(Wen T 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2
Most of the patients with pain resulting from advanced cancer need opioid for adequate analgesia. Various methods of drug administration to control the pain have been developed. One of them, continuous administration of intravenous morphine is used for more effective pain control in the patient with severe pain that cannot be satisfactorily controlled by other methods of morphine administration. But this is not a suitable method at home because of the possibility of serious infectious complications and the difficulty in managing intravenous access by untrained personnel. Continuous subcutaneous adminstration of drugs can not only overcome such disadvantages of continuous intravenous infusion but also get almost the same effect of pain control as continuous intravenous infusion, and allows opportunity to move freely and return home, improving quality of life. We used continuous subcutaneous morphine and metoclopramide in the patients with cancer pain via a portable PCA device, and accomplished satisfactory pain relief without significant side effect.
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Three Cases of Spontaneous Intracranial Hypotension (SIH) Treated with Epidural Blood Patch
신진우,윤창섭,이 철 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.1
Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most char- acteristic symptom is an occipital or frontal headache which is aggrevated in the erect position and relieved in the supine position. This syndmme usually resolves spontaneously or with strict bed rest. When the headach persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. Epidural blood produces an organized clot which effectively tamponade any dural CSF leak The rapid relief of headache immediately after the infusion of blood occur by some other mechanism, such as an increase in subarachnoid pressure that is known to occur with infusion of fluid into the lumbar epidural Space. We report three cases of spontaneous intracranial hypotension successfully treated with epidural blood patch.
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