http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
이현숙,김수연,김명희,김정환,방은치,강용인,조경숙,김수연 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.12
목적 : 무통분만을 위해 시행한 지속적 경막외제통이 분만에 미치는 영향을 살펴보고자 하였다. 연구방법 : 분만시 통증경감을 원하는 산모를 두군으로 나누어 자궁경부가 3-5cm 개대시 1군 산모 35명은 0.0625% bupivacaine과 0.2㎍/㎖ fentanyl을 혼합하여 지속적 경막외제통을 시행하였고, 2군 산모 43명은 nalbuphine 10mg을 근주하였다. 1군과 2군에서 분만 1기와 2기의 진행시 소요된 시간, 제왕절개술의 빈도, 신생아의 Apgar score 및 체중을 기록하였고 통증 정도는 0-100mm의 시각통증등급에따라 측정하였다. 통계는 모수검정에는 independent t-test, 비모수검정에는 chi-square test를 이용하여 p〈0.05인 경우 통계적 의의를 두었다. 결과 : 1. 1군에서 분만 1기와 2기가 연장되었지만 통계적 차이는 없었다. 2. 신생아의 체중 및 Apgar score는 두 군간에 차이가 없었다. 3. 제왕절개술의 빈도는 1군이 16%(7/35), 2군이 14%(6/43)로 두 군간에 유의한 차이는 없었다. 4. 통증정도는 1군에서 유의하게 낮았다. 결론 : 분만진통시 시행하는 경막외제통은 분만의 진행과정에 지장을 주지 않았고 제왕절개술의 빈도도 높이지 않았다. 경막외제통은 태아나 산모에게 안전하게 시행될 수 있으나 산모선택이나 마취방법, 산과적 수기에 세심한 주의가 필요하다고 사료된다. Background : The effect of epidural analgesia on the progress of labor is controversial. The objective of this study is to determine the effect of analgesia on the outcome of labor, especially cesarean delivery rate in the epidural group and non-epidural group, prospectively. Methods : All the parturients were divided into two groups, group 1(epidural group, n=35) and group 2(non-epidural group, intramuscular nalbuphine, n=43) randomly. Epidural analgesia was maintained with a continuous epidural injection of 0.0625% bupivacaine with 0.2 ㎍/㎖ fentanyl in the group 1 and nalbuphine 10 ㎎ was intramuscular injected in the group 2 when the cervix was dilated to at least 3-5 ㎝. The duration of first and second stage of labor, cesarean delivery rate, Apgar score and body weight of baby were recorded and pain score of parturient was recorded by 0-100 ㎜ visual analog scale. Results : The duration of first and second stage labor were prolonged in the group 1. But there were no significant differences in the duration of first and second stage labor, Apgar score and body weight of baby between the two groups. Cesarean delivery rate was 16%(n= 7/35) in the group 1 and 14%(n= 6/43) in the group 2, so there was no significant difference between the two groups. Pain score was significantly lower in the group 1 than the group 2. Conclusion : Epidural analgesia was not associated with increased cesarean delivery rate and provided safe and effective intrapartum pain control. Maternal-fetal factors and obstetric management, not epidural analgesia, are the most important determinants of the cesarean delivery rate.
방은치(Eun Chi Bang),윤덕미(Duck Mi Yoon),오흥근(H 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1
Coccygodynia is severe burning pain around the coccyx and idiopathic coccygodynia refers to the forms of coccygeal pain that are not associated with well defined pathological conditions, such as recent fractures, dislocation, infectious diseases, or tumors of the coccyx. We experienced a case of coccygodynia in which patient had suffered from intermittent se-Were pain around the coccyx for nine years without a well defined cause. So coccygeal nerve block and low caudal blocks were performed with local anesthetics and steroid and the pain was controlled effectively.