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TCI(Target Controlled Infusion)를 이용한 Propofol 의 수면 상태하 신경차단술
오완수,홍기혁,안우용 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.1
Background : The use of sedative and analgesic adjuncts during local and regional anesthesia can enhance patieet comfort and improve operative conditions. Because propofol has well-known rapid recovery characterized by clear-headedness$quot;, its use intraoperatively may result in less postoperative sedation and thus shorten the time for discharge from the hospital. The purpose of this study was designed to evaluate the patients satisfaction of hypnotic neural blockade using target controlled infusion (TCI) of propofol. Methods: Sixty-two patients scheduled to undergo elective neural blockade in the operating room were selected for this study. They had taken previous neural blockade in the awakening state. Without premedication, they amved at the operating room via pain clinic. After proper positianing, vital signs, pulse oximetry and respiratory rate were monitored. TCI of propofol was started at a target concentration of 3.0 μg/ml and an induction time of 3 minutes. We regarded loss of hand grasping power as iduction of hypnosis. Subsequently, target concentration was adjusted to a range of 0.8-1.6 times the effector site concentration at induction. Propofol infusion was stopped when the procedure was finished and the patients were transported to the recovery room and discharged. The satisfaction of patients conceming hypnotic neural blockade were evaluated by a six point numerical rating scale (6: best-1: worst). Results : Patient withdrawal movement during local anesthetic infiltration occured in 17 patients. Recovery time was 4.7 ± 3.0 min (mean ± S.D.). Patient's satisfaction for hypnotic neural blockade was 5 [3-6] (median [rangeJ]. Conclusion : Patient's satisfaction for hypnatic neural blockade was high. TCI of propofol serves as a safe sedation model during neural blockade without any residual sequelae. (Korean J Anesthesiol 2000; 39: 56~60)
만성 추간판성 요통에 대한 고주파를 이용한 추간판내 윤상성형술
오완수,강호정,김광민 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.40 No.4
Chronic discogenic low back pain remains a difficult treatment chanllenge. Also, Internal disc derangement in the lumbar spine is a common yet difficult clinical condition to treat. The reported prevalence of chronic low back pain due to intrinsic disc mediated pain is at least 40%. Internal disc derangement has characteristics such as degeneration of the collagen of the disc annulus, fissures, global disc degeneration, and herniation with or without root compression. The common treatment for chronic discogenic low back pain has been conservative, including physical therapy and pharmacological management but the effectiveness reminans controversial. Surgical fusion offers modest results at best, but ofter fails, and is associated with complications and postoperative continued pain. The intradiscal electrothermal annuloplasty has become known as a safe and effective treatment for patients suffering from discogenic pain and offers the advantage of potentially reparing the damaged disc while maintaining normal disc function. We applied a navigable catheter with a temperature controlled thernal resistive coil, deployed intradiscally through a percutaneous extrapedicular approach under two plane fluoroscopic guidance in chronic low back patients. The authors experienced tow cases of chronic discogenic pain that had failed to respond to any kind of conservative treatment but which was successfully relieved by the intradiscal electrothermal annuloplasty.
C 자형 영상증강장치를 사용한 방사선 투시하에 피부로부터 대요근 근구까지의 깊이에 대한 연구
오완수,우승훈,홍기혁,강정권 대한통증학회 2000 The Korean Journal of Pain Vol.13 No.1
Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index), Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm) x 100 (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0,05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were 6.02±0.28 cm in men, 5.44±0.22 cm in women. There is no significant correlation between the depth and other patients attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.
시상정중면에서 하악우각부 사이의 각도와 하악과두장축의 수평경사도간의 상호관계
오완수,최순철 慶北大學校 齒科大學 1989 慶北齒大論文集 Vol.6 No.3
To determine the horizontal inclination of the condylar long axis without taking the submentovertex radiograph, the author studied the interrelation between the angle formed by the midsagittal plane and the mandibular angle and the horizontal inclination of the condylar long axis. In 56 subjects, the author measured the angle formed by the midsagittal plane and both mandibualr angle using the modified Twirl Bow and the horizontal inclination of the both condylar long axis from submentovertex radiographs. The result were as follows : The mean value of the angle formed by the midsagittal plane and the mandibular angle was 18.50±1.48°in right side and 19.30±1.55° in left side. The mean value of the horizontal inclination of the condylar long axis was 19.25±7.56° in right side and 20.27±7.05° in left side. The interrelation of the two angles was represented as follows; y=20.31 -0.0094x(r=-0.482, p<0.01) in right side and y=20.64-0.066x(r=-0.301, p<0.05) in left side(y;the horizontal inclination of the condylar long axis, x;the angle formed by the midsagittal plane and the mandibular angle).