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혈관성 원인이 복합부위통증증후군에서의 Triamcinolone 을 사용한 반복적 요부교감신경절차단의 효과 - 증례 보고 -
정성미(Sung Mee Jung),한경림(Kyung Ream Han),옥경종(Kyung Jong Ock),박수경(Soo Kyeong Park),김찬(Chan Kim),김진수(Jin Soo Kim),황혁이(Hyuk E . Hwang) 대한통증학회 2001 The Korean Journal of Pain Vol.14 No.1
Complex regional pain syndrome type I of vascular origin is difficult to detect unless the classic symptoms and signs exist and/or overt extremity trauma has precipitated the pain. The diagnosis is confirmed by relief of pain following a sympathetic nerve blockade. A 36-year-old woman with arterial occlusive disease of the right lower extremity presented with burning pain and hyperesthesia after sprain had occurred which was accompanied by motor weakness of right ankle. A lumbar sympathetic ganglion blockade with 2% lidocaine 10 ml and triamcinolone 80 mg produced prompt improvement of the pain and motion.
Pfannenstiel 절개로 수술후 양측 장골서혜신경과 장골하복신경차단을 이용한 통증관리
신우종,염종훈,김경헌,옥경종,민용진 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.3
Background: Epidural administration of morphine is a common method for postoperative analgesia in the lower abdominal surgery, but many complications can be produced. Since the pfannenstial incision lies within L1 dermatome, bilateral ilioinguinal and iliohypogastric nerve blocks(IINB) should provide analgesia after surgery through that incision. Methods: Forty patients undergoing cesarean delivery or total abdominal hysterectomy(TAH) through a pfannenstiel incision were randomly assigned to one of two groups: epidural morphine group(n=20) received 3 mg of morphine epidurally after surgery with epidural anesthesia; IINB group(n=20) performed IINB with 0.5% bupivacaine, 10 ml to each side after surgery with general anesthesia. Visual analogue scale(VAS) scores at resting and moving state, and complications were checked at 0, 2, 4, 8, 12, 24 hours after surgery. Results : Postoperative VAS scores did not show significant differences between the two groups at rest after 0, 2, 4, 8, 12, 24 hours and at moving state after 0, 2, 4 hours, but IINB group had less pain with movement than epidural morphine group at 8, 12, 24 hours after surgery(p$lt;0.05). The incidence of pruritus was rare in IINB group(P$lt;0.05), but incidences of other complications were not significantly different between the two groups. Conclusions : IINB is effective for analgesia after surgery through a pfannenstiel incision because of a lower incidence of complications and less postoperative pain with movement than epidural morphine, and can be performed to patients who have contraindications and difficulty for epidural analgesia. (Korean J Anesthesiol 1997; 32: 440∼444)