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윤덕미,서영선,오흥근,Yoon, Duck-Mi,Suh, Young-Sun,Oh, Hung-Kun 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.1
Three hundred and eighty-nine cases of splanchnic nerve block were retrospectively divided into 3 groups according to the change of alcohol concentration. In Group 1 (26 cases), about 7 ml of 1% lidocaine was used bilaterally as test block followed by an injection of 20 ml of 50% alcohol bilaterally. In Group 2 (286 cases) the same test block was followed by the same amount of pure and 50% alcohol. In Group 3 (77 cases) and used 30 ml of 75% alcohol bilaterally. The overall success rate of the first alcohol block in group 1, 2 and 3 was 73.1%, 92.0% and 84.4% respectively. From the above results, that splanchnic nerve block by pure alcohol was the most reliable method for upper abdominal cancer patients.
윤덕미,Yoon, Duck-Mi 한국호스피스완화의료학회 2009 한국호스피스.완화의료학회지 Vol.12 No.2
암성 통증의 80%는 진통제를 투여하는 약물치료로서 조절될수 있지만 $10{\sim}20%$는 다른 대책이 필요하다. 신경파괴제를 사용하는 블록은 이런 경우 중요한 역할을 한다. 신경블록은 암환자의 통증을 예방하고 삶의 질을 증가시킬수 있다. 특히 암성 통증이 신체 말단부위나 어떤 한 부위에 국한되 있는 경우 말초신경블록이나 교감신경블록은 좋은 효과를 나타낸다. 신경파괴제를 사용하는 교감신경블록 특히 복강신경총블록은 조기에 시행하면 훨씬 효과적이며 장기간 효과를 나타낸다. 환자 선택이 성공적인 결과를 얻는데 중요하다. 신경파괴제를 사용하는 신경블록은 복부 및 골반강내 암성통증을 감소시키고 진통제의 사용량을 감소시킬뿐 아니라 진통제에 관련된 부작용을 감소시키므로서 삶의 질을 향상시킨다. 따라서 조기단계에서 보다 적극적인 신경블록요법이 권고된다. More than 80% of cancer-related pain is pharmacologically controllable, whereas $10{\sim}20%$ of patients require interventional treatments. Neurolytic nerve block can play a major role in cancer pain treatment, and it has been proposed to prevent the development of pain and improve the quality of life of patients with cancer. If the pain is well localized and restricted to certain peripheral parts of the body, spinal peripheral or sympathetic nerve blocks may result in excellent therapeutic effects. Neurolytic sympathetic block, especially Celiac plexsus block (CPB) performed in earlier stages, is effective with successful long term results. However, selection of patients is critical for succeful outcomes. Neurolytic plexus block significantly improves the quality of life of patients and reduces abdominal and pelvic cancer pain, analgesic consumption and adverse opioids-related side effects. Interventional pain management should be considered at earlier stages to provide patients with the best quality of life possible.
Buprenorphine 천골강내(薦骨腔內) 주입(注入)에 의(依)한 술후(術後) 제통효과(除痛效果)
윤덕미,고순영,오흥근,Yoon, Duck-Mi,Koh, Soon-Young,Oh, Hung-Kun 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.1
Caudal buprenorphine was investigated as a postoperative analgesic in a randominzed double blind study of 45 patients after abdominal surgery. At the end of surgery, patients were given 0.2 mg of caudal buprenorphine in 20 ml saline(n=30, experimental group) or no injection(n=15, control group). Pain relief was evaluated by the subsequent need for systemic analgesics(pethidine). Arterial blood gas and micturition disturbance were evaluated. In the buprenophine group, use of systemic analgesics was significantly reduced for the first 24 hours postoperatively. Arterial blond gas study values 2 hollers after buprenorphine administration were within normal range. 8 patients of the buprenorphine group developed urinary retention requiring temporary Nelaton catheterization of the bladder. Caudal buprenorphine for postoperative pain control was a good alternate method of postoperative pain management.
윤덕미(Duck Mi Yoon),이시자끼 게이지(Keiji Ishizak 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.1
N/A Upper thoracic sympathectomy is valuable for patients with vascular occlusive disease and other painful upper extremity diseases. We performed l0 upper thoracic sympahthectomies by percutaneous radiofrequency destruc- tion in painful disorder of upper extremity. Patients were supine and the needle was inserted paratracheally under C-arm fluoroscope. The second and third thoracic sympathetic gangla were destructed by radiofrequency lesion generator. Each lesion was made with a tip temperature of 90℃, 90 seconds. Good to excellent results were achieved in all patients without any adverse effect. Seven patients revealed complete sympatholytic effect and other three patients were showen signs of partial sympathetic block. Two patients were persisted sympatholytic effect for 18month in and other 5 patients were persisted sympatholytic effect at present(follow up period: mean 5.8 mon). Percutaneous radiofrequency upper thoracic sympathectomy with anterior paratracheal ap- proach is an effective and a safe method.
윤덕미(Duck Mi Yoon),이윤우(Youn Woo Lee),오흥근(H 대한통증학회 1991 The Korean Journal of Pain Vol.4 No.1
N/A Continuous epidural analgesia is widely used in pain management. We investigates the in- cidence of contamination of epidural catheters used in epidural catheters for pain control. The tips of epidural catheters were examined for bacterial growth after use. In culture from 250 patients undergoing continuous epidural catheterization, 33(l3.2%) catheters were found to be contaminated: staphylococcus epidermis 66.9%; staphylococcus aureus l2.1%; alpha streptococcus l2.1%; and others 9.l%. One significant epidural infec- tion occured. One of the most common causes of the epidural infection during long time ep- idural block is the transmission of the microorganism from the contaminated skin to the epidural space along the epidural catheter. To prevent epidural infection, sterilization of the skin around the epidural catheter is essentiaL
윤덕미(Duck Mi Yoon),김창호(Chang Ho Kim),이윤우( 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.1
We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was treated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunts hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.
윤덕미(Duck Mi Yoon),이윤우(Youn Woo Lee),박원선(W 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2
Back pain with sciatica is a common clinical syndrome that may be the expression of an uncommon pathological process. We describe a case of retroperitoneal lymphoma mimicking herniated lumbar disc. 62 year old male patient with a clinical picture of sciatica as a first manifestation of retroperitoneal lymphoma. His pain was not response to conventional therapy, and progressively worsened. We reevaluated him and found huge retroperitoneal lymphoma in his pelvic cavity. So we discuss how to identify the few who had extra attention. It is important to rule out occult pathology in patient with an atypical presentation. In assessing a patient with a low back pain, accurate evaluation require a logical, step by step method.