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Yang Jaeyoung,Kim Seonjin,Lee Bousung,Lee Kwanghaeng,Kim Dongseok,Lee Jaedo,Jun Hee Jung,Yoon Jin Sun,Cho Sam Soon 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.3
BackgroundAn airway assessment is usually best performed before an elective operation. But in an emergency operation, proper airway assessment can often be difficult. Fiberoptic intubation is a powerful and safe technique to deal with airway difficulty, but it requires a lot of training to be able to perform correctly. There are various specialized oral airways for fiberoptic intubation, but none of them have perfect functionality.CaseA 75-year-old male (body weight 71.6 kg, height 159.3 cm, body mass index 28.22 kg/m2) was diagnosed with acute appendicitis, and it was decided to do a laparoscopic appendectomy. After the induction of general anesthesia, it was impossible to insert the direct laryngoscope deep enough for vocal cord visualization without damaging the teeth because of limited mouth opening. We successfully performed fiberoptic intubation with a newly modified Guedel airway via a longitudinal channel on the convex side and a distal opened lingual end.ConclusionsOur modified Guedel airway can be useful in assisting fiberoptic intubation in unexpectedly difficult airway situations.
원종찬,Sungryul Yoon,정준혁,Bousung Lee,Kwanghaeng Lee,Dongseok Kim,Jaedo Lee,최락민,Jaeyoung Yang 대한통증연구학회 2020 International Journal of Pain Vol.11 No.1
Various complications after Percutaneous epidural neuroplasty (PEN), such as mechanical catheter failure, bleeding, infection, and neurological damage, were reported. A 79 years-old male suffered from spondylodiscitis and paraspinal muscle infection without epidural space involvement after lumbar PEN. The postprocedural infection was difficult to diagnose, because the patient didn’t have common signs and symptoms of infections such as fever, malaise, redness or swelling and hot sense around wound. After 7 weeks of antibiotics treatment, the hospital discharge decision was made, because his lab values and vital sign were almost normal. Most of all, he was symptom free. Early detection of post procedural infection followed by the early administration of antibiotics should be the most important therapeutic strategy for better prognosis.
Opioid-induced hyperalgesia after implantation of intrathecal morphine pump: a case report
Sungryul Yoon,Rakmin Choi,Jaedo Lee,Jongchan Won,Bousung Lee,Kwanghaeng Lee,Dongseok Kim,Jaeyoung Yang 조선대학교 의학연구원 2020 Medical Bilogical Science and Engineering Vol.3 No.2
Opioid-induced hyperalgesia is characterized by an increased pain response to noxious stimuli despite increased use of opioid medications. Here, we report the case of a 43-year-old woman diagnosed with post-laminectomy syndrome who presented with an increasing pain score following a morphine infusion via an implanted intrathecal drug delivery device. Her pain improved after reducing opioid doses and the administration of intravenous ketamine infusion therapy. Thus, the early suspicion of opioid-induced hyperalgesia is essential for patients with increasing pain refractory to augmented doses of opioid medications.