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하지 방산통에 대한 Pulsed Radiofrequency Thermocoagulation : 단기적 추적결과
심재철(Jae Chol Shim),조희영(Hee Young Cho),김동원(Dong Won Kim),승익상(Ik Sang Seung) 대한통증학회 2002 The Korean Journal of Pain Vol.15 No.1
N/A Background: Application of pulsed radiofrequency (RF) current to the dorsal root ganglion has been reported produce short term relief of spinal pain without causing thermal ablation in failed back surgery patients. The present study was undertaken to investigate the influence of pulsed RF thermocoagulation of dorsal root ganglion for chronic segmental pain radiating to the legs. Methods: It was an open, prospective, pilot study of the effect of pulsed RF adjacent to the dorsal root ganglion in patients with radiating lower extremity pain. Following diagnostic segmental block, a maximum of 2 dorsal root ganglia were treated. Out of 23 patients, 6 were lost to follow up, and pulsed RF was applied to the remaining 17. The short term effect of pulsed RF treatment (20 msec RF pulse delivered at a rate of 2Hz for 240 sex to produce of original pain. Five cases were successful out of 19 cases at a mean follow up period of 44.8 < 18.6 days. Transient motor weakness was observed (duration 7 days) in one case. We also found transient pain relief in patients whose pain relief was not successful (duration; 3-35 days) Conclusions: Treatment with pulsed, but not continuous, RF was associated with improvement of radiating pain in patients with or without spinal surgery. The electromagnetic field may be instrumental in producing the clinical effect of the RF lesion adjacent to the dorsal root ganglion. If a meticulous technique of pulsed RF and patient selection criteria for pulsed RF were prepared, pulsed RF would be a useful treatment modality for pain clinicians who are treating radiating pain of lower extremities.
폐쇄식 마취용 Physio Flex 마취기의 임상 사용경험
승익상 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.4
Background : The anesthesia machine PhysioFlex was especially constructed to deliver anesthetics in a closed circuit system. In this anesthesia machine the concentrations of the respiratory gases and the gas volume in the circle system are automatically controlled by a feedback mechanism. The aim of this study is to introduce 1,132 patients who have received general anesthesia in a closed circuit system using PhysioFlex, and to calculate the real consumed amount of oxygen and nitrous oxide, and to describe the advantages and disadvantages of PhysioFlex for clinical uses. Method : The author used a PhysioFlex in cases of 1,132 various surgical interventions. After induction with thiopentone and suxamethonium, general anesthesia was maintained with nitrous oxide in 50% oxygen and enflurane (or isoflurane, halothane) and supplemented with nalbuphine and pancuronium. These cases were analyzed by their sex, age, height, weight, method of airway maintenance during general anesthesia, operation position, anesthesia time, and arterial blood gases by review of anesthesia records. Average minute-consumed amount of oxygen and nitrous oxide was calculated by recording every 30 seconds throughout the anesthesia procedures except preoxygenation and flush periods. The advantages and disadvantages of PhysioFlex were described on the base of the author's clinical experience. Results : The anesthetic technique of the closed circuit system by PhysioFlex could be used adequately for any surgical procedures. In this system consumed amounts of oxygen and nitrous oxide were 179.72±2.48 ml/min and 88.49±2.78 ml/min respectively. The author found out several advantages and few disadvantages of PhysioFlex for its clinical uses. Conclusions : Closed circuit system of PhysioFlex anesthesia machine offer numerous advantages such as reduction of gas consumption, low cost, less pollution in both the operating theater and the environment, increase in inspired gas humidity, easy handling of machine, and excellent respiratory alarm sysms. (Korean J Anesthesiol 1999; 36: 571∼576)