1.Unexplained episode of sensory-motor deficit following lumbar epidural analgesia
Dibyadip MUKHERJEE ; Sujeet GAUTAM ; Anil AGARWAL ; Sandeep KHUBA ; Sanjay KUMAR
The Korean Journal of Pain 2019;32(1):53-54
No abstract available.
Analgesia, Epidural
2.Comparison between combination of marcaine and fentanyl with marcaine alone during epidural block for lumbar discectomy
Journal of Practical Medicine 2002;435(11):32-35
A prospective study involved 64 patients (43 men, 21 women) aged from 20 to 62 years with lumbar disc herniation who had operated at Military Hospital 103. These patients were divided into 2 groups. Group 1 received marcaine (0.25%-0.375%) plus fentanyl, group 2 received marcaine (0.35% - 0.5%) alone for lumbar epidural anesthesia. The volume of local anesthetic solutions injected epidurally was calculated based on number of segments that had to block, with dose of 1.5 - 1.6 ml per segment. The results showed that compare with marcaine alone, the combination of marcaine and fentanyl provided better analgesic effect, faster onset and longer duration of action, caused milder hemodynamic changes, decreased the incidence of adverse effects and produced satisfactory post-operative condition
Bupivacaine
;
Fentanyl
;
Analgesia, Epidural
3.Chronic Spinal Epidural Abscess after Epidural Analgesia: Case Report.
Tai Ki YANG ; Keun Su KIM ; Jung Chung LEE
Journal of Korean Neurosurgical Society 2003;33(6):599-601
Three cases of chronic spinal epidural abscess following spinal epidural analgesia are presented. Spinal epidural abscess is a relatively rare infectious disease. It has recently increased in frequency due to the increased use of epidural steroid injections and epidural analgesia. It is very difficult to detect the spinal epidural abscess from its variable symptoms. So, it is important in making a diagnosis of epidural abscess to take into account the previous history of epidural analgesia.
Analgesia, Epidural*
;
Communicable Diseases
;
Diagnosis
;
Epidural Abscess*
4.Efficacy of Patient-Controlled Epidural Analgesia according to Changes of Continuous Background Infusion Volume.
Dong Hee KIM ; Choong Hak PARK ; Sook LEE
Korean Journal of Anesthesiology 1997;33(5):937-943
BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) for post-cesarean section pain control and compared the suitability of four different volumes of continuous background infusion (CBI). METHODS: Sixty patients were received 0.125% bupivacaine with 5 g/ml fentanyl by PCEA (2 ml of demand dose and 10 minutes of lockout interval) and CBI. Experimental groups were divided four groups according to the volumes of CBI; 1 ml/hr, 2 ml.hr, 3 ml/hr and 4 ml/hr of CBI during 48 hours postoperatively. RESULTS: Total amount of fentanyl and bupivacaine consumption was significantly higher in 1ml/hr of CBI group than 2 ml/hr of CBI group during first 24 hours, and in 4 ml/hr of CBI group than 1 ml/hr and 3 ml/hr of CBI group during second 24 hours. CBI/maximum hourly demand dose was 15~23%. There is no significant difference between the groups in pain score, side effects and patient's satisfaction. CONCLUSIONS: This study suggests that two or three ml/hr of CBI can provide the most effective postoperative analgesia and the optimal ratio of CBI/maximum hourly demand dose is about 20%.
Analgesia
;
Analgesia, Epidural*
;
Bupivacaine
;
Fentanyl
;
Humans
5.Perioperative Pain Management in the Patient with Complex Regional Pain Syndrome: A case report.
Ji Yon JO ; Mi Geum LEE ; Hyo Min LEE ; Yun Suk CHOI ; Hey Jeong YUN ; Chul Joong LEE ; Sang Chul LEE ; Yong Chul KIM
The Korean Journal of Pain 2006;19(2):218-222
Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.
Analgesia
;
Analgesia, Epidural
;
Female
;
Humans
;
Pain Management*
6.A comparative study of epidural bupivacaine and epidural bupivacaine with clonidine in providing intraoperative and postoperative analgesia in Filipino gynecologic patients: A randomized, double-blind, clinical trial
Odi Tygran Romeo C. ; Jose Geraldine Raphaela B. ; Evangelista Enrico P ; de la Cruz-Odi Merle F.
Philippine Journal of Anesthesiology 1999;11(1):13-20
BACKGROUND: Clonidine, an alpha-agonist has been postulated to produce analgesia centrally by stimulating the post-synaptic activity of norepinephrine through receptors distinct from opioid receptors and peripherally through a mechanism similar to local anesthetics. It has been suggested that the use of a combination of local anesthetics and clonidine both at lower doses may be effective in providing adequate analgesia at the same time minimizing the deleterious side effects of each drug when used alone at higher doses. The objective of the study was the determination of the minimum dosage of clonidine in combination with bupivacaine necessary for epidural administration that would provide optimal intraoperative and postoperative analgesia with the least occurrence of side effects such as hypotension and bradycardia.
METHODOLOGY: One hundred randomly selected, healthy ASA l and 2 gynecologic patients undergoing lower abdominal surgery under epidural anesthesia were given bupivacaine 0.5 percent epidurally compounded with either saline as placebo (Group 1), or clonidine in variable doses: 0.5 ug/kg (Group 2), 1.0 ug/kg (Group 3), and 1.5 ug/kg (Group 4) in a randomized, double-blind fashion. The vital signs were noted every 5 minutes. Analgesia was monitored and recorded using the Visual Analog Scale (VAS), Verbal Rate Scoring and the systemic indicators of pain perception (SBP 30 min Hg increase from baseline or heart rate 20 percent from baseline). A top-up dose of Lidocaine 2 percent was given with systemic indications of pain perception noted intraoperatively or rescue doses of opioids were given when the systemic indications of pain perception were noted at the post anesthesia care unit, upon which data collection was terminated Eighty two patients completed the course of data collection while eighteen were dropped out because of sacral sparing, retraction pain and extension of incision. The statistical tool utilized to test significant differences between the groups was the Kruskal-Wallis Analysis of Variance test and the Partitioned Chi-square test.
RESULTS: There is prolongation in the duration of analgesia with incremental increase in clonidine dose. Hypotension occurred even without the addition of clonidine with higher incidence as the dose of clonidine increased. The least side effects occurred with doses of clonidine between 0.5 and 1.0 ug/kg.
CONCLUSION: The optimal dosage of clonidine for intraoperative analgesia that would extend to the postoperative period in Filipino women would fall between 0.5 to 1.0 ug/kg. (Author)
Human
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ANALGESIA
;
BUPIVACAINE
;
CLONIDINE
;
ANALGESIA, EPIDURAL
7.Proceedings of the tripartite symposium epidural versus non-epidural analgesia in labor and delivery
Philippine Journal of Anesthesiology 2000;12(1):51-57
Epidural analgesia provides effective pain control during labor. It however become the subject of controversy in recent years due to the perceived adverse effect on labor and delivery. There has been numerous debates concerning the effects of epidural analgesia on the progress of labor, use of oxytocin, instrumental delivery, cesarean section, neonatal and maternal effects.
ANALGESIA
;
ANALGESIA, EPIDURAL
;
LABOR PAIN
;
CESAREAN SECTION
8.Distance from Skin in the Lumbar Epidural Space in Korean Adult Male.
Zoong Han SONG ; Yun Sik KANG ; Tae Wan CHUN ; Kyung Hang CHO
Korean Journal of Anesthesiology 1994;27(11):1635-1638
The distance fmm skin to the lumber epidural space was measured in 60 male patients receiving epidural analgesia. The mean distance was found to be 4.45cm. The epidural depths were identified most frequently at 4.0 to 4.5cm deep and over 90% of total cases were less than 5.5cm deep. The epidural depths had correlations with weight and PI(P < 0.001), but not correlated with height.
Adult*
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Analgesia, Epidural
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Epidural Space*
;
Humans
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Male*
;
Skin*
9.Efficacy of Epidural Anesthesia on Uterine Contraction.
Yoon Geun LEE ; Woon Yi BAEK ; Jung Gil HONG ; Jin Woong PARK ; Byng Kwon KIM
Korean Journal of Anesthesiology 1990;23(3):464-469
The aim of this investigation was to determine whether epidural analgesia has any effect on the uterine activity. Uterine activity was checked by an intermal tocometer and calculated in uterine activity units (UAU) which were expressed as Montevideo units. Twenty two gravidas who had the term pregnancy in labor without any obstertical complications were selected and epidural analgesia was performed in 17 of these patients. Plain lidocaine was used in 10 of them, lidocaine mixed with epinephrine (200,000:1) was used in another 7 gravidas and 5 gravidas were chosen as a control group. The results were as follows: The uterine actvity of the continuous epidural anesthesia group did not differ from that of the control group. The uterine activity changes were not statistically significant between the plain Iidocaine group and the epinephrine mixed group.
Analgesia, Epidural
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Anesthesia, Epidural*
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Epinephrine
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Humans
;
Lidocaine
;
Pregnancy
;
Uterine Contraction*
10.The Breakage of Epidural Catheter during Continuous Epidural Analgesia for Cancer Pain: A case report.
Jong Ik KIM ; Deok Kyu KIM ; Jeong Woo LEE ; Ji Seon SON
Korean Journal of Anesthesiology 2007;53(4):513-515
During pain control by continuous epidural analgesia, the breakage of epidural catheter is a very rare complication. We experienced breakage of epidural catheter in patient of cancer pain during continuous epidural analgesia. We performed epidural catheterization between T12 and L1 level for pain control. After 6 weeks of epidural catheterization, abruptly patient complained severe pain. When we applied negative pressure to catheter by syringe before epidural injection of bolus dose, a few airs were aspirated. We strongly suspected breakage of catheter, and the breakage in 1617 cm from epidural catheter tip was confirmed by normal saline administration via epidural catheter. After new epidural catheter inserted again, patient's pain was controlled by VAS 24 and another complications were not appeared. We must carefully manage the catheter because of complications of epidural catheter.
Analgesia, Epidural*
;
Catheterization
;
Catheters*
;
Humans
;
Injections, Epidural
;
Syringes