1.Accidental intrathecal injection of dopamine hydrochloride resulting in analgesic effects.
Jeong Min HONG ; Ah Reum CHO ; Sun A CHOI
Korean Journal of Anesthesiology 2014;67(Suppl):S49-S50
No abstract available.
Dopamine*
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Injections, Spinal*
2.Accidental intrathecal injection of dopamine hydrochloride resulting in analgesic effects.
Jeong Min HONG ; Ah Reum CHO ; Sun A CHOI
Korean Journal of Anesthesiology 2014;67(Suppl):S49-S50
No abstract available.
Dopamine*
;
Injections, Spinal*
3.Preganglionic Epidural Steroid Injection through Translateral Recess Approach
Seok Min HWANG ; In Seok SON ; Pei Juin YANG ; Min Seok KANG
Clinics in Orthopedic Surgery 2019;11(1):131-136
The approach we suggest was developed for cases in which the fourth and fifth lumbar and first sacral spinal nerves were affected in lumbar degenerative disc disease. Retrodiscal transforaminal epidural injection is known to be very effective for lumbar radiculopathy because of excellent access to primary pathology; however, access below L5 is often restricted by the anatomic characteristics of the L5–S1. In the translateral recess approach (TLR), proper final needle placement (i.e., in the axillary portion between the exiting and traversing nerve roots) can be achieved by setting the direction of the needle laterally and superiorly from the distal tip of the infra-adjacent spinous process toward the medial wall of the pedicle and neural foramen of the given level without neural injury. This approach is possible because of the wide interlaminar space in the L5–S1. Preganglionic epidural injection through TLR is an effective and safe spinal intervention for lumbosacral radiculopathy.
Injections, Epidural
;
Needles
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Pathology
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Radiculopathy
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Spinal Nerves
4.Respiratory Arrest following Intrathecal Administration of Morphine .
Yoon Sick SONG ; Tae Yong KIM ; Hee Sun SONG
Korean Journal of Anesthesiology 1981;14(3):336-340
Epidural and subarachnoid narcotics have raised new possibilities for selective blockade of pain transmission at the spinal cord level. However, it must still be regarded as an experimental technique until detailed pharmacological and physiological data are available, since many reports have treated the development of respiratory arrest which may be related to the dynamics fo CSF flow. We experienced 2 cases of respiratory arrest after intrathecal injection of 2mg morphine. One patient developed respiratory arrest at approximately 5 1/2 hours after intrathecal morphine and the other at approximately 12 1/2 hours. Those respiratory arrests were completely reversed with naloxone hydrochloride without interfering with the analgesic effect of the drug.
Humans
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Injections, Spinal
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Morphine*
;
Naloxone
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Narcotics
;
Spinal Cord
5.Effect of Volume on Hypobaric Spinal Anesthesia for Perianal Surgery with Prone Jacknife Position .
Yang Sik SHIN ; Kyoung Min LEE ; Hyo Keun LEE ; Jong Rae KIM ; Sung Cheol NAM
Korean Journal of Anesthesiology 1991;24(4):760-763
The effect of anesthetic volume on the spread of hypobaric tetracaine were sutdied after intrathecal injection in thirty patients with prone jackknife and 15 degree Trendelenburg position for perinal surgery. The patients were assigned randomly into the one of three groups divided by the 3, 4, or 5 ml of volume of anesthetic solution. The results show that the volume of tetracaine in distilled water with hypobaric spinal anesthesia in prone jackknife and l5 degree Trendelenburg position had a important effect on the anesthetic dermatomal levels in spite of slightly rapid onset with large. volume. Therefore, we concluded that for the perianal surgery in prone jackknife position, as the volume of the anes- thetic solution with hypobaric spinal anesthesia, 3 or 4 ml of the volume are sufficient to get the adequate anesthetic levels.
Anesthesia, Spinal*
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Head-Down Tilt
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Humans
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Injections, Spinal
;
Tetracaine
;
Water
6.The Effect and Safety of Steroid Injection in Lumbar Spinal Stenosis: With or Without Local Anesthetics.
Sung Hyuk SONG ; Gi Hyeong RYU ; Jin Woo PARK ; Ho Jun LEE ; Ki Yeun NAM ; Hyojun KIM ; Seung Yeon KIM ; Bum Sun KWON
Annals of Rehabilitation Medicine 2016;40(1):14-20
OBJECTIVE: To compare the long-term effect and safety of an epidural steroid injection in spinal stenosis patients, with or without local anesthetics. METHODS: Twenty-nine patients diagnosed with spinal stenosis were included and randomly divided into two groups. Translaminar epidural and selective nerve root spinal injection procedures were performed using steroids mixed with local anesthetics or normal saline. The effects of spinal injection procedures were measured with visual analogue scale (VAS) and functional rate index (FRI). These measurements were performed before injection, at 1 month after injection and at 3 months after injection. The occurrence of side effects was investigated each time. RESULTS: The VAS and FRI scores were significantly reduced in both the local anesthetics group and normal saline group at 1 and 3 months after the injection. However, there was no significant difference in VAS and FRI score reduction between the two groups each time. Side effects are not noted in both groups. CONCLUSION: The spinal injection procedures using steroids mixed either with local anesthetics or normal saline have an effect in reducing pain and improving functional activities. However, there was no significant difference between the two groups in relation to side effects and the long-term effects of pain and function.
Anesthetics
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Anesthetics, Local*
;
Humans
;
Injections, Epidural
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Injections, Spinal
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Spinal Stenosis*
;
Steroids
7.Myoclonus following Spinal Anesthesia with Hyperbaric Bupivacaine: A case report.
Soo Kyung LEE ; Jin Woo SHIN ; Jong Sung IM ; Young Mi KIM ; Ji Hyun PARK ; Hyun CHOI ; Hyun Soo MOON
Korean Journal of Anesthesiology 2008;54(2):201-203
Myoclonus is a rare neurologic complication of spinal anesthesia.We describe here a case of spinal segmental myoclonus that we encountered in a 45-year-old woman following spinal anesthesia. Spinal anesthesia was performed using 2.4 section sign cent of 0.5% hyperbaric bupivacaine without any complications and surgery was uneventful.However, myoclonic movements were observed in her lower extremities 2 hours after the intrathecal injection. These movements were ameliorated by intravenous injection of diazepam. The patient fully recovered without any neurologic sequelae.
Anesthesia, Spinal
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Bupivacaine
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Diazepam
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Female
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Humans
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Injections, Intravenous
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Injections, Spinal
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Lower Extremity
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Middle Aged
;
Myoclonus
8.Spinal Epidural Hematoma after Pain Control Procedure.
Kyoung Hyup NAM ; Chang Hwa CHOI ; Moon Seok YANG ; Dong Wan KANG
Journal of Korean Neurosurgical Society 2010;48(3):281-284
Spinal epidural hematoma is a rare complication associated with pain control procedures such as facet block, acupuncture, epidural injection, etc. Although it is an uncommon cause of acute myelopathy, and it may require surgical evacuation. We report four patients with epidural hematoma developed after pain control procedures. Two procedures were facet joint blocks and the others were epidural blocks. Pain was the predominant initial symptom in these patients while two patients presented with post-procedural neurological deficits. Surgical evacuation of the hematoma was performed in two patients while in remaining two patients, surgery was initially recommended but not performed since symptoms were progressively improved. Three patients showed near complete recovery except for one patient who recovered with residual deficits. Although, spinal epidural hematoma is a rare condition, it can lead to serious complications like spinal cord compression. Therefore, it is important to be cautious while performing spinal pain control procedure to avoid such complications. Surgical treatment is an effective option to resolve the spinal epidural hematoma.
Acupuncture
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Hematoma
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Hematoma, Epidural, Spinal
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Humans
;
Injections, Epidural
;
Spinal Cord Compression
;
Spinal Cord Diseases
;
Zygapophyseal Joint
9.Intrathecal lamotrigine blocks and reverses antinociceptive morphine tolerance in rats.
In Gu JUN ; Jong Yeon PARK ; Yun Sik CHOI ; Tae hee KIM
Korean Journal of Anesthesiology 2009;56(6):687-692
BACKGROUND: Chronic administration of morphine leads to the development of tolerance. We investigated the effects of intrathecal lamotrigine on the spinal morphine tolerance in rats that are undergoing tail flick tests. METHODS: Sprague-Dawley rats were given intrathecal injections of saline 10 microl, lamotrigine 300 microg, morphine 15 microg or lamotrigine plus morphine combinations for 7 days (lamotrigine was given for days 1-7, days 1-3 or days 5-7). The acute and chronic nociceptive sensitivities were assessed using a tail flick test in which the distal 5 cm of the tail was dipped into warm water before and 30 minutes after the drug injection. With successive injections of morphine on day 8, a cumulative antinociceptive dose-response curve was constructed and the 50% effective dose (ED50) was calculated for each study group. RESULTS: The coinjection group of lamotrigine with morphine blocked the development of tolerance, as was shown by the preservation of morphine antinociception over 7 days and the concomitant decrease in the ED50 values on day 8, as compared with the morphine-alone group. Coinjection of lamotrigine blocked the development of morphine tolerance, as shown by the preservation of morphine antinociception over 7 days and the concomitant decrease in the ED50 values on day 8, as compared with the morphine-alone group. CONCLUSIONS: This study suggests that lamotrigine augments the antinociceptive action of both acute and chronic morphine therapy, and it also attenuates the antinociceptive morphine tolerance in rats.
Animals
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Injections, Spinal
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Morphine
;
Rats
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Rats, Sprague-Dawley
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Triazines
;
Water
10.The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia.
Kyung Mi KIM ; Young Wan KIM ; Ji Won CHOI ; Ae Ryoung LEE ; Duck Hwan CHOI
Korean Journal of Anesthesiology 2013;65(6):525-530
BACKGROUND: Intrathecal labor analgesia using new local anesthetics such as ropivacaine or levobupivacaine becomes more popular by virtues of their safety and decreased motor weakness. However, the analgesic efficacy of the clinically effective intrathecal doses of these new local anesthetics combined with fentanyl has yet to be determined. METHODS: Sixty parturients who requested neuraxial analgesia in early active labor were randomly assigned to either ropivacaine (group R, n = 30) or levobupivacaine (group L, n = 30) group. Group R received 3 mg of intrathecal ropivacaine and the group L received 3 mg of intrathecal levobupivacaine mixed with 20 microg of fentanyl as part of a combined spinal-epidural (CSE) technique. The associated block parameters, such as pain scores, duration of analgesia, the highest levels of the sensory block and motor block scores 30 mins after the injection were compared between two groups. RESULTS: Intrathecal ropivacaine offered shorter analgesia (87 +/- 41 min vs. 122 +/- 56 min, P < 0.05) with lower sensory height (T8.5 vs. T6, P < 0.05) and led to lower incidence of complete analgesia (73 vs. 97%, P < 0.05) compared with intrathecal levobupivacaine. Although motor weakness was comparable in both groups, significantly weak perineal squeezing was noticed in Group L (7 of 30 parturients vs. 16 of 30, P < 0.05). CONCLUSIONS: Clinically relevant doses of intrathecal levobupivacaine in combination with fentanyl as part of a CSE technique provides more effective analgesia than equivalent doses of intrathecal ropivacaine in early labor, but is accompanied by slight motor weakness.
Analgesia*
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Anesthetics, Local
;
Fentanyl*
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Incidence
;
Injections, Spinal
;
Virtues