경부 경막외 차단 시 약물의 용량에 따른 분포 양상 비교

A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume

  • 조대현 (포천중문의과대학교 분당차병원 통증클리닉) ;
  • 김명희 (포천중문의과대학교 분당차병원 마취통증의학교실) ;
  • 안선연 (포천중문의과대학교 분당차병원 통증클리닉) ;
  • 박사현 (포천중문의과대학교 분당차병원 통증클리닉) ;
  • 이강창 (원광대학교 의과대학 산본병원 마취통증의학교실)
  • Jo, Dae hyun (Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University) ;
  • Kim, Myoung hee (Department of Anesthesiology and Pain Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University) ;
  • Ahn, Sun Yeon (Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University) ;
  • Park, Sa Hyun (Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University) ;
  • Lee, Kang Chang (Department of Anesthesiology and Pain Medicine, Wonkwang University Sanbon Medical Center, School of Medicine, Wonkwang University)
  • 투고 : 2007.03.19
  • 심사 : 2007.06.14
  • 발행 : 2007.06.30

초록

Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

키워드

참고문헌

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