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신경파괴적 요부교감신경절 차단의 적정 부위

Other Titles
 Appropriate Block Level in Neurolytic Lumbar Sympathetic Ganglion Block 
Authors
 김희정  ;  이철오  ;  신양식  ;  이윤우 
Citation
 Korean Journal of Pain (대한통증학회지), Vol.14(2) : 199-206, 2001 
Journal Title
 Korean Journal of Pain  (대한통증학회지) 
ISSN
 2005-9159 
Issue Date
2001
Abstract
Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ㎖) and 4% lidocaine (1.5 ㎖) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than 1℃ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
이윤우(Lee, Youn Woo)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/143158
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