경추 경막외강 확인법의 비교 연구
- Alternative Title
- Comparison of Methods to Confirm the Cervical Epidural Space
- Abstract
- Background: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. Methods: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. Results: Using the drip infusion method, we identify the epidural space in all the patients as +/++ grade. The catheter insertion method was also successful in identifying those epidural spaces over a ${\pm}$ grade. The pseudo LOR was over ${\pm}$ grade in 47 patients. Conclusions: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.
- All Author(s)
- 옥시영
; 전혜림
; 백영희
; 김상호
; 김순임
; 김선종
; 박욱
; 송단
- Issued Date
- 2009
- Type
- Article
- ISSN
- 1226-2579
; 2005-9159
; 2093-0569
- Citation Title
- 대한통증학회지
The Korean journal of pain
- Citation Volume
- 22
- Citation Number
- 2
- Citation Start Page
- 158
- Citation End Page
- 162
- Language(ISO)
- kor
- DOI
- 10.3344/kjp.2009.22.2.158
- URI
- http://schca-ir.schmc.ac.kr//handle/2022.oak/393
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