The Effect of Ketorolac on Propofol Injection Pain / 대한마취과학회지

BACKGROUND: Many strategies to reduce pain during propofol injection have been investigated. Inhibitors of cyclooxygenase are frequently used to provide post operative pain relief in patients undergoing minor gynecologic surgery. Therefore, in this study, we have investigated whether ketorolac injected intravenously reduces pain during propofol injection. METHODS: Fifty healthy female patients scheduled for minor gynecological surgery were randomly allocated to one of four groups. All patients were inserted 20 G Angiocatheter into the veins on the dorsum of the hands. After applying an arm tourniquet at an inflation pressure of 40-45 mmHg, the control group received 2 ml of 0.9% saline, and those in groups I, II, and III received ketorolac 0.5, 0.75, and 1.0 mg/kg mixed with 2 ml of 0.9% saline respectively. The tourniquet was released 2 minutes later. 2 mg/kg of 1% propofol bolus was then injected with an infusion pump intravenously. After 50 mg of propofol were injected, patients were assessed for visual analogue scale (VAS) scores and pain grades. RESULTS: VAS scores during propofol injection diminished significantly in group II (0.75 mg/kg ketorolac) and group III (1 mg/kg ketorolac) compared with the control (saline) group. CONCLUSIONS: Pretreatment with intravenous ketorolac more than 0.75 mg/kg during the 2 minutes tourniquet time can reduce pain elicited by profofol injection.

Radiofrequency Thermocoagulation on Trigeminal Neuralgia: Two cases report / 대한마취과학회지

Trigeminal neuralgia is a disease of intermittent short lasting facial pain but most severe pain from which mankind suffers. It's treatment usually depends on medication, microvascular decompression surgery, and nerve block such as trigeminal nerve block, retrogasserrian ganglion block and radiofrequency destruction of gasserian ganglion. Here we report two cases performed radiofrequency(RF) thermocoagulation with TEW-TC cannular in a recurred trigeminal neuralgia patient after microvascular decompression and an inoperable patient due to hypertensive cerebral infarction. After the paresthesia and masseter muscle contracture test at 50 Hz - 0.2 volt and 2 Hz - 0.6 volt respectively, RF lesionings were performed for 60 sec at 60oC and 60 sec at 65oC. One patient got relief of pain completely and has been achieved over 8 months with mild hypoesthesia on face and the other patient got incomplete pain relief without hypoesthesia even though has satisfied over 7 months. Radiofrequency thermocogulation is a safe procedure that can be well controlled and less invasive even though inoperable or recurred trigeminal neuralgia patient.