Chemical Lumbar Sympathetic Block: Comparison of One- Versus Two-needle Techniques / 대한마취과학회지

BACKGROUND: It was frequently noticed in the course of performing a two-needle sympathectomy, that satisfactory spread of contrast solution could be produced by injection through only one of the needles. This led to a closer examination of the merits of single-needle technique. METHODS: Forty patients were randomized into two groups. Patients in the single-needle group (n = 20) were injected at the second or third lumbar sympathetic ganglia, while patients in the two-needle group (n = 20) were injected at the second and third lumbar sympathetic ganglia. Lumbar sympathetic blocks were performed using 3 ml of alcohol and the spread of injectate was verified with C-arm fluoroscopy. The indicators of a successful sympathetic block are increasing skin temperature, decreasing pain, and anhidrosis in the distal extremity. RESULTS: The duration of anhidrosis was 12.2 2.6 months (mean SD) in the single-needle group versus 13.6 3.6 months (mean SD) in the two-needle group. CONCLUSIONS: As these results were not significantly different from those obtained in patients having a two-needle sympathectomy, blockade of the single-needle technique under C-arm fluoroscopy is considered to be effective for a neurolytic lumbar sympathectomy.

Chemical Lumbar Sympathetic Block: Comparison of One- Versus Two-needle Techniques / 대한마취과학회지

BACKGROUND: It was frequently noticed in the course of performing a two-needle sympathectomy, that satisfactory spread of contrast solution could be produced by injection through only one of the needles. This led to a closer examination of the merits of single-needle technique. METHODS: Forty patients were randomized into two groups. Patients in the single-needle group (n = 20) were injected at the second or third lumbar sympathetic ganglia, while patients in the two-needle group (n = 20) were injected at the second and third lumbar sympathetic ganglia. Lumbar sympathetic blocks were performed using 3 ml of alcohol and the spread of injectate was verified with C-arm fluoroscopy. The indicators of a successful sympathetic block are increasing skin temperature, decreasing pain, and anhidrosis in the distal extremity. RESULTS: The duration of anhidrosis was 12.2 2.6 months (mean SD) in the single-needle group versus 13.6 3.6 months (mean SD) in the two-needle group. CONCLUSIONS: As these results were not significantly different from those obtained in patients having a two-needle sympathectomy, blockade of the single-needle technique under C-arm fluoroscopy is considered to be effective for a neurolytic lumbar sympathectomy.

In Moderate Anemic Patients with Normal Cardiopulmonary Function, Should Preoperative Blood Transfusion be a Mandatory Procedure in Uterine Myoma Patients / 대한마취과학회지

BACKGROUND: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. METHOD: 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8~10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. RESULTS: There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. CONCLUSION: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice.