The Spontaneous Resorption of Herniated Lumbar Disc: A case report / 대한통증학회지

The most effective treatment methods for a herniated lumbar disc remain questionable. This report follows the patients course, from the onset of pain through the completion of the non-surgical treatment, and shows that a lumbar herniated disc, with radiculopathy, can be successfully treated with a non-surgical approach. This report discusses the possible explanations for disc resorption: retraction into the intervertebral space, dehydration/shrinkage and resorption due to an inflammatory reaction. A non-surgical approach can be an effective treatment option for a herniated lumbar disc.

The Analgesic and Hemostatic Effects of Diclofenac as Adjuvant of Intravenous Opioid Using PCA after Cesarean Section / 대한마취과학회지

BACKGROUND: Diclofenac is a nonsteroidal anti-inflammatory drug widely used as adjuvant for postoperative pain management using intravenous Patient Controlled Analgesia (PCA). The analgesic and hemostatic effects of diclofenac were measured in 80 paturients after Cesarean section. METHODS: Eighty parturients were randomly allocated to four groups and each group had 20 women. The parturients were given loading dose of meperidine in D group and morphine in M group and then postoperative pain was controlled with PCA device for up to 48 hours after Cesarean section when the parturients awoke and complained pain. The parturients received intramuscular diclofenac 75 mg followed by loading dose of meperidine in DV group and morphine in MV group. Diclofenac was repeated every 12 hours. We evaluated the effects of diclofenac on postoperative opioid requirement, numerical rating score of pain and hemostasis at 48 hours after operation. RESULT: Diclofenac decreased almost 50% of opioid requirement and pain score lowered significantly at 12, 24 hours in DV group and at 12 hours in MV group. But there was no difference in laboratory data including hemoglobin, hematocrit, platelet count and bleeding time among the groups. CONCLUSION: We concluded that diclofenac is effective and safe adjuvant for postoperative pain management without hemostatic abnormality. But it is necessary to try further evaluation of hemostatic effect of diclofenac.

Assessment of the Surgical Patients with Pacemaker / 대한마취과학회지

BACKGROUND: The development of techniques and improvement of diagnostic facilities have led to the increased use of pacemakers in cardiac patients. So, anesthesiologists should have paid more attention to the patients with pacemakers, and they also need the full knowledge of wide varieties of pacemakers currently used for a safety of these patients. The purpose of this study is the assessment of fifteen pacemaker patients undergoing surgery. METHODS: This study was done in 15 cardiac patients with pacemaker who underwent noncardiac operations. We evaluated symptom, ECG rhythm, underlying cardiac disease before pacemaker implantation and the type of implanted pacemaker. The type and duration of operations, together with anesthetic techniques were also assessed. RESULTS: The pre-pacemaker symptoms were intermittent dizziness, palpitation, syncope, and general weakness. The underlying cardiac diseases were complete A-V block, sick sinus syndrome and bifascicular block. The types of implanted pacemakers were VVIR (n=14) and DDD (n=1). The kinds of anesthetic techniques were general anesthesia (N2O-O2-enflurane; n=10, N2O-O2-fentanyl; n=1), and continuous epidural block (n=3) or continuous spinal block (n=1) combined with general anesthesia (N2O-O2). CONCLUSIONS: We should evaluate the patient with pacemakers preoperatively for underlying cardiac disease and implanted pacemaker. Thereafter, we have to choose the safe anesthetic technique.