과반사 신경인성 방광환자에서 지주막하 신경 차단의 효과
Effect of Subarachnoid Block in Hyperreflexic Bladder
김상우, 임성빈, 윤광준, 설종구,
소속 상세정보
김상우 ( )
충남대학교
임성빈 ( )
충남대학교
윤광준 ( )
충남대학교
설종구 ( )
충남대학교
KMID : 0358319960370050565
Abstract
Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatment of hyperreflexic bladder are medical therapy, interruption of innervation, augmentation cystoplasty, etc.
We treated four hyperreflexic bladder patients with 12% a phenol injetion into the subarachnoid space for ssacral nerve block. Before treatment the average bladder capacity was about 100ml, and there was one case of autonomic dysreflexia. After
the
subarachnoid block the average bladder capacity increased above 300ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by
repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individulally, and is a treatment for hyperreflexic bladder refractory to medical therapy.
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