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KMID : 0363119960090010210
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Korean Journal of Pain
1996 Volume.9 No. 1 p.210 ~ p.214
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Thoracic Endoscopic sympatheitc Ganglion Cauterization on Reflex Sympathetic Dystrophy under One-Lung Ventilation
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Abstract
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Thoracic sympathetic ganglion block (TCGB) with alcohol is a traditional method for treating a variety of disease at pain clinis. But it is a difficult block to perform requiring both skill and experience. Therefore, we perormed a thoracic
endoscopic
causterization to evaluate the efficacy of this method.
A patient suffering sever forearm and hand pain due to radius fracture of the right arm, one and half years earlier, was referred to several different orthopaedic department of various hospitals with continued aggravated symptoms. He was then
admitted
to our hospital's orthopaedic department. Our diagnosis, confirmed by thermography, revealed reflex sympathetic dystrophy.
Patients was therefore referred to the pain clinic where treatment consisted of endoscopic thoracic sympathetic cauterization under general anesthesia. Patient was intubated with Robertashow 37 Fr. double lumen tube left sided. Left lateral and
slight
head up position was applief to make lesion side up. Incisions were mde to penetrate trocas 5 mm diamether on 4 th intercostal space along mid axillary line and midclavicular line. Negative pressure suction on ipsilateral lung and CO2
insufflation
under
10 mmHg was applied to reduce lung size. Cauterization on thoracic sympathetic chain at T3 level was done under endoscoic guide. 24 Fr. chest tube was insrted.
Patient's symptoms cleared and he was satisfied with the results of this treatment.
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KEYWORD
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