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- ¸ñ Â÷ -
Chapter 1 ºÎÀ§¸¶Ãë ¹æ Áغñ¿Í Àåºñ 1
1.1. ¼·Ð _ 1
1.2. Àåºñ¿Í ¸ð´ÏÅ͸µ _ 1
1.2.1. ½Å°æºí·Ï ¹æ Áغñ 2
1.2.2. Àåºñº¸°ü Ä«Æ® 2
1.2.3. ¸ð´ÏÅ͸µ 3
1.2.4. ¹Ù´Ã, Ä«Å×ÅÍ, °ü·Ã ±â±¸ 4
1.2.5. ÃÊÀ½ÆÄ Àåºñ 7
1.2.6. ½Å°æÀڱرâ 7
Chapter 2 Àü±â ½Å°æ ÀÚ±Ø 9
2.1. ¼·Ð _ 9
2.2. Àü±â »ý¸® _ 10
2.2.1. Àü±â Æĵ¿ÀÇ Æ¯Â¡ 10
2.2.2. ÀÚ±ØÀÇ ±Ø¼º°ú ȸ±Í Àü±Ø 12
2.2.3. °Å¸®-Àü·ù °ü°è 12
2.2.4. Àü±ØÀÇ Àü·ù ¹Ðµµ¿Í ÁÖ»ç¾× 13
2.3. ´Ù¾çÇÑ ÀåºñÀÇ Æí¸®ÇÑ Æ¯Â¡ _ 15
2.3.1. ÀÏÁ¤ÇÑ Àü·ù Ãâ·Â°ú Ç¥½Ã 15
2.3.2. ´Ù¾çÇÑ Æĵ¿ Æø°ú ÁÖÆļö 16
2.3.3. Æ¯ÈµÈ ±Ø¼º Àü±Ø 17
2.3.4. ºÐ¸®¿Í ¿ÀÀÛµ¿ Ç¥½Ã±â 17
2.3.5. ´Ù¸¥ º¸Á¶ ±â±¸ 17
2.4. ÀÓ»óÀûÀÎ °íÂû _ 18
2.4.1. ±â·Ï 18
2.4.2. ȯÀÚ¿¡ ´ëÇÑ °í·Á 18
2.4.3. ½Å°æ ÀڱؼúÀº È¿°úÀûÀϱî?, ÃÊÀ½ÆÄ¿¡ ÀÇÇØ ´ëüµÉ ¼ö ÀÖÀ»±î? 18
Chapter 3 ÃÊÀ½ÆÄ ±âÃÊÁö½Ä 21
3.1. ¼·Ð _ 21
3.2. ±âÃÊ ÃÊÀ½ÆÄ ¹°¸®Çаú ±â¼úü°è _ 21
3.2.1. ÇØ»óµµ¿Í Áֻ缱ÀÇ ¹Ðµµ: À̹ÌÁö Ç°Áú¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â µÎ ¿ä¼Ò 23
3.2.2. ½Ã¾ß¿Í º¸»ó ±â´É 24
3.2.3. ÁõÆø ÀÌµæ ±â´É(amplifier gain function) 26
3.2.4. ½Ã°£ ÀÌµæ º¸»ó(time gain compensation) 26
3.2.5. µµÇ÷¯ È¿°ú 26
3.2.6. Àΰø¹°(artifacts): À̹æÇ⼺(anisotropy)°ú À½ÆÄ ±×¸²ÀÚÀÇ Á߿伺 26
3.3. ´Ù¾çÇÑ Á¶Á÷ÀÇ ÃÊÀ½ÆÄ¿µ»ó _ 28
3.3.1. ½Å°æ°ú ÈûÁÙ 29
3.3.2. ±ÙÀ° 31
3.3.3. »À 31
3.3.4. Ç÷°ü ±¸Á¶ 31
3.3.5. Áö¹æ 31
3.3.6. ±Ù¸· Á¶Á÷ 31
3.3.7. È丷°ú °ø±â 31
3.4. Àåºñ ¼±Åðú Áغñ _ 32
3.4.1. Àåºñ ¼±Åà 32
3.4.2. Ư¼öÇÑ ¹Ù´ÃÀ» ¾µ ¼ö ÀÖÀ»±î, ¶Ç´Â ½á¾ß ÇÒ±î? 35
3.4.3. Àåºñ Áغñ 35
Chapter 4 ÃÊÀ½ÆÄ¿Í ½Å°æ ÀÚ±Ø À¯µµ¸¦ ÅëÇÑ ¸»ÃʽŰæºí·Ï 37
4.1. ¼·Ð _ 37
4.2. ½Å°æºí·ÏÀÇ Á¤È®¼º°ú ÁøÁ¤ÀÇ ÀÓ»óÀûÀÎ Ãø¸é _ 38
4.2.1. Á¤È®ÇÑ ½Å°æºí·ÏÀÇ Á߿伺 38
4.2.2. À̹ÌÁö Æ÷Âø 38
4.2.3. ½ÇÁ¦ÀûÀÎ Á¢±Ù: °Å½½·¯ ¿Ã¶ó°¡±â ¹æ¹ý 42
4.2.4. ¹Ù´Ã ±ËµµÀÇ Á¶Àý 45
4.2.5. ¹Ù´Ã »ðÀÔ¹æ¹ý 46
4.2.6. ¡°Training Wheel¡± ·¹ÀÌÀú ºÎÂø 48
4.2.7. Out-of-Plane ¹æ¹ý: °É¾î ³»·Á°¡±â ¹æ¹ý(walk down approach) 50
4.2.8. ±¹¼Ò¸¶ÃëÁ¦ Åõ¿© 50
4.2.9. ÁÖ»ç ¾Ð·Â 52
4.2.10. ÀûÀýÇÑ ÁøÁ¤(sedation) 54
4.3. ÃÊÀ½ÆÄ À¯µµ ±³À° _ 54
Chapter 5 »óÁö ºí·ÏÀ» À§ÇÑ ÀÓ»ó ÇغΠ57
5.1. ô¼ö½Å°æÀÇ ±â¿ø _ 57
5.2. ÆȽŰæ¾ó±â _ 58
5.2.1. ÆȽŰæ¾ó±â 59
5.2.2. ÆȽŰæ¾ó±âÀÇ ºÐÁö 59
5.3. ÆÈÀÇ Ã´¼ö½Å°æºÐÆ÷ _ 62
5.3.1. ÇǺκÐÀý 62
5.3.2. ±ÙÀ°ºÐÀý 62
5.3.3. »ÀºÐÀý 66
Chapter 6 ¸ñ°¥ºñ»çÀÌ ºí·Ï (Interscalene Block) 67
6.1. ÀÓ»ó ÇغΠ_ 67
6.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 70
6.2.1. ȯÀÚÀÇ Ã¼À§ 70
6.2.2. Ç¥¸é ÇغΠ70
6.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 71
6.3.1. ½ºÄµ¹æ¹ý 72
6.3.2. ÃÊÀ½ÆÄ¿µ»ó(12+ MHz Ž»öÀÚ) 74
6.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 75
6.4. ½Å°æÀÚ±Ø _ 76
6.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 77
Chapter 7 ºøÀåÀ§ ºí·Ï (Supraclavicular Block) 79
7.1. ÀÓ»ó ÇغΠ_ 79
7.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 82
7.2.1. ȯÀÚÀÇ Ã¼À§ 82
7.2.2. Ç¥¸é ÇغΠ82
7.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 83
7.3.1. ½ºÄµ¹æ¹ý 84
7.3.2. ÃÊÀ½ÆÄ¿µ»ó 84
7.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 85
7.4. ½Å°æÀÚ±Ø _ 87
7.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 88
Chapter 8 ºøÀå¾Æ·¡ ºí·Ï (Infraclavicular Block) 91
8.1. ÀÓ»ó ÇغΠ_ 91
8.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 94
8.2.1. ȯÀÚÀÇ Ã¼À§ 94
8.2.2. Ç¥¸é ÇغΠ95
8.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 97
8.3.1. ½ºÄµ¹æ¹ý 97
8.3.2. ÃÊÀ½ÆÄ¿µ»ó 97
8.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 99
8.4. ½Å°æÀÚ±Ø _ 100
8.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 101
Chapter 9 °Üµå¶û ºí·Ï (Axillary Block) 103
9.1. ÀÓ»ó ÇغΠ_ 103
9.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 106
9.2.1. ȯÀÚÀÇ Ã¼À§ 106
9.2.2. Ç¥¸é ÇغΠ106
9.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 107
9.3.1. ½ºÄµ¹æ¹ý 108
9.3.2. ÃÊÀ½ÆÄ¿µ»ó(12MHz, Á÷¼±Çü Ž»öÀÚ) 108
9.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 109
9.4. ½Å°æÀÚ±Ø _ 111
9.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 111
Chapter 10 À§ÆÈÀÇ ¼±ÅÃÀû ¸»ÃʽŰæºí·Ï 113
10.1. ¼·Ð _ 113
10.2. ÆȲÞÄ¡ °¡ÂÊ¿¡¼ÀÇ ³ë½Å°æºí·Ï _ 114
10.2.1. ÀÓ»ó ÇغΠ115
10.2.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ117
10.2.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 119
10.2.4. ½Å°æÀÚ±Ø 122
10.2.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 122
10.3. Á¤Á߽Űæ _ 122
10.3.1. ÀÓ»ó ÇغΠ123
10.3.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ126
10.3.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 127
10.3.4. ½Å°æÀÚ±Ø 128
10.3.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 129
10.4. ±ÙÀ°ÇǺνŰæ _ 129
10.4.1. ÀÓ»ó ÇغΠ130
10.4.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ130
10.4.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 131
10.4.4. ½Å°æÀÚ±Ø 134
10.4.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 135
10.5. ÀڽŰæ _ 135
10.5.1. ÀÓ»ó ÇغΠ135
10.5.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ137
10.5.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 137
10.5.4. ½Å°æÀÚ±Ø 141
10.5.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 141
Chapter 11 ÇÏÁö ºí·ÏÀ» À§ÇÑ ÀÓ»ó ÇغΠ143
11.1. ô¼ö½Å°æÀÇ ±â¿ø _ 143
11.2. Ç㸮¾ûÄ¡½Å°æ¾ó±â _ 144
11.2.1. Ç㸮½Å°æ¾ó±âÀÇ °¡Áö¿Í Çü¼º 144
11.2.2. ¾ûÄ¡½Å°æ¾ó±âÀÇ Çü¼º°ú °ü°è 146
11.3. ÇÏÁöÀÇ Ã´¼ö½Å°æºÐÆ÷ _ 147
11.3.1. ÇǺκÐÀý 147
11.3.2. ±ÙÀ°ºÐÀý 149
11.3.3. »ÀºÐÀý 152
Chapter 12 Ç㸮½Å°æ¾ó±â/ Ç㸮±Ù ±¸È¹ ½Å°æºí·Ï
(Lumbar Plexus/Psoas Compartment Block) 153
12.1. ÀÓ»ó ÇغΠ_ 153
12.1.1. Ç㸮±Ù ±¸È¹(psoas compartment)³» Ç㸮½Å°æ¾ó±â 153
12.1.2. Ç㸮½Å°æ¾ó±âÀÇ ¸»ÃʽŰæ 156
12.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 157
12.2.1. ȯÀÚÀÇ Ã¼À§ 157
12.2.2. Ç¥¸é ÇغΠ157
12.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 158
12.3.1. ½ºÄµ¹æ¹ý 160
12.3.2. ÃÊÀ½ÆÄ¿µ»ó(°î¼±Çü Ž»öÀÚ; 5-8 MHz) 163
12.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 164
12.4. ½Å°æÀÚ±Ø _ 167
12.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 167
Chapter 13 ³Ò´Ù¸® ½Å°æºí·Ï (Femoral Block) 169
13.1. ÀÓ»ó ÇغΠ_ 169
13.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 172
13.2.1. ȯÀÚÀÇ Ã¼À§ 172
13.2.2. Ç¥¸é ÇغΠ172
13.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 173
13.3.1. ½ºÄµ¹æ¹ý 173
13.3.2. ÃÊÀ½ÆÄ¿µ»ó(10-MHz Á÷¼±Çü Ž»öÀÚ) 175
13.3.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 176
13.4. ½Å°æÀÚ±Ø _ 177
13.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 178
Chapter 14 ±ÃµÕ½Å°æ°ú ¿À±ÝºÎÀ§¿¡¼ÀÇ ½Å°æºí·Ï
(Sciatic and Popliteal Blocks) 179
14.1. ÀÓ»ó ÇغΠ_ 179
14.2. º¼±â(labat)±ÃµÕ½Å°æºí·ÏÀÇ Á¢±Ù _ 186
14.2.1. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ186
14.2.2. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 186
14.2.3. ½Å°æÀÚ±Ø 190
14.2.4. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 191
14.3. ¾Æ·¡º¼±â±ÃµÕ½Å°æºí·ÏÀÇ Á¢±Ù _ 191
14.3.1. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ191
14.3.2. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 192
14.4. ±ÃµÕ½Å°æºí·ÏÀÇ ¾ÕÂÊ Á¢±Ù _ 195
14.4.1. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ195
14.4.2. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 197
14.4.3. ½Å°æÀÚ±Ø 199
14.4.4. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 199
14.5. ¿À±ÝºÎÀ§¿¡¼ÀÇ ±ÃµÕ½Å°æºí·Ï(µÞ¸éÁ¢±Ù) _ 201
14.5.1. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ201
14.5.2. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 202
14.5.3. ½Å°æÀÚ±Ø 207
14.5.4. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 208
14.6. ¿À±ÝºÎÀ§ÀÇ ±ÃµÕ½Å°æºí·Ï(°¡ÂÊÁ¢±Ù) _ 209
14.6.1. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ209
14.6.2. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý 210
14.6.3. ½Å°æÀÚ±Ø 212
14.6.4. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 212
Chapter 15 ¹ß¸ñºÎÀ§ÀÇ ½Å°æºí·Ï (Ankle Blocks) 213
15.1. ÀÓ»ó ÇغΠ_ 213
15.2. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 215
15.2.1. ȯÀÚÀÇ Ã¼À§ 215
15.2.2. Ç¥¸é ÇغΠ215
15.3. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 216
15.3.1. ½ºÄµ¹æ¹ý 216
15.3.2. ÃÊÀ½ÆÄ¿µ»ó 217
15.3.3. ¹Ù´Ã»ðÀÔ¹æ¹ý 219
15.4. ½Å°æÀÚ±Ø _ 219
15.5. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 221
Chapter 16 ÃÊÀ½ÆÄ¿Í ½Å°æÀÚ±Ø Ä«Å×Å͸¦ ÀÌ¿ëÇÑ
ºÎÀ§¸¶Ãë Ä«Å×ÅÍ »ðÀÔ 223
16.1. ¼·Ð _ 223
16.2. ±â±¸¿Í ÁÖ»çÁ¦ _ 224
16.2.1. ½Å°æÀÚ±Ø Ä«Å×ÅÍ(stimulating catheters) 224
16.2.2. ¾î¶² ÁÖ»çÁ¦¸¦ »ç¿ëÇØ¾ß Çϴ°¡? 226
16.3. ¹æ¹ý _ 226
16.3.1. ½Å°æÀÚ±Ø ¹æ¹ý°ú Ä«Å×ÅÍ ³¡ À§Ä¡ È®ÀÎ 227
16.3.2. ÃÊÀ½ÆÄÃÔ¿µ¼úÀ» ÅëÇÑ Ä«Å×ÅÍ ³¡ À§Ä¡ È®ÀÎ 228
16.4. Ưº°ÇÑ ½Å°æºí·ÏÀÇ ¿¹ _ 229
16.4.1. ¸ñ°¥ºñ»çÀÌ Ä«Å×ÅÍ»ðÀÔ 229
16.4.2. ºøÀå¾Æ·¡ Ä«Å×ÅÍ»ðÀÔ 229
16.4.3. ³Ò´Ù¸®½Å°æ 229
16.4.4. ±ÃµÕ½Å°æ 230
16.5. ¿ä¾à°ú ÀåÁ¡ _ 231
Chapter 17 ôÃßÁÖÀ§, °¥ºñ»çÀÌ, °æ¸·¿Ü ½Å°æºí·ÏÀ» À§ÇÑ ¸öÅë ÇغΠ233
17.1. ôÁÖ _ 233
17.1.1. ÈäÃß¿Í ¿äÃßÀÇ ¹ß»ýÇÐÀû ÇغΠ233
17.1.2. õ°ñÀÇ ¹ß»ýÇÐÀû ÇغΠ235
17.2. °¥ºñôÃß °üÀý _ 236
17.3. ôÃß¿·°ø°£(paravertebral space) _ 237
17.4. õ°ñ À§ ô¼ö¸·(³ú¼ö¸·)°ú ½Å°æ _ 238
17.5. °¥ºñ»çÀÌ ½Å°æ(intercostal nerve) _ 238
17.6. ¹ÌÃß °æ¸·¿Ü°ø°£ _ 240
17.7. ÇǺΠºÐÀý _ 241
Chapter 18 Àü±â °æ¸·¿Ü Àڱؼú°ú ÃÊÀ½ÆÄ À¯µµ¸¦ ÀÌ¿ëÇÑ °æ¸·¿Ü¸¶Ãë 243
18.1. ¼·Ð _ 243
18.1.1. °æ¸·¿Ü ÁøÅë ¹æ¹ý¿¡ ´ëÇÑ ÀïÁ¡ 244
18.1.2. ¹ÌÃß °æ¸·¿Ü°¿¡ ¹Ù´ÃÀ» »ðÀÔÇÏ°í Ä«Å×Å͸¦ ÀüÁø½ÃÅ°´Â °Í°ú °ü·ÃµÈ ÀïÁ¡ 245
18.2. Àü±â °æ¸·¿Ü° ÀÚ±Ø _ 245
18.2.1. Å×½ºÆ® Àåºñ¿Í ½Ã¼ú 246
18.2.2. Å×½ºÆ®ÀÇ ±âÀü 247
18.2.3. Å×½ºÆ® ½ÃÇà°ú Çؼ®¿¡ °üÇÑ °íÂû 248
18.2.4. ÀÚ±Ø¿ë °æ¸·¿Ü Ä«Å×ÅÍÀÇ Çʿ伺 249
18.2.5. °æ¸·¿Ü Àü±â ÀÚ±ØÀÇ ¾ÈÀü¼º 250
18.2.6. ÀÓ»ó Àû¿ë 251
18.3. ÁßÃß ½Å°æ ¸¶Ãë(neuraxial anesthesia)¿¡¼ ÃÊÀ½ÆÄÀÇ ¿µ»ó _ 253
18.3.1. ÃÊÀ½Æĸ¦ ÅëÇÑ °¡½Ã¼º 254
18.3.2. ÁßÃß ½Å°æ°è ±¸Á¶ÀÇ ÃÊÀ½ÆÄ¿µ»ó ¿ä¾à 258
18.3.3. ÀÓ»ó Àû¿ë 261
18.4. °á·Ð _ 263
Chapter 19 ôÃß¿· ¹× ôÃß»çÀÌ ºí·Ï 265
19.1. ¼·Ð _ 265
19.2. ÀÓ»ó ÇغΠ_ 266
19.2.1. ¸öÅëÀÇ °ñÇغÎ(skeletal anatomy) 266
19.2.2. ôÃß¿·°ø°£°ú °¥ºñ»çÀ̽ŰæÀÇ ÇغΠ267
19.3. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸é ÇغΠ_ 268
19.3.1. ȯÀÚÀÇ Ã¼À§ 268
19.3.2. Ç¥¸é ÇغΠ268
19.4. ÃÊÀ½ÆÄ¿µ»ó°ú ¹Ù´Ã »ðÀÔ¹æ¹ý _ 269
19.4.1. ½ºÄµ¹æ¹ý 269
19.4.2. ÃÊÀ½ÆÄ¿µ»ó(sonographic appearance) 273
19.4.3. ¹Ù´Ã »ðÀÔ¹æ¹ý 273
19.5. ½Å°æÀÚ±Ø _ 277
19.5.1. ôÃß¿· ºí·Ï 277
19.6. ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç _ 278
Chapter 20 ¹ÌÃß¿Í °æ¸·¿Ü ºí·Ï (Caudal and epidural blockade) 279
20.1. ¼·Ð _ 279
20.1.1. ¹ÌÃߺí·Ï(caudal blocks): ÀÏȸÁÖ»ç¿Í ¹ÌÃ߷κÎÅÍ µÎÃøÀ¸·Î Ä«Å×ÅÍÀÇ ÁøÀÔ 279
20.1.2. ¿äÃß¿Í ÈäÃß °æ¸·¿Üºí·Ï 281
20.2. ÀÓ»ó ÇغΠ_ 282
20.3. ȯÀÚÀÇ Ã¼À§¿Í Ç¥¸éÁöÇ¥(surface landmark) _ 283
20.3.1. ȯÀÚÀÇ Ã¼À§ 283
20.3.2. Ç¥¸é ÇغΠ283
20.4. ÀÏȸ¼º ¹ÌÃ߸¶Ãë(single shot caudal aneshthesia) _ 285
20.4.1. ÃÊÀ½ÆÄ¿µ»ó°ú ÃÊÀ½ÆÄÀ¯µµÇÏ ºí·ÏÀÇ ¼ø¼ 285
20.4.2. ¹Ù´Ã»ðÀÔ°ú ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 287
20.4.3. °æ¸·¿ÜÀÚ±Ø °¡À̵å¿Í ºí·Ï ¹æ¹ý 287
20.5. ¹ÌÃ߰渷¿Ü°(caudal epidural space)À¸·ÎºÎÅÍ Ä«Å×ÅÍ ÁøÀÔ _ 289
20.5.1. ÃÊÀ½ÆÄ¿µ»ó°ú ÃÊÀ½ÆÄ À¯µµÇÏ ºí·Ï ¼ø¼ 289
20.5.2. Ä«Å×ÅÍ »ðÀÔ°ú ±¹¼Ò¸¶ÃëÁ¦ ÁÖ»ç 292
20.5.3. °æ¸·¿Ü ÀÚ±Ø °¡ÀÌµå ¹æ¹ý 293
20.5.4. ½ÉÀüµµ °¨½Ã ±â¹ý 295
20.6. Á÷Á¢ ¿äÃß ¹× ÈäÃß °æ¸·¿Ü ¸¶Ãë _ 296
20.6.1. ÃÊÀ½ÆÄ¿µ»ó°ú ÃÊÀ½ÆÄ À¯µµÇÏ ºí·Ï ¼ø¼ 296
20.6.2. Á÷Á¢Àû ¿äÃß ¹× ÈäÃß °æ¸·¿Ü ¸¶Ã븦 À§ÇÑ °æ¸·¿Ü Àڱؿä¹ý 302
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