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1 Radiofrequency Ablation Korean 환자교육 고주파절제 시술의과정과기대하는효과 이안내서는환자분의통증의요인인신경을 태우는 고주파절제술에관하여설명합니다. 시술이끝난후에환자분은통증의증상을기록하셔야하고 4 주이내에그결과를클리닉에전화로보고하셔야될것입니다. 고주파절제술은무엇입니까? 고주파절제술은환자분의뇌로통증을충격시키는신경에고강도의전기를보내서이같은통증충격의전달을차단시키는최소한의침습성치료입니다. 이시술은신경을지져서이런충격의전달을차단하게만듭니다. 어떻게시행합니까? 의사선생님께서바늘이삽입될부분의피부에감각을없게하기위하여국부마취제를사용할것입니다. 의사선생님은바늘을적절한신경으로유도하기위하여엑스레이를사용합니다. 바늘이정확한곳에들어갔는지를확인하기위해서신경에작은 실험 용량의전기를보냅니다. 환자분은바늘이그신경에놓였을때, 저린감각, 깊숙한통증그리고약간의근육경련을느끼실것입니다. 환자분은이같은증상이왔을때의사선생님께말하셔야될것입니다. 의사선생님께서바늘이정확한곳에들어갔는지확신이설때작은량의마취제를투입하시고그런다음신경을태웁니다. 환자분은약간의불편을느끼실수도있습니다. 환자분은이시술을위하여가벼운진정제를주사받으실수도있지만말할수있고의사선생님의질문에대답하실수있도록깨어있을것입니다. 효과가얼마나있습니까? 환자분의통증이나저린감이처음의몇일이나몇주동안은증가할수도있지만이것은천천히나아질것입니다. 저희는통증이완전히제거되기를바라지만, 환자분의통증이 50% 퍼센트에서 80% 퍼센트까지완화되면좋은결과입니다. 이시술을받는 80% 의환자분들 (10 명중 8 명 ) 의통증이어느정도는완화됩니다. 시술로인한통증완화는 8 개월에서 24 개월까지지속됩니다. 하지만, 신경은다시자라나기떄문에환자분의통증은되돌아올수도있습니다. 이기간이후에통증이되돌아오면시술을다시받아야할수도있습니다. 그러나통증완화가 6 개월정도만지속되면, 통증이다음시술후더빨리돌아올가능성이있기때문에의사선생님께서는절제술을반복하지않을것입니다.

2 페이지 2 고주파절제 만일시술이효과가없으면어떻게합니까? 이시술이누구에게나효과가있지는않습니다. 만일시술이환자분의통증을완화시키지않으면, 에후속방문때주치의사선생님이다른치료선택에관하여상의하실것입니다. 부작용어떠한의료시술도그에따른부작용의위험이있습니다. 치료를받기전에부작용에관하여주치의와상의하십시오. 고주파절제술로부터올수있는부작용들 : 주사부위통증. 감염. 출혈. 신경손상. 알레르기반응. 치료받은신경을따라따끔거리는느낌. 치료한자리근처의멍들음. 몇주까지갈수도있는통증증가그리고 / 아니면무감각. 만일목에있는신경을치료받았으면, 어지러움과불안정한걸음. 이것은몇시간까지갈수도있음. 시간이얼마나걸립니까? 시술은약 45 분걸리지만, 환자분이접수하실때부터집에가실때까지클리닉에 2 시간정도계실것을계획하십시오. 고추파절제술받는준비는어떻게합니까약조절환자분은고추파절제술이전에와파린 ( 쿠마딘 ), 클로피도그렐 ( 플래빅스 ), 에녹사파린 ( 로브녹스 ) 과그외의다른혈액을묽게하는약들의복용을중단해야합니다. 만일혈액을묽게하는약을복용하고계시면, 이시술을위한예약이되는즉시약처방을해주신의사선생님과상의하십시오. 작은량의아스피린과항소염제는복용하셔도됩니다. 시술받는날주목 : 만일진정제주사를받지안을것이면, 먹거나마시는것은정상대로드셔도됩니다. 모든환자를위하여 : 클리닉에예약된시간보다적어도 30 분일찍오십시오. 꼭끼지않고편안한옷을입으십시오.

3 페이지 3 고주파절제 귀금속을착용하지마십시오. 질문있으십니까? 환자분의질문은중요합니다. 만일질문이나걱정되는점이있으시면담당의사선생님이나건강관리인에게전화하십시오. 또한 UWMC 클리닉직원들도언제든지도와드릴준비가되어있습니다주중에는오전 8 시부터오후 5 시까지 : 로전화하십시오. 업무시간이후와주말과공휴일에는 : 으로전화해서당직통증과의사를호출해달라고요청하십시오. 목면내의만착용하십시오. 가능하면, 집에운전해서모시고갈사람을데리고오십시오. 만일환자분의혈압이높고조절이잘안되면, 시술이다른날로변경될수도있습니다. 만일환자분이진정제주사를받으실것이면 : 시술이후환자분을집에운전해서모시고갈사람을꼭데리고오셔야합니다. 예약 8 시간전에시작할것들 : 고형음식을드시지마십시오. 첫 4 시간은맑은액체는마셔도됩니다. 예약 4 시간전에는절대로아무것도마시지마십시오. 그동안에약을복용해야되면작은량의물로약을드십시오. 만일이와같은규칙을따르지않으시면저희는진정제를주사드리지않을것입니다. 만일당뇨병이있으시고진정제를받으실것이면, 환자분은금식을하실것이므로당뇨전문의에게시술하는날아침당뇨약을어떻게해야하는지물어보십시오. 언제정상활동을다시시작할수있습니까? 만일진정제를맞으셨으면시술이후 24 시간은운전이나기계작동을하지마십시오. 시술직후통증이제거되어도통증때문에할수없었던모든할동들을곧바로시작하지마십시오. 통증의원인인근본적인문제가아직있는것을기억하십시오. 무리하면, 몇일안으로나아진느낌이있다해도환자분의통증이금방돌아올수도있습니다. 통증때문에사용하지못하던근육들을천천히강화시키는운동프로그램을따라서하는것이중요합니다. 근육의힘을늘리기에는시간이걸립니다. 차후예약 Box Roosevelt Way N.E., Suite 401 Seattle, WA 고주파절제술을받으신, 후집에가시기전에환자자신보고 4 주통증일기를받으실것입니다. 이서류를집에가지고가서기록하시고, 그런다음시술받은 4 주이후에결과를에전화로보고하셔야합니다. 시술받은 6 주이후에클리닉에다시오실것입니다. University of Washington Medical Center Radiofrequency Ablation Korean 08/2009 Translation by UWMC Interpreter Services Reprints on Health Online:

5 Patient Education Radiofrequency Ablation What to expect from your procedure This handout explains radiofrequency ablation, which burns the nerve that is causing your pain. You will need to keep track of your pain symptoms after your procedure and call the clinic to report your results in 4 weeks. What is radiofrequency ablation? Radiofrequency ablation is a minimally invasive treatment in which high-frequency electricity is applied to the nerve that sends pain impulses to your brain. This process burns the nerve, which makes it stop sending these impulses. How is it done? The doctor will use local anesthetic to numb the skin where a needle will be inserted. The doctor uses X-ray to guide the needle to the correct nerve. To make sure the needle is in the right place, a small test dose of electricity is applied to the nerve. When the needle is placed on the nerve, you will feel tingling, a deep ache, and some muscle twitching. You will tell the doctor when this happens. When the doctor is sure the needle is in the right place, a small amount of anesthetic is injected and then the nerve is burned. You may feel some discomfort. You may receive a light sedation for this procedure, but you will stay awake so that you can talk with the doctor and answer questions. What results can I expect? During the first days or weeks, your pain or numbness might increase, but this should slowly ease. Even though we expect complete pain relief, relief from 50% to 80% of your pain is a good outcome. As many as 80% of patients (8 out of 10) who have this procedure have some pain relief. Pain relief from the procedure may last 8 to 24 months. But, because nerves usually grow back, your pain might return. If your pain returns after this time, the procedure may need to be done again. But, if your pain relief lasts for less than 6 months, the doctor will not repeat the ablation, since the pain is likely to return more quickly after another procedure.

6 Page 2 Radiofrequency Ablation What if the procedure does not help my pain? This procedure does not work for everyone. If the procedure does not ease your pain, your doctor will talk with you about other treatment options during your follow-up visit at the. Side Effects There is a risk for side effects with any medical procedure. Talk with your doctor about side effects before having any treatment. Some possible side effects from radiofrequency ablation are: Pain at the injection site. Infection. Bleeding. Nerve injury. Allergic reaction. A burning sensation along the treated nerve. Bruising near the treatment site. Increased pain and/or numbness, which may last for several weeks. Dizziness and unsteady walking if the treatment was applied to nerves in your neck. This may last for several hours. How long does it take? The procedure takes about 45 minutes, but plan to spend 2 hours at the clinic from the time you are admitted until you leave. How to Prepare for Radiofrequency Ablation Medicine Changes You must stop taking blood-thinning medicines such as warfarin (Coumadin), clopidogrel (Plavix), enoxaparin (Lovenox), and others before having radiofrequency ablation. If you take any blood-thinning medicine, talk with your doctor who prescribed the medicine as soon as you are scheduled for this procedure. You may keep taking low-dose aspirin and anti-inflammatory medicines. On the Day of the Procedure Note: You may eat and drink as usual if you will not receive sedation. For all patients: Arrive at the clinic at least 30 minutes before your appointment. Wear loose, comfortable clothing. Do not wear jewelry.

7 Page 3 Radiofrequency Ablation Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC clinic staff are also available to help. Weekdays from 8 a.m. to 5 p.m.: Call the Center for Pain Relief at After hours and on weekends and holidays: Call and ask for the Pain Fellow on call to be paged. Box Roosevelt Way N.E., Suite 401 Seattle, WA Wear underwear made of only cotton. If possible, bring someone with you who can drive you home. If your blood pressure is high and not well-controlled, your procedure may need to be scheduled for another time. If you will be receiving sedation: You must bring someone with you who can drive you home after the procedure. Starting 8 hours before your appointment: - Do not eat any solid food. - For the first 4 hours, you may drink only clear liquids. - For the 4 hours before your appointment, do not drink anything. - If you need to take any medicines during this time, take them with only a small sip of water. We will not be able to give you sedation if you do not follow these diet guidelines. If you will be receiving sedation and you have diabetes, you must also ask your diabetes care provider how to manage your medicines the morning of your procedure since you will be fasting. When can I resume my usual activities? If you had sedation, do not drive or operate machinery for 24 hours after your procedure. If you have pain relief right after your procedure, do not start doing all the activities you have not been able to do because of your pain. Remember, you still have the underlying problem that caused your pain. If you overdo it, your pain may return quickly, even within a few days of feeling better. It is important to do an exercise program that slowly strengthens the muscles you have not been able to use because of your pain. It will take time to build up your strength. Follow-up Before you go home after having radiofrequency ablation, you will receive the Patient Self-Reported 4-Week Pain Diary. Take this form home and fill it out, then call the 4 weeks after your procedure to report your results. You will return to the clinic for a follow-up visit 6 weeks after your procedure. University of Washington Medical Center 08/2009 Reprints on Health Online:

Going Home - Korean

Going Home - Korean Going Home After an illness or injury, some things may change in your life. Make sure you and your family know the answers to these questions before you go home from the hospital. Medicines Am I taking