• Title/Summary/Keyword: Intractable pain

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Thoracoscopic Splanchnicectomy for Relief of Intractable Pain in Pancreatic Cancer - 2 case reports - (췌장암 환자의 난치성 통증 해소를 위한 흉강경하 내장신경절제술 - 2예 보고 -)

  • Kim, Jae-Jun;Wang, Young-Pil;Park, Jae-Kil;Suh, Jong-Hui;Moon, Seok-Whan;Kim, Young-Du
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.785-788
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    • 2009
  • Many patients with upper abdominal organ cancers, including pancreatic cancer, suffer from severe pain, and various methods and techniques have been used for relieving this pain. We present here two cases of patients with pancreatic cancer and they were both successfully relieved of their abdominal pain by performing video-assisted thoracoscopic sympathectomy and splanchnicectomy. This minimally invasive procedure offers promise in carefully selected patients with severe pain from pancreatic cancer and other conditions.

Treatment of Malignant Sacral Pain by Radiofrequency Lesion Generator (전기적(電氣的) 열응고술(熱凝固術)을 이용(利用)한 암성천골통증(癌性薦骨通症)의 관리(管理))

  • Chung, Hyun-Sook;Kang, Sung-Hee;Kim, Kyung-Han;Chang, Tae-Ho;Kim, Se-Hwan
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.196-199
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    • 1991
  • Efforts from many different approaches have been made to manage malignant sacral pain that commonly occurs in cancers from pelvic origin. Radiofrequency thermocoagulation provides a safe method of achieving long standing relief of intractable pain without some of the objectable side effects associated with other forms of chemical or surgical therapy. Radiofrequency sacral rhizotomy is a new method for the relief of the sacrococcygeal pain. We report a case in which we managed a patient with malignant sacrococcygeal pain with radiofrequency thermocoagulation.

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Inferior Mesenteric Plexus Block Performed in the Lateral Position (측와위에서 시행한 하 장간막 신경총차단)

  • Kim, Chun-Sook;Cha, Young-Deog
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.144-148
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    • 1995
  • Inferior mesenteric plexus block(IMPB) sa useful nerve block for the relief of intractable lower abdominal and pelvic pain caused by a lower abdominal visceral or a pelvic malignancy. IMPB has been performed in the prone position. But there are many patients who can't lie in the prone position, because ascites is frequently noticed in cancer patients and they also frequently received abdominal operations. We performed IMPB in the lateral position on two patients with lower abdominal pain, Case 1: A 77 year old female who had a right ovarian cancer with metastatic cancer of descending colon and rectum, experienced complete pain relief. Case 2: A 72 year old female who had a far advance pancreatic cancer with intestinal obstruction due to carcinomatosis received right and left celiac plexus block and right and left IMPB. The patient was satisfied with the result of these pain blocks. Conclusion; IMAPB performed in the lateral position on two patients with lower abdominal pain and their results were excellent for pain relief.

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Occurrence of Trochlear Nerve Palsy after Epiduroscopic Laser Discectomy and Neural Decompression

  • Yoon, Keon Jung;Lee, Eun Ha;Kim, Su Hwa;Noh, Mi Sun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.199-202
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    • 2013
  • Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS).

Multicenter survey of symptoms, work life, economic status, and quality of life of complex regional pain syndrome patients

  • Lee, Jaemoon;Lim, Yun Hee;Hong, Sung Jun;Jeong, Jae Hun;Choi, Hey Ran;Park, Sun Kyung;Kim, Jung Eun;Park, Eun Hi;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.288-303
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    • 2021
  • Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed. The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions: Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

Blockade of the Ganglion Impar in Rectal Cancer Pain -A case report- (외톨이 교감신경절 차단을 이용한 직장암성 통증의 치험 -증례 보고-)

  • Lee, Young-Bok;Yoon, Kyung-Bong;Park, Jeong-Sim
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.419-422
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    • 1996
  • Pain arising from pelvic viscera and perineum is frequently associated with discomfort and disability and caused by local trauma, inflammation and malignancy within the pelvis. Although various interventions have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. The ganglion impar is a solitary retroperitoneal structure located at the level of the sacrococcygeal junction that marks the terminations of sympathetic chains. We propose that blockade of the ganglion impar is an effective method in the management of patient suffered from perianal pain due to advanced rectal cancer.

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Experience with Spinal Cord Stimulation for Relief of Causalgia on the Right Lower Extremity -A case report- (척수신경 자극기를 이용한 우하지 작열통의 치험 -증례 보고-)

  • Lee, Dong-Ki;Kim, Yong-Ik;Park, Wook
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.229-231
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    • 1996
  • Spinal cord stimulation(SCS) was first attempted to relieve intractable pain in 1966. SCS has evolved into percutaneously implanted electrode with aim of activating spinal pain-inhibiting mechanism via dorsal columns. SCS is valuable for the treatment of many painful and difficult to treat conditions such as postamputation pain, painful peripheral neuropathies, chronic sciatic pain and so on. We treated a case of causalgia of the right lower extremity with successful outcome of 90% sustained relief of pain. And patient has satisfied using SCS(Model MNR-94, Neuromed) for 6 months follow-up.

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High Thoracic Epidural Analgesia for the Control of Pain in Unstable Angina Pectoris -A case report- (불안정형 협심증 환자의 고위 흉부 경막외 진통 효과 -증례보고-)

  • Lee, Bong Jae
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.271-274
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    • 2006
  • Unstable angina is a critical phase of coronary heart disease, with widely variable symptoms and prognoses. Recently, despite the advances in surgical revascularization, catheter-based revascularization and medical treatment, an increasing number of patients with angina pectoris are refractory to medical therapy and; therefore, can not be considered as candidates for coronary artery bypass grafting or interventional angioplasty. These patients are often treated with narcotics for pain relief, and forced to severely reduce their levels of activity and productivity. It has become clear that alleviating the pain caused by myocardial ischemia may be possible by altering the sympathetic afferent nerve fibers. Sympathetic blockade can be produced using high thoracic epidural analgesia. Herein, the case of a patient with intractable angina and poor ventricular function, who received high thoracic epidural analgesia to relieve ischemic chest pain, is reported.

Alcohol Neurolysis for the Treatment of Trigeminal Neuralgia (Alcohol Neurolysis를 이용한 삼차 신경통 치험예)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.45-48
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    • 1989
  • Trigeminal neuralgia is one of the diseases which cause most chronic and intractable pain on the facial area. Several drugs includding analgegics, anticonvulsants, tranquilizers, vitamins or hormonal preparations have been expected to be effective but no drug could effectively relieve the patients from the pain. The pain could be relieved by surgical neurectomy or neurolysis of the Gasserian ganglion or the involved branches with absolute alcohol alternatively. Surgical microvascular decompression may be performed if the pain resulted from compression of the nerve by adjucent arterial loops. 4 cases of trigeminal neuralgia are presented. They were treated with alcohol neurolysis of the involved peripheral nerves combined with or without carbamazepine and/or amitriptyline with favorable result of pain relief.

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The Intrathecal Drug Administration System (척수강 내 약물 주입술)

  • Nahm, Francis Sahngun;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.117-123
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    • 2009
  • The intrathecal drug administration system (ITDAS) has recently been introduced for treating chronic intractable pain patients who have failed with conservative pain treatments. The obvious advantages of its use are the direct intrathecal delivery of drugs, which yields reduced adverse effects and the increased strength of drugs, as compared to its oral or intravenous route. This article offers a review of the ITDAS with a brief review of its evidence-based effectiveness, the technical approach, and the complications.