• The Korean Journal of Pain
• /
• v.5 no.1
• /
• pp.89-91
• /
• 1992

Coccygodynia is a pain syndrome resulting from trauma, fractures, infection and tumor, and is usually amenable to conservative treatment. We present one case of coccygodynia that developed 2 days after percutaneous cordotomy done for pain control of cervix cancer unresponsive to conservative treatment which subsequently was treated with a caudal injection of lidocaine and triamcinolone. Caudal epidural steroid injection is less invasive and has less potential for complication than the neurosurgical interruption of the pain pathway.

• The Korean Journal of Pain
• /
• v.8 no.2
• /
• pp.293-297
• /
• 1995

Despite applying recent advances in research and technology and taking into acount proper histories and performing thorough physical examinations, a high percentage of patients with low back pain have no identifiable pathology. Problems especially of the sacroiliac joint are commonly missed. The purpose of this article is to describe the effects of sacroiliac injection of local anesthetics and corticosteroids on patients with acute sacroiliac sprain. The sacroiliac joints are essentially nonweight-bearing joints that allows a small amount of anteroposterior rotatory movement around transverse axis usually about 5 to 10 cm below the promontory of the sacrum vertically. The ligamentous portion of sacroiliac joint is vulnerable to rotatory movement particularly when the individual is in an awkward position. Injections of 3 ml of 2% lidocaine and 10 mg of methylprednisolone were given twice at two day intervals to 26 patients with acute sacroiliac sprain. Most of those patients obtained excellent results without any adverse effects.

• The Korean Journal of Pain
• /
• v.6 no.2
• /
• pp.265-269
• /
• 1993

Subdural block is a rare but well recognized complication of epidural anesthesia. The placement of local anesthetics into the subdural space can lead to potentially life-threatening conditions. A healthy 46-year-old women underwent total abdominal hysterectomy under continuous lumber epidural anesthesia. The technical procedure for continuous epidural catheterization went smoothly without a single problem. However, signs of high epidural block such as apnea, cranial nerve paralysis and pupil dilatation developed gradually, about 20 minutes after the epidural injection of 2% lidocaine 20 ml through the epidural catheter. Such extensive segmental block can only be explained as the result of injection into subdural space even if it was not confirmed radiologically.

• Proceedings of the PSK Conference
• /
• 2002.10a
• /
• pp.410.1-410.1
• /
• 2002

Local anesthetics are used to reduce pain. but they are so frequently injected to patients. So we prepared lidocaine solid lipid nanopaticles for long acting subcutaneous injection to decrease the number of times of injection. Solid lipid nanoparticles were prepared by spray drying method. First. drug. lipid. plasticizer and surfactant were dissolved in methylene chloride. and we operated spray dryer using this solution at setting value. (omitted)

• Asian Oncology Nursing
• /
• v.12 no.4
• /
• pp.323-330
• /
• 2012

Purpose: Gamma knife radiosurgery (GKR) requires frame positioning because the treatment target should be as close as possible to the center of the frame. The purpose of this study was to identify the level of pin-fixing (PFP) and removal pain (PRP), and the associated factors with the pain undergoing GKR. Methods: A total of 116 patients who underwent GKR for their brain tumor were recruited from C University hospital located in H city, J province. The level of pain was measured by the 10 cm VAS. Results: The level of PFP and PRP were 6.36 and 3.26 points, respectively. Step-wise multiple regressions found that the group who have not perceived numbness after applying 5% EMLA cream was the highest associated factor with PFP, following the time from lidocaine injection to pin-fixation, which explained 21% of total variance of the level of PFP. On the other hand, a group who did not perceive numbness after applying 10% lidocaine spray was the highest factor with PRP, among female patients, which explained 27% of total variance of the level of PRP. Conclusion: Both of PFP and PRP of the stereotactic frame were moderate so that nurses should consider diverse strategies to reduce pain among patients undergoing gamma knife radiosurgery.

• The Korean Journal of Pain
• /
• v.8 no.1
• /
• pp.156-158
• /
• 1995

Total spinal anesthesia is a well documented serious life threatening complication which results from an attempted spinal or epidural analgesia. We had an accidental total spinal anesthesia associated with a cranial nerve paralysis and an eventual unconsciousness during epidural analgesia. A 45-year-old female with an uterine myoma was scheduled for a total abdominal hysterectomy under the epidural analgesia. A lumbar tapping for the epidural analgesia was performed in a sitting position at a level between $L_{3-4}$, using a 18 gauge Tuohy needle. Using the "Loss of Resistance" technique to identify the epidural space, the first attempt failed; however, the second attempt with the same level and the technique was successful. The epidural space was identified erroneously. However, fluid was dripping very slowly through the needle, which we thought was the fluid from the normal saline which was injected from the outside to identify the space. Then 20 ml of 2% lidocaine was administered into the epidural space. Shortly after the spinal injection of lidocaine, many signs of total spinal anesthesia could be clearly observed, accompanied by the following progressing signs of intracrainal nerve paralysis: phrenic nerve, vagus nerve, glossopharyngeal nerve and trigeminal nerve in that order. Then female was intubated and her respiration was controlled without delay. The scheduled operation was carried out uneventfully for 2 hours and 20 minutes. The patient recovered gradually in th4e reverse order four hours from that time.

• The Korean Journal of Pain
• /
• v.2 no.2
• /
• pp.194-197
• /
• 1989

Epidural morphine provides excellent analgesia for the management of postoperative pain, but nausea and vomiting are a commonly reported side effect. Scopolamine, a belladona alkaloid, is an effective antiemetic when nausea is induced by morphine. Transdermal scopolamine patches have the advantage of delivering a constant low dosage of the drug over a prolonged period. To evaluate the efficacy of prophylacitic transdermal scopolamine in reducing nausea or vomiting associated with postoperative epidural morphine analgesia, I studied 60 healthy adult patients. The patients were divided into 3 groups, each group consisting of 20 patients. Group 1; no scopolamine for control Group 2; transdermal scopolamine placebo patch Group 3; transdermal scopolamine patch All patients were anesthetized by epidural injection of 2% lidocaine 15 ml and 0.5% bupivacaine 10 ml with morphine 4 mg. A Comparison with the control group, the placebo group, and Group 3, indicated, that the transdermal scopolamine reduced the incidence of nausea or vomiting associated with postoperative epidural morphine analgesia (group 1; 35%, group 2; 25%, group 3; 10%). However there were no statistically significant differences between groups at a level of p>0.05.

• Archives of Plastic Surgery
• /
• v.50 no.1
• /
• pp.70-81
• /
• 2023

Background The clinical results of conservative treatment options for ulnar compression at the elbow have not been clearly determined. The aim of this review was to evaluate available conservative treatment options and their effectiveness for ulnar nerve compression at the elbow. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a systematic review and meta-analysis of studies was performed. Literature search was performed using Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Results Of the 1,079 retrieved studies, 20 were eligible for analysis and included 687 cases of ulnar neuropathy at the elbow. Improvement of symptoms was reported in 54% of the cases receiving a steroid/lidocaine injection (95% confidence interval [CI], 41-67) and in 89% of the cases using a splint device (95% CI, 69-99). Conclusions Conservative management seems to be effective. Both lidocaine/steroid injections and splint devices gave a statistically significant improvement of symptoms and are suitable options for patients who refuse an operative procedure or need a bridge to their surgery. Splinting is preferred over injections, as it shows a higher rate of improvement.

• The Korean Journal of Pain
• /
• v.14 no.1
• /
• pp.104-109
• /
• 2001

We describe the accidental injection of local anesthetics containing steroid into the subdural space during an attempted lumbar epidural injection for intractable radiculopathy in a patient with failed back surgery syndrome. A 24-year-old man complained of severe radiating pain to left lower extremity and showed a walking disturbance and severe lumbar scoliosis. The MRI finding was a left paramedian recurred disc herniation on L4-5 in a laminectomy state. Several therapeutic modalities such as epidural steroid injection, transforaminal injection, L2 root block, medication, and exercise therapy, etc failed. Initially, during epidural block at L4-5 under fluoroscopic guidance, a railroad track appearance appeared on epidurogram suggesting the presence of a subdural space. A second epidural block was tried at L5-S1. Following confirmation of epidural space upon epidurogram, 6 ml of 0.5% lidocaine including triamcinolone 40 mg was injected. The patient showed signs of the subdural injection including an unexpectedly high sensory block (T2) and a motor weakness of both lower extremities. Following this event, the severe radiculopathy and lumbar scoliosis were improved. Therefore, we conclude that subdural injection of steroid could be helpful in intractable radiculopathy, especially in the failed back surgery syndrome. However, it must be used cautiously with careful patient selection.

• Journal of Veterinary Clinics
• /
• v.23 no.2
• /
• pp.190-193
• /
• 2006

Two weeks of therapy with intra-articular hyaluronic acid and oral caprofen failed to improve the clinical signs of hip osteoarthritis radiologically confirmed in a dog. Then, over the period of 30 days (7 sessions at 5-day intervals), bee- venom acupuncture (BV-AP, injection of bee venom at acupoints, also called apitoxin-aquapuncture) plus Trigger Point (TP) therapy was used. Five acupoints on the affected right limb were injected each time: GB30(as local point), plus ST35, GB33, BL40 and LIV08 (as distant points). The injection mixture (0.2 ml/point; total 1 ml/session) was saline + apitoxin + 2% lidocaine, so that the injected solution contained $100{\mu}g$ apitoxin diluted in 0.2% lidocaine-saline solution/ml. The total dose of apitoxin used was, therefore, $100{\mu}g/session$, divided over the 5 acupoints. One TP in the middle of the right quadriceps muscle was injected with 2% lidocaine (0.2 ml/point) each time. BV-AP improved the clinical signs rapidly; lameness and ataxia were disappear after 7 sessions (30 days); the right hind limb muscular atrophy was much improved and the hip radiograph was almost normal two weeks after 7 sessions (44 days). The present patient was a case with canine hip osteoarthritis which showed favorable therapeutic response by BV-AP plus TP therapy.