• The Korean Journal of Pain
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• v.9 no.1
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• pp.105-108
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• 1996

Localized or radiating pain in the arm and shoulder joint may result after faulty alignment causing compression or tension on nerves, blood vessels, or supporting soft tissues. The critical site of faulty alignment is the quadrangular space in the axilla bounded by the teres major, teres minor, long head of triceps, and humerus. The axillary nerve emerges through this space to supply the deltoid and teres minor. The activity of the trigger point on teres minor compressing the axillary nerve causes pain to develop through the area of sensory distribution of cutaneous branch of the axillary nerve. Relieving compression on the axillary nerve and suprascapular nerve is the key point to relieving the pain. Spasm of the supraspinatus and infraspinatus compressing the suprascapular nerve caused pain to develop in the shoulder joint and scapular area. We treated those patients experiencing such pain with local anesthetic infiltration or I-R laser stimulation on the identified trigger points.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.279-283
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• 2005

Biplane fluoroscopy is usually used in angiography. Biplane fluoroscopy gives a biplane image with high resolution during the performance of operations. Trigeminal nerve blocks are effective treatment modalities for trigeminal neuralgia, and maxillary nerve block is the most dangerous procedure among them. The anatomic structures can change after head and neck surgery, so the trigeminal nerve block procedures cannot be done so easily. We used biplane fluoroscopy in these difficult cases. Our first case was a 60-year-old man who had undergone maxillary nerve block. The second case was of a 64-year-old man who had pulsed radiofrequency lesioning of mandibular nerve performed after head and neck surgery. With biplane fluoroscopy, we got good results without any complications.

• Clinical Pain
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• v.18 no.1
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• pp.36-39
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• 2019

Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.81-84
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• 2011

Purpose: Nerve injury is one of the complication which can develop after brow lift. Peripheral nerve ending which is stretched from supraorbital nerve and supratrochlear nerve can be injured and symptoms such as pain, dysesthesia may appear. Usually, developed pain disappeared spontaneously and does not go on chronic way. We experienced a case that a patient complained chronic pain after brow lift which was not controlled by conservative management such as medications, local nerve block and report a successful surgical treatment of chronic pain after brow lift. Methods: A 24-year-old male who received brow lift with hairline incision at local hospital was admitted for chronic pain at the right forehead. The pain was continued for 3 months even though fixed thread was removed. Local nerve block at trigger point with mixed 1 mL 2% lidocaine and 1 mL Triamcinolone acetonide was done and oral medications, Gabapentine and carbamazepine, were also applied but there was no difference in the degree of pain. Therefore the operation was performed so that careful dissection was carried out at right supraorbital neurovascular bundle and adhered supraorbital nerve was released from surrounding tissues and covered with silastic sheet to prevent adhesion. Results: The pain was gradually relieved for a week. The patient was discharged without complications. No evidence of recurrence has been observed for 2 years. Conclusion: The pain developed after brow lift was engaged with nerve injury and sometimes remains chronically. Many kinds of conservative management to treat this complication such as medications, local nerve block have been reported and usually been used. But there are some chronic cases that conservative treatment do not work. In sum, we report 1 case of successful surgical treatment for relief of intractable pain developed after brow lift surgery.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.1-8
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• 1992

A total of 578,886 nerve blocks were performed during a period of 28 years. Based on our experience, we introduced the concept of compartment block, and then improved our technique of nerve blocking. If the location of a compartment was defined by injecting a contrast medium under fluoroscopic monitoring, the effect of nerve block could be estimated. As a result, we can safely perform nerve blocks with alcohol within a short period of time.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.89-93
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• 1996

Hemifacial spasm commonly occurs in muscles about the eye, but may also involve or spread to the entire side of the face. One hundred and seventy eight patients with hemifacial spasm visited our Neuro-Pain clinic from January 1992 to April 1996. There were 121 female and 57 male patients, a 2.1:1 ratio respectively. Largest percentages of patients were in the 50 year old range. Among them, 96 patients were treated by facial nerve block or O'Brien block. In most cases, induced facial palsy disappeared within one or two months. Among the 96 patients who received nerve block, 46 patients received a second block within 5 to 24 months. The average interval from first and second nerve block was 11.5 months. After nerve block, all patients were free from spasm for 1 to 21 months. We conclude that facial nerve block is a satisfactory and reliable method for the treatment of facial spasm.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.43-48
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• 1994

Twenty seven patients with hemifacial spasm were treated by facial nerve block at the foramen stylomastoideum and O'Brien block from January 1992 to March 1994. There were 16 female and ll male patients, a 1.5:1 ratio respectively. Most patients were 40~60 years old. Among the 27 patients treated by nerve blocks, 26 responded well to the facial nerve block, including two cases of O'Brien block. One patient failed to respond to the facial nerve block. Induced facial palsy disappeared within one or two months within the majority of patients. Among the 26 patients who received nerve block, 6 patients required a second block within 3 to 9 months. After successful nerve block, all patients were free of spasm for 1 to 16 months. Although the follow-up period was short in duration, these results suggest that facial nerve block is a satisfactory and reliable method in the treatment of facial spasm.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.83-88
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• 1996

This is a retrospective analysis of 158 patients who visted our Neuro-Pain clinic, April 1992 to March 1996, suffering from trigeminal neuralgia. Most patients received nerve blocks in its triggering peripheral branches of pain. All patients experienced pain relief for 3 months after initial successful nerve block. Twenty two patients complained of recurring pain within 4 to 32 months. Mean duration of pain relief was as follows: infraorbital nerve block 15.2 months, maxillary nerve block 16.8 months, and mandibular nerve block 23.4 months. Demographic and clinical characteristics of all patients were also evaluated. This study demonstrates that alcohol block is a safe and effective method of treating trigeminal neuralgia.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.186-190
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• 2009

Sciatic nerve block is frequently used for anesthesia or analgesia during lower leg surgery or chronic lower leg pain syndrome. Recently, a lot of ultrasound-guided peripheral nerve block has been reported because there are several benefits compared to blind technique. We performed ultrasound-guided right sciatic nerve block successfully to the patient who has been suffering from right buttock pain after previous radiation therapy.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.101-104
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• 1998

Backgrouds: Twent five years have passed since the opening of the first pain clinic in korea, in 1973 at Yonsei University Hospital. The number of pain clinics are gradually increasing in recent times. It is important to plan for future pain clinics with emphasis on improving the quality of pain management. Therefore we reviewed the patients in our hospital to help us in planning for the future of our pain clinic. Methods: We analyzed 2656 patients who had visited our Kim Chan Pain Clinic, accordance to age, sex, disease, and type of treatment block, from July 1996 to August 1997. Results: The prevalent age group was in the fifties, 27.3%, seventy years and older compromised 9.2%. The most common disease were as follows: lower back pain(46.2%); cervical and upper extremities pain(23.1%); trigeminal neuralgia(7.2%); and hyperhydrosis(5.8%) Both nerve blocks and medication were prescribed as treatment. Lumbar epidural block(16.3%) and stellate ganglion block(15.6%) were the most frequent blocks performed among various nerve blocks. Among nerve block under C-arm guidance, lumbar facet joint block(24.4%) and lumbar root block(22.5%) were performed most frequently. Trigeminal nerve block(18.4%), thoracic(17.0%) and lumbar sympathetic ganglion block(11.4%) were next most prevalent blocks performed frequent block. Conclusions: Treatments at our hospital were focused on nerve blocks and medications prescriptions. Nerve blocks are of particular importance in the diagnosis and treatment of chronic pain. However in future, to raise the quality of pain management, we need to fucus on a multidisciplinary/interdisciplinary team approach.