• Title/Summary/Keyword: Pain, intractable

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Splanchnic Nerve Block at T12 Level (제 12흉추부위에서 시행한 내장신경차단)

  • Park, Chung-Hyun;Yoon, Kuck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.17-22
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    • 1992
  • Splanchnic nerve block(SNP) is performed to relieve intractable upper abdominal cancer pain. Boas, in a technique using fluoroscopy, was the first to note the difference between transcrural celiac plexus block and retrocrural splanchnic nerve block(SNB). We have experienced 10 cases of SNB at the T12 level under control of fluoroscopy. Our results support this approach as an effective method for upper abdominal cancer pain control.

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Dolichoectasia of vertebrobasilar artery presenting as facial pain: a case report

  • Prasanna Vadhanan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.4
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    • pp.237-240
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    • 2023
  • Dolichoectasia of the intracranial arteries is a rare condition characterized by elongated and tortuous arteries due to progressive destruction of the vessel walls. Although most patients present with cerebrovascular accidents, our patient presented with intractable facial pain along the distribution of the trigeminal nerve. Clinical examination revealed involvement of the 5th, 7th, and 8th cranial nerves, and subsequent MRI showed dolichoectasia of the left basilar artery. The patient experienced symptomatic relief after a trial of carbamazepine along with botulinum toxin injections.

A study on Intractable disease in the sight of Lee Je Ma (이제마(李濟馬)의 난치병(難治病)에 대(對)한 시각(視角)에 관(關)한 연구(硏究))

  • Jang, Hyun Jin
    • Journal of Sasang Constitutional Medicine
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    • v.7 no.2
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    • pp.129-134
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    • 1995
  • Lee Je Ma (1837~1900) wrote the DongEuSuSeBoWon in 1894. Constitutional Medicine what is called Sasang Medicine has originated from him. In this book he refers to mild, serious, intractable, incurable and fatal disease. In the sight of his Medical theory each state of disease deserves to be researched. 1. In the case of Soumin exhaustion of Yang, Taeyang-Kwolum, noxious Yin, Yang is kept in the exterior by excessive Yin in the interior, middle diabetes and swelling belong to intractable disease and solid mass in the right epigastric zone belongs to fatal disease. 2. In the case of Soyangin exhaustion of Yin, lower diabetes, afternoon fever due to deficiency of Yin, spitting blood and swelling belong to intractable disease and distention of abdomen with gas or fluid belongs to fatal disease. 3. In the case of Taeumin syncope due to chills, dryness-heat, diabetes, pain of chest and abdomen and swelling belong to intractable disease and apoplexy with dosed eyes belongs to fatal disease. 4. In the case of Taeyangin vertebral disease makes flaccidity of lower limbs and dysphagia with vomiting of frothy fluid belongs to fatal disease.

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Alcohol Neurolysis of the Celiac Plexus of Upper Abdominal Pain Relief (상복부(上腹部) 통증완화(痛症緩和)를 위한 복강신경총차단(腹腔神經叢遮斷))

  • Kim, Inn-Se
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.164-170
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    • 1988
  • Neurolysis of the celiac plexus is performed to relieve intractable pain caused by carcinoma of the stomach, liver and pancreas, and upper abdominal metastasis of tumors having more distant origins. It is also occasionally effective in controlling the pain of chronic pancreatitis. Alcohol celiac plexus blocks were done in 22 patients of whom 18 had intractable upper abdominal pain from cancer and 4 had pain from chronic pancreatitis. In most cases, an initial diagnostic block with 0.2 percent bupivacaine was followed by the therapeuntic block performed by injecting 50ml of 60 percent ethyl alcohol. Good to excellent pain relief occurred in 86 percent of patients. Duration of pain relief was from 4 months to 7 months in 55 percent of patients. Complications and side effects were infrequently seen but did include a 16 percent decrease of mean systolic arterial pressure and 16 cases of facial flushing. This block is remarkably safe as well as effective for the relief of upper abdominal pain from cancer origin.

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Fluoroscopy and Sonographic Guided Injection of Obliquus Capitis Inferior Muscle in an Intractable Occipital Neuralgia

  • Kim, Ok-Sun;Jeong, Seung-Min;Ro, Ji-Young;Kim, Duck-Kyoung;Koh, Young-Cho;Ko, Young-Sin;Lim, So-Dug;Shin, Hwa-Yong;Kim, Hae-Kyoung
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.82-87
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    • 2010
  • Occipital neuralgia is a form of headache that involves the posterior occiput in the greater or lesser occipital nerve distribution. Pain can be severe and persistent with conservative treatment. We present a case of intractable occipital neuralgia that conventional therapeutic modalities failed to ameliorate. We speculate that, in this case, the cause of headache could be the greater occipital nerve entrapment by the obliquus capitis inferior muscle. After steroid and local anesthetic injection into obliquus capitis inferior muscles under fluoroscopic and sonographic guidance, the visual analogue scale was decreased from 9-10/10 to 1-2/10 for 2-3 weeks. The patient eventually got both greater occipital neurectomy and partial resection of obliquus capitis inferior muscles due to the short term effect of the injection. The successful steroid and local anesthetic injection for this occipital neuralgia shows that the refractory headache was caused by entrapment of greater occipital nerves by obliquus capitis inferior muscles.

Treatment of Failed Back Surgery Syndrome with a Spinal Cord Stimulator -A report of 2 cases- (척추수술후증후군에서 척수자극술을 이용한 치료경험 -증례 보고-)

  • Park, Chan Hong;Cho, Chul Bum
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.123-126
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    • 2006
  • Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.

Acute Respiratory Failure during Splanchnic Nerve Block in COPD Patient (만성폐색성 폐질환 환자에서의 내장신경차단중 발생한 급성호흡부전)

  • Chang, Won-Young;Choe, Kun-Chun
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.200-204
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    • 1991
  • Neurolytic splanchnic nerve block is a relatively safe and effective method for the relief of intractable pain caused by upper abdominal cancer. We have experienced a case of severe acute respiratory failure during splanchnic nerve block under control of X-ray fluoroscopy. We think that the most likely cause of the acute respiratory failure was an asthmatic attack due to anxiety and dyspnea from the injury or stimulation of the diaphragm and pleura in this case.

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The Effect of Ganglion Impar Block for Excessive Perianal Sweating -A case report- (외톨이 교감신경절 차단을 이용한 항문 주위 다한증의 치험 -증례 보고-)

  • Lee, Hyo-Keun;Yang, Seung-Kon;Lee, Hee-Jeon;Lee, Seong-Yeon;Kim, Seong-Mo;Kim, Boo-Seong;Kim, Chan;Kim, Soon-Yul
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.363-366
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    • 1995
  • Blockade of the ganglion impar was performed as an alternertive means of managing intractable neoplastic perineal pain of sympathetic origin. We successively treated a patient who had suffered from excessive perianal sweating with ganglion impar block using pure alcohol. Eight months after block, the patient has no complaint of perianal sweating. Ganglion impar block is an effective method in the treatment of excessive perianal sweating as well as perineal pain of sympathetic origin.

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Neurolytic Splanchnic Nerve Block for the Treatment of Upper Abdominal Pain (상복부 암성통증 환자관리에 있어서 내장신경통 차단술의 임상적 고찰)

  • Yoon, Young-Joon;Jin, Sang-Ho
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.181-188
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    • 1989
  • Neurolytic splanchnic nerve block is an effective method for the relief of pain of upper abdominal cancer. Nine cases of intractable upper abdominal cancer pain were treated by splanchnic nerve block with absolute alcohol (25 ml) at the pain clinic of Kangdong Sacred Heart Hospital, Hallym University, during a 19 month period from March, 1988 to September, 1989. The group included six patients with stomach cancer, two patients with pancreatic cancer, and one patient with hepatobiliary cancer. We used fluoroscopy in all cases of alcohol spianchnic nerve block to determine both, the position of the needle tip, and the spread of the neurolytic solution. Of the 9 patients, 6 patients had excellent pain relief, and 3 patients who had combined upper abdominal and lower back pain had relieved upper abdominal pain only, but remaining lower back pain. Of the 9 patients', 5 patients had excellent pain relief through the patients remaining life (1-2 months) in which follow up was possible.

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Pulsed Radiofrequency Ablation Under Ultrasound Guidance for Huge Neuroma

  • Kim, Young Ki;Jung, Il;Lee, Chang Hee;Kim, Se Hun;Kim, Jin Sun;Yoo, Byoung Woo
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.290-293
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    • 2014
  • Amputation neuroma can cause very serious, intractable pain. Many treatment modalities are suggested for painful neuroma. Pharmacologic treatment shows a limited effect on eliminating the pain, and surgical treatment has a high recurrence rate. We applied pulsed radiofrequency treatment at the neuroma stalk under ultrasonography guidance. The long-term outcome was very successful, prompting us to report this case.