• The Korean Journal of Pain
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• 제14권1호
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• pp.118-122
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• 2001

Complex regional pain syndrome type I of vascular origin is difficult to detect unless the classic symptoms and signs exist and/or overt extremity trauma has precipitated the pain. The diagnosis is confirmed by relief of pain following a sympathetic nerve blockade. A 36-year-old woman with arterial occlusive disease of the right lower extremity presented with burning pain and hyperesthesia after sprain had occurred which was accompanied by motor weakness of right ankle. A lumbar sympathetic ganglion blockade with 2% lidocaine 10 ml and triamcinolone 80 mg produced prompt improvement of the pain and motion.

• The Korean Journal of Pain
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• 제9권1호
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• pp.219-222
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• 1996

Superior hypogastric plexus block is extensively recognized as a unique nerve block method for the treatment of low abdominal pain originating from organs of the pelvic area. This block is difficult to perform on older patients, especially those with osteophyte, as they will experience a high degree of pain with this technique. Therefore we reported trans-discal superior hypogastric plexus by method of approach needle through disc. This method is less painful to the patient as compared to bilateral approach; and easier to place the needle tip at precise and proper location.

• The Korean Journal of Pain
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• 제13권2호
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• pp.232-236
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• 2000

Bilateral trigeminal neuralgia is uncommon and usually occurs in 1% to 11% of patients with trigeminal neuralgia. There has been no report of a patient with bilateral trigeminal neuralgia in Korea. Based on our review, the incidence of bilateral trigeminal neuralgia among the trigeminal neuralgia patients who visited our pain clinic numbered 0.7% (4 out of 531). This is much lower than those of other previous studies. This lower incidence might be explained by the fact that we excluded those patients with mild bilateral trigeminal neuralgia which did not require treatment and also patients whose symptom on controlateral side was relieved by injection of local anesthetics for that side. Among the four patients with bilateral trigeminal neuralgia, three patients received alcohol block of the branches of trigeminal nerve and one refused the treatment. Overall, three patients maintained good or excellent pain relief without any serious complications throughout the follow-up period.

• The Korean Journal of Pain
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• 제30권2호
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• pp.116-125
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• 2017

Background: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. Methods: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient's satisfaction and other factors were analyzed. Results: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient's satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient's necessity of a post-treatment management and patients' performance rate of post-treatment management (P < 0.01). Conclusions: These results show that sufficient explanation increased patients' satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients' post-treatment management.

• The Korean Journal of Pain
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• 제10권2호
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• pp.301-303
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• 1997

A 35-year-old female patient was referred to our hospital with neurologic symptoms after continuous epidural block performed 2 days earlier. She die not have any prior no previous lumbar surgery or experience trauma, intraspinal hemorrhage, infections or other known causative factors to associate with neurologic symptoms. Continuous epidural block is widely used for postoperative pain control. Complications can occur with this block including postduralpuncture headache, epidural abscess and rare cases of arachnoiditis etc. We experienced such a case of spinal arachnoiditis after continuous epidural block. Neurologic examination revealed painful bilateral hypoesthesia below $S_2$ level dermatomes, urinary and fecal incontinence and various degrees of leg weakness. The following day, the patient was noted to have bilateral sacral radiculopathies and lesion on proximal portion of both tibial nerve. CSF study reported: protein 264 mg/dl, sugar 64 mg/dl, WBC $7/mm^3$. L-spine MyeloCTscan results were unremarkable. She was discharged after a month of hospitalization and has regular checkups but her neurologic symptoms show no signs of improvement.

• The Korean Journal of Pain
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• 제9권1호
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• pp.39-45
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• 1996

Tachyphylaxis to local anesthetics has shown to be promote longer interanalgesic intervals between injections. Previous study demonstrated thermal hyperalgesia accelerates development of tachyphylaxis to sciatic nerve blockade in rats, while MK-801 prevents development of tachyphylaxis. Dextromethorphan is one of NMDA receptor antagonist similar to MK-801. A hypothesis that dextromethorphan would prevent the development of tachyphylaxis was tested in this study. A catheter was surgically implanted along the sciatic nerve a in rat. After recovery from surgery, the animal received repeated injections of 3% 2-chloroprocaine followed by motor block testing with or without hot-plate testing at $56^{\circ}C$. In other experiments, dextromethorphan was administrered by intraperiotneal injection prior to an injection of local anesthetic therough the implanted catheter. Sensory and motor testing was then carried out. Rats injected with 2-chloroprocaine and subjected to hot-plate testing, developed tachyphylaxis to motor and sensory blockade. However, animals pretreated with dextromethorphan did not develop tachyphylaxis over series of three injections. Dextromethorphan seems to prevent development of tachyphylaxis to sciatic nerve blockade in this rat model. Dextromethorphan, one of N-Methyl-D-aspartate receptor antagonist, can be applied to prolong the effect of local anesthetic.

• The Korean Journal of Pain
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• 제1권1호
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• pp.103-105
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• 1988

Ramsey Hunt Syndrome occurs when herpes zoster afters the facial nerve. It causes vesicular eruption of the pinna, external auditory meaturs and ear drum, severe otalgia with associated facial paralysis and vertigo. We experienced a case of Ramsey Hunt syndrome and managed it with repeated sympathetic blocks using a stellate ganglion block. We achieved early resolution of the eruption, relief of pain and prevention of postherpetic neuralgia. We concluded that SGB was effective treatment against Ramsey Hunt Syndrome.

• The Korean Journal of Pain
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• 제7권1호
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• pp.69-73
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• 1994

A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

• The Korean Journal of Pain
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• 제11권1호
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• pp.155-159
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• 1998

Epidural neurolysis with phenol has appeared in literature since 1960. Complications due to accidental subdural block is a rare and unexpected sensory and/or motor disturbance, but it does occur. A 74 years old woman had postherpectic neuralgia for 3 weeks and VAS score of 10. She was treated with intercostal nerve block and intravenous infusion of lidocaine for 7 days and VAS score decreased to 6. To proceed further, we decided to perform epidural neurolysis with 4% phenol 1.5 ml. During thoracic epidural catherization, we encountered unexpected subdural catheterization in subdurographic finding, but we could not precisely rule out subdural catheterization. We had to check CT for exact location of catheter tip. We then performed subdural neurolysis with phenol. This procedure reduced VAS score to between 3 and 4, and we removed the catheter. She had no complication.

• The Korean Journal of Pain
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• 제11권1호
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• pp.105-108
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• 1998

Backgrounds: Cervical epidural nerve block is useful in the management of a variety of acute, chronic and cancer related pain syndromes involving the head, face, neck and upper extrimity. To safely perfom the cervical epidural block, an appreciation of the expected distance from skin to epidural space is important. We studied the distance from skin to cervical epidural space of adults to determine if any relationship exists between patient height, weight and neck circumference and the distance from skin to epidural space. Methods: Patients 170, suffering from neck and upper extremity pain with cervical HIVD(herniated intervertebral dics) were selected. Cervical epidural block was performed at $C_{6\sim7}$ or $C_{7-}T_1$ intervertebral space. Then measured the distance from skin to epidural space and analysed the relationship between age, height, weight and neck circumference and the distance from skin to epidural space. Results: The cervical epidural depth of male $C_{6\sim7}$, male $C_{7-}T_1$, female $C_{6\sim7}$ and female $C_{7-}T_1$ groups were $5.17{\pm}0.63$, $5.47{\pm}0.59$, $4.84{\pm}0.56$ and $5.01{\pm}0.60$ cm respectively. Cervical epidural depth significantly correlated with body weight, ponderal index and neck circumference. Conclusions: The distance from skin to cervical epidural space has significant relationships with weight, ponderal index and neck circumference. Although experience is important, patient's weight and neck circumference are indicating factor, of the cervical epidural depth.