• The Korean Journal of Pain
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• 제12권1호
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• pp.21-26
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• 1999

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of central nervous system (CNS) and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative low dose epidural bupivacaine and morphine could affect postoperative pain, changes plasma cortisol, and serum glucose. Methods: Thirty patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. General anesthesia was induced in all patients and after that, epidural blocks were done except the control group (n=10) patients. Preoperative block group (n=10) received 0.5% bupivacaine 50 mg and morphine 2 mg epidurally as a bolus before operation and followed by 0.1% bupivacaine $5\;mghr^{-1}$ and morphine $0.2\;mghr^{-1}$ for 10 hours. Postoperative block group (n=10) received the same doses of bupivacaine and morphine under the same method postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative pain by visual analogue scores (VAS), analgesic requirement (first requirement time, total amounts used), side effects, plasma cortisol level and serum glucose level were compared. Results: Until postoperative 6 hrs, VAS of control group was higher than those of the epidural groups. No difference was observed in VAS between the two epidural groups. First analgesics requirement time and total amounts of used analgesics were not different between the two epidural groups, but first analgesic requirement time of preoperative block group was significantly prolonged compared with control group. Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Low dose preoperative epidural bupivacaine and morphine could not reduce postoperative pain, plasma cortisol level and serum glucose level compared with postoperative block group.

• The Korean Journal of Pain
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• 제25권4호
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• pp.272-274
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• 2012

Phantom limb pain is a painful sensation that is perceived in a body part that no longer exists. To control this pain, many methods have been used such as medication, physical treatment, nerve block, neuromodulation, surgical treatment and mirror therapy. However, until now, there effects have been uncertain. We report the successful reduction of phantom limb pain using mirror therapy when other treatments initially failed to control the pain.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.264-266
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• 2007

Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.196-201
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• 2005

Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

• 성인간호학회지
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• 제14권2호
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• pp.174-183
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• 2002

Purpose: The purpose of this study was to determine the effect of nurses' pain experience on the inference of their patients' suffering. Method: Study subjects were sampled from 184 nurses who worked in general wards in one S university hospital located at Seoul. Nurses' pain experience consists of personal pain experience and professional pain experience. The Standard Measure of Inference of Suffering (Davitz & Davitz, 1981) was used for suffering inference measure, and patients' suffering which consists of physical pain and psychological distress. Result: Suffering inference scores of nurses without personal pain experience revealed a higher value than that of nurses with personal pain experience. But these differences were not statistically significant. The higher intense pain was experienced, the higher were suffering inference scores. This physical pain inference score was statistically significant(p=.044). Of the nurses who had personal pain experience, suffering inference scores of nurses with unrelieved pain experience revealed a higher value than that of nurses with relieved pain experience. Physical pain and psychological distress inference scores were statistically significant(p=.010, p=.006). Suffering inference scores of nurses without professional pain experience(internal medicine, general surgery, orthopedic surgery) revealed a higher value than that of nurses with professional pain experience. Professional pain experience of internal medical illness was statistically significant in psychological distress of internal medical illness(p=.044), and professional pain experience of orthopedic surgical illness was statistically significant in physical pain of orthopedic surgical illness(p=.027). Conclusion: Nurses who have experienced low pain intensity or good pain relief are inclined n to underestimate patient' pain. Although nurses who care for the same patient over a long time deal skillfully with that patient, nurses are inclined to underestimate that patients' pain. Nurses need to be aware of possible biases related to pain assessment as a result of pain experience.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.11-18
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• 2008

소아의 급성 복통은 많은 환자들이 복통의 성격에 대해 적절히 표현하지 못하므로 진단에 어려움을 겪는 경우가 많다. 연령별 급성 복통의 원인들을 잘 숙지하고, 복통의 위치에 따른 진단적 접근을 시행한다. 가장 우선적으로 외과적 복통 여부를 가능한 빠른 시간 내에 감별해야 하며, 다음으로 장 폐쇄, 궤양성 질환, 간담도계 질환 등을 확인해야 한다. 이 때 주의해야 할 것은, 환자의 복통이 완전히 좋아질 때까지 반복적인 문진과 진찰을 게을리 하지 않아야 하는 것이다. 이렇게 함으로써 진단이 지연되거나 피할 수 없는 오진으로 인해 발생하는 환자의 고통을 최소한으로 줄일 수 있을 것이다. 끝으로, 지금까지 금기시 해왔던 급성 복통 환아들에 대한 통증 치료에 대한 인식의 전환이 필요한 때이다.

• The Korean Journal of Pain
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• 제10권1호
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• pp.82-85
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• 1997

Destruction of the gasserian ganglion can be carried out by creating a radiofrequency lesion under biplanar fluoroscopic guidance. This procedure is reserved for patients who have failed various interventions for intractable trigeminal neuralgia including retro-gasserian injection of glycerol and whose physical status otherwise precludes more invasive neuro-surgical treatments such as microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion provides a safe method of achieving long-standing relief from trigeminal neuralgia with low risk. This technique is currently emerging worldwide as the surgical treatment of choice for trigeminal neuralgia. Recently we performed a successful radiofrequency gasserian ganglionotomy, without any complication, under fluoroscopic guidance. The procedure was successful and complete pain relief was achieved for a patient who already had treatments of various interventions including microvascular decompression but never experienced pain relief.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• The Korean Journal of Pain
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• 제29권2호
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• pp.129-135
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• 2016

Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

• 국제물리치료학회지
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• 제10권1호
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• pp.1746-1749
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• 2019

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.