• Journal of Korean Neurosurgical Society
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• v.39 no.1
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• pp.11-15
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• 2006

Objective : A prospective, randomized, controlled clinical study is performed to verify the effectiveness of epidural dexamethasone-soaked gelatin sponges to reduce postoperative pain following lumbar microdiscectomy. Methods : Twenty-three patients (10 men and 13 women) undergoing lumbar microdiscectomy were included. Five pieces of gelatin sponge measuring $1{\times}1cm$ [Gelfoam; Pharmacia & Upjohn. Kalamazoo, MI, USA], soaked with either 5mg dexamethasone or an equal amount [2mL] of saline, were left on the decompressed nerve root after unilateral hemilami-nectomy, flavectomy and discectomy. Results : Subjective visual analog scale[VAS] scores of leg pain in the dexamethasone group on the first, third and first postoperative days [2.5, 2.5, 1.7, respectively] were significantly lower than in the control group [5.0, 4.8, 3.6][P<0.05]. No side effects related to the dexamethasone-soaked gelatin sponges were observed. Conclusion : The intraoperative application of dexamethasone-soaked gelatin sponges during lumber microdiscetomy can provide effective-postoperative analgesia without complications.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.8-12
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• 2015

Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.251-260
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• 2009

Objectives : To investigate reliability and validity of Korean translation of Western Ontario and McMaster Universities(WOMAC) osteoarthritis index. Methods : The reliablity, construct validity of the Korean WOMAC Index in the patient of knee osteoarthritis was investigated. Test-retest reliability was quantified with pearson's correlation coefficient and intraclass correlation coefficient. Internal consistency was quantified with Cronbach's ${\alpha}$. and construct validity with pearson's correlation coefficient by correlating of the Visual Analog Scale(VAS). Results : Test-retest reliability of Korean WOMAC Index for pain was 0.76 to 0.95, stiffness was 0.89 to 0.94, and physical function was 0.71 to 0.95. Intraclass correlation coefficient for pain was 0.76 to 0.94, stiffness was 0.54 to 0.89, and physical function was 0.70 to 0.95. Internal consistency were 0.94 and 0.94 for the first and second time, respectively. Construct validity for pain was 0.79, for stiffness was 0.66, and physical function was 0.67. Conclusions : The Korean translation of Western Ontario and McMaster Universities(WOMAC) osteoarthritis index is reliable, valid assessment tool in knee osteoarthritis.

• Journal of Acupuncture Research
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• v.35 no.4
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• pp.248-251
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• 2018

This retrospective study reports the effects of combined traditional Korean treatment of cervical radiculopathy in patients who underwent ineffective epidural steroid injection treatment. This study analyzed cervical radiculopathy in patients who visited traditional Korean medicine hospital following an ineffective epidural steroid injection. There were 29 cases included in this study. Scores for Visual Analog Scale (VAS) and Neck Disability Index (NDI) were measured before and after combined treatment with acupuncture, herbal medicine, and chuna therapy. The results of this study showed that patient VAS scores for neck and shoulder pain were significantly reduced (p < 0.001) when comparing scores before treatment ($6.03{\pm}2.04$) with after treatment ($2.14{\pm}1.27$). In addition, the VAS score for radiating pain before treatment ($6.67{\pm}1.44$) compared with after treatment ($2.89{\pm}1.83$) showed a significant reduction (p < 0.001). Furthermore, the NDI score before treatment ($25.85{\pm}6.33$) compared with after treatment ($11.33{\pm}7.47$), also showed a significant reduction (p < 0.001). The results in this study showed the positive effects of combined traditional Korean medicine treatment in significantly reducing pain for patients with cervical radiculopathy, who had ineffective anesthesia.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.176-182
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• 2017

Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.23-30
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• 2022

PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.34-41
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• 1997

Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.44-50
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• 2008

Background: The use of regional local anesthetics or opioids during laparoscopic cholecystectomy (LC), in combination with general anesthesia, has been investigated in several interventional studies. Methods: We studied a total of 240 (n = 60, each) patients who were undergoing LC, and they received local infiltration and intraperitoneal instillation with normal saline or 0.25% levobupivacaine 60 ml. Group R (S) received infiltration of normal saline 20 ml before incision and at the end of surgery and then 40 ml intraperitoneal instillation after removal of the gall bladder under remifentanil-based anesthesia. Group R (L) received 0.25% levobupivacaine instead of normal saline in the same method like group R (S). Group S (S) received the same method as group R (S) under sevoflurane based anesthesia in place of remifentanil. Group S (L) received 0.25% levobupivacaine instead of normal saline with the same method as group S (S). Pain was assessed on a visual analog scale at 1, 6, 12 and 24 hours after operation. Results: The pain intensity of Group R (L) was significantly lower than that of group R (S), and the the incisional pain of group S (L) was significantly lower than that of group S (S) in the first six hours. The time delay to first operative analgesics in group R (S) and group S (S) was significantly shorter than that of group R (L) and group S (L). Conclusions: Infiltration and instillation of levobupivacaine reduced the postoperative pain and remifentanil did not increase the pain severity and opioid requirement when performing the LC.

• Physical Therapy Korea
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• v.28 no.1
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• pp.53-58
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• 2021

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.43-52
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• 2021

Purpose : Chronic neck pain negatively impacts the quality of life and causes various problems in daily life due to pain, insomnia, and sleep disturbances in patients with this condition. Therapeutic interventions to solve these problems in rehabilitation and physical therapy are being introduced; however, the evidence of the efficacy of myofascial release (MFR) is still insufficient. This study aimed to investigate the effects of applying MFR on pain, insomnia, and sleep disturbances in patients with chronic neck pain. Methods : Ten patients with chronic neck pain were randomly selected and grouped into the experimental group (n₁ = 10) and control group (n₂ = 10) by cross-over design. Pain was measured before and after MFR intervention. Moreover, insomnia was measured only after MFR intervention. Polysomnography was performed after MFR intervention. Wilcoxon signed rank test and Mann-Whitney U test were used for the visual analog scale (VAS). Independent sample t-test was separately performed to measure insomnia and sleep. Results : After MFR intervention, the VAS score of the experimental group (p = 0.005) significantly decreased than that of the control group (p = 0.002). The insomnia score of the experimental group significantly decreased than that of the control group (p = 0.001). The total sleep time (p = 0.001), sleep efficiency (p = 0.001), and sleep latency (p = 0.001) of the experimental group significantly increased than those of the control group in the polysomnographic measurement. Conclusion : The application of MFR of the neck and upper trunk may have a positive effect on pain, insomnia, and sleep disturbances in patients with chronic neck pain. It was also suggested that an objective and quantitative polysomnography can be used more often in the field of rehabilitation and physical therapy.