• The Korean Journal of Pain
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• 제29권3호
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• pp.193-196
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• 2016

Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

• 대한정형외과스포츠의학회지
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• 제5권2호
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• pp.100-104
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• 2006

서혜부 손상은 축구 손상의 약 10% 정도를 차지하고 있다. 이런 손상은 경기 중 컷팅이나, 사이드 스텝, 가속, 감속, 급격한 방향 전환 등의 긴장력이 서혜부에 가해질 때 발생 할 수 있다. 증상 또한 다양해서, 수일 내에 복귀 할 수도 있으나 동통이 심해져서 운동을 포기해야 할 경우까지 있다. 또한, 어느 한 질환에 국한된 것이 아니기 때문에 서혜부에 동통이 발생할 경우 여러가지 질환을 염두에 두어야 하며, 흔한 손상으로는 서혜부 주변의 근육 및 인대 손상이며 그 외에 신경압박 증상(nerve entrapment), 탈장(hernia), 복부 근육 약화(sportsman's hernia), 치골유합부염(symphysitis), 피로골절 (stress fracure) 및 고관절 질환 등을 들 수 있다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권1호
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• pp.21-26
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• 2013

Objectives: Full thickness skin grafts (FTSG) offer several advantages; they are esthetically superb, have less postoperative shrinkage, and offer minimal postoperative pain and scar formation at the donor site. As a donor site of FTSG, the groin offers a relatively large area of skin with high elasticity. The aim of this study was to evaluate FTSG from the groin for reconstruction in oral and maxillofacial surgery. Materials and Methods: In a retrospective study, 50 patients (27 males, 23 females) who received FTSG from the groin were evaluated for their operation records, clinical photography, and medical records. Results: The width of skin from the groin was distributed from 2-8 cm (mean: 5.1 cm) at the donor site, while the long axis length was distributed from 3-13 cm (mean: 7.4 cm). A high number of patients, 47 patients (94%) out of 50, showed good healing at the donor site. Wound impairment was seen in 3 patients (6%), minor wound dehiscence in 2 patients, and severe wound dehiscence in 1 patient. In the recipient site, delayed healing was observed in 2 patients (4%). Conclusion: FTSG from the groin to repair soft tissue defects in reconstruction surgery is a good method due to the relatively big size of the graft, decreasing morbidity at the donor site, and higher graft survival rates.

• The Korean Journal of Pain
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• 제18권1호
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• pp.92-95
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• 2005

Primary hyperhidrosis, a disorder of unknown etiology, is characterized by excessive uncontrollable sweating, most often of the palm surface of the hands, armpits, groin and feet. To decrease the symptoms of hyperhidrosis, drug therapy, iontophoresis, excision of axillary sweat glands and thoracoscopic sympathectomy have been attempted. A lumbar sympathectomy is one of the available choices for the treatment hyperhidrosis of the lower extremities. A 28-year old female patient presented with excessive sweating of her hands and feet. For the treatment of her foot hyperhidrosis, a bipolar radiofrequency ablation system was used to ablate the lumbar sympathetic ganglion, with a successful result. This modality will receive greater attention as an available alternative to lumbar sympathetic neurolysis.

• The Korean Journal of Pain
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• 제8권2호
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• pp.341-346
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• 1995

Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.

• The Korean Journal of Pain
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• 제20권2호
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• pp.203-207
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• 2007

Inguinal hernia repair can result in paresthesia and/or pain in the inguinal region. Pharmacological and surgical management often yield inconsistent results associated with considerable risks and side effects. Radiofrequency thermocoagulation (RF) is a neuro-destructive treatment for severe pain, but associated with hypoesthesia, neuritis-like reactions, and occasional neuroma formation. Pulsed radiofrequency (PRF), unlike RF, delivers high intensity currents in pulses, is non-neurodestructive, and therefore less painful, without the potential complications. Here we report on PRF in chronic postoperative inguinal pain. A 23-year-old male who received right inguinal hernia repair and complained of right sided groin pain for approximately 10 years underwent PRF at the L1 and L2 dorsal root ganglia (DRG). He then reported a decrease in pain from 80-90/100 mm to 15-30/100 mm on a visual analogue scale (VAS), which lasted for twelve months.

• The Korean Journal of Pain
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• 제37권4호
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• pp.332-342
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• 2024

Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.

• 대한한방내과학회지
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• 제40권5호
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• pp.841-850
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• 2019

Objective: The aim of this study was to report the effects of traditional Korean medicine as a treatment for the pain of a compression fracture in a patient with metastatic prostate cancer. Methods: A 60-year-old male patient with a compression fracture was treated with herbal medicines, acupuncture, and pharmacopuncture for 25 days. His chief complaints were severe low back pain, pain and numbness in both legs, and right groin pain. The effect of treatment was evaluated by the numerical rating scale (NRS) score for pain, the Oswestry Disability Index (ODI) score, and blood test results (CBC-diff count, CRP, ESR, etc.). Results: After 25 days of inpatient treatment, the patient's pain was controlled. The NRS and ODI scores were lower and most pathological symptoms had decreased. Conclusions: Traditional Korean medicine can be a solution for patients with compression fractures arising from metastasis of prostate cancer to the spine.

• Journal of Chest Surgery
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• 제5권1호
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• pp.19-24
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• 1972

The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

• Archives of Plastic Surgery
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• 제41권3호
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• pp.225-230
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• 2014

The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition $12{\times}-15{\times}$ digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-$CO_2$ laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.