• The Korean Journal of Pain
• /
• 제3권2호
• /
• pp.131-138
• /
• 1990

대상포진 후 신경통환자 38예를 분석하여 다음과 같은 결과를 얻었다. 1) 성별의 차이는 없었고 대부분 50대 이상에서 발생하였다. 2) 이환 부위는 흉추부가 가장 않았고 두경부 중에서는 상안신경 분포영역이 가장 많았다. 3) 통중은 대부분 쑤신다, 찌른다, 쏜다는 등이 특징이었으며 그 외에도 다양한 성격의 통증을 동반하였다. 4) 치료 약물로는 TCA, Chloropromazine을 가장 많이 사용하였다. 5) 신경차단은 두경부의 경우 성상신경절 차단, 그 이외 부위는 경막외 차단을 가장 많이 시행하였고 경막외 차단시에는 스테로이드를 혼합 사용하였다. 6) 합병증으로는 신경차단에 따른 기술적 합병증과 약물 부작용으로 대별되었다. 이상의 결과를 종합하면 질병 자체의 난치성 때문에 어느 치료법도 만족스럽지는 못하나 TCA와 Choloropromazine을 처방하고 반복적인 신경 차단과 스테로이드 요법을 시행하는 것이 좋을 것으로 사료된다.

• The Korean Journal of Pain
• /
• 제20권2호
• /
• pp.181-185
• /
• 2007

Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.

• 대한한의학회지
• /
• 제20권4호
• /
• pp.106-114
• /
• 2000

The herpes zoster infecting ophthalmic branch of trigeminal Nerve that is similar to migraine at first stage symptom has been treated with oriental medication at Dept. of Internal Medicine, Semyung University Oriental Hospital. The fIrst symptom of roster is burning pain, tingling or extreme sensitivity in one area of the skin, usually limited to one side of the body. This may be present for one to three days before a red rash appears at that site. There may also be a fever or headache. The rash soon turns into groups of blisters. The blisters start out clear but then pus or dark blood collects in the blisters before they crust over (scab) and begin to disappear. The pain may last longer. In this case, the severe pain was present for five days, the blisters and scabsdisappeared entirely on the seventeenth day, but postherpetic neuralgia, the most common complication and is observed most frequently in the ophthalmic branch of trigeminal nerve, was not prevented entirely. We have observed this case and report to help treatment on this disease at oriental medicine clinic.

• The Korean Journal of Pain
• /
• 제36권1호
• /
• pp.4-10
• /
• 2023

Herpes zoster (HZ) is a common disease in the aging population and immunocompromised individuals, with a lifetime risk of 20%-30% that increases with age. HZ is caused by reactivation of the varicella-zoster virus (VZV), which remains latent in the spinal dorsal root ganglia and cranial sensory ganglia after resolution of the primary VZV infection. The main focus of HZ management is rapid recovery from VZV infection as well as the reduction and prevention of zoster-associated pain (ZAP) and postherpetic neuralgia (PHN). The use of antivirals against VZV is essential in the treatment of HZ. However, limited antivirals are only licensed clinically for the treatment of HZ, including acyclovir, valacyclovir, famciclovir, brivudine, and amenamevir. Fortunately, some new antivirals against different types of Herpesviridae have been investigated and suggested as novel drugs against VZV. Therefore, this review focuses on discussing the difference in efficacy and safety in the currently licensed antivirals for the treatment of HZ, the applicability of future novel antivirals against VZV, and the preventive or therapeutic effects of these antivirals on ZAP or PHN.

• The Korean Journal of Pain
• /
• 제31권4호
• /
• pp.235-243
• /
• 2018

Postherpetic neuralgia (PHN) is the most troublesome side effect of Herpes Zoster (HZ), which mainly affects the elderly and immunocompromised populations. Despite the current advancement of treatments, PHN persists in many individuals influencing their daily activities and reducing their quality of life. Anticonvulsants, antidepressants, topical therapies including lidocaine and capsaicin, and opioids, are the most widely used therapies for the treatment of PHN. These medications come with their adverse effects, so they should be used carefully with the elderly or with patients with significant comorbidities. Other measures like botulinum toxin, nerve blocks, spinal cord stimulation, and radiofrequency have also contributed significantly to the management of PHN. However, the efficacy, safety, and tolerability of these invasive methods need to be carefully monitored when administering them. Early diagnosis and early initiation of treatment can reduce the burden associated with PHN. The zoster vaccine has effectively reduced the incidence of HZ and PHN. In this article, we discuss the treatment options available for the management of PHN, mainly focusing on the efficacy and safety of different therapeutic modalities.

• The Korean Journal of Pain
• /
• 제5권2호
• /
• pp.258-262
• /
• 1992

1991년 3월 부터 1992년 2월까지 부산대학교병원 통증치료실에 내원한 27명의 대상포진후 신경통 환자를 대상으로 하여 저출력 레이저의 치료효과를 관찰한 바를 아래와 같이 요약한다. 1) 주된 병소부위는 흉추신경분포부위이었다. 2) 70세 미만의 환자에서는 VAS의 개선율이 57%로 효과가 있었으나, 70세 이상의 환자에서는 VAS 개선율이 27%로 현저히 감소하였다. 3) 발병후 치료시간 까지의 기간이 1개월 이내인 환자는 저출력 레이저에 의한 치료효과가 좋았으나, 12개월이상 경과한 환자는 치료효과가 좋지 않았다. 4) 발병후 1개월이내에 치료를 실시한 환자의 VAS개선율이 50%가 되기까지의 평균 조사횟수는 5.7회이었다.

• The Korean Journal of Pain
• /
• 제26권1호
• /
• pp.21-26
• /
• 2013

Background: Postherpetic neuralgia (PHN) is a serious complication resulting from herpes zoster infections, and it can impair the quality of life. In order to relieve pain from PHN, various treatments, including pharmacological and interventional methods have been used. However, little information on the recommendations for the interventional treatment of PHN, along with a lack of nation-wide surveys on the current status of PHN treatment exists. This multicenter study is the first survey on the treatment status of PHN in Korea. Methods: Retrospective chart reviews were conducted on the entire patients who visited the pain clinics of 11 teaching hospitals from January to December of 2011. Co-morbid disease, affected site of PHN, routes to pain clinic visits, parenteral/topical medications for treatment, drugs used for nerve block, types and frequency of nerve blocks were investigated. Results: A total of 1,414 patients' medical records were reviewed. The most commonly affected site was the thoracic area. The anticonvulsants and interlaminar epidural blocks were the most frequently used pharmacological and interventional methods for PHN treatment. For the interval of epidural block, intervals of 5 or more-weeks were the most popular. The proportion of PHN patients who get information from the mass media or the internet was only 0.8%.The incidence of suspected zoster sine herpete was only 0.1%. Conclusions: The treatment methods for PHN vary among hospitals. The establishment of treatment recommendation for PHN treatment is necessary. In addition, public relations activities are required in order to inform the patients of PHN treatments by pain clinicians.

• The Korean Journal of Pain
• /
• 제34권4호
• /
• pp.509-533
• /
• 2021

Background: Postherpetic neuralgia (PHN) is a refractory complication of herpes zoster (HZ). To prevent PHN, various strategies have been aggressively adopted. However, the efficacy of these strategies remains controversial. Therefore, we aimed to estimate the relative efficacy of various strategies used in clinical practice for preventing PHN using a network meta-analysis (NMA). Methods: We performed a systematic and comprehensive search to identify all randomized controlled trials. The primary outcome was the incidence of PHN at 3 months after acute HZ. We performed both frequentist and Bayesian NMA and used the surface under the cumulative ranking curve (SUCRA) values to rank the interventions evaluated. Results: In total, 39 studies were included in the systematic review and NMA. According to the SUCRA value, the incidence of PHN was lower in the order of continuous epidural block with local anesthetics and steroids (EPI-LSE), antiviral agents with subcutaneous injection of local anesthetics and steroids (AV + sLS), antiviral agents with intracutaenous injection of local anesthetics and steroids (AV + iLS) at 3 months after acute HZ. EPI-LSE, AV + sLS and AV + iLS were also effective in preventing PHN at 1 month after acute HZ. And paravertebral block combined with antiviral and antiepileptic agents was effective in preventing PHN at 1, 3, and 6 months. Conclusions: The continuous epidural block with local anesthetics and steroid, antiviral agents with intracutaneous or subcutaneous injection of local anesthetics and a steroid, and paravertebral block combined with antiviral and antiepileptic agents are effective in preventing PHN.

• The Korean Journal of Pain
• /
• 제30권1호
• /
• pp.62-65
• /
• 2017

Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ.

• 성인간호학회지
• /
• 제16권2호
• /
• pp.202-210
• /
• 2004

Purpose: this study was to examine the differences of the level of pain, depression and self-efficacy according to the classifications of pain among chronic pain patients. Method: The data were collected by means of self-reported questionnaire from 164 patients with chronic pain visited in one university hospital and one local pain clinic in Busan, from October 7 to November 16, 2002. Analysis was done by ANOVA, and Scheffe test using SPSS program. Result: The subjects were divided into five classifications of chronic pain : 26.2% low back and extremity pain, 23.2% neck, shoulder and upper extremity pain, 19.5% postherpetic neuralgia, 15.9% complex regional pain syndrome and 15.2% peripheral neuralgia. There were significant differences in pain (p=.000), depression (p=.000) and self-efficacy (p=.003) according to the 5 kinds of chronic pain. With the results of the Scheffe test, the patients with peripheral neuralgia experienced pain and depression higher than those with the other kinds of chronic pain. The patients with neck, shoulder and upper extremity pain experienced self-efficacy higher than those with peripheral neuralgia. Conclusion: Chronic pain patients should be provided effective individualized intervention depending on the classifications of chronic pain. Therefore the development of interventions for pain management according to the classifications of pain in chronic pain patients is needed.