• The Korean Journal of Pain
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• v.7 no.2
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• pp.231-237
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• 1994

Epidural steroid injection is a treatment for low back pain which allows smaller doses with less risk of side effects and longer duration of relief than systemic administration. From 1 June 1992 to 31 January, 1994, 1 mg/kg of triamcinolone diacetate in 8 ml of lidocaine 1% was administered 56 times to 33 patients who complained of low back pain. Results of epidural steroid injection provided effectiveness in treating various low back pain diseases except postlaminectomy syndrome. However there are no gains about repeated epidural steroid injection.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.103-109
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• 1995

The pain clinic in our institution opened on of June, 1984. since then until December 1994, we have had 1,741 patients who had been treated on an out-patient basis. The patients were analysed retrospectively according to their sex, age, and retrospective disease. There were 969 male(55.7%) and 772 female patients(44.3%) In the age distribution of the patients, the highest incidence was in the forties with 463 patients(26.6%). The second highest age incidence was in the thirties with 357 patients(20.5%), and the third highest age incidence was in the sixties with 341 patients(19.6%). In this figure, there were 203(26.6%) stomach cancer patients, 135(17.7%) cervix and uterine cencer patients, 81(10.6%) colorectal cancer patients, 74(9.7%) hepatoma patients, and 68 (8.9%) pancreatic cancer patients. The patients with non malignant chronic pain numbered 977(56.1%). In this figure, there were low back pain of 188(19.2%), sudden deafness of 17.5%, Buerger's disease of 63(6.5%) and postherpetic neuralgia of 56(5.7%).

• The Korean Journal of Pain
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• v.11 no.2
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• pp.302-306
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• 1998

The authors report the result achieved in the treatment of trigeminal neuralgia patient, especially V2 involved patient, using radiofrequency (RF) thermocoagulation of Gasserian ganglion. A 62-year old female patient had severe burning pain on right cheek usually initiating from upper molar teeth area for 10 years. She was treated with microvascular decompression operation 10 years ago. However, there was no pain relief by operation. She wanted non-surgical treatment. Therefore, we recommended RF thermocoagulation therapy. After 2 times of RF thermocoagulation, there was excellent pain relief without complications. And, for 6months follow-up, there were no pain, and no evidences of complication and recurrence.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.268-270
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• 1996

We treated a patient who experienced motor weakness and sensory change on left lower extremity after thoracic sympathetic ganglion block with pure alcohol. The following factors were suspected of contributing to neurologic complication: (1) ischemia of spinal cord, (2) infection, (3) re-expression and aggravation of pre-existing neurologic disease, (4) improper position. Patient spontaneously recovered from neurologic complication with conservative therapy.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.29-36
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• 1992

This study was objected to evaluate clinical progressions about both the degree of pain relief and the occurrence of morphine tolerance while the epidural analgesia with low dose of morphine, bupivacaine and antidepressant continued repeatedly at every 5 day intervals of the constant-rate infusion(0.5 ml/hr, 60 ml capacity). The subjects were divided to 56 cancer and 36 non-cancer patients who failed to respond to palliative treatments. Before the relief of pain, the pain severity was moderate(10%) and severe(90%). The dose escalation of morphine noted to 11(20%)patients in cancer pain and to one(5%) case only in non-cancer. During the epidural analgesia, the effect of pain relief was moderate(11%) and good(89%). It suggest that the morphine tolerance may be reduced to some degree such as an initial minimum dose of epidural morphine with local anesthetic and antidepressant should be adjusted on an individual basis using the constant-rate infusor, even though rapid dose escalation occurrs in some patients who the diseases progress over a short period of time.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.140-143
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• 1999

Ramsay-Hunt syndrome is a related but more serious disorder caused by herpes zoster viral infection of the geniculate ganglion. It is characterized by unilateral painful vesicular rash of the uvula, palate, auricle, ear canal, and postauricular area, but it can extend into the facial tissues as well. Paralysis of the facial nerve is often seen, and there can be disequilibrium and hearing problems also. We experienced continuous cervical epidural block (CCEB) with intermittent stellate ganglion block is effective in Ramsay-Hunt syndrome. CCEB should be considered to the treatment of choice in Ramsay-Hunt syndrome.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.304-307
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• 1995

1,666 patients treated by nerve block from September 1994 to August 1995 we statistically analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Diseases and ailments were as follows: low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7%, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trigger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows: facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic ganglion block 15.4%.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.383-385
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• 1995

Postpuncture headache is the most common complication of epidural block, others include abscission of the tip of catheter, epidural abscess and subarachnoid infection, etc. A 69-year-old female patient visited the Neuro-Pain Clinic of Seran General Hospital for treatment of lower back pain and both sciatica. She received continuous epidural block, psoas compartment block, lumbar facet joint block and lumbar facet thermocoagulation. During the epidural block procedure the dura was accidently punctured and auto-logous blood patch was performed. Three days later, she manifested fever, nausea, vomiting, mild neck stiffness and mental deterioration. Meningitis was suspected as the cause of these signs. The CSF study reported: protein 400 mg/dl, sugar 14 mg/dl, WBC $468/mm^3$. She was recovered from the meningitis after adequate antibiotic therapy.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.213-217
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• 2006

Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.415-418
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• 1996

The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.