• The Korean Journal of Pain
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• v.12 no.1
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• pp.148-151
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• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.111-114
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• 2000

Pain around the posterior iliac crest area is usually attributed to disorders of the lower lumbar or lumbosacral spine. However, low back pain arising from the thoracolumbar region is common and it is very similar to low back pain of lumbosacral origin. Low back pain of thoracolumbar origin is clinically distinguished from other nonspecific low back pain syndrome. It is characterized by symptoms localized at one posterior iliac crest innervated by posterior branch of $T_{12}$ spinal nerve. Patients never complain of spontaneous pain at the thoracolumbar junction. Only localized tenderness over involved segments of thoracolumbar junction can be noted. We report two cases of posterior iliac crest pain of thoracolumbar origin which was relieved by the treatment on the thoracolumbar junction.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.143-145
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• 1998

There are reports on cervical epidural anesthesia for surgery of neck, chest and upper limb. However, there are limited published data on the specific problems with this procedure, including dural puncture, epidural abscess, and vasovagal syncopes. We experienced two cases of vasovagal syncope during cervical epidural anesthesia in the sitting position. These syncopes consisted of sudden hypotention and bradycardia, associated with nausea, dizzness and sweating. The patients were resuscitated successfully and recovered without any adverse effects. Current literature is being reviewed and the possible mechanisms of cardiac arrest under cervical epidural anesthesia in the sitting position are being discussed.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.60-64
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• 1995

Stellate ganglion block is a selective sympathetic blockade affecting the head and neck, and the upper extemity. It is an important method which has been used most frequently in neuro-pain clinic due to its wide range of indications. The authors attermpted to define the minimal volume of local anesthetic which need for successful stellate ganglion block by using 1% mepivacaine HCl mixed with dye. In 40 heathy volunteers, two different volumes, 3 ml in the group 1 (n=20) and 4 ml in the group 2 (n=20), were injected by an anterior paratracheal technique at the sixth cervical vertebral level. We compared the degree in sympathetic blockade by clinical sings and symptoms and also checked the spread range of dye by plain X-ray. With seven criteria for an effective block. mean score was 5.7 in group 2, while 3.4 in group 1. These results suggest that 4 ml of local anesthetic are adequate for a successful stellate ganglion block.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.135-138
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• 1995

We experienced two cases of malignancy diagnosed during the treatment of postherpetic neuralgia. One case was a lung cancer and the other case was a pancreatic cancer. Generally, herpes zoster frequently occurred in the patients who have immunosupressive disease, diabetes mellitus, malignancy and tuberculosis, etc. It is necessary to rule out malignancy in the patients who have herpes zoster, especially those patients whth severe eruptive cluster, persisting to the therapy or multifocal pain. So, we must carefully observe and follow up the patients to find out malignancy as well as to diminish the pain.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.65-68
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• 1994

Carpal tunnel syndrome is the most common compressive neuropathy of the upper extremity. Clinical manifestations include pain as well as motor and sensory dysfunction in the distribution of the median nerve. As nonoperative treatment, median nerve block is performed to relieve pain for carpal tunnel syndrome. We have experienced 5 such cases. Our results support median nerve block as an excellent treatment for carpal tunnel syndrome.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.77-81
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• 1997

Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.33-38
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• 2009

Background: Complex regional pain syndrome (CRPS) is still difficult to diagnose in the field of chronic pain management. CRPS is diagnosed by purely clinical criteria based on the characteristic signs and symptoms, which have to be differentiated from similar pain conditions like posttraumatic neuropathic pain. Until now, there has been a lack of objective diagnostic tools to confirm the diagnosis of CRPS. The aim of this study was to evaluate the usefulness of a three phase bone scan (TBS) for making the diagnosis of CRPS. Methods: A total of 121 patients who had been diagnosed with CRPS were evaluated. All the patients were examined by performing a TBS as a part of the diagnostic work-up. A diffuse increased tracer uptake on the delayed image (phase III) was defined as a positive finding for CRPS. Results: Forty-one patients (33.9%) out of 121 showed the positive results on the TBS. The patients with a duration of pain of less than 24 months had a significantly higher positive result (43.4%) on the TBS than did the patients with duration of pain longer than 24 months (12.1%). Conclusions: A TBS could give a better objective result for diagnosing CRPS for patients with a shorter duration of pain and a TBS gives little information for the diagnosis of CRPS in patients with a duration of pain longer than 24 months.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.283-287
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• 1998

Background: Recently, pain clinic is attracting attention and interest of both physicians and laymen. It is the purpose of this article to analyze our 10 years' experience to seek and improve better protocol of treating pain. Methods & Materials: We analyzed retrospectively 11,235 patients who visited the clinic during 10 years from 1986 to 1996. Total number of hospital visits was 51,908. Male to female ratio was 35：65(3910：7325). Treatment modalities employed were SGB(stellate ganglion block), TPI(trigger point injection), etc. Results: Yearly distribution showed a gradual upward curve until 1992 and remains in a horizontal pattern thereafter. Of age distribution, 6th decades occupied the largest proportion(27.29%). As of disease entities, Low back pain & lower extremities pain comprised of the majority(34.01%) and the epidural block was most frequently given as a treatment. Conclusion: Pain clinic is improving rapidly as an important part of medical science in Korea and outpatients of clinic are on an increasing trend. So, anesthesiologists should be make every efforts to research for treatment of good quality.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.183-186
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• 1996

When medical therapy fail to relieve pain at tolerable level for patients confirmed with trigeminal neuralgia, presence of mass lesion excluded, surgery is indicated. Innumerable surgical strategies have been attempted for the treatment of trigeminal neuralgia but only four have proven appropriate: (1)stereotactic radiofrequency gasserian ganglionotomy, (2) percutaneous glycerol gangliolysis, (3) percutaneous microcompression, (4) microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion stems from the efforts of Sweet. This technique is the surgical treatment of choice around the world for surgical treatment for trigeminal neuralgia. Since 1986, over 14,000 cases have been reported utilizing this technique. To improve the treatment method further, an electrode with a flexible curved tip has been developed for easier and more precise electrode placement and lesion production during the thermocoagulation of gasserian ganglion. This operation was performed recently on three patients at Hallym University Hospital. using a curved tip electrode. Complete relief of pain was achieved for all patient. However, some complications were noted.