• The Korean Journal of Pain
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• 제14권2호
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• pp.211-213
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• 2001

Background: Recently, the number of pain clinics in Korea is gradually increasing. It is the purpose of this article to analyze and assess our patients over a 1-year period to improve the overall quality of pain management. Methods: We analyzed 1,133 patients who visited the Chosun University Hospital Pain Clinic from May 2000 to April 2001, according to months, age, sex, disease, and type of blocks administered. Results: The most frequent age group was in their sixties. About one half of the patients complained of lower back pain (45.6%) and epidural blocks (46.5%) were most frequently administered as a treatment. Conclusions: More personnel are required to be involved in pain management. Additionally, we should make every effort to conduct research to develop good quality treatments.

• The Korean Journal of Pain
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• 제7권2호
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• pp.277-281
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• 1994

Both pelvic pain associated with cancer and chronic benign conditions may be alleviated by blocking the superior hypogastric plexus. Traditional bilateral placement of needles is the appropriate technique for the patient with pelvic pain due to the bilateral distribution of the disease as well as allowing for individual difference of pelvic cavity. However the technique is a very difficult procedure and painful for the paient. However we have performed transdiscal superior hypogastric plexus neurolysis free of complication.

• The Korean Journal of Pain
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• 제9권1호
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• pp.94-97
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• 1996

Two hundred and eighty eight patients suffering from excessive sweating of palms, soles and axillae etc., visited our Neuro-Pain clinic from November 1991 to March 1996. The sex ratio was 1:1.2. the third decade of age was the major age group. the onset time of hyperhidrosis was prepubertal period (in 95.1% of them). the provocative factors fo excessive sweating were tension and stress from interpersonal relationship. they had the family history (30.9%) and the past history treated with herb medication (56.9%), medicine (30.6%), operation (1.4%), and no treatment (39.6%). We treated 113 patients by sympathetic ganglion block with pure alcohol. the average times of thoracic sympathetic ganglion block were 2.1 (left), 2.4 (right) and those of lumbar sympathetic ganglion block were 1.2 (left), 1.6 (right). Average admission period was 14.7 days. Recurrence rare was 7.1%. Most longstanding effective period was 45 months. We conclude from our results that sympathetic ganglion block is one of the most effective treatments for hyperhidrosis owing to its simple technique and low recurrence rate.

• The Korean Journal of Pain
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• 제2권1호
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• pp.57-60
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• 1989

The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

• The Korean Journal of Pain
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• 제7권1호
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• pp.69-73
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• 1994

A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

• The Korean Journal of Pain
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• 제9권2호
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• pp.390-394
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• 1996

Background: Occipital neuralgia is characterized by pain, usually deep and aching, in the distribution the second and/or third cervical dorsal root. Two broad groups of patients include primary occipital neuralgia with no apparent etiology and secondary neuralgia with structural pathology. Patients with occipital neuralgia can develop autonomic changes and hyperesthesia. In patients who have not improved with conservative treatment, we have carried out various nerve blocks and evaluated the effectiveness. Methods: In a series of 20 occipital neuralgia patients with no apparent etiolgy, we have carried out great occipital nerve blocks with needle TEAS. In patients who have not improved more than 75% on VAS with great occipital block, we have carried out C2 ganglion blocks and in patients who have not improved more than 75% with C2 ganglion block, C3 root blocks, C2/C3 facet joint blocks have been carried out in due order. Results: In 3 patients out of 10 patients who have not improved with great occipital nerve block, C2 ganglion block led to pain relief. A good response of C3 root block was achived in 2 of 7 patients without response to C2 ganglion block and C2/C3 facet joint block led to improvement in 1 of 5 patients without response to C3 root block. Conclusions: Nerve blocks like great occipital nerve block, C2 ganglion block, C3 root block, or C2/C3 facet joint block were effective in the patients who have not improved with conservative treatment.

• The Korean Journal of Pain
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• 제12권1호
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• pp.144-147
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• 1999

A 72-year-old female patient was presented complaining of unbearable abdominal pain in the upper left quadrant at our hospital. Two weeks earlier she had developed a vesicular eruption on the right C3 dermatome and 1 week earlier she had experienced a vesicular eruption on the left T11 dermatome. Her medical history was unremarkable. She had suffered from severe abdominal pain in the upper left quadrant for 10 days and the mild pain in the right shoulder region for 20 days. The pain in the upper left quadrant had increased and was unresponsive to drugs prescribed by the local clinic. And we performed T11 root block with 0.5% lidocaine 5 ml and dexametasone 5 mg, and thoracic epidural blockade on 1st hospital day under diagnosis of herpes zoster infection. Her VAS were improved from 10 to 2 on 2nd hospital day. We performed thoracic epidural blockade with 0.5% lidocaine 6 ml. Her VAS were changed from 2 to 7 and so then we performed the thoracic epidural blockade with 0.5% lidocaine 5 ml and triamcinolone 40 mg on 3rd hospital day. On 4th hospital day, her VAS were from 7 to 1. After 4 month of our managements she was tolerable without any medications.

• The Korean Journal of Pain
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• 제12권2호
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• The Korean Journal of Pain
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• 제10권1호
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• pp.131-133
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• 1997

Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

• The Korean Journal of Pain
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• 제9권1호
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• pp.215-218
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• 1996

Frostbite involves freezing of tissues and usually affects the distal aspects of the extremities or exposed parts of the face. such as the ears, nose, chin, and cheeks. It produces tissue injury by ice crystal formation between the cells, cellular dehydration, and microvascular occulsion. There are four degrees of frostbite. First degree is accompanied by erythema and edema; second degree, by vesiculation, blistering, and eschar formation; third degree, by hemorrhagic blistering and bluish gray discoloration; and fourth degree, by injury to subcutaneous tissue, muscle, tendon, and bone leading to mottled, dry, black, and necrotic changes. We successfully treated 2 patients suffering from frostbite by performing sympathetic ganglion block with pure alcohol. We concluded sympathetic ganglion block is one of the most effective treatments for frostbite.