• The Korean Journal of Pain
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• v.12 no.2
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• pp.263-267
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• 1999

We have observed retroperitoneal hematoma after trigger point injections of quadratus lumborum in a patient with chronic low back pain. Severe flank pain and dyspnea was observed three hours after injection of local anesthetic and steroid to the trigger point of quadratus lumborum muscle. There was fuge hematoma in abdominal CT image around the right kidney, which displaced and compressed the kidney anteriorly. Following infusion of contrast media, extravasation through renal vein and IVC was notified. Patient had a past history of having been treated with platelet aggregation inhibitor and lower dose aspirin treatment after cerebral ischemia for a year, but coagulative function was within normal range. Patient was admitted 12 days for bed rest, pain control and transfusion. We need to take greater care with a frequent aspiration and exact direction of needle, during trigger point injection of quadratus lumborum, particu right side, to avoid vascular injury.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.226-229
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• 1998

Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.75-80
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• 1999

Background: Despite tension type headache is popular, the exact mechanism and method of treatment are not certain yet. So, we supposed the basic mechanism of tension type headache is myogenic, and did Tienchu acupoint block, occipital nerve block, and trigger point injection in tension type headache patients. Methods: Fifty-seven tension type headache patients were treated with local anesthetics and small dose of steroid. The intensity of pain and effect of every treatment was evaluated as Verbal Rating Score (VRS; 0~10) before and after every treatment. Evaluation of treatment was based on the time of treatment (1,2 times, 3 times, 4,5 times). Goal of treatment was VRS reaching below two point and it was considered as treated state. Results: Symptom improvement rates of each treatment were 90% (1, 2 times), 91% (3 times), 70% (4, 5 times) respectively. VRS reduction more than 50% rates were 60%, 64%, 60% respectively. Treated state (VRS<2) rates were 33%, 27%, 30% respectively. Conclusion: Tienchu acupoint block, occipital nerve block, trigger point injection were sorts of most effective and simply applicable modalities of treatment in tension type headache.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.14 no.1
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• pp.101-110
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• 2010

Objective : A case of idiopathic spasmodic torticollis rapidly improved after Oriental Medical treatments and supplementary trigger point injection is reported. Methods & Results : The oriental medical treatment for spasmodic torticollis including acupuncture, bee-venum therapy, herb medication, taping therapy, chuna therapy and physical therapy was performed for pain alleviation, and trigger point steroid injections were also performed. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Tsui Score were used for outcome measure of the spasmodic torticollis. After treatment for 15 days, the TWSTRS showed a decrease from 56 to 22.3 and the Tsui score also decreased from 13 to 5. Conclusions : We concluded that the oriental medical treatment including acupuncture, bee-venum therapy and taping therapy rapidly induced spasmodic torticollis to remission.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.303-318
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• 1998

Cutaneous stimulation and distraction are independent nursing interventions used in various painful conditions, which is explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation, distraction and combination of cutaneous stimulation and distraction on the reduction of intravenous injection pain levels of chemotherapy patients. Repeated measurement post test research design was used for one group. Fifty-three cancer patients who received intravenous chemotherapy regulary in outpatient injection rooms of D medical center and Y medical center in Taegu were studied from June 23, 1997 to July 12, 1997. First the intravenous injection pain level of the control period was measured. Second, the intravenous injection pain level of the experimental period using cutaneous stimulation was measured. Third, the intravenous injection pain level of the experimental period using distraction was messured. Fourth, the intravenous injection pain level of the experimental period using a combination of cutaneous stimulation and distraction was measured. The instruments used for this study were a visual analogue pain scale as subjective pain measurement and an objective pain behavior checklist. Analysis of data was done by use of repeated measure ANOVA, bonferni, t-test, and F-test. The results of this study were summerized as follows : 1) The first hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was rejected. 2) The second hypothesis that the objective pain behavior score of intravenous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 3) The third hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with distraction will be lower than in the control period was rejected. 4) The fourth hypothesis that the objective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 5) The fifth hypothesis that the subjective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=3.04, p=0.031, Bonferni p<.05). 6) The sixth hypothesis that the objective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bonferni p<.05).

• The Korean Journal of Pain
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• v.1 no.2
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• pp.203-206
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• 1988

Evaluation of inadvertent dural puncture occuring among 308 epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1.6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspiration of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• Journal of Life Science
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• v.20 no.4
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• pp.496-502
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• 2010

The acidic saline animal model of pain has been suggested to mimic fibromyalgia (FM). Oligomeric proanthocyanidin complexes (OPC) from grape seeds are known to act as an antioxidant. We studied the effects of OPC on the pain threshold in the acidic saline animal model of pain. The left gastrocnemius muscle was injected with $100\;{\mu}l$ of saline at pH 4.0 under brief isoflurane anesthesia on days 0 and 5. Control rats (n=5) received identical injections of physiological saline (pH 7.2) on the same schedule. Rats (n=10) with acidic saline injection were separated into two study subgroups. After measurement of pre-drug pain thresholds, rats were injected intraperitoneally with either saline or OPC 300 mg/kg. Paw withdrawal thresholds to pressure were again measured 60 min after intraperitoneal injection. Nociceptive thresholds were measured with a Dynamic Plantar Aesthesiometer by applying an increasing pressure to right or left hind paw until the rat withdrew the paw. Compared to baseline (day 0), acid injections produced mechanical hyper-responsiveness on day 7 (pre-drug) in these rats [p<0.05]. A potent antihyperalgesic effect was observed when rats were injected intraperitoneally with OPC 300 mg/kg [injected paw, p=0.001; contralateral paw, p=0.002]. OPC treatment decreased the expression of acid sensing ion channel 3 in the brain motor cortex area on immunohistochemical staining when OPC 300 mg/kg was administered intraperitoneally in the animal model of FM pain [p<0.05]. Further research is required to determine the efficacy of OPC treatments in FM pain in humans.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.329-338
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• 2018

This study was conducted to examine musculoskeletal disorder and analyze the effects of musculoskeletal pain control and self-efficacy on musculoskeletal disorders in dental hygienists. Material and Methods; 483 dental hygienists residing in Gwangju were collected by the convenience sampling method and the self-administered questionnaire survey was conducted. Frequency analysis, crosstab analysis, t-test, and multiple logistic regression analysis were used for analysis. Results: the prevalence of musculoskeletal pain among subjects was 83.9% for the prior year, with 29.8% of patients being afflicted by musculoskeletal disorders. The factors influencing musculoskeletal disorders were musculoskeletal pain resolution. For pain resolution, the odds ratio of musculoskeletal disorders of the group who answered treatment in a hospital, an Oriental medicine clinic, or a pharmacy was 0.22 (95% confidence interval, 0.14-0.34) compared with the group who answered sick leave or task change, suggesting a negative relationship. These findings indicate that people with musculoskeletal disorders were not treated in the hospital, Oriental medicine clinic, or pharmacy. Therefore, it is necessary to improve medical management (oriental medicine, intravenous injection or medication, heat therapy or cryotherapy, steroid treatment, counseling, endovascular treatment using spinal cord stimulation, physical therapy, stretching, rehabilitation, and manual therapy) and job environment and to make a good approach to the prevention of musculoskeletal disorders to control dental hygienists' musculoskeletal pain.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.551-558
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• 2010

연구목적 : 미세전류 자극이 아주반트로 류마티스 관절염을 유발한 실험동물의 염증반응과 통증에 미치는 효과를 알아보기 위하여 실험동물의 발허리발가락관절내 염증반응 정도를 나타내는 인터루킨-6(interleukin-6)의 발현과 핫플레이트(hot plate)를 이용한 발도피지연시를 측정하여 미세전류의 효과에 대하여 알아보고자 하는데 목적이 있다. 연구방법 : 실험동물은 무작위로 대조군(n=18)과 미세전류를 적용한 실험군(n=18)으로 구분하였고, 각 군당 6마리씩 1일군, 7일군, 14일군으로 배정하였다. 류마티스 관절염 유발후 1일, 7일, 14일에 모든 실험동물의 열통각 역치를 나타내는 발도피지연시와 발허리발가락관절내 인터루킨-6의 발현정도를 측정하였다. 각 집단 내의 기간에 따른 발도피지연시와 인터루킨-6의 면역반응성은 일원배치 분산분석을 실시하였고, 사후분석으로는 Duncan의 다중범위검정을 실시하였다. 실험군과 대조군을 비교하기 위하여 독립표본 t-test를 실시하였다. 연구결과 : 실험결과는 다음과 같다. 1) 아주반트 주사 1일후, 실험군과 대조군에서 인터루킨-6 면역반응성과 발도피지연시는 비슷한 양상을 보였다. 2) 인터루킨-6 면역반응성은 아주반트 주사 7일, 14일 후 대조군이 실험군보다 유의하게 증가되었다(p<.05). 3) 발도피지연시는 아주반트 주사 7일, 14일 후 실험군이 대조군보다 유의하게 증가되었다(p<.05). 결론 : 이상의 결과로부터, 미세전류 자극이 아주반트로 유발된 류마티스관절염 모델에서 활액 조직내 염증반응을 감소시키고 열통각역치는 증가되는 것을 알 수 있었다.