• Title/Summary/Keyword: Complication: pain

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Unilateral Paralysis of Lower Extremity Following Thoracic Sympathetic Ganglion Block -A case report- (흉부 교감신경절 차단 후 발생한 편측 하지마비 -증례 보고-)

  • Kim, Sung-Mo;Yang, Seung-Kon;Lee, Hyo-Keun;Lee, Hee-Jeon;Kil, Shun-Hee;Kim, Chan
    • 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.

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Opioid-induced Muscle Rigidity with a Delayed Manifestation Misunderstood as a Tension Pneumothorax -A case report- (긴장성 기흉으로 오인된 지연 발현된 아편양 제제 유발 근경축 -증례보고-)

  • Kang, Bong Jin;Kim, Sung Hoon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.66-70
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    • 2008
  • Opioid-induced rigidity is a potentially life-threatening complication that can occur after treatment with large doses of opioids, but with early recognition it can be treated effectively with naloxone or with muscle relaxants. Regarding its onset time, there have been few case reports that have described delayed manifestations of opioid-induced rigidity. The mechanism of this complication is not well understood. In this report we describe a case of incidental overdose injection of sufentanil and subsequently review the confusing clinical features that require immediate diffenrentiation and the possible mechanim of this complication.

Brachial Plexus Injury as a Complication after Nerve Block or Vessel Puncture

  • Kim, Hyun Jung;Park, Sang Hyun;Shin, Hye Young;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.210-218
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    • 2014
  • Brachial plexus injury is a potential complication of a brachial plexus block or vessel puncture. It results from direct needle trauma, neurotoxicity of injection agents and hematoma formation. The neurological presentation may range from minor transient pain to severe sensory disturbance or motor loss with poor recovery. The management includes conservative treatment and surgical exploration. Especially if a hematoma forms, it should be removed promptly. Comprehensive knowledge of anatomy and adept skills are crucial to avoid nerve injuries. Whenever possible, the patient should not be heavily sedated and should be encouraged to immediately inform the doctor of any experience of numbness/paresthesia during the nerve block or vessel puncture.

Delayed Pneumocephalus Following Fluoroscopy Guided Cervical Interlaminar Epidural Steroid Injection : A Rare Complication and Anatomical Considerations

  • Kim, Yeon-Dong;Ham, Hyang-Do;Moon, Hyun-Seog;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.57 no.5
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    • pp.376-378
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    • 2015
  • Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

The Relationship between Pain and Quality of Life in Stroke Patients (뇌졸중 후 통증 발생과 삶의 질과의 관계)

  • Kwon, Mi-Ji
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.83-90
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    • 2017
  • PURPOSE: Central post-stroke pain (CPSP), a chronic pain condition of stroke patients, can impair activities of daily living and worsen the quality of life (QOL), thereby negatively influencing the rehabilitation process. However, CPSP remains an underestimated complication of stroke. This study aimed to describe the prevalence and types of new-onset chronic pain and to identify the relation between pain and QOL in stroke patients. METHODS: All patients hospitalized because of a diagnosis of stroke were included. Questionnaire was used. Pain intensity was measured using Numerical rating scale (NRS), and pain characteristics were assessed using DN4. QOL was measured using SF-36. Descriptive statistics were used to analyze the characteristics and pain data, and chi-square test was used to compare QOL categorical data between the nociceptive and neurological pain groups. RESULTS: CPSP development was reported by 34% of the post-stroke pain patients. Perceived QOL was low in both groups, especially with respect to the physical functioning, bodily pain, physical-role functioning, emotional-role functioning, and mental health domains. However, no significant difference was observed in QOL between the nociceptive and neurological pain groups (p<.05). CONCLUSION: Our results indicated that CPSP is a common and disabling complication that is difficult to treat, often decreases QOL, and may negatively affect rehabilitation treatment.

Intraspinal Neurolytic Block for the Treatment of Cancer Pain (암성통증에 대한 척추내 신경 파괴제요법)

  • Choe, Huhn;Choe, Hyun-Kyu;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.31-36
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    • 1991
  • Intraspinal alcohol or phenol administration has been used for the treatment of intractable pain due to terminal cancer. It has been alleged to produce good pain relief with minimal complication if performed carefully. We analysed 35 patients who received epidural or subarachnoid neurolytic block out of 83 patients with malignancy who were referrecl to our pain clinic. Most of the patients needed additional treatment modalities including epidural catheterization or systemic narcotic administration. The incidence of complication was high, especially when the neurolytic agents were administered in the lumbar region. This suggest that intraspinal neurolytic block is unreliable and unsafe, although it may temporarily reduce the analgesic requirement.

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Sternal Fracture occurred after Thai Massage : A Case Report (마사지 시술 후 발생한 흉골골절 환자 증례보고)

  • Song, Young-Il;Kim, Dong-Eun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.51-60
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    • 2015
  • Objectives: The purpose of this study is to investigate the safety, injury mechanism, complication and adverse reactions associated with Chuna manual theraphy(CMT), to report one case of adverse reaction with Thai Massage(TM). Methods: A 76-year-old woman presented with chest pain and dorsalgia. The patient undertook a TM. The patient's chest pain didn't improve by Korean medecine. In MRI study, sternal fracture was diagnosed. Results and Conclusions : It is supposed that this patient suffered chest pain and dorsalgia due to a TM. From this case, we can understand the etiology of sternal fracture to some extent and consider the complication of Chuna manual theraphy through TM. In addition, This study raises the awareness of the possibility of a sternal fracture caused by a low-energy CMT technique.

Ilioinguinal and Iliohypogastric Nerve Block for Neuropathic Pain Following the Laparoscopic Surgery -A case report- (복강경 수술후 발생한 신경병증성 통증 치료를 위한 장골서혜신경 및 장골하복신경 차단 -증례 보고-)

  • Choy, Yoon-Keun;Kim, Myoung-Hee;Jo, Dae-Hyun;Kim, In-Hyun
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.124-126
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    • 1998
  • As laparoscopic surgery becomes more popular, various complications following the laparoscope are also increasing. Nerve injury following the laparoscope is an infrequent but serious complication for both the doctor and patient. A 30-year old female patient suffered severe burning pain of the left buttock, inguinal area, external genitalia and inner side of vagina following laparoscopic surgery for ovarian mass. We successfully treated this patient with ilioinguinal, iliohypogastric nerve block in combination with epidural blocks.

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Spinal Myoclonus Developed during Cervical Epidural Drug Infusion in Postherpetic Neuralgia Patient

  • Jeon, Young-Hoon;Baek, Sung-Uk;Yeo, Jin-Seok
    • The Korean Journal of Pain
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    • v.24 no.3
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    • pp.169-171
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    • 2011
  • Postherpetic neuralgia is the most frequent complication of herpes zoster. Treatment of this neuropathic pain syndrome is difficult and often disappointing. Although postherpetic neuralgia is generally a self-limited condition, it can last indefinitely. Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment. However, continuous epidural block has some complications such as infection, dural puncture, and total spinal and nerve damages. We report a case of myoclonus during continuous epidural block with ropivacaine, morphine, and ketamine in an acute zoster patient.

The Sensory Change on the $S_2$ Area after Epidural Adhesiolysis -A case report- (경막외강 유착제거술후 발생한 $S_2$ 피부분절부위의 감각변화 -증례 보고-)

  • Lee, Sang-Chul;Jo, Dae-Hyun;Yoon, Tae-Gyoon;Lee, Byeong-Geon
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.256-259
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    • 1996
  • Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.

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