• The Korean Journal of Pain
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• 제8권2호
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• pp.293-297
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• 1995

Despite applying recent advances in research and technology and taking into acount proper histories and performing thorough physical examinations, a high percentage of patients with low back pain have no identifiable pathology. Problems especially of the sacroiliac joint are commonly missed. The purpose of this article is to describe the effects of sacroiliac injection of local anesthetics and corticosteroids on patients with acute sacroiliac sprain. The sacroiliac joints are essentially nonweight-bearing joints that allows a small amount of anteroposterior rotatory movement around transverse axis usually about 5 to 10 cm below the promontory of the sacrum vertically. The ligamentous portion of sacroiliac joint is vulnerable to rotatory movement particularly when the individual is in an awkward position. Injections of 3 ml of 2% lidocaine and 10 mg of methylprednisolone were given twice at two day intervals to 26 patients with acute sacroiliac sprain. Most of those patients obtained excellent results without any adverse effects.

• The Korean Journal of Pain
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• 제3권2호
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• pp.150-159
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• 1990

The patient with muscle contraction headache usually have one or more specific trigger points. These trigger points have been treated with various treatment modalities including "stretch and spray" and regional infiltration with local anesthetics with or without corticosteroids. I treated 36 patients with muscle contraction headache with regional infiltration of local anesthetics and steroid into trigger points and the results were as follows 1) The diagnosis of muscle contraction headache was possible by confirming specific trigger points by palpation. 2) Patients relieved rapidly from headache by regional infiltration of local anesthetics and steroid into the tender point. 3) Single injection was effective in relieving headache. But the curability of the single injection could not be assessed because of difficulty in follow-up study. 4) Active trigger points could be occasionally inactive, which also made difficult in assessing the effectiveness of the treatment.

• 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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• 제32권4호
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• pp.301-306
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• 2019

Background: Ganglion impar blockade is a reliable and effective treatment option used in patients with coccydynia. Our primary objective was to specify the role of corticosteroids in impar blockade. We compared applications of local anesthetic with the local anesthetic + corticosteroid combination in terms of treatment efficiency in patients with chronic coccydynia. Methods: Our study was a prospective randomize double-blind study. The patients were divided into 2 groups after randomization. The first group (group SL) was made up of patients where a corticosteroid + local anesthetic were used during ganglion impar blockade. In the second group (group L) we used only local anesthetic. We evaluated numeric rating scale (NRS) and Beck depression scale, which were employed before the procedure and in 1st and 3rd months after the procedure. Results: Seventy-three patients were included in the final analysis. We detected a significantly greater decrease in NRS values in the 1st month in group SL than in group L (P = 0.001). In the same way, NRS values in the 3rd month were significantly lower in the group with steroids (P = 0.0001). During the evaluation of the Beck test, we detected significantly greater decreases in the 1st month (P = 0.017) and 3rd month (P = 0.021) in the SL group than in the L group. Conclusions: Ganglion impar blockade decreases pain in the treatment of chronic coccydynia and improve depression. Addition of steroids in a ganglion impar blockade is required for treatment response that should accumulate over a long period of time.

• The Korean Journal of Pain
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• 제25권1호
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• pp.55-59
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• 2012

Lumbar spinal stenosis is a commonly treated with epidural injections of local anesthetics and corticosteroids, however, these therapies may relieve leg pain for weeks to months but do not influence functional status. Furthermore, the majority of patients report no substantial symptom change over the repeated treatment. Utilizing balloon catheters, we successfully treated with three patients who complained persistent symptoms despite repeated conventional steroid injections. Our results suggest that transforaminal decompression using a balloon catheter may have potential in the nonsurgical treatment of spinal stenosis by modifying the underlying pathophysiology.

• The Korean Journal of Pain
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• 제13권1호
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• pp.93-96
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• 2000

Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.