• The Korean Journal of Pain
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• 제8권2호
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• pp.374-377
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• 1995

Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed by simultaneously injecting 3 ml of pure alcohol into the $T_2$ and $T_3$ levels after testng with same amount of local anesthetics on the same sites. We experienced poor sympatholytic effect or intercostal neuritis and Horner's Syndrome as the result of complication of thoracic sympathetic ganglion block. In Case 1, in spite of the good testing result, neurolytic block effect was poor. In Case 2, intercostal neuritis occurred, but neuralgia subsided within 3 weeks. In Case 3, Horner's Syndrome occurred for 1 day. To increase the success rate of block and decrease the incidence of complications, good radio-opaque dye appearance and good test block effect should be obtained.

• The Korean Journal of Pain
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• 제36권4호
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• pp.450-457
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• 2023

Background: Genicular nerve neurolysis with phenol and radiofrequency ablation (RFA) are two interventional techniques for treating chronic refractory knee osteoarthritis (KOA) pain. This study aimed to compare the efficacy and adverse effects of both techniques. Methods: Sixty-four patients responding to diagnostic blockade of the superior medial, superior lateral, and inferior medial genicular nerve under ultrasound guidance were randomly divided into two groups: Group P (2 mL phenol for each genicular nerve) and Group R (RFA 80℃ for 60 seconds for each genicular nerve). The numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the effectiveness of the interventions. Results: RFA and phenol neurolysis of the genicular nerves provided effective analgesia within groups at 1 week, 1 month, and 3 months compared to baseline. There was no significant difference between the groups in terms of NRS and WOMAC scores at all measurement times. At the 3rd month follow-up, 50% or more pain relief was observed in 53.1% of patients in Group P and 50% of patients in Group R. The rate of transient paresthesia was 34.4% in Group P and 6.3% in Group R, and this was significantly higher in Group P. Conclusions: Neurolysis of the genicular nerves with both RFA and phenol is effective in the management of KOA pain. Phenol may be a good alternative to RFA. Further studies are needed on issues such as dose adjustment to prevent transient paresthesia response.

• The Korean Journal of Pain
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• 제35권1호
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• pp.124-125
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• 2022

• 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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• 제4권1호
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• pp.37-41
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• 1991

Celiac Plexus neurolysis (C. P. N) has been commonly used to treat malignant pain of the abdominal area that is intractable. It relieves the pain effectively instead of using massive systemic narcotic analgesics. C. P. N. with modified transaortic technique was performed under C-T guidance, in which a single needle was advanced from a left posterior paramedian approach through the aorta in order to inject anesthetic agents directly into the celiac plexus. There was marked pain relief without any hemorrhagic and neurological or other complications. We found this modified transaortic method of C. P. N. to be very effective, safe and easy to perform compared with the classic two needle technique.

• The Korean Journal of Pain
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• 제35권3호
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• pp.356-357
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• 2022

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.128-136
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• 1996

Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

• The Korean Journal of Pain
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• 제35권2호
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• pp.202-208
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• 2022

Background: Neurolytic celiac plexus block (NCPB) is a typical treatment for severe epigastric cancer pain, but the therapeutic effect is often affected by the variation of local anatomical structures induced by the tumor. Greater and lesser splanchnic nerve neurolysis (SNN) had similar effects to the NCPB, and was recently performed with a paravertebral approach under the image guidance, or with the transdiscal approach under the guidance of computed tomography. This study observed the feasibility and safety of SNN via a transdiscal approach under fluoroscopic guidance. Methods: The follow-up records of 34 patients with epigastric cancer pain who underwent the splanchnic nerve block via the T11-12 transdiscal approach under fluoroscopic guidance were investigated retrospectively. The numerical rating scale (NRS), the patient satisfaction scale (PSS) and quality of life (QOL) of the patient, the dose of morphine consumed, and the occurrence and severity of adverse events were recorded preoperatively and 1 day, 1 week, 1 month, and 2 months after surgery. Results: Compared with the preoperative scores, the NRS scores and daily morphine consumption decreased and the QOL and PSS scores increased at each postoperative time point (P < 0.001). No patients experienced serious complications. Conclusions: SNN via the transdiscal approach under flouroscopic guidance was an effective, safe, and easy operation for epigastric cancer pain, with fewer complications.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.664-670
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• 2020

Lipofibromatous hamartoma (LFH) is a rare tumor of the peripheral nerves, which usually involves the median nerve. The authors reported on two rare cases of carpal tunnel syndrome due to LFH of the median nerve. A 49-year-old female patient complained of the mass and symptoms consistent with LFH. Magnetic resonance imaging (MRI) showed typical LFH findings. The symptoms were successfully ameliorated with carpal tunnel release and external neurolysis. A 37-year-old female patient complained of weakening thumb abduction and the mass where the MRI showed atypical findings. Opponensplasty and debulking operations were performed after which thumb abduction was improved; however, neurological sequelae remained. LFH of the median nerve is managed on a case-by-case basis as treatment guidelines are not very clearly defined yet. However, the less invasive treatment such as carpal tunnel release and external neurolysis than more aggressive surgical treatment should be recommended as a treatment option.

• The Korean Journal of Pain
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• 제7권2호
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• pp.249-253
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• 1994

Postherpetic neuralgia is one of the most troublesome disease in pain clinic. Nine patients who suffered from postherpetic neuralgia for 1.5 to 8 month, has been treated with the epidural block for prognostic or therapeutic purpose. Epidural catheter was inserted as close to the involved neural roots as possible, and tip of epidural catheter was confirmed under fluroscopic guide. Epidural neurolysis was performed out intermittent injection of 1~3 ml of 6% phenol in saline and repeated 2~6 times over one or 7 days interval. Two patients reported satisfactory pain relief and 3 patients reported some pain relief. But 4 patients unchanged after phenol block. The overall duration of pain relief was not studied. Validity and safety of epidural phenol block was not confined. Further study will be necessary before application of epidural phenol block to postherpetic neuralgia.