• Title/Summary/Keyword: Pain%3A acute

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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.

Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial

  • Eun Kyung Choi;Saeyoung Kim;Do young Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.247-251
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    • 2023
  • Background: While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia. Methods: Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed. Results: No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery. Conclusion: PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.

Associations of unspecified pain, idiopathic pain and COVID-19 in South Korea: a nationwide cohort study

  • Kim, Namwoo;Kim, Jeewuan;Yang, Bo Ram;Hahm, Bong-Jin
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.458-467
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    • 2022
  • Background: Few studies have investigated unspecified or idiopathic pain associated with COIVD-19. This study aimed to provide the incidence rates of unspecified pain and idiopathic pain in patients with COVID-19 for 90 days after COVID-19 diagnosis. Methods: A propensity score matched cohort was used, including all patients with COVID-19 in South Korea, and analyzed their electronic medical records. The control group consisted of those who had not had tests for COVID-19 at all. Unspecified pain diagnoses consisted of diagnoses related to pain included in the ICD-10 Chapter XVIII. Idiopathic pain disorders included fibromyalgia, temporomandibular joint disorders, headaches, chronic prostatitis, complex regional pain syndrome, atypical facial pain, irritable bowel syndrome, and interstitial cystitis. Results: After matching, the number of participants in each group was 7,911. For most unspecified pain, the incidences were higher in the COVID-19 group (11.7%; 95% confidence interval [CI], 11.0-12.5) than in the control group (6.5%; 95% CI, 6.0-7.1). For idiopathic pain, only the headaches had a significantly higher incidence in the COVID-19 group (6.6%; 95% CI, 6.1-7.2) than in the control group (3.7%; 95% CI, 3.3-4.1). However, using a different control group that included only patients who visited a hospital at least once for any reasons, the incidences of most unspecified and idiopathic pain were higher in the control group than in the COVID-19 group. Conclusions: Patients with COVID-19 might be at a higher risk of experiencing unspecified pain in the acute phase or after recovery compared with individuals who had not had tests for COVID-19.

Pharmacological and non-pharmacological strategies for preventing postherpetic neuralgia: a systematic review and network meta-analysis

  • Kim, Junhyeok;Kim, Min Kyoung;Choi, Geun Joo;Shin, Hwa Yong;Kim, Beom Gyu;Kang, Hyun
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.509-533
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    • 2021
  • Background: Postherpetic neuralgia (PHN) is a refractory complication of herpes zoster (HZ). To prevent PHN, various strategies have been aggressively adopted. However, the efficacy of these strategies remains controversial. Therefore, we aimed to estimate the relative efficacy of various strategies used in clinical practice for preventing PHN using a network meta-analysis (NMA). Methods: We performed a systematic and comprehensive search to identify all randomized controlled trials. The primary outcome was the incidence of PHN at 3 months after acute HZ. We performed both frequentist and Bayesian NMA and used the surface under the cumulative ranking curve (SUCRA) values to rank the interventions evaluated. Results: In total, 39 studies were included in the systematic review and NMA. According to the SUCRA value, the incidence of PHN was lower in the order of continuous epidural block with local anesthetics and steroids (EPI-LSE), antiviral agents with subcutaneous injection of local anesthetics and steroids (AV + sLS), antiviral agents with intracutaenous injection of local anesthetics and steroids (AV + iLS) at 3 months after acute HZ. EPI-LSE, AV + sLS and AV + iLS were also effective in preventing PHN at 1 month after acute HZ. And paravertebral block combined with antiviral and antiepileptic agents was effective in preventing PHN at 1, 3, and 6 months. Conclusions: The continuous epidural block with local anesthetics and steroid, antiviral agents with intracutaneous or subcutaneous injection of local anesthetics and a steroid, and paravertebral block combined with antiviral and antiepileptic agents are effective in preventing PHN.

The Clinical Experiences with Laser Therapy in Pain Patients (치료용 레이저를 이용한 통증치료 경험)

  • Chae, Ki-Young;Kim, Hae-Kyu;Kim, Inn-Se
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.30-35
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    • 1989
  • Two hundred patients with acute and chronic pain were treated with a low power laser and 115 patients among them were divided into several groups by their pathology and evaluated their response rate to the laser therapy was evaluated through follow-up study. 1) The ages of patients were between the early twenties and late sixties, and there was no differences between sexes. 2) Degenerative spondylosis and chronic lumbar sprain were the most common diseases among those patients. 3) The average duration of therapy was about 16 days and response to the therapy appeared from the fourth day of laser therapy. 4) Acute lumbar sprain and acute spinal compression fracture showed rapid response to laser therapy. 5) The spinal pathology group was the most common at 37.5% of cases and the response rate to laser therapy was the lowest at 58.7%. 6) The articular pathology group occupied 24.6% and the response rate was the highest at 81.3%. 7). The response rate of the posttraumatic and postsurgical pathology group was 76.5%. 8) The response rate of the tendinous and sports pathology group was 75%. 9) The response rate of the miscellaneous group was 66.7%. 10) The mean response rate of all patients was 71.6%.

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A Clinical Study Comparing the Effects of Supine JS Cervical Therapy and Muscle Release/Strengthening Technique on the Patients with Acute Neck Pain Caused by Traffic Accidents: A Retrospective Study (교통사고로 유발된 급성 경항통 환자에 대한 앙와위 경추 JS 신연 교정기법과 근육 이완/강화기법의 효과 비교: 후향적 연구)

  • Park, Jeong-Wook;Gu, Ji-Hyang;Ha, Hyun-Ju;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.3
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    • pp.129-139
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    • 2020
  • Objectives The purpose of this study was to compare the effect of supine JS cervical therapy and muscle release/strengthening technique in patients with acute neck pain caused by traffic accidents. Methods We studied 42 patients with acute neck pain caused by traffic accidents from July 1, 2019 to November 30, 2019. The study was conducted as a retrospective study which analyzes the patient's medical records. 21 patients (group A) had received supine JS cervical therapy and 21 patients (group B) had received muscle release/strengthening technique. We used the neck disability index (NDI) and visual analog scale (VAS) to evaluate improvements in symptoms and pain, and used the five point Likert scale to evaluate patient's satisfaction with chuna manual therapy. In each group, we compared the NDI and VAS of hospitalization day to those of 5 days later. Then we compared the NDI, VAS variation and five point Likert scale between the groups. Statistical analysis was conducted using the IBM SPSS for windows 25.0. Result Both group A and group B showed a statistically significant decrease in the NDI and VAS on the 5th day of hospitalization. In group A, there was a statistically significant decrease in the NDI compared to group B. The VAS and Five Point Likert Scale decrease was greater in group A than in group B, but the difference was not statistically significant. Conclusion We found that using supine JS cervical therapy may be more effective than muscle release/strengthening technique in acute stage after traffic accidents.

Takotsubo cardiomyopathy in a patient with oral cancer

  • Jeon, Da-Nee;Park, Kun-Hyo;Lee, Jung-Han;Kim, Uk-Kyu;Kim, Eun-Jung;Yoon, Ji-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.157-160
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    • 2015
  • A patient with squamous cell carcinoma on the left mandible presented with symptoms similar to acute coronary syndrome just after surgery. The exact etiology was unclear, but following transthoracic echocardiogram, takotsubo cardiomyopathy was diagnosed. This is a rare, acute, and reversible form of heart failure, and the patient recovered completely within weeks. Related risk factors are believed to include extended surgery times and extended time under general anesthesia. Early recognition, followed by postoperative control of pain and anxiety are crucial to patient recovery.

A Comparative Study on the Effect of Herb Medication Based on Go-bang Treatment, Huse-bang Treatment for Patients with Acute Neck Pain Caused by Traffic Accidents: A Retrospective Study (교통사고로 유발된 급성 경항통 환자에 대한 고방 치료와 후세방 치료의 효과 비교: 후향적 연구)

  • Kim, Sang Woo;Gu, Ji Hyang;Ha, Hyun Ju;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.3
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    • pp.117-127
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    • 2020
  • Objectives The purpose of this study was to compare the effect of herb medication based on 'Go-bang' treatment, 'Huse-bang' treatment for patients with acute neck pain caused by traffic accidents. Methods We studied 40 patients with acute neck pain after traffic accidents who had admitted to Department of Korean Medicine Rehabilitation, College of Korean Medicine, Daejeon University from November 25, 2018 to November 25, 2019. 20 patients had received Herb Medication Based on 'Go-bang' and 20 patients had received herb medication based on 'Huse-bang' three times a day. The study was conducted as a retrospective observation study which analyze the patient's medical records. We used visual analogue scale (VAS) to evaluate pain reduction and neck disability index (NDI) to evaluate function improvement twice (hospitalization day and 5 days later). Statistical analysis was performed using the IBM SPSS statistics 25 program. Result The VAS scores, NDI scores decreased statistically significantly after treatment in all patients. Both 'Go-bang' and 'Huse-bang'groups showed a statistically significant VAS reduction and improvement of NDI on the fifth day of hospitalization. In the 'Huse-bang' group, there was a statistically significant improvement of NDI than in the 'Go-bang' group. Conclusion We found that both types of herbal-medication were significantly effective on acute neck pain and neck disability after traffic accident. Further study is needed about the comparison of effectiveness between Go-bang' and 'Huse-bang'groups.

The case report on pain treatment by extravascular laser system (비침습 레이저 조사기를 이용한 통증 치료에 대한 증례 보고)

  • Hwang, Young-Jun;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.3
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    • pp.51-60
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    • 2006
  • Objectives : The purpose of this study was to assess the ability of Extravascular Laser System on pain treatment. Methods : On this study, we carried out with the 9 cases of children who visited in the Department of Pediatrics, OO University Oriental Hospital as pain. 9 children suffering from pain were treated with Extravascular Laser System, and two of these were treated with combined acupuncture. In order to determine the degree of pain relief, a visual analogue scale was used. Results : Extravascular Laser System for pain resulted in a significant decline in the visual analogue scale. For Extravascular Laser System combined with acupuncture, VAS score has fallen by 30% each time compared to 17.5% of Extravascular Laser System only. In 2 cases of chronic pain, VAS score decreased to 0. In 7 cases of acute pain, All of 7 children improved 50% on VAS score, On average VAS score have seen 79.2% reduction. The average treatment times of chronic pain were 5 times, while that of acute pain were 4.1 times. Conclusions : We report the good result of the efficacy of extravascular laser system on children's pain. but, this study's cases were small in number. so more study is need.

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Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.