• Title/Summary/Keyword: Pain clinic: nerve block

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Median Nerve Block for Treatment of Carpal Tunnel Syndrome -Report of 5 cases- (수근관 증후군 환자에서의 정중 신경차단 -5예 보고-)

  • Jung, Pyung-Sik;Lee, Hyo-Kun;Kim, Soon-Yul;Yoon, Kyung-Bong;Kim, Chan
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.65-68
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    • 1994
  • Carpal tunnel syndrome is the most common compressive neuropathy of the upper extremity. Clinical manifestations include pain as well as motor and sensory dysfunction in the distribution of the median nerve. As nonoperative treatment, median nerve block is performed to relieve pain for carpal tunnel syndrome. We have experienced 5 such cases. Our results support median nerve block as an excellent treatment for carpal tunnel syndrome.

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Long-term Outcome of Trigeminal Nerve Block with Alcohol for the Treatment of Trigeminal Neuralgia (삼차신경통 환자에서 알코올 신경차단의 장기 추적 결과)

  • Han, Kyung Ream;Kim, Chan;Kim, Do Wan;Cho, Oi Gyeong;Cho, Hye-Won
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.45-50
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    • 2006
  • Background: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. Methods: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. Results: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. Conclusions: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.

Nerve Blocking Techniques of Pain Clinic (Pain Clinic에서의 신경차단법(神經遮斷法))

  • Shiotani, Masahiro
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.1-8
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    • 1992
  • A total of 578,886 nerve blocks were performed during a period of 28 years. Based on our experience, we introduced the concept of compartment block, and then improved our technique of nerve blocking. If the location of a compartment was defined by injecting a contrast medium under fluoroscopic monitoring, the effect of nerve block could be estimated. As a result, we can safely perform nerve blocks with alcohol within a short period of time.

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Alcohol Block for Trigeminal Neuralgia -Analysis of 41 patients- (삼차신경통 환자에서의 알코올 신경차단 -41예 분석-)

  • Kim, Chan;Chung, Young-Pyo;Lim, Hyun-Kyo;Yoon, Kyung-Bong;Um, Dae-Ja
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.39-42
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    • 1994
  • The purpose of this study was to review the results of the neurolytic trigeminal nerve block in 41 patients from April 1992 to March 1994. Most common site of trigeminal neuralgia was the second division(27 patients, 68.3%). Nineteen patients of these were treated with infraorbital nerve block. Another 4 patients had cerebello-pontine angle tumor close to TREZ in MRI findings therefore they were excluded from this study. Thirty nine patients (95.1%) remained free of pain. Only 2 patients treated with infraorbital nerve block experienced recurring pain. Although the follow-up period was short, alcohol blocks proved effective and safe for treatment of trigeminal neuralgia.

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Stroke after the Procedure of Lumbar Facet Joint block and Lumbar Epidural Block -Case reports- (요부 추간관절차단 및 요부 경막외차단 후 발생한 뇌졸증 -증례 보고-)

  • Lee, Hyo-Keun;Kim, Sung-Mo;Han, Kyung-Ream;Lee, Jong-Moo;Ko, Seok-Shin;Kim, Chan
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.131-133
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    • 1997
  • Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

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Splanchnic Nerve Block with Transdiscal Approach -A case report- (경추간판 접근법에 의한 내장 신경 차단 -증례 보고-)

  • Na, Young-Du;Lee, Jung-Koo;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.89-92
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    • 1997
  • Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

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Experience of Two Types of Headache -Episodic tension-type headache and benign exertional headache- (두 종류의 두통 치험)

  • Kim, Tae-Heon;Song, Myung-Ja
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.88-91
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    • 1994
  • Headache, like low back pain, is one of the most common of pain conditions. Many data suggest that nerve block can be one of effective treatments in managing headache except pure psychologic or surgical origin, because mechanism of headaches have neurologic, vascular or local tissue pathology. We experienced two types of headache; episodic tension-type headache, and benign exertional headache; successful treatment consist of nerve block and modulation of exercise, respectively.

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CT Guided Chemical Facial Nerve Block in the Treatment of Facial Spasm (안면경련의 치료에 있어 CT 유도하 화학적 안면신경 차단 -증례 보고-)

  • Jeong, Jin-Ou;Kwon, Jae-Young;Kim, Hae-Kyoo;Baik, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.251-254
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    • 1993
  • Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of all or parts of the muscles innervated by the facial nerve. This occurrence is most common in middle-aged women. Because etiology of idiopathic hemifacial spasm has remained undefined, no causative agent nor reliable treatment has been established. This report describes a case of CT guided chemical facial nerve block for the treatment of hemifacial spasm. An injection of small amount(0.1 ml) of alcohol(95%) provided relief of the facial spasms.

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Nerve Root Block with Corticosteroids, Hyaluronidase, and Local Anesthetic in the Failed Back Surgery Syndrome (FBSS) (Failed Back Surgery Syndrome (FBSS) 환자에서 Hyaluronidase를 사용한 신경근차단술의 효과)

  • Lee, Kyung-Jin;Han, Sang-Gun;Yoon, Seuk-Hwan;Kim, Jin-Soo;Lee, Young-Suk
    • The Korean Journal of Pain
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    • v.12 no.2
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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.

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Clinical Survey of the Patients of Pain Clinic (통증 치료 환자에 대한 임상통계적 고찰)

  • Lim, Kyung-Im;Kim, Byung-Ki;Sohn, Hang-Soo
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.288-293
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    • 1998
  • We had retrospective analysis of 421 patients who were consulted from other departments. From 1994 to 1997, these patients received nerve blocks, intravenous lidocaine infusion, lasers and so on for their pain. From these results, we are gathering information and making some recommandations. The largest percentage of patients were in their fifties with a distribution of 32.8% male and 55.1% female. The most common condition requiring treatment was low back pain 44.6%, followed by cancer pain 19.2%, cervical pain 7.4%, and shoulder pain 4.3%. In case of low back pain, the largest portion was HNP(27%), followed by spinal stenosis(16%), sprain(11%), and postlaminectomy(10%). The most common cacer was colorectal(28.4%) and the next was stomach(19.7%). The most commonly done nerve block was stellate ganglion block 32.3%, followed by lumbar epidural block 24.5% and caudal block 7.2%.

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