• The Korean Journal of Pain
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• v.8 no.1
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• pp.164-167
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• 1995

Stellate ganglion block(SGB) is a widely used sympathetic block to diagnose or treat various painful conditions. We experienced a rare case who exhihited a contralateral Horner's syndrome following SGB. A 64-year-old female patient suffering from postherpetic neuralgia on mandibular branch of trigeminal nerve visited our pain clinic. She complained of severe burning and shooting pain on right side lower lip, ear and temporal area. We modified her previous medications and performed repeated right SGB daily, in combination with mandibular or mental and auriculotemporal nerve blocks twice a week. Her symptoms were progressively improved. A contralateral Horner's syndrome occured after the thirteenth SGB, which was performed under several attempts in the same manner and the same physician. She had no evidence of subarachnoid or brachial plexus blocks. She did not need any special treatment and returned home 2 hours later. Subsquent blocks were followed on ipsilateral Horner's syndromes.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.140-143
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• 1999

Ramsay-Hunt syndrome is a related but more serious disorder caused by herpes zoster viral infection of the geniculate ganglion. It is characterized by unilateral painful vesicular rash of the uvula, palate, auricle, ear canal, and postauricular area, but it can extend into the facial tissues as well. Paralysis of the facial nerve is often seen, and there can be disequilibrium and hearing problems also. We experienced continuous cervical epidural block (CCEB) with intermittent stellate ganglion block is effective in Ramsay-Hunt syndrome. CCEB should be considered to the treatment of choice in Ramsay-Hunt syndrome.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.148-151
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• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.

• 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.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.96-98
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• 2009

Twelfth rib syndrome is thought to be due to intercostal nerve irritation by a mobile twelfth rib, and presents with upper abdominal pain, or low thoracic pain. This syndrome appears to be a fairly common entity and diagnosis is based on clinical findings. Patients with twelfth rib syndrome can be misdiagnosed when it has been overlooked. We report a case of a 34-year-old male along with a presentation of twelfth rib syndrome. One patient was transferred from urologic clinic to pain clinic due to right flank pain and admitted. The patient had direct tenderness on twelfth rib area and direct tenderness was reproducible. Pain increased when the patient flexed laterally, rotated trunk. There were no specific abnormal findings in laboratory test, electrocardiogram, and radiologic examination. After intercostal nerve block and epidural block, pain decreased and the patient was discharged.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.105-108
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• 1993

A myofascial syndrome due to continuous muscle contraction with the trigger point at the upper lateral edge of the nuchal muscles where they attach to the occipital bone is frequently seen in daily pain clinic practice. The Tienchu syndrome is a myofascial condition of the posterior neck region with a trigger point at the Tienchu acupoint(B10). When advanced, occipital neuralgia and muscle contraction headache follow. Therefore, a Tienchu block and/or occipital nerve block with local anesthetic combined with a small dose of steroid is a most effective therapeutic method for many patients who complain of posterior headache or posterior neck pain.

• Clinical Pain
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• v.18 no.1
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• pp.36-39
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• 2019

Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.131-134
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• 1995

Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

• The Journal of the Korean dental association
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• v.56 no.1
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• pp.49-57
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• 2018

The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.