• PNF and Movement
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• v.13 no.1
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• pp.25-30
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• 2015

Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.116-118
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• 1994

Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer in. The possibility of neurologic complication cannot be completely precluded. A 53 year-old female patient with hepatoma and lung metastasis was submitted for splanchnic nerve block with alcohol. Splanchnic nerve block was performed under radiologic control by image intensifier without any difficulty during procedure. One day after the block, she complained of numbness with sensory deficit in bilateral inguinal area. Neurologic examination revealed that asymmetrical anesthesia, hypoesthesia at $T_{12}-L_2$. She was discharged 70 days after the block with partial improvement. The possibility of alcohol spreading to the low theracic and upper lumbar somatic nerves cannot be excluded.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.2
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• pp.89-94
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• 2014

Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

• Clinical Pain
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• v.18 no.2
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• pp.130-132
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• 2019

Acupuncture is generally regarded as a safe procedure and as a popular treatment for patients with musculoskeletal disorders. We report a case of a 47-year-old male patient with late-onset tetraplegia, developed after acupuncture. He had no trauma, medical, and social history relevant to tetraplegia. Right after the acupuncture, he felt discomfort in his right arm. After 6 days, all 4 extremity weakness developed. Whole-spine magnetic resonance imaging revealed the presence of spinal subdural hematoma extending from the C5 vertebra to the coccyx level. Hand coordination dysfunction, neurogenic bladder, and neuropathic pain were other symptoms. After the management, he recovered muscle strength, but incomplete bladder control and neuralgia were sustained. It is important to be aware of the possibilities of severe complications after acupuncture.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.214-222
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• 2014

Purpose: The method of percutaneous endoscopic gastrostomy (PEG) tube placement can be divided into the pull and introducer techniques. We compared short-term complications and prognosis between patients who underwent the pull technique and two other types of introducer techniques, the trocar introducer technique and T-fastener gastropexy technique. Methods: Twenty-six patients who underwent PEG were enrolled in this study. We retrospectively investigated the age, sex, body weight, weight-for-age Z-score, underlying diseases, PEG indications, complications, duration of NPO (nil per os), pain control frequency, and duration of antibiotic therapy. The patients were classified into three groups according to the PEG technique. The occurrence of complications was monitored for 10 weeks after the procedure. Results: The age, sex, body weight, and weight-for-age Z-score were not significantly between the three groups. Most patients had cerebral palsy and seizure disorders. Dysphagia was the most common indication for PEG. Major complications occurred in 5 (50%), 4 (66.7%), and 0 (0%) patients in group I, II, and III, respectively (p=0.005). Further, peristomal infection requiring systemic antibiotic therapy occurred in 2 (20%), 3 (50%), and 0 (0%) patients in group I, II, and III, respectively (p=0.04). There was no significant difference between the groups with respect to minor complications, duration of NPO, pain control frequency, and duration of antibiotic therapy. Conclusion: The results indicate that the T-fastener gastropexy technique was associated with the lowest rate of major complications.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.422-430
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• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2853-2856
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• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.550-553
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• 2020

Acupuncture, which is a procedure of inserting needles in a specific portion of the body to control pain, is conducted widely. The procedure is considered relatively safe because of its minimal side effects and low occurrence (1 in 200,000). On the other hand, its side effects include neurological damage, infection, hematoma, emphysema, etc. The authors report a case of cervical neurological damage that occurred after an acupuncture procedure.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.415-424
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• 2014

PURPOSE: This study examined the effect of high-frequency transcutaneous electrical nerve stimulation (TENS) and San-Yin-Jiao (SP6) acupressure on primary dysmenorrhea. Furthermore, the difference in effectiveness between the two methods were compared. METHODS: Twenty-six students participated in this study, and were randomly assigned to a high-frequency TENS group(experimental 1, n=9), a San-Yin-Jiao (SP6) acupressure group(experimental 2, n=9), and no treatment group(control, n=8). They were assessed and treated on the first day of their menstruation. The TENS protocol included applying 20 minutes of stimulation with a frequency of 100Hz, $100{\mu}sec$ pulse width. Four electrodes were placed on the skin 3 cm from midline at T12-L1 and S2-3 paravertebral muscles. San-Yin-Jiao (SP6) acupressure should be applied with the thumb for 10 minutes(8 seconds pressure and 2 seconds rest) on the SP6 acupoint. This procedure should be repeated for the other foot. Dysmenorrheal pain measured two pain assessment tools (VAS, DPT) pre-treatment; immediate post-treatment; 30minutes, 1, 2hours; and 3, 4, 5, 6, 24 hours after the VAS test were added. RESULTS: The results showed significant differences in pain assessments (VAS, DPT) after treatment for subjects of experimental group1 (p<.05) and experimental group2 (p<.05), whereas the between-group comparison found no statistically significant differences. CONCLUSION: This result supports the idea that using two methods could be effective in pain reduction among students who suffered from primary dysmenorrhea.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.111-116
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• 2016

Background: Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners. Methods: Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores. Results: A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were $2.5{\pm}1.85$ and $2.1{\pm}1.8$ while injecting and delivering local anesthesia, respectively. Conclusions: The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.