• The Korean Journal of Pain
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• 제25권1호
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• pp.33-37
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• 2012

Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.

• 대한약침학회지
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• 제17권1호
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• pp.74-79
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• 2014

Objectives: This study was conducted to clarify the analgesic effect of toad cake and toad-cake-containing herbal drugs. Methods: We counted the writhing response of mice after the intraperitoneal administration of acetic acid as a nociceptive pain model and the withdrawal response after the plantar surface stimulation of the hind paw induced by partial sciatic nerve ligation of the mice as a neuropathic pain model to investigate the analgesic effect of toad cake and toad-cake-containing herbal drugs. A co-treatment study with serotonin biosynthesis inhibitory drug 4-chloro-DL-phenylalanine methyl ester hydrochloride (PCPA), the catecholamine biosynthesis inhibitory drug ${\alpha}$-methyl-DL-tyrosine methyl ester hydrochloride (AMPT) or the opioid receptor antagonist naloxone hydrochloride was also conducted. Results: Analgesic effects in a mouse model of nociceptive pain and neuropathic pain were shown by oral administration of toad cake and toad-cake-containing herbal drugs. The effects of toad cake and toad-cake-containing herbal drugs disappeared upon co-treatment with PCPA, but not with AMPT or naloxone in the nociceptive pain model; the analgesic effect of toad-cake-containing herbal drugs also disappeared upon co-treatment with PCPA in the neuropathic pain model. Conclusion: Toad cake and toad-cake-containing herbal drugs have potential for the treatments of nociceptive pain and of neuropathic pain, such as post-herpetic neuralgia, trigeminal neuralgia, diabetic neuralgia, and postoperative or posttraumatic pain, by activation of the central serotonin nervous system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.268-272
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• 2007

Herpes zoster is caused when the varicella zoster virus(VZV) that has remained latent since an earlier varicella infection is reactivated with cutaneous and mucous manifestations. They occur in 20% cases in the trigeminal area and typical manifestations are neuralgias simulating dental pain, also vesicles with an erythematous halo located in the territory of the second and third trigemial branch. They erupt on the skin, the lips, tongue, palate and cheeks. With an ever-increasing number of elderly and immunocompromised patients attending the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Furthermore, the oral and maxillofacial surgeons must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations and oral complication of herpes zoster of the trigeminal nerve. As presentation of our patient with ulcer on hard palate caused by herpes zoster, current treatment of herpes zoster and post-herpetic neuralgia are discussed.

• The Korean Journal of Pain
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• 제14권2호
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• pp.249-252
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• 2001

Total spinal anesthesia is a serious life threatening complication of spinal and epidural anesthesia. We report an accidental total spinal anesthesia developed during a thoracic epidural block in a practitioner's pain clinic. A 69-year-old female with post-herpetic neuralgia was treated by a thoracic epidural block. A thoracic tapping for the epidural block was performed in the right lateral position at a level between $T_{5-6}$, using a 23 gauge Tuohy needle. After the epidural space was identified, a mixed solution of 10 ml of 0.3% lidocaine and 20 mg of triamcinolone was injected into the epidural space. After removal of the syringe, fluid was dripping through the needle. The patient subsequently complained of dyspnea and dizziness, and she became unconscious. She was intubated immediately and cardiopulmonary resuscitation was performed because there was no pulse palpable. The patient recovered an hour after transfer to a general hospital and was discharged without any further complication 19 days later.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.177-183
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• 2012

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves. Oral vesicles usually appear after the skin manifestations. The vesicles rupture and coalesce, leaving mucosal erosions without subsequent scarring in most cases. The worst complication of HZI is post-herpetic neuralgia; other complications include facial scarring, motor nerve palsy and optic neuropathy. Osteonecrosis with spontaneous exfoliation of the teeth is an uncommon complication associated with HZI of the trigeminal nerve. We report several cases of osteomyelitis appearing on the mandible, caused by HZI, and triggering osteonecrosis or spontaneous tooth exfoliation.

• The Korean Journal of Pain
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• 제12권1호
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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.

• 구강회복응용과학지
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• 제29권4호
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• pp.391-398
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• 2013

보툴리눔 독소는 사시, 안검경련, 뇌성마비, 경부근 근육긴장이상, 다한증, 얼굴의 주름 같은 미용 치료, 그리고 만성 편두통 치료에 미국 식약청의 승인을 받아 사용되고 있다. 이외에도 강직유발 통증, 포진후 신경통, 근막통증, 아프타성 구내염 등과 같은 통증을 조절하는 데 효과가 있을 것이라 기대되어 다양한 의료영역에서 연구가 진행되고 있는데, 최근 코골이 및 수면무호흡 치료에 있어서 보툴리눔 독소의 효과에 관한 연구들이 보고된 바 있어 그 유용성에 관해 고찰해 보고자 한다.

• Journal of Acupuncture Research
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• 제40권1호
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• pp.16-34
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• 2023

Herpes zoster (HZ) results from the reactivation of a varicella-zoster virus infection and is accompanied by moderate-to-severe pain in most patients. The most common treatment is medication; however, there are still limitations. Acupuncture reportedly has meaningful therapeutic effects and is a possible alternative option in HZ. However, no systematic reviews examining the use of acupuncture and electro-acupuncture (EA) alone have been published; in this study, we therefore aimed to systematically review those techniques. We searched for clinical trials of acupuncture and EA treatment for HZ up to October 2022. Trials that used acupuncture were included. Outcomes were visual analog scale (VAS) and effective rate. Secondary outcomes were time to pain relief, time to pain elimination, incrustation, decrustation, lastly incidence of post-herpetic neuralgia (PHN). In total, 22 randomized controlled trials were included in this research. Compared with conventional medication therapy, acupuncture was associated with a significant improvement in VAS, effective rate, and times to pain relief and elimination. Times to new blister cessation, incrustation, and decrustation (days) were significantly improved. Furthermore, the incidence rate of PHN was lower in acupuncture groups. The results suggest that acupuncture could be a reasonable treatment option for patients with HZ who suffer from pain and accompanying symptoms.