• Title/Summary/Keyword: Referred pain

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Medical adhesive related skin injury after dental surgery

  • Kim, Tae-Heung;Lee, Jun-Sang;Ahn, Ji-Hye;Kim, Cheul-Hong;Yoon, Ji-Uk;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.5
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    • pp.305-308
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    • 2018
  • An 87-year-old woman was referred for the extraction of residual teeth and removal of tori prior to prosthetic treatment. After surgery under general anesthesia, the surgical tape was removed to detach the bispectral index sensor and the hair cover. After the surgical tape was removed, skin injury occurred on the left side of her face. After epidermis repositioning and ointment application, a dressing was placed over the injury. Her wound was found to have healed completely on follow-up examination. Medical adhesive related skin injury (MARSI) is a complication that can occur after surgery and subjects at the extremes of age with fragile skin are at a higher risk for such injuries. Careful assessment of the risk factors associated with MARSI is an absolute necessity.

The study of muscular system about Large Intestine Channel of Hand Yangmyung Muscle. (수양명대장경근(手陽明大腸經筋)에 대(對)한 근육학적(筋肉學的) 고찰(考察))

  • Kim, Tae-Young;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.17 no.1
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    • pp.137-143
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    • 2008
  • We have conclusions after the study of muscular system about large intestine channel of hand yangmyung muscle. 1. Judging from many studies of interrelation between Meridian muscle and muscle. it is considered that Meridian muscle theory has some similarities with modern anatomical muscular system. 2. There is a wide defference betwean myofacial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. It is considered that large intestine channel of hand yangmyung muscle contains extensor digitorum muscle, extensor muscle of index finger, brachioradialis muscle, triceps brachii muscle, Rhomboid major muscle, trapezius muscle, sternocleidomastoid muscle and muscle levator labii. 4. The symptoms of large intestine channel of hand yangmyung muscle is similar to referred pain of modern Myofacial pain syndrome, and the medical treatment of "I-Tong-Wi-Su" is similar to that of Myofacial pain syndrome.

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Local anesthesia of the temporomandibular joint to reduce pain during mouth opening for dental treatment in a patient with spinal muscular atrophy

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk;Lee, Jong Ho;Chang, Juhea
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.2
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    • pp.137-140
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    • 2016
  • Spinal muscular atrophy (SMA) is an autosomal recessive, severe neuromuscular disorder in which degeneration of alpha motor neurons in the spine progressively weakens and ultimately paralyzes the proximal muscles. It occurs in one per 6,000-10,000 infants, and is a genetic disorder with the second-highest mortality rate worldwide. An 18-year-old male patient with SMA was referred for general anesthesia for difficulty in performing dental treatment due to limited mouth opening caused by temporomandibular joint (TMJ) pain. However, the patient had a high risk of general anesthesia complications, so TMJ pain during mouth opening was reduced through local anesthesia of the TMJ. Fortunately, the anesthesia was successful in reducing pain during mouth opening, enabling the patient to receive dental treatment with an adequate mouth opening.

Airway foreign body occurs unintentionally during anesthetic management of patient with asthma

  • Cho, Woo Jin;Yun, So Hui;Choi, Yun Suk;Lee, Bang Won;Kim, Mi Ok;Park, Jong Cook
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.43-45
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    • 2019
  • Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

The Study to standardize the ST36 Acupoint Location on Rats (흰쥐에서 족삼리 취혈 위치 표준화를 위한 연구)

  • Kim, Jong-Yeop;Choi, Il-Hwan;Hong, Yo-Han;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.27 no.3
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    • pp.97-108
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    • 2010
  • Background : The location of acupoints on rat, which may differ from that of human body due to anatomical structure, is defined variously among researchers, which may cause the problem of low repeatability and objectivity. Design : The measurement of hind limb consist of measuring the distance between knee joint and tibia tubercle in order to set the knee joint as common criteria. Based on it, the three mostly referred location of ST36 were represented with the knee joint as a datum point and compared. The electroacupuncture stimulation was administrated after the abdominal pain was induced by acetic acid. And the analgesic activity of each ST36 acupoint was evaluated by measuring the number of writhing reflex, in order to observe the differences of treatment effect in accordance with the location of ST36 acupoints. Results : The result of measurement confirmed the differences in the acupoint location of ST36 among researchers. The writhing reflex test using the acetic acid-induced abdominal pain stimulated with electroacupuncture of 100Hz showed that there were statistically significant differences in the analgesic effect between control group and three ST36 groups (P<0.05). However there were no differences observed among three mostly referred location of ST36 acupoints (P>0.05). Conclusions : We recommend "the point located 6.5 mm below the knee joint at the anterior tibial muscle" as a standard ST36 acupoint location qualified by the WHO Standard Acupuncture Point Locations in 2008.

영적 간호중재가 호스피스환자의 통증과 불안에 미치는 효과

  • Yun, Mae-Ok
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.1-17
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    • 2001
  • The purpose of this study was to elucidate the effects of spiritual nursing intervention on pain and anxiety of the hospice patients. This study was devised with a quasi-experimental design using non-equivalent contrast group non-synchronized design. The data were collected during the period from July 10 to September 25 in 2000 at the general hospital in CheonJu city. The subjects were sixty-seven patients who referred the hospice service. They were assigned to two groups, 36 members of the experimental group and 30 members of the contrast group. They also did not any complication, were alert enough tobe interviewed and agree willingly to participate in this study. The tools used were Yoon's Korean Version of Brief Pain Inventory and Spielberger's State Anxiety Scale. The spiritual care intervention was carried out through Hymn, Scripture, Prayer, the therapeutic use of self over a period of three weeks. Data were analyzed by mean, standard deviation, $x^2$-test, t-test, paired t-test and Pearson's Correlation Coefficients. The results of this study were as follows: 1.The examination of the same quality showed that there were not significant differences in the general characters, disease and therapeutic characters, religional characters between the experimental group and the contrast group. 2.After the spiritual nursing intervention pain scores of the experimental group were remarkably lower than those of the contrast group(right now pain: t=-2.634, p=0.012). 3.Decreasing rate in the pain scores of the experimental group were remarkably lower than those of the contrast group(right now pain: t=5.017, p=0.000). 4. After the spiritual nursing intervention state anxiety of the experimental group were remarkably lower than those of the contrast group(t=-5.987, p=0.000). 5. A positive correlation was found between reported pain and depression following the spiritual nursing intervention. In conclusion, the hospice patients who were offered spiritual care became lower than those who were not offered spiritual care and confirmed to decrease pain. According to these results, spiritual nursing intervention can be regarded as an effective nursing intervention that relieved pain and anxiety of the hospice patients.

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A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume (경부 경막외 차단 시 약물의 용량에 따른 분포 양상 비교)

  • Jo, Dae hyun;Kim, Myoung hee;Ahn, Sun Yeon;Park, Sa Hyun;Lee, Kang Chang
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.46-49
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    • 2007
  • Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

Nephrotomy for Removal of Renal Calculi in Two Dog (개에서 신 절개를 통한 신 결석 제거 2례)

  • 김혜진;장화석;송영성;김성미;김순신;최치봉;김휘율
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.66-71
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    • 2004
  • 2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

Interventional Pain Management in Rheumatological Diseases - A Three Years Physiatric Experience in a Tertiary Medical College Hospital in Bangladesh

  • Siddiq, Md. Abu Bakar;Hasan, Suzon Al;Das, Gautam;Khan, Amin Uddin A.
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.205-215
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    • 2011
  • Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

A Case Report of Giant Cell Arteritis Combined with Oculomotor Nerve Palsy (동안신경마비가 동반된 거대세포 동맥염 환자의 치료 경험 - 증례보고 -)

  • Ryu, Young Bin;Han, Kyung Ream;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.255-257
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    • 2007
  • Giant cell arteritis, which is also referred to as temporal arteritis, is defined as a systemic vasculitis in individuals over 50 years of age. Here, we report a case of giant cell arteritis combined with oculomotor nerve palsy. An 81-year old female patient experienced a headache for 10 days in her left temporoparietal area, that was characterized by a continuous dull ache and heaviness with intermittent shooting and lancinating pain. Her symptoms persisted in spite of receiving strong analgesics in another hospital. Upon physical examination, she was found to have marked tenderness over the left temporal area, especially along the path of the temporal artery as well as limitation of adduction, supraduction and infraduction of the left eyeball. At the time of admission, her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 52 mm/hr and 3.94 mg/dl. In addition her brain MRI revealed no specific findings. Giant cell arteritis was suspected based on the clinical symptoms and signs as well as the elevated ESR and CRP. Oral steroid therapy started was started with an initial dose of 40 mg of prednisolone per day that was gradually tapered to 5 mg a day for 2 weeks. Her headache subsided one day after the steroid therapy and oculomotor nerve palsy was markedly improved after 2 weeks of the therapy. After 2 months she had recovered completely from her symptoms.