• The Korean Journal of Pain
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• 제9권2호
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• pp.340-343
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• 1996

Background: In our hospital, stellate ganglion block(SGB) has been performed for the prevention and treatment of vasospasm after microscopic reimplantation of finger(s). If brachial plexus block(BPB) has the same effect of sympathetic block on the upper extremity as SGB, it may be preferable to the SGB because it povides postoperative analgesia and is administered continuously. So we measured and compared the change of skin temperature on the forearm as the parameter of sympathetic blockade after SGB and BPB. Methods: The forty-two patients, belonged to ASA class 1~2, were received BPB for hand surgery. The skin temperature was measured before and after BPB on the forearm with patient monitor(LN 6199, YSI 400 Series Temperature Probe, Hellige, Germany). After 24 hours, ipsilateral SGB was performed and skin temperature was recorded before and after SGB. Results: The increase of skin temperature after procedures was $1.1{\pm}0.5^{\circ}C$(from $34.5{\pm}0.7^{\circ}C$ to $35.6{\pm}0.5^{\circ}C$) in BPB and $0.6{\pm}0.3^{\circ}C$(from $34.9{\pm}0.5^{\circ}C$ to $35.5{\pm}0.5^{\circ}C$) in SGB. The changes of skin temperature in both blocks were statistically significant(p<0.01), and the skin temperatures after each procedure were revealed no significant difference(p$\simeq$0.62). Conclusion: We thought that BPB produced sympathetic blockade on the upper extremity as much as SGB. Moreover, it provides postoperative pain relief and may be employed as continuous BPB could be used for hand surgery with many advantages.

• The Korean Journal of Pain
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• 제18권1호
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• pp.85-88
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• 2005

Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.

• The Korean Journal of Pain
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• 제11권1호
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• pp.138-142
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• 1998

Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

• The Korean Journal of Pain
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• 제14권2호
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• pp.266-270
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• 2001

An 85-year old female patient visited our pain clinic because of pin pricking pain and allodynia on the left forehead area for 2 days. Vesicular eruptions were seen along the left supraorbital nerve distribution. She experienced similar pain and eruptions on the contralateral forehead, the supraorbital counter area, 8 years previous. She had been taking antihypertensive medications for 15 years. She also had suffered from diabetes mellitus. She received a total hysterectomy and anterior posterior colporrhapy due to procidentia uteri and severe cystocele and rectocele. She had been treated intermittently for back pain due to advanced osteoarthritis and spondylosis. She was treated with famciclovir and triamcinolone acetonide with daily stellate ganglion block and supraorbital nerve block. Nortriptyline (a tricyclic antidepressant) and midazolam was prescribed to relieve pain and difficulty in sleeping. After 3 days, all treatment was ended because it was impossible to assess the severity of pain due to the senile psychosis of the patient. She eventually expired after 2 months. We report this case because it is rare for herpes zoster to recur, and particularly on the contralateral counter area.

• The Korean Journal of Pain
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• 제14권2호
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• pp.164-170
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• 2001

Background: Infrared Thermal Imaging (ITI) is an effective tool for the diagnosis of disease and evaluation of the therapeutic effects following pain treatment. Patients who were treated for pain in pain clinic described the intensity of pain and the degree of change of their pain using a visual analogue scale (VAS). In this study, the usefulness of ITI following multimodal methods for pain management were compared with the change of VAS. Methods: 1119 patients were evaluated. The patients were treated with stellate ganglion block, epidural block or trigger points injection. Before treatment, the temperature difference (${\Delta}T$) of the involved area and the corresponding area on the opposite side of the body was measured using ITI and VAS was assessed. After treatment, the temperature difference (${\Delta}T$) between the normal and involved areas, the change of ${\Delta}T$ (${\Delta}dT$), VAS and the change of VAS (${\Delta}VAS$) were measured. Statistic correlations between ${\Delta}dT$and ${\Delta}VAS$ were calculated in all groups. Results: Correlation of the ${\Delta}dT$ and ${\Delta}VAS$ was significant by contingency coefficient test. (SGB group, C = 0.358, Epi group, C = 0.377, TPI group, C = 0.374, P < 0.05) Conclusions: ITI is a reliable tool for the assessment of therapeutic effects following multidimensional management of painful disease.

• The Korean Journal of Pain
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• 제10권1호
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• pp.97-100
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• 1997

We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was teated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunt's hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9505-9509
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• 2014

Objective: To investigate the effects of stellate ganglion block (SGB) on the peri-operative vasomotor cytokine content and intrapulmonary shunt in patients with esophagus cancer who underwent thoracotomy. Materials and Methods: Forty patients undergoing elective resection of esophageal cancer patients who had I~II American Society of Anesthesiologist (ASA) were randomly divided into total intravenous anesthesia group (group N, n=20) and total intravenous anesthesia combined with SGB group (group S, n=20, 0.12 mL/kg 1% lidocaine was used for SGB 10 min before induction). Heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (MPAP) and continuous cardiac output (CCO) were continuously monitored. The blood from internal jugular vein was drawn respectively before induction ($T_0$), and 30 min ($T_1$), 60 min ($T_2$) and 120 min ($T_3$) after one-lung ventilation (OLV), and 30 min (T4) after two-lung ventilation. The contents of plasma endothelin (ET), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) were detected with enzyme linked immunosorbent assay (ELISA). Meanwhile, arterial and mixed venous blood samples were collected for determination of blood gas and calculation of intrapulmonary shunt fraction (Qs/Qt). Results: During OLV, ET contents were increased significantly in two groups (P<0.05), and no significant difference was presented (P>0.05). NO content in group S was obviously higher than in group N at T3 (P<0.05), whereas CGRP content in group N was markedly lower than in group S at each time point (P<0.05). Qs/Qt was significantly increased in both groups after OLV, but there was no statistical significant regarding the Qs/Qt at each time point between two groups. Conclusions: Total intravenous anesthesia combined with SGB is conducive to regulation of perioperative vasomotor cytokines in thoracotomy, and has little effect on intrapulmonary shunt at the time of OLV.

• The Korean Journal of Pain
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• 제6권2호
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• pp.208-212
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• 1993

1990년 5월부터 1993년 4월까지 알레르기성 비염으로 대구가톨릭대학 병원 통증치료실을 방문한 환자를 대상으로 하여 SGB와 E-AP로 병용 치료 하였는바 2회 이상 시행한 49명을 본 대상으로 하여 회고적으로 관찰하였다. 나이는 7세에서부터 70세까지로 평균 34.1세 였으며, 연령별로는 41~50세 사이가 많았으며, 내원 계절별로는 가을과 여름 순으로 많았다. SGB의 평균 시행 횟수는 $6.02{\pm}4.29$회였고, E-AP의 평균 시행 횟수는 $7.15{\pm}5.57$회였다. 환자의 병력은 평균 $5.53{\pm}7.10$년 이었으며, 1주일에서 30년까지 다양하였다. 6개월 이하의 병력시 SGB의 평균 시행 횟수가 $3.13{\pm}1.81$회로 6개월 이상 병력시의 평균 시행 횟수 $6.51{\pm}4.40$회 보다 통계적으로 의의있게 적었으며, 또한 치료기간도 6개월 이상 병력시의 $49.67{\pm}37.30$일 보다 6개월 이하 병력시의 $18.00{\pm}14.88$ 일이 통계적으로 의의있게 짧았다. 24명의 남자중 1명이, 25 명의 여자중 1명이 재발 내원하여 재 치료하였다. 치료 도중에 1명의 남자와 1명의 여자에게서 연하곤란증이 있었고, 1명의 여자에게서 4~5시간의 애성이 있었으나 그 후 정상으로 회복되었다. 본 질환은 일단 발병 하게되면 그 원인 규명도 어려울 뿐만 아니라 치료 역시 재발 악화 등 개운치 않은 질환인데도 전기침자극과 국소마취제에 의한 성상신경절 차단등 비교적 간단한 방법으로 매우 효과적인 반응을 얻게 되어 향후 널리 보급될 것으로 사료된다.

• Korean Journal of Acupuncture
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• 제22권1호
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• pp.55-66
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• 2005

Objectives : This study is a random-controlled post-design for confirmation of headache degree, quality of life, and satisfaction to therapeutical effect on chronic headache adults after management of non-medicinal treatment (acupuncture therapy and stellate ganglion block therapy). Methods : 51 clinical experiment participants were gathered and through a questioutaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified in to two groups, acupuncture group (AT group, n=28) and stellate ganglion block group (SGB group, n=23). Treatment was applied 2 times a weeks for 4 weeks. The effects of both groups were analyzed using VAS scores, BPI (Brief Pain Inventory) and the satisfaction degree to the therapy. Results : 1. The recognized score of the headache of AT group and SGB group was reduced indicating the degree of the headache was released. 2. The recognition at damage to the quality of life was reduced post therapy of AT group and SGB group, in which general activity, mood, enjoyment of life, personal relationship, and sleeping showed significant improvement of life quality, 3. The satisfaction degree to the therapy showed lower score than expectation to it in AT group and SGB group, however, it was not significant. Conclusions : The results showed that the four-week non-medicinal treatment (AT and SGB) in chronic headache patients was effective for reducing headache and releasing its damage in daily life, however, no difference in superiority was found. Therefore, non-medicinal treatment (AT therapy and SGB) could be utilized in chronic headache patients.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.199-204
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• 2018

Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.