• The Korean Journal of Pain
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• 제8권1호
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• pp.139-143
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• 1995

Hyperhidrosis is the state of abnormal sweating on the palm, sole and axillary region. The main treatment of hyperhidrosis are surgical sympathectomy and a thoracic sympathetic ganglion block with neurolytics. Among them, a thoracic sympathetic ganglion block is used in pain clinic for the treatment of hyperhidrosis. I have successfully performed a thoracic sympathetic ganglion block on a 21 year old female patients with pure alcohol. I concluded that the thoracic sympathetic ganglion block was one of the most effective treatment of hyperhidrosis.

• The Korean Journal of Pain
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• 제18권2호
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• pp.161-164
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• 2005

Background: Chemical lumbar sympathetic ganglion block could potentially be used to treat plantar hyperhidrosis; therefore, we analyzed the outcome of lumbar sympathetic ganglion block using alcohol for the treatment of plantar hyperhidrosis. Methods: Between March 1992 and June 2003, 356 patients with plantar hyperhidrosis underwent lumbar sympathetic ganglion block using alcohol. All 356 patients were followed up for 2 years and the results evaluated. There were 185 and 171 male and female patients, respectively, with a mean age of 25.1 years, ranging from 15.3 to 56.5 years old. Lumbar sympathetic ganglion block using alcohol was performed with fluoroscopic guidance under local anesthesia. Results: The recurrence rate after 2 years was 34%. Compensatory hyperhidrosis, ejaculation failure, lower back pain and genitofemoral neuritis developed as complications in 132, 4, 12 and 2 patients, respectively. Of the 356 patients, 65% were satisfied. Conclusions: Lumbar sympathetic ganglion block using alcohol is an effective and safe method for the treatment of plantar hyperhidrosis, but more information about the complications and relatively high recurrence rates should be provided to the patient.

• The Korean Journal of Pain
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• 제23권1호
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• pp.11-17
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• 2010

Background: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. Methods: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. Results: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was $30.5{\pm}0.4^{\circ}$ and entry point was $7.7{\pm}0.2\;cm$ and $6.7{\pm}0.1\;cm$ lateral from midline in males and females respectively. Conclusions: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.

• The Korean Journal of Pain
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• 제5권1호
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• pp.103-107
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• 1992

Thoracic sympathetic ganglion block was not applied routinely because of high incidence of complication such as pneumothorax. We successfully managed a patient with sternal pain and a patient with scapular pain by thoracic sympathetic ganglion block. We concluded that thoracic sympathetic ganglion block was an effective treatment for intractable cancer pain. However precise anatomical knowledgement is essential.

• The Korean Journal of Pain
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• 제7권2호
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• pp.162-169
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• 1994

Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

• The Korean Journal of Pain
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• 제9권1호
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• pp.94-97
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• 1996

Two hundred and eighty eight patients suffering from excessive sweating of palms, soles and axillae etc., visited our Neuro-Pain clinic from November 1991 to March 1996. The sex ratio was 1:1.2. the third decade of age was the major age group. the onset time of hyperhidrosis was prepubertal period (in 95.1% of them). the provocative factors fo excessive sweating were tension and stress from interpersonal relationship. they had the family history (30.9%) and the past history treated with herb medication (56.9%), medicine (30.6%), operation (1.4%), and no treatment (39.6%). We treated 113 patients by sympathetic ganglion block with pure alcohol. the average times of thoracic sympathetic ganglion block were 2.1 (left), 2.4 (right) and those of lumbar sympathetic ganglion block were 1.2 (left), 1.6 (right). Average admission period was 14.7 days. Recurrence rare was 7.1%. Most longstanding effective period was 45 months. We conclude from our results that sympathetic ganglion block is one of the most effective treatments for hyperhidrosis owing to its simple technique and low recurrence rate.

• 생명과학회지
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• 제18권1호
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• pp.91-95
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• 2008

In human, sympathetic nerve blocks with local anesthetics are widely used to treat a variety of diseases in the innervating regions. However, its procedure in dogs is difficult to approach and process repeatedly because of anatomically location. Therefore, this study was designed to develop a new technique of sympathetic nerve block in beagle dogs. Fifteen healthy beagle dogs, which did not show any neurologic abnormalities and disease, were used for the study. Radiograghs were taken after injected radiopaque material mixed with 2% lidocaine at the cranial cervical ganglion and injected methylene blue using the same percutaneous technique to verify the reliability of this newly developed technique. The successful block rate of the cranial cervical ganglion block was present in 80% of all dogs and the stained cranial cervical ganglions were shown in all dogs. The results show that this new technique of the cranial cervical ganglion block is a reliable and simple method that can be used for clinical studies in dogs.

• The Korean Journal of Pain
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• 제8권2호
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• pp.312-318
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• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

• The Korean Journal of Pain
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• 제8권2호
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• pp.374-377
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• 1995

Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed by simultaneously injecting 3 ml of pure alcohol into the $T_2$ and $T_3$ levels after testng with same amount of local anesthetics on the same sites. We experienced poor sympatholytic effect or intercostal neuritis and Horner's Syndrome as the result of complication of thoracic sympathetic ganglion block. In Case 1, in spite of the good testing result, neurolytic block effect was poor. In Case 2, intercostal neuritis occurred, but neuralgia subsided within 3 weeks. In Case 3, Horner's Syndrome occurred for 1 day. To increase the success rate of block and decrease the incidence of complications, good radio-opaque dye appearance and good test block effect should be obtained.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.159-163
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• 2016

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.