• Title/Summary/Keyword: cervical pressure pain

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Accidental Vertebral Artery Cannulation as a Complication of the Central Venous Catherization (우발적인 척추동맥으로의 중심정맥 카테터의 삽관)

  • Jeong, Ju Ho
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.33-37
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    • 2014
  • Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

The Analgesic Efficacy and Side Effects of Subarachnoid Sufentanil-Bupivacaine on Parturients in Advanced Labor (지주막하강 수펜타닐과 뷰피바케인의 혼합 투여가 분만 제 1 기 산모의 진통 효과에 미치는 영향)

  • Han, Tae-Hyung;Cho, Yong-Sang
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.21-27
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    • 1997
  • Background : Previous studies have proven beneficial in labor analgesia to use subarachnoid sufentanil(alone or with adjuvant) on parturients in early first stage of labor. We designed this prospective study to evaluate analgesic efficacy and side effects of subarachnoid sufentanil plus bupivacaine in women with cervical dilatation of 7 cm greater. Methods : This was an open-label, nonrandomized trial of 32 parturients in late first stage labor who requested labor analgesia. After signing the consent form each patient received subarachnoid sufentanil (10 ${\mu}g$) and bupivacaine (2.5 mg). Patients were asked to rate their verbal pain score (0-10 scale) before regional anesthesia and 5 minutes after subarachnoid injection, and every 20 minutes thereafter until delivery or request for additional analgesia. Blood pressure, pruritus, Bromage motor block score, mode of delivery and need for supplemental analgesics were recorded. Results : Thirty women were included in the study. Mean pain scores (mean${\pm}$SD) were $8.7{\pm}1.0$ pre-spinal, $0.7{\pm}1.5$ 5 minutes post-injection, and remained less than 5 for 130 minutes after spinal injection. Of 30 patients, 24 had unassisted vaginal delivery, 4 instrumental vaginal delivery (vacuum), and 2 cesarean delivery. Of 28 patients who delivered vaginally, 19 did not require supplemental analgesics and had a delivery pain score of 5 or lower. Blood pressure decreased in three patients after spinal analgesia (p<0.05), which necessitated treatment. The Bromage motor block score was 0 in 26 patients and 1 in 4 patients. Pruritus was noted in 22 patients. Conclusion : Subarachnoid sufentanil-bupivacaine provides rapid analgesia for an effective duration of approximately 130 minutes in parturients in late first stage of labor.

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The Occurence Properties of the Complications in Spinal Cord Injury (척수손상환자의 합병증 발생특성)

  • Son Jung-Woo;Nam Chul-Hyun
    • The Journal of Korean Physical Therapy
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    • v.4 no.1
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    • pp.27-42
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    • 1992
  • The purpose of this study is to investigate the occurence properties of the complications in spinal cord injured patients. Clinical observation were for 116 cases in and out wards, were carried out during one year from july, 1990 to June, 1991 at 4 general hospitals in Taegu, Korea. The results of this study is summarized as follows : 1. Among the 116 cases, $67.7\%$ was male and $35.3\%$ was female. The largest groups were noted in $60.7\%$, of the forties by age, in $34.5\%$ of the middle school by educational career, in $27.6\%$ of the administer by professional division. 2. The number of complications in a patient in the largest group was two-type. The next groups were three-type, $23.3\%$ and five-type, $20.7\%$. Of each factors, the largest numbers of two-type recorded tuberculosis of spine$(71.4\%)$, thoracic cord injury$(63.4\%)$, incomplete paraplegia$(48.4\%)$, and inwards during 1-2 months $(47.4\%)$. 3. Total number of the complications were counted to 367 cases. The largest group of complications was pain, $24.8\%$. The next groups were pressure sores, $19.9\%$. spasticity, $12.5\%$, and urinary tract infection, $9.3\%$. 4. The number of the 4 major complications(pain, pressure sores, joint contracture, spasticity) was counted to 280 cases. The largest group of the major complications was pain, $32.5\%$. The next groups were pressure sores, $26.1\%$, joint contracture, $25.9\%$ and spasticity, $16.4\%$. Of each factors, the largest numbers of the pain recorded female$(40.5\%)$, thirties$(49.2\%)$, non-educate $(53.8\%)$, labor$(38.2\%)$, traffic accidents$(32.8\%)$, thoracic cord injury$(34.4\%)$, complete paraplegia$(58.1\%)$, and inwards during above 13 months$(37.5\%)$. 5. The largest group of the pain portion was shoulder. $49.4\%$. The non groups were lower extremity, $25.2\%$, hip, $11.0\%$, and all bodies, $4.3\%$. The largest numbers of the shoulder pain recorded thirties$(59.4\%)$, traffic accidents $(52.7\%)$, cervical cord injury$(67.2\%)$. complete quadriplegia$(81.8\%)$, and inwards during above 13 months$(100.0\%)$. 6. The largest group of the pressure sores sites was sacral portion, $83.6\%$. The next groups were hip, $6.8\%$, maleollus, $4.1\%$. The largest numbers of pressure sores formation in the sacral portion recorded below 19 and above $60(100.0\%)$, falling objects$(100.0\%)$, lumbar cord injury$(100.0\%)$, incomplete paraplegia$(100.0\%)$, and in wards during 3-4 months$(95.9\%)$. 7. The largest group of the joint contracture portion was lower extremity, $61.4\%$, follows was upper extremity, $38.6\%$. The largest numbers of the joint contrcture portions recorded thirties$(100.0\%)$, traffic accidents$(86.1\%)$, cervical cord injury$(80.4\%)$, complete quadriplegia$(86.7\%)$, and inwards during 3-4 months $(82.2\%)$ 8. The largest group of spasticity portion was lower extremity, $53.0\%$. The next groups were hip. 23.9, 23.9, ankle, $8.7\%$, and elbow, $4.3\%$. The largest numbers of the spasticity portions recorded above $60(100.0\%)$, falling $(100.0\%)$, cervical cord injury$(71.4\%)$, incomplete quadriplegia$(71.4\%)$, and inwards during 1-2 months $(100.0\%)$.

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The Effect of Corrective Exercise and TECAR therapy on neck alignments and pain in Forward Head Posture Patients (교정 운동과 TECAR 치료가 전방머리자세를 가진 환자의 목정렬과 통증에 미치는 영향)

  • Park, Si-Eun;Lee, Hyoung-Ryeol;Park, Shin-Jun
    • Journal of Digital Convergence
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    • v.16 no.11
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    • pp.543-551
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    • 2018
  • This study investigated the effects of corrective exercise and TECAR on cervical alignment, pain threshold, and pain in forward head posture patients. The subject includes 30 forward head posture patients. In the intervention methods, the experimental group combined corrective exercise and TECAR treatment. Only the corrective exercise was applied to the control group. Assessments were made on cervico vertebra angle (CV angle), pain pressure threshold (PPT) and neck disability index (NDI) visual analog scale (VAS). The intervention was conducted six times a week for two weeks. Both groups showed significant differences in CV angle, PPT, NDI, and VAS. Also, PPT, NDI, and VAS excluding CV angle were significantly improved in the study group compared to the control group. These results suggest that the intervention method that combines corrective exercise and TECAR treatment has a more positive effect on pain and ADL ability of forward head posture patient.

Effect of Ischemic Compression on Sternomastoidcleido Muscle on Chronic pain in Upper Trapezius Muscle (목빗근에 대한 허혈성 압박법이 위등세모근의 만성 통증에 미치는 영향)

  • Sim, Ji-Hun;Park, Tae-Sung;Kang, Jong-Ho
    • Journal of Convergence for Information Technology
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    • v.11 no.12
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    • pp.194-200
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    • 2021
  • Recently, incorrect and unhealthy postures have become increasingly prevalent due to reasons such as smartphone use. Consequently, imbalanced muscle contraction occurs. In particular, if the oblique muscle is contracted, the accessory nerve will be compressed, causing ischemic pain in the upper trapezius muscle. To investigate the effect on pain in the upper trapezius muscle, this study applied the ischemic compression method to the accessory nerve capture point at the 1/3-point of the oblique cervical muscle. In this study, the ischemic compression method was applied to eight women twice a week for four weeks, and pain was evaluated before, immediately after, and three weeks after application. The visual analogue scale, McGill Pain Questionnaire, and pressure dynamometer were used to evaluate subjects' pain. As a result of this study, it was confirmed that the pain was significantly reduced after treatment, and that the pain reduction was still effective three weeks after completion of the intervention, indicating that the intervention on the accessory nerve compression point on the oblique cervical muscle was both effective and long-lasting for pain reduction in the upper trapezius muscle. Future studies should increase the number of subjects to check not only pain reduction in the upper trapezius muscle, but also improvement of neck function.

Strength and Endurance of the Deep Neck Flexors of Industrial Workers With and Without Neck Pain (경부 통증 유무에 따른 심부 경부 굴곡근의 근력과 지구력 비교)

  • Kim, Jae-Cheol;Yi, Chung-Hwi;Kwon, Oh-Yun;Oh, Duck-Won;Jeon, Hye-Seon
    • Journal of the Ergonomics Society of Korea
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    • v.26 no.4
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    • pp.25-31
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    • 2007
  • The purpose of this study was to investigate the strength and endurance of the deep neck flexor muscles in individuals with work-related neck pain. Subjects consisted of two groups: twenty industrial workers with neck pain and twenty age-matched healthy subjects. To evaluate the strength and endurance of deep cervical flexors, maximum voluntary contractile strength (MVCS) and a sustained time at sub-maximal voluntary contractile strength (SMVCS) (80% and 50% of MVCS) were measured using a pressure biofeedback unit and a stop watch in supine. The MVCS of deep neck flexor muscles was 29.67${\pm}$4.56 in neck pain group and 54.27${\pm}$6.78㎜Hg in normal group. The sustained time at 80% SMVCS was 12.42${\pm}$2.64 seconds and 55.12${\pm}$12.76 seconds in the groups with and without neck pain. The sustained time at 50% SMVCS was 25.40±5.88 seconds and 109.70${\pm}$31.50 seconds in the groups with and without neck pain. The difference of the lower jaw position was 16.75${\pm}$3.57㎜ and 23.03${\pm}$2.51㎜. The MVCS, endurance at the two sub-maximal levels and the difference of the lower jaw position were significantly greater in the group without neck pain than with neck pain (p$<$0.05). The findings indicate that the maximal strength and endurance of the deep neck flexors were decreased in the workers with neck pain compared to those without neck pain. Therefore, it is necessary to include strengthening and endurance exercises of the deep neck flexor muscles in therapeutic program of work-related musculoskeletal disorders involving neck pain.

The Study of Pain-Increased Factors on Cervical and Shoulder Pain by 3 Dimensional Moire Scanner (3차원 체형 측정기를 통한 경.견부 통증요인 분석)

  • Yang, Hoe-Song;Heo, Ja-Eun;Kim, Bo-Young;Seo, Dong-Yong;An, Chang-Heon;Yang, Hun-Kyung;Jeong, Chan-Ju;Lee, Hyoung-Soo
    • Journal of Korean Physical Therapy Science
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    • v.12 no.3
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    • pp.27-34
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    • 2005
  • The purpose of this study is to find out factors(shoulder level, acromion-occipital length, spine alignment, spine-scapula inferior angle length) of pain of neck & shoulder by 3 Dimensional Moire Scanner. 50 female student s aged 20 to 25 years old participated who lived in Sun-cheon si Jeonnam. They were examined with three measurement methods(Visual Analogue Scale : VAS, Algometer, 3 Dimensional Moire Scanner(IBS-2000). According to the results of multiple regression analysis. 1) There was a significant difference with shoulder level and spine-scapula inferior angle based on VAS. 2) There was a significant difference with shoulder level based of Algometer measurement value in Rhomboid muscles.

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Effects of Elastic Band-Resistive Exercise using Audio-visual Medium on Pain, Proprioceptive Sense, and Motor Function in Adult Females with Chronic Neck and Shoulder Pain (만성 목-어깨 통증이 있는 여성 성인에게 시청각 매체를 활용한 탄력밴드 저항운동이 통증, 고유수용성 감각과 운동기능에 미치는 영향)

  • Nam Gi Lee;Jeong-Woo Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.33-45
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    • 2024
  • Background: This study aimed to investigate the effect of elastic band-resistive exercise using audio-visual medium on pain, proprioception, and motor function in adults with chronic neck and shoulder pain. Design: One group pretest-posttest follow-up experimental design. Method: Twenty adult women with neck and shoulder pain voluntarily participated in this study. Elastic band-resistive exercise using audio-visual medium including cervical flexion and extension, shoulder external rotation, and scapular retraction-protraction motions was conducted 5 times a week for 3 weeks. The Numerical Rating Scale, pressure threshold tool, CROM goniometer, and Image J software were used to assess subjective pain level, tenderness threshold (pain), joint position sense error (proprioception), joint range of motion, and postural alignment (motor function), respectively. Result:: The pain intensity and threshold and joint position sense error showed significant decreases after the intervention, whereas the joint range of motion angle revealed significant increases. The postural alignment including forward head posture and rounded shoulder revealed significant improvements after the intervention. Conclusions: Therefore, we suggest that elastic band-resistive exercise through audio-visual medium would be helpful in preventing and managing pain and physical dysfunction in individuals with chronic neck and shoulder pain, and then it would support the development of health management-related online education content.

A Study of the Evaluation of the Spinal Cord Injuries (척수 손상 환자에 관한 실태 조사)

  • Kim, Myung-Hoon
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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Analysis of the Change of the Pressure Pain Threshold in Chronic Tension-Type Headache and Control (만성 긴장성 두통 환자와 정상 대조군의 압력통각 역치 변화에 대한 비교연구)

  • Kim, Min-Jung;Kang, Wee-Chang;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.12 no.2
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    • pp.41-50
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    • 2009
  • Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.