• Title/Summary/Keyword: nerve block: epidural

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The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019

  • Kayir, Selcuk;Kisa, Alperen
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.82-93
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    • 2021
  • Background: This study used bibliometric analysis of articles published about the topic of regional anesthesia from 1980-2019 with the aim of determining which countries, organizations, and authors were effective, engaged in international cooperation, and had the most cited articles and journals. Methods: All articles published from 1980-2019 included in the Web of Science database and found using the keywords regional anesthesia/anaesthesia, spinal anesthesia/anaesthesia, epidural anesthesia/anaesthesia, neuraxial anesthesia/anaesthesia, combined spinal-epidural, and peripheral nerve block in the title section had bibliometric analysis performed. Correlations between the number of publications from a country with gross domestic product (GDP), gross domestic product (at purchasing power parity) per capita (GDP PPP), and human development index (HDI) values were investigated with the Spearman correlation coefficient. The number of articles that will be published in the future was estimated with linear regression analysis. Results: Literature screening found 11,156 publications. Of these publications, 6,452 were articles. The top 4 countries producing articles were United States of America (n = 1,583), Germany (585), United Kingdom (510), and Turkey (386). There was a significant positive correlation found between the GDP, GDP PPP, and HDI markers for global countries with publication productivity (r = 0.644, P < 0.001; r = 0.623, P < 0.001, r = 0.542, P < 0.001). The most productive organizations were Harvard University and the University of Toronto. Conclusions: This comprehensive study presenting a holistic summary and evaluation of 6,452 articles about this topic may direct anesthesiologists, doctors, academics, and students interested in this topic.

Continuous Caudal Block for Intractable Pain (지속적(持續的) 미추차단(尾椎遮斷)에 의한 동통관리(疼痛管理) 3예(三例))

  • Park, Wyun-Kon;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.85-88
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    • 1989
  • We experienced 3 cases of continuous caudal block. The first case had suffered from severe pain of the external genitalis after urethral injury from a car accident and this was controlled by continuous caudal block. The other 2 cases were a metastaric malignant tumor of the lumbar vertebra from cancer of the cervix and histiocytoma of the breast, and both had suffered from intractable pain of the lower extremity. But lumbar epidural block was impossible because of radiation fibrosis and previous operation scar of the spine. So a continuous caudal block was performed and the pain was controlled effectively. The longest duration was 50 days and there were no problems related catheter indwelling. Pain in the area of the lumbar and sacral nerve distribution can be controlled by continuous caudal block. Here in we reported 3 cases and reviewed the literature.

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Serratus Anterior Plane (SAP) Block Used for Thoracotomy Analgesia: A Case Report

  • Okmen, Korgun;Okmen, Burcu Metin;Uysal, Serkan
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.189-192
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    • 2016
  • Thoracotomy is a surgical technique used to reach the thoracic cavity. Management of pain due to thoracotomy is important in order to protect the operative respiratory reserves and decrease complications. For thoracotomy pain, blocks (such as thoracic epidural, paravertebral, etc.) and pleural catheterization and intravenous drugs (such as nonsteroidal anti-inflammatory drugs [NSAIDs], and opioids, etc., can be used. We performed a serratus anterior plane (SAP) block followed by catheterization for thoracotomy pain. We used 20 ml 0.25% bupivacaine for analgesia in a patient who underwent wedge resection for a lung malignancy. We provided analgesia for a period of close to seven hours for the patient, whose postoperative VAS (visual analog scale) scores were recorded. We believe that an SAP block is effective and efficient for the management of pain after thoracotomy.

Facial Palsy Accompanied with Herpes Zoster on the Cervical Dermatome -A case report- (상 경부 대상포진에 병발한 안면신경 마비 -증례 보고-)

  • Yoon, Duck-Mi;Kim, Chang-Ho;Lee, Youn-Woo;Nam, Yong-Tack
    • The Korean Journal of Pain
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    • v.10 no.1
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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.

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Treatment of a Twelfth Rib Syndrome -A case report- (열두 번째 갈비뼈 증후군 환자의 치료경험 -증례보고-)

  • Choi, Jong Bum;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.96-98
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    • 2009
  • Twelfth rib syndrome is thought to be due to intercostal nerve irritation by a mobile twelfth rib, and presents with upper abdominal pain, or low thoracic pain. This syndrome appears to be a fairly common entity and diagnosis is based on clinical findings. Patients with twelfth rib syndrome can be misdiagnosed when it has been overlooked. We report a case of a 34-year-old male along with a presentation of twelfth rib syndrome. One patient was transferred from urologic clinic to pain clinic due to right flank pain and admitted. The patient had direct tenderness on twelfth rib area and direct tenderness was reproducible. Pain increased when the patient flexed laterally, rotated trunk. There were no specific abnormal findings in laboratory test, electrocardiogram, and radiologic examination. After intercostal nerve block and epidural block, pain decreased and the patient was discharged.

Unusual Complications from nerve Blocks used for Pain Control (통증치료를 위한 신경차단 중 발생한 드문 합병증 3예)

  • Kim, Gab-Dong;Choe, Hyun-Kyu;Yun, Young-Moo;Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.203-207
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    • 1989
  • Anesthesiologists are usually responsible for the major works in pain clinics and are often called for many sophisticated nerve blocks in the management of acute or chronic intractable pain. It is, therefore, not uncommon for the anesthesiologists to meet some unexpected and unusual complications during his or her performance. We experienced a case of a pneumothorax following a thoracic intrathecal alcohol block. There was an unusual and yet unexplainable cephalad spread of alcohol following an injection through the 4th sacral foramen, and a shearing off of the catheter by a Tuohy epidural needle following the epidural catheterization. All these three cases are herein presented.

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Continuous Axillary Branchial Plexus Block -I. Modification of catheter insertion method- (지속적 액와부 상완신경총 차단술 -I. 카테테르 삽입방법의 변형-)

  • Lee, Hoo-Jeon;Tae, Il-San
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.225-230
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    • 1997
  • Background: Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. Method: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23~25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The "pop" was well noted well. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. Result: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13($10.0{\pm}1.7$) cm. Tip of catheter was placed in infraclavicular space(66.7%), about the humeral head(17.9%) and in upper arm in 3 cases as U-shape(7.9%). Catheters were maintained for $6.7{\pm}2.6$(3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma. Conclusion: This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

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Pain Management in the Patient with Herpes Zoster (대상포진 환자의 통증치료에 관하여)

  • Choe, Huhn;Kim, Dong-Chan
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.34-39
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    • 1990
  • Fifty-one cases of acute herpes zoster infection were analyzed to search for the most effective management strategy of the disease, including pain relief and decreasing the incidence of postherpetic neuralgia. Anti-viral treatment was not included. Analgesics and nerve blocks, such as stellate ganglion block or epidural block, were helpful. Corticosteroid was administered in most of the cases either systemically or epidurally or both. Epidural administration of local anesthetic in combination with corticosteroid seemed to have certain advantages of excellent pain relief as a result of sympathetic blockade and regional plus systemic anti-inflammatory effects of the steroid, although this was not proved by definite statistical evidence.

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Treatment of Intractable Hiccup with Midazolam and Baclofen -A case report- (Midazolan과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험 -증례 보고-)

  • Yang, Nae-Yun;Moon, Dong-Eon;Park, Cheol-Joo;Kwon, Ou-Kyoung;Park, Chong-Min;Shim, Jae-Yong;Choi, Jong-Ho
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.246-249
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    • 1997
  • Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

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Survey on the Treatment of Postherpetic Neuralgia in Korea: Multicenter Study of 1,414 Patients

  • Nahm, Francis Sahngun;Kim, Sang Hun;Kim, Hong Soon;Shin, Jin Woo;Yoo, Sie Hyeon;Yoon, Myung Ha;Lee, Doo Ik;Lee, Youn Woo;Lee, Jun Hak;Jeon, Young Hoon;Jo, Dae Hyun
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.21-26
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    • 2013
  • Background: Postherpetic neuralgia (PHN) is a serious complication resulting from herpes zoster infections, and it can impair the quality of life. In order to relieve pain from PHN, various treatments, including pharmacological and interventional methods have been used. However, little information on the recommendations for the interventional treatment of PHN, along with a lack of nation-wide surveys on the current status of PHN treatment exists. This multicenter study is the first survey on the treatment status of PHN in Korea. Methods: Retrospective chart reviews were conducted on the entire patients who visited the pain clinics of 11 teaching hospitals from January to December of 2011. Co-morbid disease, affected site of PHN, routes to pain clinic visits, parenteral/topical medications for treatment, drugs used for nerve block, types and frequency of nerve blocks were investigated. Results: A total of 1,414 patients' medical records were reviewed. The most commonly affected site was the thoracic area. The anticonvulsants and interlaminar epidural blocks were the most frequently used pharmacological and interventional methods for PHN treatment. For the interval of epidural block, intervals of 5 or more-weeks were the most popular. The proportion of PHN patients who get information from the mass media or the internet was only 0.8%.The incidence of suspected zoster sine herpete was only 0.1%. Conclusions: The treatment methods for PHN vary among hospitals. The establishment of treatment recommendation for PHN treatment is necessary. In addition, public relations activities are required in order to inform the patients of PHN treatments by pain clinicians.