• The Korean Journal of Pain
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• 제22권3호
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• pp.241-244
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• 2009

Retrobulbar hematoma can arise from orbital trauma and periorbital or intraorbital procedures, and it can result in several morbidities including vision loss. Making the immediate diagnosis and performing decompression of the retrobulbar hematoma are crucial for preventing serious morbidities such as permanent vision loss. We present here a case of temporary vision loss that was due to iatrogenic retrobulbar hematoma in a patient who received infraorbital nerve block for the treatment of trigeminal neuralgia. A 70-year-old woman with trigeminal neuralgia was treated with infraorbital nerve block. Just after the procedure she experienced acute periorbital swelling, proptosis and worsening visual acuity. Immediate orbital computed tomography was done, and this revealed a retrobulbar hematoma. The patient underwent lateral canthotomy with cantholysis and administration of dexamethasone and mannitol. Improvement of visual acuity began 3 hours after these procedures. Her visual acuity was greatly improved 12 days after admission.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.269-282
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• 2021

This review aimed to assess and compare the outcomes of the anesthetic efficacy of inferior alveolar nerve block (IANB) and Gow-Gates mandibular nerve block (GGMNB) in patients with symptomatic irreversible pulpitis. A descriptive systematic review of quantitative research was conducted wherein the "Preferred Reporting Items for Systematic Reviews (PRISMA)" was adopted, and the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) criteria were used to structure the research question. A literature search was performed using PubMed/Medline, Cochrane Library, Google Scholar, and Ovid. Selection criteria were applied for populations over nine years of age, of either sex, with irreversible pulpitis, and articles published in English regarding conventional IANB or IANB and Gow-Gates techniques between 2009 and 2019. Prospective randomized clinical trials or randomized controlled trials were included in the review, in which anesthetic efficacy or success was measured. After screening, four articles were included. Three studies were randomized clinical trials, and two were randomized controlled trials. The validity and reliability of the individual studies were examined. There was evidence of the higher efficacy of the GGMNB technique than that of the IANB technique. However, both techniques can be mastered through training.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.205-210
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• 2009

Purpose: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages ranging from possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. Methods: A total of 80 patients were recruited in our study during the period between Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. Results: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. Conclusion: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.

• The Korean Journal of Pain
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• 제6권2호
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• pp.251-254
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• 1993

안면근 경련의 치료로서 물리적 안면신경차단(physical facial nerve block)은 직접적으로 바늘을 사용하여 안면신경을 직접 천자하여 안면근 경련을 치료하는 방법이다. 그러나 이 방법은 기술적으로 어렵고, 안면신경차단의 정도가 안면경련을 해소할 만큼 충분하지 못하기 때문에 부가적으로 소량의 국소마취제나 알코올을 사용한 화학적 안면신경차단이 필요한 경우가 많다. 이러한 화학적 신경차단을 보다 정확하고 부작용없이 시행하기 위하여 CT 유도하에서 본 증례를 시행한 결과 간헐적인 안면근경련의 재발이 있었으나, 통증의 강도가 많이 줄어들었으며, 통증기간도 줄어들었다.

• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.278-290
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• 1997

The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.

• 한방재활의학과학회지
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• 제19권4호
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• pp.219-228
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• 2009

Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.129-139
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• 2022

Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). Conclusions: Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

• The Korean Journal of Pain
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• 제7권2호
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• pp.217-221
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• 1994

Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed in 40 patients by simultaneously injecting 3 ml of pure alcohol into the T2 and T3 levels after 3 ml of injection of local anesthetic agent on the same sites. Using a skin temperature probe, finger tip temperatures were measured on the index finger ipsilateral to the nerve block before block, 15 and 30 minutes after test block, and 30 minutes after alcohol block. Alcohol block was performed immediately after 30 minutes test block. Finger tip temperatures obtained at 30 minutes post alcohol block and test block and the differences in the temperatures measured before and 30 minutes after alcohol block were shown to be statistically important as potential indicators for prediciting long term outcome of therapy for palmar hyperhidrosis using this technique. These results demonstrate that the palmar temperature monitoring method is sufficiently sensitive to predict the outcome of nerve block during and after thoracic sympathetic ganglion block.

• Clinical Pain
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• 제18권1호
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• pp.24-30
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• 2019

Objective: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques. Method: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed. Results: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups. Conclusion: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.

• The Korean Journal of Pain
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• 제7권1호
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• pp.92-95
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• 1994

Most neoplasm of the floor of the mouth are squamous cell carcinoma. They originate from anterior midline floor of the mouth and penetrate into the sublingual gland. Invasion of the mandible is a late manifestation. Lymphatic spread is the submaxillary and subdigastric nodes and advanced lesions of them produce severe pain, The initial step in managing patients with cancer pain is the oncology therapy in the form of radiotherapy, surgery, or chemotherapy, alone or combined. When oncologic therapy is ineffective, the pain must be treated by systemic analgesic, psychologic, neurostimulating, regional analgesic,and meuroablative techniques. We successfully treated with gasserian ganglion block on the left side and mandibular nerve block on the right side with pure alcohol in the patient having severe submandibular, lower lip and tongue pain.