• The Korean Journal of Pain
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• 제19권1호
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• pp.45-50
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• 2006

Background: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. Methods: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. Results: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. Conclusions: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권5호
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• pp.251-253
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• 2013

Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

• The Korean Journal of Pain
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• 제8권1호
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• pp.152-155
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• 1995

Meralgia paresthetica is a disorder characterized by a pain or dysaesthesia, or both, in the anterolateral aspect of the thigh caused by entrapment or neurinoma formation of the lateral femoral cutaneous nerve. Currently available modes of therapy include conservative treatment, lateral femoral cutaneous nerve block with steroids and local anesthetics, and surgery. At our neuro-pain clinic, w recently encountered three cases of meralgia paresthetica, all of which were treated by lateral femoral cutaneous nerve block. In which of them, two cases were successfully treated but one case was associate with pain relapse due to entrapment of lateral femoral cutaneous nerve by a retroperitoneal mass, schwannoma. In this paper we report our experience along with a review of the current literatures.

• Journal of Chest Surgery
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• 제27권11호
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• pp.942-947
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• 1994

Post-thoracotomy pain is so severe that lead to postoperative pulmonary complications due to the patient`s inability to cough, deep breathing and chest wall motion. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1990, we reported the result that the cryoanalgesia reduce the immediate postoperative pain significantly. We try to compare the effect of cyroanalgesia with the effect of Bupivacain intercostal nerve block for the post-thoracotomy pain control. Ninety patients, who undergoing thoracotomy in Korea University Medical Center Guro Hospital between the January 1993 and September 1993, were evaluated. The patients were divided into three groups : Group A, control, the patients without pain control procedure [N=30], Group B, the patients with Bupivacain intercostal nerve block [N=30], Group C, the patients with cryoanalgesia [N=30]. Postoperative analgesic effects were evaluated by the scoring system which made arbiturary by author. The results were that the Bupivacain intercostal nerve block markedly reduced the immediate postoperative pain compare with two other groups, the cryoanalgesia reduced the immediate postoperative pain significantly compare with control group, the pain reduction effect of the two groups- cryoanalgesia and Bupivacain intercostal nerve block- were not different at postoperative seventh day, probably due to the action time of Bupivacain and the result that there were no significant complications of the procedures.

• The Korean Journal of Pain
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• 제29권3호
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• pp.193-196
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• 2016

Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

• The Korean Journal of Pain
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• 제18권2호
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• pp.279-283
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• 2005

Biplane fluoroscopy is usually used in angiography. Biplane fluoroscopy gives a biplane image with high resolution during the performance of operations. Trigeminal nerve blocks are effective treatment modalities for trigeminal neuralgia, and maxillary nerve block is the most dangerous procedure among them. The anatomic structures can change after head and neck surgery, so the trigeminal nerve block procedures cannot be done so easily. We used biplane fluoroscopy in these difficult cases. Our first case was a 60-year-old man who had undergone maxillary nerve block. The second case was of a 64-year-old man who had pulsed radiofrequency lesioning of mandibular nerve performed after head and neck surgery. With biplane fluoroscopy, we got good results without any complications.

• Advances in pediatric surgery
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• 제20권1호
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.814-820
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• 2020

Objective : Trigeminal neuralgia (TN) is a severe neuropathic condition that affects several elderly patients. It is characterized by uncontrolled pain that significantly impacts the quality of life of patients. Therefore, the condition should be treated as an emergency. In the majority of patients, pain can be controlled with medication; however, other treatment modalities are being explored in those who become refractory to drug treatment. The use of the trigeminal nerve block with a local anesthetic serves as an excellent adjunct to drug treatment. This technique rapidly relieves the patient of pain while medications are being titrated to effective levels. We report the efficacy and safety of percutaneous trigeminal nerve block in elderly patients with TN at our outpatient clinic. Methods : Twenty-one patients older than 65 years with TN received percutaneous nerve block at our outpatient clinic. We used bupivacaine (1 mL/injection site) to block the supraorbital, infraorbital, superior alveolar, mental, and inferior alveolar nerves according to pain sites of patients. Results : All patients reported relief from pain, which decreased by approximately 78% after 2 weeks of nerve block. The effect lasted for more than 4 weeks in 12 patients and for 6 weeks in two patients. There were no complications. Conclusion : Percutaneous nerve block procedure performed at our outpatient clinic provided immediate relief from pain to elderly patients with TN. The procedure is simple, has no serious side effects, and is easy to apply.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.129-134
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• 2017

Efforts to apply augmented reality (AR) technology in the medical field include the introduction of AR techniques into dental practice. The present report introduces a simple method of applying AR during an inferior alveolar nerve block, a procedure commonly performed in dental clinics.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.93-96
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• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.