• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.129-137
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• 2021

Background: Inappropriate use of intravenous and inhaled anesthetics may be dangerous in infants undergoing facial cleft surgeries. This study primarily aimed to compare the effect of infraorbital nerve block on sevoflurane requirement in infants undergoing cheiloplasty. Intraoperative opioid consumption, hemodynamics, blood glucose levels, extubation time, and delirium were also compared. Methods: This prospective, randomized, double-blinded study was conducted in 34 infants undergoing cheiloplasty under general anesthesia. After induction, group A received bilateral infraorbital nerve block with 0.5 mL of 0.5% bupivacaine and group B 0.5 mL saline. An increase in heart rate or blood pressure > 20% was managed by increasing sevoflurane by 2-2.5%, followed by fentanyl 0.5 ㎍/kg bolus. The chi-square test and independent-sample t-test were used where applicable. Results: Demographics, duration of surgery, and intravenous fluids used were comparable between the groups. Compared to group A, patients in group B had significantly higher consumption of fentanyl (14.2 ± 4.4 ㎍ vs. 22.1 ± 6.2 ㎍) and sevoflurane (14.2 ± 4.8 mL vs. 26.8 ± 15.6 mL). Intraoperative hemodynamic parameters were significantly lower in group A, the number of times increases in hemodynamic parameters occurred, and fentanyl supplemental bolus was required remained significantly lower in group A than in group B. Intraoperative glycemic levels remained higher in group B, and the extubation time was significantly shorter in group A than in group B (4.40 ± 1.60 min vs. 9.2 ± 2.18 min). Group A had a lesser occurrence of postoperative delirium. Conclusion: Supplemental infraorbital block in infants undergoing cheiloplasty under general anesthesia resulted in significantly decreased anesthetic requirements and optimal hemodynamic and glycemic levels with faster extubation and lesser delirium.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.84-88
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• 2014

Purpose: The purpose of this study was to analyze the effectiveness of suprascapular nerve block using platelet-rich-plasma (PRP) under ultrasonographic guidance in patients treated with arthroscopic rotator cuff repair. Material and Methods: 50 cases of patients, from March 2013 to March 2014, treated with arthroscopic rotator cuff repair were retrospectively analyzed. We performed ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) to these patients in the outpatient clinics at the 6 weeks follow-up after operation. We evalulated results for visual analogue score (VAS) for pain, range of motion (ROM), Constant Shoulder Score (CSS) for these patients before arthroscopic operation, following 6 weeks and 3 months after operation. Results: There was clinically significant improvement in VAS, ROM, CSS after ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP). Conclusion: Ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) is an effective treatment method not only for around shoulder pain but also postoperative residual shoulder pain and limitation of shoulder motion.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.41-46
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• 2018

Background: The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods: Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results: The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions: Relative head position has no effect on the anesthetic success rate of IANB.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.135-141
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• 2019

Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

• The Journal of the Korea Contents Association
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• v.10 no.10
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• pp.237-245
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• 2010

Nerve conduction studies (NCS) are the most objective measure of nerve function and essential for the diagnosis of sub-clinical neuropathy in diabetes mellitus and diabetic polyneuropathy (DPN). This study evaluates the characteristic of electrophysiological abnormalities in DPN. Electrodiagnostic data from 120 patients with diabetic polyneuropathies and 77 control subjects were reviewed. Motor nerve conduction velocities (MNCV), distal motor latencies (DML), compound muscle action potential (CMAP) amplitudes, No potential frequency and conduction block were analyzed. Data were normalized based on normative reference values, and the proportion of nerves with abnormal values in the lower and upper limbs were evaluated. DPN was systemic demyelinating peripheral polyneuropathy and more severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in peroneal nerve. It was no statistically significant difference of conduction block in control and DPN group. Our findings suggest that DPN had more common and severe peroneal nerve involvement in the motor nerve conduction studies (MNCS). These findings have important implications for the electrophysiological evaluation of DPN.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.28-32
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• 2014

Purpose: We aim to determine sciatic nerve bifurcation location and depth at the level of the popliteal fossa in Korean female. Materials and Methods: Thirty three subjects were enrolled in Korean female. M-turbo ultrasound system (SonoSite, bothell, WA, USA)with 38 mm high frequency linear array transducer, 13-6 MHz probe was used for ultrasound measurements. With subject lying prone, the location of the sciatic nerve in relation to the popliteal crease and skin to nerve distance were assessed via ultrasound. Analyses were performed with SAS version 9.3 using multiple linear regression. Results: Thirty three subjects were enrolled. Distance from the popliteal crease to the sciatic nerve was 4.5-7.5 (mean 5.7 cm), and the depth of the sciatic nerve from the skin was 1.8-3.2 (mean 2.4 cm). Multiple linear regression for the usefulness of the model has a p value of 0.036, shows between weight and depth. Conclusion: We show that variability exists for sciatic nerve bifurcation location in Korean female, The success rate is creased if consider the relations between weight and depth when performs sciatic nerve block in Korean female. In our study, a sciatic nerve block is recommend that performed 7.5 cm proximal to the crease in the popliteal fossa.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.187-190
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• 1996

Facial nerve palsy is not an uncommon disease encountered at the department of otolaryngology or pain clinic. It usually occurs following viral infection(Bell's palsy, BP). However, it is rare to develop bilaterally, and that not simultaneously. We experienced a rare case of bilateral facial nerve palsy. Patient first experienced left side paralysis, then right side paralysis approximately two months later. We treated the patient with serial bilateral stellate ganglion blocks(SGB). When left side paralysis improved, we performed unilatertal SGB for right side paralysis. Patient was also treated with intermittent electro-acupuncture stimulations, to right side first, then left side. Four months of treatment provided good results. This may be the first case, in Korea, of facial nerve paralysis bilaterally within a certain interval, treated with serial SGB and electro-acupuncture stimulation. However, the etiology of this bilateral BP was not fully confirmed as being a cause of viral origin.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.97-101
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• 2011

Intravenous Patient Controlled Analgesia (IV PCA0 after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.138-143
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• 2020

Background: Severe pain associated with proximal femur fractures makes the positioning for regional anesthesia a challenge. Systemic administration of analgesics can have adverse effects. Individually, both the fascia iliaca block (FIB) and femoral nerve blocks (FNB) have been studied. However, there is little evidence comparing the two. The aim of this study was to compare the overall efficacy of the two blocks in patients with proximal femur fracture before positioning for spinal anesthesia. Methods: ASA (American Society of Anesthesiologists) class I, II, and III patients scheduled for elective and emergency surgery with the diagnosis of proximal femur fracture between October 2018 and June 2019 were included in the study. The patients were assigned to two groups by convenience nonprobability sampling of 35 each. Results: Our study showed a reduction in visual analogue scale scores at 3, 4, and 5 minutes after administration of the FIB being 5.1 ± 1.1, 4.1 ± 1.3, and 2.8 ± 0.8, and those after the FNB as 4.4 ± 1.1, 3.3 ± 1.1, and 2.1 ± 1.4 with P < 0.05, which was statistically significant. The mean first rescue analgesia time for the FIB was 7.1 ± 2.1 hours, while for the FNB it was 5.2 ± 0.7 hours. The P value was less than 0.001, which was significant. Conclusions: Both ultrasound guided FNB and FIB techniques provide sufficient analgesia for patient's positioning before spinal anesthesia. However, the duration of postoperative analgesia provided by FIB was greater than that of the FNB.