• Journal of Korean Physical Therapy Science
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• v.4 no.3
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• pp.499-509
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• 1997

The facial nerve have a long pathway. Thus facial nerve fibers easily involved at any point along their course will lead to a facial palsy of lower motor neuron type and upper motor neuron type. The electrophysiologic examination can evaluate and anticipating that prognosis of facial nerve palsy. The electrophysiologic examination are Nerve Excitability Test(NET), Elecctroneurography(ENG), Electro-myography(EMG), Blink Reflex, and Electrogustometry et.al. The NET is very useful method for assessment of prognosis and distinguish between nerve degeneration and physiological block as early as 72 hour after onset of the facial palsy. And other examination also give objectively information of facial nerve for prognosis and treatment. Treatment goal of physiotherapy are prevent contracture and disuse atrophy of facial muscle with muscle reeducation and strengthening and maintain symmetry facial motion. The treatment better start as early as possible.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.105-107
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• 2011

Hiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.247-250
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• 2000

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between $L_4$ and $L_5$ and spinal stenosis in $L_4$ area. And epiduroscopic feature showed severe adhesion in $L_4$, $L_5$ and $S_1$. After we blocked $L_2$ root, pain score decreased 10 to 2. Therefore, the $L_2$ root block may be a useful diagnostic procedure as well as provide therapeutic value.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.226-229
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• 1998

Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.

• Korean Journal of Adult Nursing
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• v.29 no.2
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• pp.143-153
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• 2017

Purpose: Purpose of the study was to identify the effect of the Comprehensive Education Program (CEP) on intra-procedure anxiety, post-procedure uncertainty and athletic performance of back strengthening of patients undergo spinal nerve block (SNB). Methods: The participants (experimental group=33, control group=33) were recruited from a university hospital in G metropolitan city. Data were collected from July to November 2015. The experimental group was individually provided with a booklet/motion picture about the SNB and back strengthening exercise training before the SNB. This group also received a leaflet about back strengthening exercise post SNB. The Anxiety-Visual Analog Scale (A-VAS), the Mishel adapted uncertainty scale and newly created knowledge scale/athletic performance checklist were utilized as our study tools. Results: Intra-procedure anxiety score (F=25.70, p<.001), post-procedure uncertainty score (F=82.56, p<.001), post-procedure knowledge score (F=14.63, p<.001) and athletic performance rate of back strengthening (p=.003) of the experimental group showed statistically significant differences in comparison with the control group. Conclusion: This CEP is a cost and time-effective intervention for patients who undergo spinal injections, so it should be actively utilized as an educational management strategy in outpatient.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.227-231
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• 2022

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

• The Korean Journal of Pain
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• v.3 no.2
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• pp.108-118
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• 1990

Splanchnic nerve block (SNB) is performed to relieve intractable upper abdominal pain caused by carcinoma of the upper G-I tract. Not all patients achieve satisfactory pain relief; therefore, a second or third nerve block trial may need to be performed. In this study, an attempt was made to analyze the possible factors which might affect the result of repeated SNB in 42 the patients among 264 patients who received SNB at Severance Hospital during the period from January 1985 to December 1989. The results are as follows: 1) Among the 42 patients, including 30 males and 12 females, the fifties and forties were the major age groups. 2) Among the underlying diseases, stomach cancer was the most common (18 cases) and pancreatic cancer was next (14 cases). 3) The main locations of pain were the upper abdomen, epigastrium and entire abdomen in decreasing order. 4) Among the thirty-nine cases of first SNB combined with ascites, 13 cases received a repeat block, 81.0% of whom had had metastatic lesion. 5) There were 54.2% who had had single or combined treatment, operation, chemotherapy or radiotherapy before SNB. 6) Twently seven cases (64.3%) had received opioid medication for pain control. 7) In the 75% alcohol group, 11.7% of patients required a second block, and in the pure and 50% alcohol group, 9.6% of patients required a second block within two weeks of the first block. Three cases in both of these repeated block groups required a third block; representing 3.9%, of the 75% alcohol group and 1.6% of the pure and 50% alcohol group. 8) The volume of alcohol used was more than 16 ml bilaterally in both cases. 9) The points of the inserted needle were positioned in the upper and anterolateral part of the $L_1$ vertebra on both sides on the anteroposterior roentgenogram. The contrast media was spread upward along the anterior margin of the vertebral body and posteriorly in repeat block. The frequency of repeat block was higher in cases with ascites or metastasis. The instance of repeat block within 2 weeks of the first block was lower in the pure and 50% alcohol group than in the 75% alcohol group. Thus, alcohol concentration and patient status may be considered factors which influence the result of repeated SNB. We suggest early application of SNB in upper abdominal cancer patients.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.177-182
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• 1999

Background: Clonidine, an ${\alpha}_2$ adrenergic agonist blocks nerve conduction. However, in our previous experiment we found that adrenaline neither blocks nerve conduction by itself nor augment nerve conduction blockade by lidocaine near clinical concentrations. Possible explanations are: 1) there may be antagonism between some of adrenergic receptors, 2) clonidine may block nerve conduction via non-adrenergic mechanism. The purpose of this study is to obtain dose-response curves of several different forms of adrenergic receptor agonist to see the relative potencies of each adrenergic receptors to block nerve conduction. Methods: Recordings of compound action potentials of A-fiber components (A-CAPs) were obtained from isolated sciatic nerves of adult male Sprague-Dawley rats. Nerve sheath of the sciatic nerve was removed and desheathed nerve bundle was mounted on a recording chamber. Single pulse stimuli (0.5 msec, supramaximal stimuli) were repeatedly applied (2Hz) to one end of the nerve and recordings of A-CAPs were made on the other end of the nerve. Dose-response curves of epinephrine, phenylephrine, isoproterenol, clonidine were obtained. Results: $ED_{50}$ of each adrenergic agonist was: $4.51\times10^{-2}$ M for epinephrine; phenylephrine, $7.74\times10^{-2}$ M; isoproterenol, $9.61\times10^{-2}$ M; clonidine, $1.57\times10^{-3}$ M. Conclusion: This study showed that only clonidine, ${\alpha}_2$ adrenergic agonist, showed some nerve blocking action while other adrenergic agonists showed similar poor degree of nerve blockade. This data suggest that non-effectiveness of epinephrine in blocking nerve conduction is not from the antagonism between adrenergic receptors.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.206-206
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• 2009