• 제목/요약/키워드: pain clinic

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한국 통증치료실의 현황 (Current Status of Pain Clinics in Korea)

  • 문동언;양내윤;최영국;유건희;심재용;윤건중;김욱성;민진혜
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.273-282
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    • 1998
  • Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment Methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic. Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain management and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

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Botulinum Toxin을 이용한 안면 경련의 치험 -증례 보고- (Botulinum Toxin Injection Treatment for Facial Spasm -Two Cases Report-)

  • 김철홍;신상욱;김해규;김인세
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.235-240
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    • 1997
  • Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of, all or parts, of the muscles innervated by facial nerve. This ailment is most common among middle-aged women. Neither causative agent nor reliable treatment has been established because etiology of idiopathic hemifacial spasm has remained undefined to date. This report describes two cases of hemifacial spasm treatment by injection of Botulinum toxin. An injection of Botulinum toxin provided relief of hemi facial spasm. Botulinum toxin therapy is an effective and convenient treatment of hemifacialspasm.

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안면신경마비환자의 치료경과에 대한 Computer Aided Thermogrpahy를 이용한 관찰 (The Clinical Experience with Computer Aided Thermography during Treatment of Bell's Palsy)

  • 이규창;이진경;우남식;이예철
    • The Korean Journal of Pain
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    • 제4권1호
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    • pp.47-50
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    • 1991
  • Bells palsy is a usually innocuous but psychologically distressing disease. The majority of cases are of the so-called idiopathic type, the etiology of which is unknown. This 52 year-old female patient was treated with repeated stellate ganglion bupivacaine blocks, acupuncture and transcutaneous electric nerve stimulation, with return of function. In our case studies, using thermographic images to diagnosis and to evaluate objective assessment of treatment of Bells palsy, we observed the correlation between neurologic symptoms and thermographic image.

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피부에서 경부 경막외강까지의 깊이에 대한 연구 (The Distance from Skin to Cervical Epidural Space)

  • 한경림;곽노길;황혁이;김지영;김찬;김성모
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.105-108
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    • 1998
  • Backgrounds: Cervical epidural nerve block is useful in the management of a variety of acute, chronic and cancer related pain syndromes involving the head, face, neck and upper extrimity. To safely perfom the cervical epidural block, an appreciation of the expected distance from skin to epidural space is important. We studied the distance from skin to cervical epidural space of adults to determine if any relationship exists between patient height, weight and neck circumference and the distance from skin to epidural space. Methods: Patients 170, suffering from neck and upper extremity pain with cervical HIVD(herniated intervertebral dics) were selected. Cervical epidural block was performed at $C_{6\sim7}$ or $C_{7-}T_1$ intervertebral space. Then measured the distance from skin to epidural space and analysed the relationship between age, height, weight and neck circumference and the distance from skin to epidural space. Results: The cervical epidural depth of male $C_{6\sim7}$, male $C_{7-}T_1$, female $C_{6\sim7}$ and female $C_{7-}T_1$ groups were $5.17{\pm}0.63$, $5.47{\pm}0.59$, $4.84{\pm}0.56$ and $5.01{\pm}0.60$ cm respectively. Cervical epidural depth significantly correlated with body weight, ponderal index and neck circumference. Conclusions: The distance from skin to cervical epidural space has significant relationships with weight, ponderal index and neck circumference. Although experience is important, patient's weight and neck circumference are indicating factor, of the cervical epidural depth.

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자기 공명분석기에 의한 특발성 다한증의 치험 (Experience with the Application of Magnetic Resonance Diagnostic $Analyser^{(R)}$ -A case of idiopathic hyperhidrosis-)

  • 김진수;김진호;김일호;박욱;김성열
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.280-283
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    • 1993
  • Idiopathic hyperhidrosis is a physically and emotionally distressing symptom, which lacks a precise definition. Although operative and nonoperative methods have been shown to be effective in the treatment of idiopathic hyperhidrosis, limitations, cautions and complications are inherent in their extended use. The purpose of this report is to describe the theraputetic effects of magnetic resonance for managing idiopathic hyperhidrosis. A 28 years old woman had been suffering from profuse sweating on both planter and palmar sides for 15 years. We successfully treated this symptom with the 6 magnetic resonance treatments without any complications. Now she lives well in a condition of normal sweating after the applications. It suggest that short daily periods of exposure to appropriate magnetic resonance can beneficially modulate the balance of autonomic nervous system that are responsible for sympathetic overflow, and that there is an effective window of induced electrical magnetism in which sympathetic function can be controlled in the absence of side effects.

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안면경련 환자에서의 안면 신경차단 -27예의 환자분석- (Facial Nerve Block for the Treatment of Facial Spasm -A retrospective analysis of 27 patients-)

  • 김찬;이영복;이효근;윤경봉;최령
    • The Korean Journal of Pain
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    • 제7권1호
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    • pp.43-48
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    • 1994
  • Twenty seven patients with hemifacial spasm were treated by facial nerve block at the foramen stylomastoideum and O'Brien block from January 1992 to March 1994. There were 16 female and ll male patients, a 1.5:1 ratio respectively. Most patients were 40~60 years old. Among the 27 patients treated by nerve blocks, 26 responded well to the facial nerve block, including two cases of O'Brien block. One patient failed to respond to the facial nerve block. Induced facial palsy disappeared within one or two months within the majority of patients. Among the 26 patients who received nerve block, 6 patients required a second block within 3 to 9 months. After successful nerve block, all patients were free of spasm for 1 to 16 months. Although the follow-up period was short in duration, these results suggest that facial nerve block is a satisfactory and reliable method in the treatment of facial spasm.

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급·만성 요통 환자군의 통증, 기능장애, 정서 상태 및 교육 요구 (Pain, Disability, Emotional Status and Educational Needs between Acute and Chronic Low Back Pain Groups)

  • 안지혜;김희승;김혜진
    • Journal of Korean Biological Nursing Science
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    • 제21권1호
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    • pp.77-84
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    • 2019
  • Purpose: This study aimed to identify pain, disability, anxiety, depression and educational needs between acute and chronic low back pain groups. Methods: A total of 153 patients aged 18 to 64, recruited from S-neurosurgical clinic for low back pain in Gyeonggi-do. Out of 153 subjects, 70 were Acute Low Back Pain (ALBP) group and 83 were Chronic Low Back Pain (CLBP) group. The collected data was analyzed using the SAS System V 9.4 program by chi-square test/Fisher's exact test and t-test. Results: The pain and disability scores were higher in ALBP group while the depression score was higher in CLBP group. The educational needs score in the area for the time for lumbar operation was higher in CLBP group. In the Low Back Pain (LBP) treatment management, ALBP group visited clinic (60.0%) most frequently and CLBP group visited both clinic & traditional medicine (66.3%) regularly. Conclusion: In order to minimize the progression from acute to chronic LBP, it is necessary for patients who visited the clinic to be accompanied with an education program that reflects educational needs of patients and with proven alternative therapy.

정맥내 통증 자가조절법을 이용한 말기 암환자의 통증조절 (Intravenous PCA for Pain Management in Terminal Cancer Patients during the Last Days of Life)

  • 송선옥;여정은;김흥대;박대팔;구본업;이병용;허남석;이경숙
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.75-82
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    • 1996
  • Background: Nerve blocks, including epidural analgesia, can be risky for terminal cancer pain patients in generally poor conditions. We performed this study to evaluate the efficacy of intravenous patient-controlled analgesia(PCA) to treat severe pain of terminally ill cancer patients during the last days of life. Methods: We explained the patient's poor general condition to relatives and received a written consent to administer PCA. The starting dose of opioid for PCA in cancer pain management was based on previous 24-hour dose. Previous 24-hour opioid dose was converted to intramuscular morphine equivalent. The concentration of opioid mixed into Basal Bolus $Infusor^{(R)}$ was controlled to allow for one half of the previous 24-hour equianalgesic dose to infuse continuously. Patients controlled their pain by pushing the PCA module themselves. Patients were observed by pain service team. Some discharged patients were treated at home until death. Results: Forty eight patients received PCA for last two years. The most common reason receiving a PCA was the patient's poor general condition(52.0%). The mean starting dose of PCA was $20.6{\pm}16.2$ mg of morphine. Over eighty percents of the patients were in good or tolerable state of analgesia. Half of the patients expired within one week. The mean duration of PCA was $8.7{\pm}7.0$ days. The problems during PCA were: difficulty in maintaining intravenous routes, early loss of mentality after starting PCA, hypotension and nausea. Conclusion: We concluded that PCA, if correctly, is an effective, relatively safe and readily controllable method of pain management in terminally ill cancer patients during the last days of life. For future considerations, terminal patients may expire at the comfort of their own homes after the resolution of legal problems regarding using opioid in home care.

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Preconsent Video-Assisted Instruction Improves the Comprehension and Satisfaction in Elderly Patient Visiting Pain Clinic

  • Kim, Sung-Hoon;Koh, Won-Uk;Rhim, Jin-Ho;Karm, Myong-Hwan;Yu, Hye-Suk;Lee, Bo-Yoeng;Shin, Jin-Woo;Leem, Jeong-Gill
    • The Korean Journal of Pain
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    • 제25권4호
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    • pp.254-257
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    • 2012
  • Background: Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Methods: Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. Results: We observed significantly better comprehension in the video education compared with paper instruction (P < 0.001). Patient satisfaction was also higher in the video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P < 0.001). Proportion of referral-line call for further explanation were similar (P = 0.302). Conclusions: Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

$Bovie^{(R)}$를 이용한 Percutaneous Lumbar Medial Branch Neurotomy (Percutaneous Lumbar Medial Branch Neurotomy Using Bovie Electrosurgical Unit)

  • 신근만;김종균;김수관;최홍철;홍순용;최영룡
    • The Korean Journal of Pain
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    • 제8권2호
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    • pp.350-353
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    • 1995
  • The first lesion in neural tissue produced by electrical currents were made in the 19th century by workers using direct current. In 1953, Sweet and Mark clearly demonstrated that DC lesions have unpredictable and ragged borders and may vary in size. They, as well as Hunsperger and Wyss, suggested that the use of high frequency currents might provide improved results and were proved correct. However, $Bovie^{(R)}$ electrosurgical unit may also be used in percutaneous medial branch neurotomy if a lesion made at a point or the dorsal surface of the transverse process just caudal to the most medial end of the superior edge of the transverse process (Bogduk's method). At this point the medial branch lies on the bone and its depth and medial displacement are defined by the bone which precludes the need for lateral radiographs to check placement. A lesion was made at same target point using the $Bovie^{(R)}$ electrosurgical unit in a 41 year male patient who had received a Kaneda operation because of L2 compression fracture. The patient was relieved of pain without any adverse effects.

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