• Title/Summary/Keyword: pain clinic

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Lumbar Sympathectomy in the Management of Rectal Tenesmoid Pain (항문 이급후중의 치료에 있어 요부 교감 신경절 차단)

  • Yoon, Keon-Jung;Kim, Jong-Lul;Park, Kyu-Ho
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.354-356
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    • 1995
  • Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. Lumbar sympathectomy was performed in patient whose main complaint was rectal tenesmoid pain resulting from hemorrhoid operation, and in whom analgesic or psychotropic drugs had failed in controlling the symptom. After chemical lumbar sympathectomy, patient was free from the rectal tenesmoid pain. It is concluded that lumbar sympathectomy is a safe and effective treatment for rectal tenesmus.

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Splanchnic Nerve Block with Transdiscal Approach -A case report- (경추간판 접근법에 의한 내장 신경 차단 -증례 보고-)

  • Na, Young-Du;Lee, Jung-Koo;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.89-92
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    • 1997
  • Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

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Survey of Recognition in Parturients for Vaginal Delivery Controlled by Epidural Block (경막외차단을 시행 받은 질식분만 산모들의 인식 조사)

  • Jang, Young-Ho;Park, Eun-Ji;Kim, Ae-Ra;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.96-100
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    • 1998
  • Bakground: At our institution, We have controlled pain during vaginal delivery with epidural block since 1986. We designed a questionaire for parturients to analyze the degree of satisfaction of epidural block. Method: The self-questionaire were sent to parturients(N=200), who had epidural block to control labor pain during vaginal delivery. The questionaire covered topics dealing with motivation, fear, satisfaction and complications, of epidural block. Results: Motivation by an experienced person was 72.5%(145 parturients), fear of epidural block was 66%(132 parturients), and satisfactory response was 84%(168 parturients). Parturients who knew the role of anesthesiologist numbered 105(52.5%). Scarcely, 46 parturients displayed confidence for safety of fetus; 111 parturients experienced more than one complications. But special therapy for complications were not necessary. Conclusions: Publicity through mass-media and direct contact will improve the recognition and merit of epidural block by parturients as well as the role of the department of anesthesiology.

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Epidural Neurolysis with Phenol in Postherpetic Neuragia (대상포진후 신경통에 적용한 경막외 Phenol 주입법)

  • Moon, Bong-Ki;Seo, Young-Sun;Yoon, Duck-Mi;Oh, Hung-Kun;Lee, Suk-Kun
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.249-253
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    • 1994
  • Postherpetic neuralgia is one of the most troublesome disease in pain clinic. Nine patients who suffered from postherpetic neuralgia for 1.5 to 8 month, has been treated with the epidural block for prognostic or therapeutic purpose. Epidural catheter was inserted as close to the involved neural roots as possible, and tip of epidural catheter was confirmed under fluroscopic guide. Epidural neurolysis was performed out intermittent injection of 1~3 ml of 6% phenol in saline and repeated 2~6 times over one or 7 days interval. Two patients reported satisfactory pain relief and 3 patients reported some pain relief. But 4 patients unchanged after phenol block. The overall duration of pain relief was not studied. Validity and safety of epidural phenol block was not confined. Further study will be necessary before application of epidural phenol block to postherpetic neuralgia.

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The Relationship between Visual Analogue Scale and R(III) Nociceptive Flexion Reflex (Visual Analogue Scale과 R(III) Nociceptive Flexion Reflex와의 상관관계)

  • Kim, Yong-Ik;Kim, Sang-Hyun;Lee, Ju-Chul;Jeon, Jae-Soo;Hwang, Kyung-Ho;Park, Wook
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.175-181
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    • 2000
  • Background: Pain is often measured using psychophysical scaling techniques. However, all of these methods found their limits, since they were based on the subjective sensations reported by the subjects. It is, therefore, desirable to validate psychophysical pain measures by simultaneously measuring some physiological correlate of nociception. We studied an objective method for measuring pain in human volunteer using R(III) nociceptive flexion reflex. Methods: Four different intensity of electrical stimuli between perception and 1.4 times the R(III) nociceptive flexion threshold were delivered to the sole of the feet in 8 normal volunteers. We measured the flexion reflex activity in the skin over the ipsilateral tibialis anterior muscle and subjects rated each stimulus on a visual analog scale (VAS) Results: Both R(III) nociceptive flexion reflex activity and VAS ratings showed a linear relationship with stimulus intensity and with each other in all volunteers. Conclusions: R(III) nociceptive flexion reflex elicited through electrical stimulation may used as an objective pain measurement, previsionary based on our study paradigm.

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The Clinical Characteristics of Pain and the Usefulness of Pain Clinics from the Perspective of Professional Ballet Dancers in Korea (한국 직업 발레 무용수 통증의 임상적 특징 및 통증클리닉에 대한 인식)

  • Kim, Chang Jae
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.131-135
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    • 2008
  • Background: There has recently been a rapid increase in the number of pain clinics and significant advancement in the treatment of pain in Korea. Therefore, this study was conducted to identify possible problems associated with pain clinics and to use this information to help design future pain clinics. This assessment was conducted from the perspective of professional ballet dancers, who are at high risk for pain like other athletes. Methods: One-hundred professional ballet dancers responded to questionnaires designed to ascertain their preference for different types of clinics, the extent of the pain they experience, and their overall opinion of pain clinics. Results: All of the respondents complained of pain in one or more sites and reported that they had visited some type of clinic for treatment at least once. Overall, the respondents preferred using the following methods to treat pain: orthopedic surgery (76 dancers), oriental medicine (49 dancers), and therapy at pain clinic (48 dancers). Fifty-three percent of the 48 dancers who had received treatment at pain clinics were satisfied with their treatment. Forty-four percent of the 52 dancers who had not been treated at a pain clinic had no knowledge of the existence of such facilities. Conclusions: This survey revealed that, although professional ballet dancers have a high prevalence of pain, many have no knowledge of pain clinics. Therefore, efforts should be made by pain clinics to make information regarding their facilities widely available to professional ballet dancers so they can serve the widest range of clientele.

Studies on the Pseudo-Gastric Pain (가성위장통에 관한 연구)

  • Choi, Joong-Rieb;Lee, Kyeung-Sook;So, Keum-Young;Wang, Beung-Jin
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.109-113
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    • 1996
  • Even in the absence of any specific abnormal pathologic findings of the gastrointestinal tract, many patients still suffer from : fullness, anorexia and postprandial abdominal pain. As these symptoms are similar to visceral origin pain, many physicians focus on the discovery of pathologic abnormality of the gastrointestinal tract. At our Yoido Pain Clinic, after diagnosing myofascial pain syndrome, we treated 64 patients by trigger point injection and physical therapy on abnormal abdominal muscle, from June 1993 to April 1995. Most patients' conditions improved after these treatments.

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Stellate Ganglion Phenol Block -Case reports- (성상신경절 페놀차단 -증례 보고-)

  • Kim, Dae-Young;Cho, Hee-Won;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.312-318
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    • 1995
  • Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

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Effects of HP228 on Analgesia Alone or in Combination with Morphine (새로운 해열, 진통, 소염제인 HP228의 단독 또는 Morphine과의 병용투여가 제통효과에 미치는 영향)

  • Lee, Seung-Gu;Lee, Seung-Hoon;Kim, Tae-Sung;Kim, Hyun-Soo;Kim, Kwang-Min
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.64-69
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    • 1999
  • Background: The new drug HP228 is a cytokine restraining agent with a broad spectrum of anti-inflammatory, analgesic, and antipyretic activity. Six healthy, adult, male volunteers were studied to determine the independent and interactive effects of HP228 and morphine on pain perception. Methods: Two groups of stimuli were applied to each volunteers before drug administration as control, 20 min after morphine and HP228 administration, and 20 min after combined administration of these two drugs. Two adhesive electrically-conducting pads were applied on opposite sides of the arm approximately 8 cm apart. The electrode were connected to an electrical impulse generator and 50 Hz 1 msec pulses of incrementally increasing intensity were delivered at 1 sec intervals. The analgesic endpoints were the current intensity (mA) at which the subject first detected the stimulus (THRESH), the intensity at which the stimulus was first idenfied as being painful (PAIN), and the intensity at which the subject requested that the stimulus be terminated due to discomfort (LIMIT). A second series of stimuli were applied immediately thereafter using 1-sec duration 50 Hz tetanus pulses with increasing intensities at 2~5 sec intervals. Results: There were significant differences between drug treatments (Morphine, HP228, HP228/Morphine) and control (No drugs) in any of the measurements (PAIN, LIMIT) except THRESH with the twitch and tetanus test. Conclusions: The data suggests that HP228 is an analgesic, but it does not appear to interact with morphine in an additive manner.

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A Patient with Kikuchi's Disease: What Should Pain Clinicians Do?

  • Park, Kyeong-Eon;Kang, Se-Bin;Ok, Seong-Ho;Shin, Il-Woo;Sohn, Ju-Tae;Chung, Young-Kyun;Lee, Heon-Keun
    • The Korean Journal of Pain
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    • v.25 no.3
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    • pp.188-190
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    • 2012
  • Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.