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Is Fluoroscopy-guided Suprascapular Nerve Block Better Than Other Techniques?.

Jae Hang SHIM

The Korean Journal of Pain.2013;26(1):102-103. doi:10.3344/kjp.2013.26.1.102

No abstract available.
Nerve Block

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Clinical Experiences on the Effect of Scrambler Therapy for Patients with Postherpetic Neuralgia.

Young Kwon KO ; Ho Young LEE ; Wang Yong LEE

The Korean Journal of Pain.2013;26(1):98-101. doi:10.3344/kjp.2013.26.1.98

Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster, especially in elderly and comorbid patients. Unfortunately, the currently available treatments have shown limited efficacy and some adverse events that are poorly tolerated in elderly patients. Scrambler Therapy, proposed as an alternative treatment for chronic neuropathic pain recently, is a noninvasive approach to relieve pain by changing pain perception at the brain level. Here, we report our clinical experiences on the effect of Scrambler Therapy for three patients with PHN refractory to conventional treatment.
Aged ; Brain ; Herpes Zoster ; Humans ; Neuralgia ; Neuralgia, Postherpetic ; Pain Perception

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Repeat Vertebroplasty for the Subsequent Refracture of Procedured Vertebra.

Sang Sik CHOI ; Won Seok HUR ; Jae Jin LEE ; Seok Kyeong OH ; Mi Kyoung LEE

The Korean Journal of Pain.2013;26(1):94-97. doi:10.3344/kjp.2013.26.1.94

Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the 1st and 4th (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.
Female ; Flank Pain ; Fractures, Compression ; Humans ; Lumbar Vertebrae ; Polymethyl Methacrylate ; Spine ; Vertebroplasty

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Effectiveness of Oral Glycopyrrolate Use in Compensatory Hyperhidrosis Patients.

Tai Kyung GONG ; Do Wan KIM

The Korean Journal of Pain.2013;26(1):89-93. doi:10.3344/kjp.2013.26.1.89

Compensatory hyperhidrosis or reflex hyperhidrosis is the increase in sweating in the postoperative stage of thoracic sympathectomy or lumbar sympathectomy. It shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oralglycopyrrolate is one of the treatment options available. This study reviewed case notes in a series of 19 patients with compensatory hyperhidrosis. We made a comparison between the Milanez de Campos score of a pre-glycopyrrolate medication group and the Milanez de Campos score of a post-glycopyrrolate medication group. The Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the pre-medication and post-medication groups. In the post-glycopyrrolate medication group, there was decrease in the Milanez de Campos score, BAI score, and BDI score (P < 0.05). But no meaningful change was seen in the ANS score in the post-glycopyrrolate medication group (P > 0.05). Glycopyrrolate is an effective medication in the treatment of compensatory hyperhidrosis that, can alleviate anxiety and improve patients' quality of life.
Anxiety ; Anxiety Disorders ; Autonomic Nervous System ; Cholinergic Antagonists ; Depression ; Glycopyrrolate ; Humans ; Hyperhidrosis ; Quality of Life ; Reflex ; Sweat ; Sweating ; Sympathectomy

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Ultrasound-Guided Infraorbital Nerve Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: A Case Report.

Seung Mo LIM ; Hae Lang PARK ; Hyong Yong MOON ; Kyung Ho KANG ; Hyun KANG ; Chong Hwa BAEK ; Yong Hun JUNG ; Jin Yun KIM ; Gill Hoi KOO ; Hwa Yong SHIN

The Korean Journal of Pain.2013;26(1):84-88. doi:10.3344/kjp.2013.26.1.84

A 60-year-old man presented with pain on the left cheek and lateral nose. The patient had been diagnosed with facial herpes zoster in the left V2 area 6 months previously. Medical treatment was prescribed for 6 months but it had little effect. We blocked the left infraorbital nerve under ultrasound guidance, but pain relief was short term. Therefore, we performed pulsed radiofrequency treatment on the left infraorbital nerve under ultrasound guidance. Six months after the procedure, the reduction of pain was still maintained, and there was no need for further management.
Cheek ; Herpes Zoster ; Humans ; Nose ; Pulsed Radiofrequency Treatment

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Stevens-Johnson Syndrome Induced by Carbamazepine Treatment in a Patient Who Previously Had Carbamazepine Induced Pruritus: A Case Report.

Hyun Min BAE ; Yoo Jung PARK ; Young Hoon KIM ; Dong Eon MOON

The Korean Journal of Pain.2013;26(1):80-83. doi:10.3344/kjp.2013.26.1.80

Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction. In addition, we strongly recommend gradual titration when initiating treatment with carbamazepine.
Carbamazepine ; Humans ; Pruritus ; Skin ; Stevens-Johnson Syndrome ; Trigeminal Neuralgia

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Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient.

Mi Hyun LEE ; Jang Ho SONG ; Doo Ik LEE ; Hyun Soo AHN ; Ji Woong PARK ; Young Deog CHA

The Korean Journal of Pain.2013;26(1):76-79. doi:10.3344/kjp.2013.26.1.76

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.
Hematoma ; Herpes Zoster ; Humans ; Lower Extremity ; Myelitis ; Neuralgia ; Neuralgia, Postherpetic ; Urinary Retention

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The Analgesic Effect of Nefopam with Fentanyl at the End of Laparoscopic Cholecystectomy.

Ju Hwan LEE ; Jae Hong KIM ; Yong Kwan CHEONG

The Korean Journal of Pain.2013;26(4):361-367. doi:10.3344/kjp.2013.26.4.361

BACKGROUND: Nefopam is a centrally acting analgesic that is used to control pain. The aim of this study was to find an appropriate dose of nefopam that demonstrates an analgesic effect when administered in continuous infusion with fentanyl at the end of laparoscopic cholecystectomy. METHODS: Ninety patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive analgesia with fentanyl alone (50 microg, Group 1, n = 30), or with fentanyl in combination with nefopam 20 mg (Group 2, n = 30) or in combination with nefopam 40 mg (Group 3, n = 30) at the end of surgery. Pain and side effects were evaluated at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours, and 12 hours after arrival in the post-anesthesia care unit (PACU). RESULTS: Pain was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes, 2 hours, and 6 hours after arrival in the PACU. Nausea was statistically significantly lower in Group 2 than in Groups 1 and 3 at 10 minutes after arrival in the PACU. Shivering was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes after arrival in the PACU. CONCLUSIONS: Nefopam is a drug that can be safely used as an analgesic after surgery, and its side effects can be reduced when fentanyl 50 microg is injected with nefopam 20 mg.
Analgesia ; Cholecystectomy, Laparoscopic ; Fentanyl ; Humans ; Nausea ; Nefopam ; Shivering

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The Effect of Urinary Trypsin Inhibitor Against Neuropathic Pain in Rat Models.

Ki Tae JUNG ; Hyun Young LEE ; Myung Ha YOON ; Kyung Joon LIM

The Korean Journal of Pain.2013;26(4):356-360. doi:10.3344/kjp.2013.26.4.356

BACKGROUND: Nerve injury sometimes leads to chronic neuropathic pain associated with neuroinflammation in the nervous system. In the case of chronic neuropathic pain, the inflammatory and algesic mediators become predominant and result in pain hypersensitivity following nervous system damage. It is well known that urinary trypsin inhibitor (ulinastatin, UTI) has an anti-inflammatory activity. Recently, the neuroprotective action of UTI on the nervous system after ischemic injury has been reported. Thus, we evaluated the neuroprotective effect of ulinastatin in a rat model of neuropathic pain. METHODS: Neuropathic pain was induced with L5 spinal nerve ligation (SNL) in male Sprague-Dawley rats weighing 100-120 g. The rats were divided into 3 groups, with n = 8 in each group. The rats in the control group (group 1) were administered normal saline and those in group 2 were administered UTI (50,000 U/kg) intravenously through the tail vein for 3 days from the day of SNL. Rats in group 3 were administered UTI (50,000 U/kg) intravenously from the 5th day after SNL. The paw withdrawal threshold was measured using the von Frey test for 3 days starting from the 5th day after SNL. RESULTS: The paw withdrawal thresholds were significantly increased in the rats of group 2 compared to the other groups (P < 0.05). CONCLUSIONS: Ulinastatin, which was administered for 3 days after SNL, increased the paw withdrawal threshold and it could have a neuroprotective effect in the rat model of neuropathic pain.
Animals ; Glycoproteins ; Humans ; Hypersensitivity ; Ligation ; Male ; Nervous System ; Neuralgia ; Neuroprotective Agents ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves ; Trypsin ; Veins

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An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses.

Niharika JAIN ; Abhishek GUPTA ; Meena N

The Korean Journal of Pain.2013;26(4):347-355. doi:10.3344/kjp.2013.26.4.347

Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.
Dental Care ; Dental Pulp ; Hand ; Humans ; Inflammation ; Neurophysiology ; Pulpitis

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