Postdural Puncture Headache after Cervical Medial Branch Block

Cervical medial branch block (MBB) is a frequently performed procedure for management of neck pain that rarely has complications. With fluoroscopic guidance, the procedure is considered a relatively safer procedure than epidural block. We report a case of a 27-year-old woman presenting with postural headache after cervical MBB. Dural penetration by inappropriate needle placement was suspected after reviewing fluoroscopic images of the procedure. After conservative treatment, including bed rest and analgesic treatment, the patient completely recovered without any neurological complications. Complications associated with MBB are rare and previous case reports have focused only on infection or vascular injection as etiologies. This is the first report of complications related to dural puncture after cervical MBB. Our findings suggest that misplacement of the block needle by inaccurate alignment of both sides of the cervical articular pillar, assessed by fluoroscopic view during the procedure, can result in dural injury.

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.

The Comparison of the Result of Epiduroscopic Laser Neural Decompression between FBSS or Not

BACKGROUND: Epiduroscopic laser neural decompression (ELND) has been performed as a treatment tool for chronic refractory low back pain and/or radicular pain. There are some studies about the usefulness of epiduroscopy for post lumbar surgery syndrome, however, few studies about the effectiveness of epiduroscopy for patients without back surgery. We compared the satisfaction of patients who underwent ELND for chronic low back pain and/or radicular pain after back surgery and for the same symptoms without surgery. METHODS: We compared the degree of satisfaction of patients after ELND between who had underwent the lumbar spine surgery and who had not retrospectively by chart reviewing. We divided 39 patients who had received ELND into two groups, one is the group of patients who got the lumbar surgery (group 1), and the other is the group of patients who did not (group 2). Their medical records including age, sex, previous treatment, duration of illness, degree of symptom relief were investigated. We compared each items between two groups. RESULTS: The number of patients in group 1 was 17, and group 2 was 22. In group 1, 16 patients (94.1%) showed more than 'Acceptable', and 19 patients (86.4%) showed more than 'Acceptable' in group 2. There is no significant differences statistically in percentage of patients who showed more than 'Acceptable' in the satisfaction after ELND between two groups. CONCLUSIONS: ELND provided satisfaction (more than 85%) for patients with chronic low back pain and/or leg pain regardless of previous back surgery history.

Abdominal distention and constipation followed by herpes zoster infection / 대한마취과학회지

No abstract available.

Ultrasound-guided Pulsed Radiofrequency of the Third Occipital Nerve

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.

The Effect of Distraction Induced by ReliefBand(R) on the Pain Threshold and Temporal Summation Threshold / 대한마취과학회지

BACKGROUND: Pain is recognized as a cognitive phenomenon, which involves the processing of information. Given that human information processing is largely restricted to a number of simultaneous tasks, many interventions and techniques have been used to modify pain perception by distracting the cognitive processing of pain. This study tested the hypothesis that the pain threshold to electrical stimuli is increased as a result of distraction using a ReliefBand(R). METHODS: Twenty volunteers were enrolled in this study. After attaching surface electrode to the medial plantar nerve territory of left foot, electrical stimuli were delivered to obtain baseline pain threshold and temporal summation threshold. After 15 minutes, while distracting with ReliefBand(R), the same parameters were obtained. RESULTS: Pain threshold and temporal summation threshold before distraction were 7.9+/-2.2 mA and 7.0+/-2.1 mA respectively. During distraction pain threshold and temporal summation threshold were increased to 9.0+/-2.4 mA and 7.8+/-2.2 mA respectively. CONCLUSIONS: Pain and temporal summation threshold to electrical stimuli were increased during distraction with ReliefBand(R). Although we applied a technique with weak distracting ability, this distracted the processing of pain perception significantly. Further research about various distraction technique will be required.