Effects of Electrical Stimulation of Transcutaneous Electrical Nerve and Acupuncture Stimulation in Patients with Myofascial Pain Syndrome

OBJECTIVE: To evaluate the effective stimulating mode of transcutaneous electrical nerve stimulation (TENS) and acupuncture for pain relief. METHOD: The subjects were 40 patients with MPS. In 20 patients, TENS were applied to the trigger point. In other 20 patients, acupuncture mode electrical stimulation were applied to the acupuncture site by measuring skin impedance of affected muscle. RESULTS: The visual Analogue Scale (VAS) decreased 20.48 (19.15%) in the group applied TENS mode and 30.08 (16.97%) in the group applied acupuncture mode after 1 week. The VAS decreased 33.19 (25.76%) in the groupapplied TENS mode and 46.48(17.76%) in the group applied acupuncture mode after 2 week (p<0.05). The pressure threshold was increased 16.07 (17.45%) in the group applied TENS mode and 26.09 (22.20%) in the group applied acupuncture mode after 1 week. The pressure threshold increased 24.88 (23.25%) in the group applied TENS mode and 41.11 (27.35%) in the group applied acupuncture mode after 2 week. CONCLUSION: Acupuncture mode was more effective treatment modality in MPS for pain relief than TENS mode.

The Change of Skin Temperature after Thoracic Sympathectomy in Patients with Palmar Hyperhidrosis

OBJECTIVE: The purposes of this study were to evaluate the change of temperature before and after thoracic sympathectomy in patients with palmar hyperhidrosis and to find the usefulness of infrared thermography for the assessment of effects of thoracic sympathectomy. METHOD: The skin temperature was measured before, one day and 30 days after sympathectomy in 28 patients with palmar hyperhidrosis. Temperature was recorded on forehead, cheek, neck, axilla, umbilicus and 6 sites of each hand and foot by infrared thermography and thermometer. Patient's satisfaction with operation was assessed by 10 point scale. RESULTS: All patient who had undergone sympathectomy showed significantly decreased discomfort owing to hyperhidrosis by 10 point scale (p<0.05). The temperature significantly elevated on postoperative 1 day and 30 days on both palms as compared with preoperative state, bilaterally (p<0.05). There were no significant differences of sole temperatures among preoperative, postoperative 1 day and postoperative 30 days, bilaterally. CONCLUSION: We proved significant effect of thoracic sympathectomy to the patients with palmar hyperhidrosis objectively, and we also quantified the elevation of palm temperature after sympathectomy.

Surface Anatomical Landmark and Optimal Insertion Angle in Cervical Epidural Block

OBJECTIVE: The aim of this study is to evaluate the surface anatomical landmark for the cervical epidural block by investigating the proportion of patient's prominence in the 7th cervical vertebra. And the most optimal insertion angle over the mid point between the 6th and the 7th cervical spinous process is also measured. METHOD: Patients who did a plane x-ray examination of cervical spine were selected. We performed plane x-ray after marking on cervical vertebra prominence that was assumed as the spinous process of the 7th cervical vertebra by inspection and palpation. We identified where the marker were located on the spinous process. Moreover, we measured optimal insertion angle in the plane x-ray of cervical spine lateral. RESULTS: A total 100 cases were identified. The vertebra prominence was on the 7th cervical vertebra in 62 cases and the 6th cervical vertebra in 29 cases. The 1st thoracic vertebra was in the 2 cases and the 6th and 7th cervical vertebra in the 7 cases. CONCLUSION: The vertebra prominence was identified as the spinous process of the 7th cervical vertebra in sixty two percent of the cases. And the most optimal insertion angle is a -25.28 degree angle from the perpendicular line of the skin.