• 대한방사선기술학회지:방사선기술과학
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• 제45권2호
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• pp.171-177
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• 2022

The purpose of this study was to investigate the effect of the characteristics of patients who underwent spinal nerve block on the fear of injection and the risk of radiation. Subjects were 137 patients (67 males, 70 females) who visited the Department of Anesthesiology and Pain Medicine in Cheongju. The method was conducted as a research study using a total of 28 questionnaires consisting of patient characteristics, experience characteristics of nerve block surgery, nerve block fear scale, and radiation risk perception scale. The reliability of the questionnaire response was secured with a Cronbach's alpha coefficient of 0.6 or higher. For statistical analysis, correlation was tested by descriptive statistics, frequency analysis, independent sample T-test, and Pearson and Spearman correlation coefficients by measurement scale and factor. As a result, the fear scale of nerve block was significantly higher in women than in men (p<0.05). The fear scale of nerve block injection was significantly higher in the first-visit patients than in the second-visited patients (p<0.05). However, there was no significant difference among all variables in radiation risk perception. In conclusion, patients undergoing spinal nerve block were more aware of the fear of injection than the risk of radiation exposure during the procedure.

• The Korean Journal of Pain
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• 제8권1호
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• pp.156-158
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• 1995

Total spinal anesthesia is a well documented serious life threatening complication which results from an attempted spinal or epidural analgesia. We had an accidental total spinal anesthesia associated with a cranial nerve paralysis and an eventual unconsciousness during epidural analgesia. A 45-year-old female with an uterine myoma was scheduled for a total abdominal hysterectomy under the epidural analgesia. A lumbar tapping for the epidural analgesia was performed in a sitting position at a level between $L_{3-4}$, using a 18 gauge Tuohy needle. Using the "Loss of Resistance" technique to identify the epidural space, the first attempt failed; however, the second attempt with the same level and the technique was successful. The epidural space was identified erroneously. However, fluid was dripping very slowly through the needle, which we thought was the fluid from the normal saline which was injected from the outside to identify the space. Then 20 ml of 2% lidocaine was administered into the epidural space. Shortly after the spinal injection of lidocaine, many signs of total spinal anesthesia could be clearly observed, accompanied by the following progressing signs of intracrainal nerve paralysis: phrenic nerve, vagus nerve, glossopharyngeal nerve and trigeminal nerve in that order. Then female was intubated and her respiration was controlled without delay. The scheduled operation was carried out uneventfully for 2 hours and 20 minutes. The patient recovered gradually in th4e reverse order four hours from that time.

• 성인간호학회지
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• 제29권2호
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• pp.143-153
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• 2017

Purpose: Purpose of the study was to identify the effect of the Comprehensive Education Program (CEP) on intra-procedure anxiety, post-procedure uncertainty and athletic performance of back strengthening of patients undergo spinal nerve block (SNB). Methods: The participants (experimental group=33, control group=33) were recruited from a university hospital in G metropolitan city. Data were collected from July to November 2015. The experimental group was individually provided with a booklet/motion picture about the SNB and back strengthening exercise training before the SNB. This group also received a leaflet about back strengthening exercise post SNB. The Anxiety-Visual Analog Scale (A-VAS), the Mishel adapted uncertainty scale and newly created knowledge scale/athletic performance checklist were utilized as our study tools. Results: Intra-procedure anxiety score (F=25.70, p<.001), post-procedure uncertainty score (F=82.56, p<.001), post-procedure knowledge score (F=14.63, p<.001) and athletic performance rate of back strengthening (p=.003) of the experimental group showed statistically significant differences in comparison with the control group. Conclusion: This CEP is a cost and time-effective intervention for patients who undergo spinal injections, so it should be actively utilized as an educational management strategy in outpatient.

• The Korean Journal of Pain
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• 제33권2호
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• pp.138-143
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• 2020

Background: Severe pain associated with proximal femur fractures makes the positioning for regional anesthesia a challenge. Systemic administration of analgesics can have adverse effects. Individually, both the fascia iliaca block (FIB) and femoral nerve blocks (FNB) have been studied. However, there is little evidence comparing the two. The aim of this study was to compare the overall efficacy of the two blocks in patients with proximal femur fracture before positioning for spinal anesthesia. Methods: ASA (American Society of Anesthesiologists) class I, II, and III patients scheduled for elective and emergency surgery with the diagnosis of proximal femur fracture between October 2018 and June 2019 were included in the study. The patients were assigned to two groups by convenience nonprobability sampling of 35 each. Results: Our study showed a reduction in visual analogue scale scores at 3, 4, and 5 minutes after administration of the FIB being 5.1 ± 1.1, 4.1 ± 1.3, and 2.8 ± 0.8, and those after the FNB as 4.4 ± 1.1, 3.3 ± 1.1, and 2.1 ± 1.4 with P < 0.05, which was statistically significant. The mean first rescue analgesia time for the FIB was 7.1 ± 2.1 hours, while for the FNB it was 5.2 ± 0.7 hours. The P value was less than 0.001, which was significant. Conclusions: Both ultrasound guided FNB and FIB techniques provide sufficient analgesia for patient's positioning before spinal anesthesia. However, the duration of postoperative analgesia provided by FIB was greater than that of the FNB.

• The Korean Journal of Pain
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• 제30권2호
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• pp.116-125
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• 2017

Background: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. Methods: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient's satisfaction and other factors were analyzed. Results: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient's satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient's necessity of a post-treatment management and patients' performance rate of post-treatment management (P < 0.01). Conclusions: These results show that sufficient explanation increased patients' satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients' post-treatment management.

• 대한정형외과 초음파학회지
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• 제3권2호
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• pp.74-78
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• 2010

정형외과 영역에서 근골격계 초음파의 활용 범위가 넓어짐에 따라 슬와부 신경 차단(좌골 신경 차단)이나 대퇴 신경 차단(또는 복재 신경 차단)이 초음파를 이용하여 신경 손상이나 불완전 마취에 대한 걱정없이 쉽고, 안전하게 시행될 수 있게 되었다. 그로 인하여 족부 수술 뿐만 아니라 족관절 및 하퇴부의 정형외과적 수술이 전신 마취나 척추 마취의 부담없이 시행될 수 있게 되었다. 이러한 초음파 유도 대퇴좌골 신경 차단에 대한 자세한 술기를 120예 이상의 경험을 바탕으로 보고하고자 한다.

• The Korean Journal of Pain
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• 제13권2호
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• pp.247-250
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• 2000

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between $L_4$ and $L_5$ and spinal stenosis in $L_4$ area. And epiduroscopic feature showed severe adhesion in $L_4$, $L_5$ and $S_1$. After we blocked $L_2$ root, pain score decreased 10 to 2. Therefore, the $L_2$ root block may be a useful diagnostic procedure as well as provide therapeutic value.

• The Korean Journal of Pain
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• 제8권2호
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• pp.304-307
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• 1995

1,666 patients treated by nerve block from September 1994 to August 1995 we statistically analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Diseases and ailments were as follows: low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7%, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trigger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows: facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic ganglion block 15.4%.

• The Korean Journal of Pain
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• 제34권4호
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• pp.487-500
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• 2021

Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions: Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

• The Korean Journal of Pain
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• 제28권2호
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• pp.148-152
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• 2015

The goal of cancer treatment is generally pain reduction and function recovery. However, drug therapy does not treat pain adequately in approximately 43% of patients, and the latter may have to undergo a nerve block or neurolysis. In the case reported here, a 42-year-old female patient with lung cancer (adenocarcinoma) developed paraplegia after receiving T8-10 and $11^{th}$ intercostal nerve neurolysis and T9-10 interlaminar epidural steroid injections. An MRI results revealed extensive swelling of the spinal cord between the T4 spinal cord and conus medullaris, and T5, 7-11, and L1 bone metastasis. Although steroid therapy was administered, the paraplegia did not improve.