지주막하강 Morphine에 관한 고찰 -수술후 진통효과 및 분절차단효과에 대한 연구-

최중립,Choi, Joong-Rieb 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.2

Recent studies have shown that narcotic drugs produce an intense prolonged analgesic action when injected into the subarachnoidal or extradural space of animals and man. In order to study the effects of intrathecal injection of morphine on postoperative pain relief and segmental block effect, we administered 0.25 mg of morphine sulfate (0.25 mg of morphine/1 ml normal saline) into lumbar subarachnoid space prior to brahial plexus block for upper extremity surgery group The results were as follows: 1) more than 20 hours analgesic effect at least 2) no segemental block effect in analgesia 3) some adverse effect (Nausea, Vomiting, Pruritus, Urinary retention).

추간관절증후군의 치료

최중립(Joong Rieb Choi),송찬우(Chan Woo Song),이경 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.2

The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself. So facet joint block has been known only as a therapeutic and diagnostic modality of facet syndrome. Based on clinical experience and anatomical study, we have concluded varying opinions from common sense about facet syndrome. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. We therefore conclude that spasmolytic treatment of muscles connecting the two verte-bral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.

이장근 증후근의 치험

최중립(Joong Rieb Choi) 대한통증학회 1989 The Korean Journal of Pain Vol.2 No.1

N/A Sciatic neuralgia has been considered as the symptom of herniated lumbar disk, but disk disease is met the only causes of sciatic neuralgia. Sciatic neuralgia uncombined with disk disease in thought to be a sign of myofascial syndrome of the piriform is muscle. Local anesthetic injection into piriform is muscle is recommended for the therapeutic treatment of sciatica without lumbago.

이상근 증후군에 관한 연구

최중립(Joong Rieb Choi),이준원(Joon Won Lee),이경 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

N/A It has been reported by some authors that caudal block with local anesthetic and steroid is the most effective therapeutic modality for piriformis syndrome; and the incidence ratio of fe- male to male being 6 to l. We treated 89 patients with piriformis syndrome in 1995. From those clinical experiences and anatomical studies we have arrived at several conclusions different from other authors. Our results indicate the following: 1) Piriformis syndrome does not provoke lower back pain. 2) Our rate of incidence showed a very different profile as results showed a female to male ratio of 33: 56. 3) Releasing the compressed nerves(gluteal,sciatic) with spasmolytic treatment on the pirifor- mis muscle itself is thought to be the only therapeutic modality for piriformis syndrome.

목덜미와 어깨의 통증에 관한 연구

최중립(Joong Rieb Choi) 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.2

N/A Two hundred sisty five patients who complained of neck pain with stiffness and pain of the suprascapular area were studied. In most cases the anatomical locations of pain were in the levator scapulae muscles or trape- zius muscles. Hyperactivity of dorsal scapular nerve or spinal accessory nerve which innervate those mus- cles was thought to be responsible for these pains. The hyperactivity of the nerves may be due to the spasm of the sternocleidomastoid muscle and the scalenus medius muscle which the nerves meet during their courses to the levator scapulae or trapezius muscles. Therefore, spasmolytic treatment on the scalenus medius provided effective relief for neck or shoulder pain.

Tennis Elbow에 관한 연구

최중립(Joong Rieb Choi) 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.1

The common disorder called tennis elbow exhibits typical clinical characteristics, i.e. painful condition at the lateral aspect of elbow joint on resisted wrist extension. However an exact cause for this painful condition has not yet been established. Many observers believe that the usual lesion of tennis elbow is a partial rupture of the ex- tensor tendon at the tenoperiosteal juction on the lateral epicondyle of humerus. However the mechanism of the tendon rupture has never been explained. Conservative treatments on the tender area have been the most common therapeutic modali- ties for pain relief of tennis elbow. Based on my clinical experiences and anatomical studies, I discerned that tennis elbow is a periostitis of lateral epicondyle of humerus secondary to spastic contraction of muscular belly of extensor carpi radialis after over-stretched injury. Therefore, spasmolytic treatment on the extensor carpi radialis muscle provided a favorable result for permanent relief for tennis elbow pain.

근긴장성 요통의 치료에 대한 새로운 소견

최중립(Joong Rieb Choi) 대한통증학회 1993 The Korean Journal of Pain Vol.6 No.1

In out-patient clinic, it seems to be common that most back pain arise from muscular origins rather than from skeletal origins. Most physicians have wished to diagnose lower back pain from the radiologic findings only. From dinical experiences and anatomical studies, I have gotten a different opinion from common sense about backaches If I met a patient who had lower back pain around the posterior superior iliac crest(P.S.I.C.) area, I would had to search a trigger point in the erector spinae muscles at the level of thoraco-lumber junction rather than at the level of the painful site. It is why that sensory innervation over the posterior superior iliac crest area is the posterior pri- mary branch of T12 spinal nerve running down through the erector spinae musdes. Pain on the iliac crest area is supposedly due to hyperirritability of the sensory nerve distributing to this area. Hyperirritability of the posterior primary branch of T spinal nerve may be due to the spasm of the longissimus thoracis muscle in the erector spinae muscles at the level of the thoraco-lumbar junction. So finally, I would like to insist that spasmolytic treatment on the muscle at the level of the thoraco-lumbar junction would be better for pain relief around P.S.I.C. than treatment at the pain- ful site only.

대퇴신경통에 관한 연구

최중립(Joong Rieb Choi) 대한통증학회 1993 The Korean Journal of Pain Vol.6 No.2

N/A Most patients who have suffered from pain and muscle weakness on femoral nerve distribut- ing area show no definite pathologic finding on X-ray or laboratory examinations. Therefore proper diagnosis is difficult to determine for the proper treatment of the symptoms. Based on my clinical experiences and anatomical studies, I have found most of these symp- toms are a result of femoral nerve compression on trigger point of psoas major muscle. Accordingly, releasing the compression of femoral nerve by Laser stimulation and local anes- thetic injection to the identified trigger point of psoas inajor muscle was found to be an effective treatment for femoral neuralgic pain.

가성위장통에 관한 연구

최중립(Joong Rieb Choi),이경숙(Kyung Sook Lee),소 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

N/A 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 discov- ery of pathologic abnormality of the gastrointestinal tract. At our Yoido Pain Clinic, after di- agnosing myofascial pain syndrome, we treated 64 patients by trigger point injection and physi- cal therapy on abnormal abdominal muscle, from June 1993 to April 1995. Most patients cendi- tions improved after these treatments.

근긴장성 두통에 관한 연구

최중립(Joong Rieb Choi) 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.2

N/A The patient with muscle contraction headache usually have one or more specific trigger points. These trigger points have been treated with various treatment modalities including stretch and spray and regional infiltration with local anesthetics with or without corticosteroids. I treated 36 patients with muscle contraction headache with regional infiltration of local anes- thetics and steroid into trigger points and the results were as follows 1) The diagnosis of muscle contraction headache was possible by confirming specific trigger points by palpation. 2) Patients relieved rapidly from headache by regional infiltration of local anesthetics and steroid into the tender point. 3) Single injection was effective in relieving headache. But the curability of the single injection could not be assessed because of difficulty in follow-up study. 4) Active trigger points could be occasionally inactive, which also made difficult in assessing the effectiveness of the treatment.