요통 치료를 위한 경막외강내 스테로이드 투여의 장기 효과

최 훈(Huhn Choe),황정한(Chung Han Whang),이준례(Ju 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2

N/A Background: Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy have led to wide trials of corticosteroids injected either systemically or into the intraspinally. Although epidural steroid is known to be very effective in the treatment of the patients with low back pain, few data showed the therapeutic duration of epidural steroid. Methods: We studied 120 patients who were treated with epidural steroid for the treatment of low back pain or sciatica or both. We retrospectively analysed the duration of analgesia, number of injections per each session, and complications. Results: The duration of analgesia ranged from 17 days to 300 days, and the mean duration was 73.7 ±70.5 (SD) days. The mean number of injections per each session was 1.8±1.3 (range: 1 to 12). There were no significant complications with epidural steroid injections. Conclusions: One to three epidural steroid injections at one week interval leads more than two months of pain relief without significant complications.

지주막하강내 고장성 생리식염수 투여후 발생한 마비증후군

최 훈(Huhn Choe) 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.1

N/A

폐쇄성 혈관 질환의 치료를 위한 Bier Block 중에발생한 Prostaglandin E1의 혈관외 유출

최 훈(Huhn Choe),이용태(Yong Tae Lee),김동찬(Dong 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.2

Prostaglandin El(PGEl) is a potent vasodilator and is a useful drug for the treatment of oc- clusive peripheral vascular disease. It has been used systemically via intravenous route or re- gionally via intraarterial route. We tried intravenous regional administration of PGEl for the treatment of a patient with occlusive arterial disease involving left fingers. During the l3th in- jection, the patient complained of severe pain at the injection site during the drug administration. Thereafter, the patient developed painful and severe swelling with blebs on his left hand. Systemic antibiotics were given together with stellate ganglion block of the affected left side. PGE1 was substituted to reserpine, which is subcutaneously injectable, for the second term treatment.

성상신경절 차단으로 치료했던 양성 발작성 현기증

최 훈(Huhn Choe),한영진(Young Jin Han) 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.2

A fourty-year-old housewife was admitted to the Department of Ear, Nose, and Throat from the emergency room, because of severe vertigo associated with positional changes of the head. Hallpike maneuver produced typical patterns of bilateral nystagmus consistent with benign paroxysmal positional vertigo(BPPV), and further geotropic rotatory nystagmus with position- al change of the head in each direction. Direction of nystagmus reversed when the patient was repositioned upright. Particle repositioning maneuver was administered to her left ear but failed to relieve the se- vere dizziness associated with the head turning to the right. She was then referred to the pain clinic where we determined, right stellate ganglion block (SGB), as the course of treatment. During the next month the patient received 27 SGB treatments and the patient was almost eompletely healed. It is unusual for the BPPV to occur bilaterally therefore reference concerning the effective- ness of SGB for the treatment of BPPV was difficult to obtain. In conclusion we would like to report the successful treatment of BPPV with SGB.

양측성 안면신경 마비 치험 예

최 훈(Huhn Choe),한영진(Young Jin Han),고성훈(Seon 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

Facial nerve palsy is not an uncommon disease encountered at the department of otolaryngology or pain clinic. It usually occurs following viral infection(Bells palsy, BP), However, it is rare to develop bilaterally, and that not simultaneously. We experienced a rare case of bilateral facial nerve palsy. Patient first experienced left side paralysis, then right side paralysis approximately two months later. We treated the patient with serial bilateral stellate ganglion blocks(SGB), When left side paralysis improved, we performed unilatertal SGB for right side paralysis. Patient was also treated with intermittent electro-acupuncture stimulations, to right side first, then left side. Four months of treatment provided good results. This may be the first case, in Korea, of facial nerve paralysis bilaterally within a certain interval, treated with serial SGB and electro-acupuncture stimulation. However, the etiology of this bilateral BP was not fully confirmed as being a cause of viral origin.

Buerger 병 치료를 위한 국소 정맥내 Prostaglandin E1 주입

최 훈(Huhn Choe),김동찬(Dong Chan Kim),한영진(Youn 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1

Buerger's disease is a chronic occlusive arterial disease in which a non-arteriosclerotic lesion involves medium-sized arteries, veins, and nerves of the distal leg or arm. Sympathetic inter- ruption is indicated to improve blood flow to the involved extremity, although sympathetic blockade can provide temporally relief of vasospasm and pain. Chemical or surgical sympa- thectomy has been performed for this purpose and intravenous regional sympathetic block (IRSB) is an alternative. Guanethidine or reserpine has been administered for IRSB. Intra- arterial or intravenous systemic administration of prostaglandin El(PGE1) has been recom- mended for the treatment of Buerger's disease. We used PGE1 for intravenous regional administration as an IRSB with results as good as that of intra-arterial injection. The advantages of the method include that it is less expensive than systemic administration, less invasive than intra-arterial injection, and simplc in technical application.

대상포진 환자의 통증치료에 관하여

최 훈(Huhn Choe),김동찬(Dong Chan Kim) 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.1

N/A Fifty-one cases of acute herpes zoster infection were analyzed to search for the most effective management strategy of the disease, including pain relief and decreasing the incidence of postherpetic neuralgia. Anti-viral treatment was not included. Analgesics and nerve blocks, such as stellate ganglion block or epidural block, were helpful. Corticosteroid was administered in most of the cases either systemically or epidurally or both. Epidural administration of local anesthetic in combination with corticosteroid seemed to have certain advantages of excellent pain relief as a result of sympa- thetic blockade and regional plus systemic anti-inflammatory effects of the steroid, although this was not proved by definite statistical evidence.

암성 통증에 대한 척추내 신경파괴제 요법

최 훈(Huhn Choe),최현규(Hyun Kyu Choe),김동찬(Dong 대한통증학회 1991 The Korean Journal of Pain Vol.4 No.1

N/A Intraspinal alcohol or phenol administration has been used for the treatment of intractable pain due to terminal cancer. It has been alleged to produce good pain relief with minimal compli- cation if perfomed carefully. We analysed 35 patients who received epidural or subarachnoid neurolytic block out of 83 patients with malignancy who were referrecl to our pain clinic. Most of the patients needed additional treatment modalities including epidural catheterization or systemic narcotic administration. The incidence of complication was high, especially when the neurolytic agents were administered in the lumbar region. This suggest that intraspinal neurolytic block is unreliable and unsafe, although it may temporarily reduce the analgesic re- quirement.

대상포진 후 신경통 치료에 대한 고찰

최 훈(Huhn Choe),한영진(Young Jin Han) 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.2

N/A Postherpetic neuralgia (PHN) causes intractable pain which disturbs sleep and daily life. Numerous drugs and treatment strategies have been introduced for the management of PHN. However, no single regimen has proved to be effective. I analysed 38 patients with PHN. Amitriptyline, a tricyclic antidepressant and chlorpromazine were most commonly prescribed. Stellate ganglion blocks for the head and neck pain and epidural blocks for the rest part of the body were most frequently given. Triamcinolone acetate was administered epidurally in most of the cases or by iontophoresis on the affected skin area in two cases. Complications were related to the technique of the nerve block and the side effects of drugs administered. Repeated nerve blocks with tricyclic antidepressant and steroid therapy were thought to be the most effective for the treatment of postherpetic pain.

돌발성 난청의 치료를 위한 성상신경절 차단

최 훈(Huhn Choe),최영순(Young Soon Choi),김동찬(Do 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.2

N/A We compared the effectiveness of vasodilator therapy with histamine and stellate gang!ion block(SGB) for the treatment of sudden sensoryneural hearing impairment retrospctively. 24 patients were treated with histamine and nicotinic acid(histamine group), and 30 patients were treated with SGB(SGB group). Corticosteroids and low molecular weight dextran(Rheomacro- dex) were given to all patients. The degree of hearing impairment and the evidence of im- provement were checked with audiogram. 52.8/o(10 out of l9 follow-up ckecked patients) of pa- tients in histamine group and 56.7%(17 out of 30) of patients in SGB group had improved within three weeks of treatment, which means both histamine and SGB are equally effective. As a consequence, we concluded that SGB ia a good substitute for histamine as a vasodilator thera- py for sudden sensoryneural hearing impairment with minimal complication, few absolute contraindications, and simple and safe technique.