Transforaminal Epidural Block and Erector Spinae Plane Block to Manage Acute Zoster-Associated Pain: A Retrospective Case-Control Study.

Achieving adequate pain reduction in the acute phase of herpes zoster is essential for preventing postherpetic neuralgia (PHN). For this purpose, appropriate antiviral medications, oral analgesic medications, and various nerve block methods could be applied. Erector spinae plane block (ESPB) is a simple, novel ultrasound-guided block technique, and its use has increased because the procedure is convenient and relatively safe.

Abdominal Wall Block Decreases Intraoperative Opioid Con-Sumption by Surgical Pleth Index-Guided Remifentanil Administration in Single-Port Laparoscopic Herniorrhaphy: A Prospective Randomized Controlled Trial.

Abdominal wall blocks (AWBs) can reduce pain during surgery and lessen opioid demand. Since it is difficult to know the exact level of intraoperative pain, it is not known how much the opioid dose should be reduced. In this study, using the surgical pleth index (SPI), which indicates pain index from sympathetic fibers, the amount of remifentanil consumption was investigated.

Role of erector spinae plane block in controlling functional abdominal pain: Case reports.

Rationale: Functional abdominal pain is an intractable medical condition that often reduces quality of life. Celiac plexus block is a representative intervention for managing intractable abdominal pain. However, celiac plexus block can be technically difficult to perform and carries the risk of potential complications.

Comparison of Touhy and Quincke needles on intravascular injection rate in lumbar transforaminal epidural block: a randomized prospective trial.

Background: Transforaminal epidural steroid injection is widely used in clinical practice to effectively deliver injectate into the ventral epidural space. Complications associated with intravascular injection such as spinal cord infarction and paraplegia can occur during transforaminal epidural steroid injection. To improve the safety of the procedure, avoidance of intravascular injection is crucial, for which appropriate needle selection is important.

Novel method for modified interlaminar approach using contralateral oblique view: A technical suggestion.

A modified interlaminar (MIL) approach has been proposed for improved accessibility to the target epidural space. However, even with fluoroscopic guidance, uncertainty about the distance between the needle tip and the epidural space can remain. Using the contralateral oblique (CLO) view, determination of the epidural space can be easier with clearer identification of the interlaminar opening.

A Prospective, Randomized Cross-Over Trial of T2 Paravertebral Block as a Sympathetic Block in Complex Regional Pain Syndrome.

Background: Sympathetic block is commonly performed in clinical practice for management of intractable pain conditions. However, stellate ganglion block (SGB) alone often does not achieve sufficient sympatholysis of the upper extremity. The paravertebral space continues up to the cervical sympathetic chain and includes the stellate ganglion.

Ultrasound-Guided Block of the Axillary Nerve: A Prospective, Randomized, Single-Blind Study Comparing Interfascial and Perivascular Injections.

Background: The ultrasound-guided block of the axillary nerve may be complicated in cases in which the posterior circumflex humeral artery (PCHA) follows an abnormal course.

Objectives: To develop a new technique that does not rely on direct visualization of the PCHA or the axillary nerve, and to compare interfascial injection and conventional perivascular injection for a block of the axillary nerve.

Study Design: A prospective randomized study.

Response to Transforaminal Epidural Block as a Useful Predictive Factor of Postherpetic Neuralgia.

Despite the high frequency of nerve blocks in the acute phase of herpes zoster, factors associated with intervention, such as response to epidural block, have not been analyzed as predictive factors of postherpetic neuralgia (PHN). To determine the predictive factors of progression to PHN in the presence of interventions, we analyzed the medical records of 145 patients who underwent transforaminal epidural injection (TFEI) in the acute phase of herpes zoster. A total volume of 5 mL (a mixture of 0.

Clinical effects of pulsed radiofrequency to the thoracic sympathetic ganglion versus the cervical sympathetic chain in patients with upper-extremity complex regional pain syndrome: A retrospective analysis.

Pulsed radiofrequency (PRF) to the thoracic sympathetic ganglion (TSG PRF) or to the cervical sympathetic chain (CSC PRF) can be performed to overcome transient effects of single sympathetic blocks in patients with upper-extremity complex regional pain syndrome (CRPS).We retrospectively compared the clinical effects of TSG PRF and CSC PRF. Seven TSG PRF cases and 10 CSC PRF cases were enrolled in the present analysis.

Clinical efficacy of transforaminal epidural injection for management of zoster-associated pain: a retrospective analysis.

Objectives: Transforaminal epidural injection (TFEI) has superior accessibility to the dorsal root ganglion, which is an essential location of pain signaling in herpes zoster. However, the effectiveness of TFEI for herpes zoster patients has not previously been studied. We retrospectively analyzed the efficacy of TFEI for pain control and prevention of PHN in patients with acute and subacute herpes zoster.

Comparison of efficacy of continuous epidural block and pulsed radiofrequency to the dorsal root ganglion for management of pain persisting beyond the acute phase of herpes zoster.

Background: There is little evidence regarding the effectiveness of intervention methods in the treatment of zoster-related pain (ZAP) after the acute phase of zoster. Generally, if ZAP remains after more than 180 days from its onset, the likelihood of pain reduction is very low; this condition is considered as a "well established" post-herpetic neuralgia (PHN). Although the clinical efficacy of intrathecal steroid injection and spinal cord stimulation (SCS) for ZAP management has been reported, these interventions are not widely used due to inherent disadvantages.

Pulsed Radiofrequency to the Dorsal Root Ganglion in Acute Herpes Zoster and Postherpetic Neuralgia.

Background: Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute herpes zoster can result in neuropathic conditions such as postherpetic neuralgia (PHN).

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.

Ultrasound-guided pulsed radiofrequency treatment of the cervical sympathetic chain for complex regional pain syndrome: A retrospective observational study.

The stellate ganglion is a common target to manage neuropathic pain in the upper extremities. However, the effect duration of a single stellate ganglion block is often temporary. To overcome the short-term effects of a single sympathetic block, pulsed radiofrequency (PRF) can be applied.

Efficacy of continuous epidural block in acute herpes zoster: Incidence and predictive factors of postherpetic neuralgia, a retrospective single-center study.

The aim of the present study was to investigate efficacy of continuous epidural block for prevent postherpetic neuralgia (PHN) progression in cases of acute herpes zoster with severe pain and also to identify predictive factors for PHN in such conditions.We retrospectively analyzed the clinical data of patients with herpes zoster who underwent continuous epidural block between March 2013 and October 2015. Time points were set as 1 month, 3 months, and 6 months after zoster onset.

Continuous Thoracic Sympathetic Ganglion Block in Complex Regional Pain Syndrome Patients with Spinal Cord Stimulation Implantation.

The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS). However, single sympathetic block often provides only short-term effect. Moreover, frequent procedures for sympathetic block may increase the risk of complications.

Comparison of the Ventral Epidural Spreading in Modified Interlaminar Approach and Transforaminal Approach: A Randomized, Double-Blind Study.

Objective: To evaluate the effectiveness of a modified interlaminar (MIL) approach for accessing ventral epidural space compared with the transforaminal (TF) approach.

Study Design: Randomized double blinded control trial

Methods: Eighty-four patients with lumbar radicular pain were randomly assigned into two groups in which drug delivery to the ventral epidural space was performed through either the MIL (n = 42) or the TF approach (n = 42). Within each group, subgroups were classified according to the dominant pathology as assessed by magnetic resonance imaging (MRI): bulging disc, herniated nucleus pulposus (HNP), and foraminal stenosis.

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.