Seoul National University · Medicine
Professor Pyung Bok Lee's research lab specializes in regional anesthesiology and interventional pain management, with a focus on spinal and peripheral nerve blocks, epidural drug delivery, and neuromodulation for chronic pain. The lab investigates the anatomical and physiological variations—such as lumbosacral transitional vertebrae—that affect nerve root localization and block efficacy, while also exploring safe and effective drug combinations for epidural injections. A key direction involves evaluating novel topical and epidural therapies, including high-concentration capsaicin patches and gabapentin, for neuropathic pain, with a strong emphasis on translational safety and efficacy. The lab also examines alternative agents like hypertonic saline in peripheral nerve blocks, aiming to optimize treatment outcomes with reduced side effects.
Figures are computed from collected data and may differ slightly.
In Brief BACKGROUND: The presence of a transitional vertebra can create difficulty in identifying the lumbar level corresponding to an exiting nerve root at the time of a spinal nerve block. We investigated the possibility that the muscle innervation pattern and sensory dermatomes of the lumbar nerve roots are altered when a lumbosacral transitional vertebra is present using electrical stimulation. METHODS: We determined the existence of transitional vertebrae using Castellvi’s criteria. Patient
Non-particulate steroids can form crystals upon combination with local anesthetics. Crystal formation may be caused by alkalinization of steroids. The mixing of ropivacaine or levobupivacaine and betamethasone sodium phosphate may require caution during an epidural steroid injection. Lidocaine or bupivacaine is recommended as a local anesthetic. Dexamethasone palmitate is a candidate for a mixture, but additional studies on its safety and effectiveness are needed.
Good prognostic predictors were identified as no previous lumbar surgery or root compression with HIVD or foraminal stenosis. These results are expected to contribute to the establishment of indications for PA.
Our data indicate that the 0.625% CP may prove to be an effective and safe alternative with which to treat patients with peripheral neuropathy and could replace the high concentration (8%) CP. Further studies are now needed to definitively establish efficacy.Key words: Capsaicin, patch, CP, topical capsaicin, neuropathic pain, peripheral neuropathic pain, PNP, high concentration CPTrial Registration: ClinicalTrials.gov, NCT02228928.
In PEA, 5% hypertonic saline exhibited similar positive outcomes after 6 months of follow-up as 10% hypertonic saline, with less infusion-related pain. This result suggests that infusion of 5% hypertonic saline may be considered as an alternative to 10% hypertonic saline in lumbar PEA. Further prospective randomized studies are required to better appreciate the outcome with regard to the use of different concentrations of hypertonic saline for PEA.
Gabapentin acts primarily on the central nervous system. Therefore, we hypothesized that the direct epidural administration of gabapentin could have various advantages over its oral administration with respect to required dose, side effects, and efficacy. However, before administering gabapentin into the epidural space in a clinical setting, its neurotoxicity must be examined in animals. Thus, we evaluated neurotoxicity of epidural gabapentin by observing behavioral and sensory-motor changes, an
TSGB in BCRL patients appears to be effective in decreasing the affected arm circumference. TSGB may be an alternative option in BCRL patients who do not respond to conservative therapy.
Spinal stenosis is a common condition in elderly individuals. Many patients are unresponsive to the conventional treatment. If the transforaminal epidural block does not exert a sufficient treatment effect, percutaneous transforaminal epidural adhesiolysis (PTFA) through the safe-triangle approach using an inflatable balloon catheter can reduce the patients' pain and improve their functional capacity. We aimed to evaluate the safety and efficacy of the Kambin's-triangle approach for PTFA using a
The epidurographic changes following PEN correlate with patient-assessed pain relief and satisfaction.
Background . Complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP) model, a novel experimental model of CRPS. Materials and Methods . After generating the CPIP animal model, we perfor
NSDT may be a suitable treatment option for conservative treatment of subacute L-HIVD.
Background: The optimal management of pain using magnetic irradiation modalities continues to attract considerable debate. Therefore, we conducted a randomized, double-blind, placebo-controlled clinical trial to determine the effectiveness of pulsed electromagnetic therapy for the treatment of chronic lower back pain. Methods: Fifteen-minute sessions of active (n = 20) or placebo (n = 20) electromagnetic therapy were repeated 3 times a week for 3 weeks. Patients were assessed using the 11-point
Background: The optimal management of pain using magnetic irradiation modalities continues to attract considerable debate. Therefore, we conducted a randomized, double-blind, placebo-controlled clinical trial to determine the effectiveness of pulsed electromagnetic therapy for the treatment of chronic lower back pain. Methods: Fifteen-minute sessions of active (n = 20) or placebo (n = 20) electromagnetic therapy were repeated 3 times a week for 3 weeks. Patients were assessed using the 11-point
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