• 제목/요약/키워드: 통증조절법

검색결과 41건 처리시간 0.023초

스포츠와 관련된 과사용 증후군 - 슬관절 -

  • Kyung, H.S.
    • Journal of Korean Orthopaedic Sports Medicine
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    • 제7권2호
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    • pp.75-83
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    • 2008
  • 과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

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Effects of Red or Black Ginseng Extract in a Rat Model of Inflammatory Temporomandibular Joint Pain (흰 쥐의 턱관절 염증성 통증모델에서 홍삼 및 흑삼추출물의 효과)

  • Lee, Hyeon-Jeong;Kim, Yun-Kyung;Choi, Ja-Hyeong;Lee, Jung-Hwa;Kim, Hye-Jin;Seong, Mi-Gyung;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • 제17권1호
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    • pp.65-72
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    • 2017
  • Temporomandibular joint (TMJ) pain is characterized by persistent jaw pain associated with dysfunction and tenderness of the temporomandibular muscles and joints. The aim of this study was to investigate whether treatment with red or black ginseng extract helps in the modulation of inflammatory TMJ pain. Male Sprague-Dawley rats weighing 220~260 g were used. The experimental group was subdivided into 4 groups based on the treatment method (n=6, each group): formalin (5%, $30{\mu}l$), formalin after distilled water (vehicle), formalin after red or black ginseng extract (per oral, single or repeated, respectively). To induce TMJ pain, $30{\mu}l$ of formalin was injected into the articular cavity under ether inhalation anesthesia. The number of noxious behavioral responses of scratching the facial region proximal to the injection site was recorded for 9 successive 5-min intervals following formalin injection. Repeated treatment with red or black ginseng extract reduced the nociceptive responses in the second phase (11~45 min). Nuclear factor erythroid 2-related factor 2 (Nrf2) is an oxidative stress-mediated transcription factor. Both ginsengs significantly down-regulated the increased Nrf2 level compared to the vehicle group. In the test for liver and kidney functions, repeated treatment with red or black ginseng was not different compared to the vehicle group. These results indicate that red and black ginseng extract might be promising analgesic agents in the treatment of inflammatory TMJ pain.

Early Results of the Nuss Procedure (Nuss 술식의 조기 결과)

  • 박경택;김기봉;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • 제34권6호
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    • pp.472-476
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    • 2001
  • Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.

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Epidural Morphine for Pain Control in Patients with Terminal Cancer in Hospice Ward (호스피스 병동의 암환자에서 경막외 모르핀 주입을 이용한 통증 조절)

  • Lee, Jang-Eun;Hur, Ki-Hoon;Kang, Yoo-Jin;Jeon, Yon-Soo;Lee, Ok-Kyung;Shim, Byoung-Yong;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • 제11권3호
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    • pp.136-139
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    • 2008
  • Purpose: Epidural morphine infusion has been used to control pain in cancer patients whose cancer pain can not be controlled high dose intravenous morphine injection. To study the effectiveness and side effects of epidural morphine for the treatment of cancer pain in terminal patients at Hospice Ward, we evaluated the change in morphine equivalent daily dose for effectiveness and complications of epidural morphine infusion. Methods: We retrospectively analyzed 24 terminal cancer patients who were treated with continuous epidural morphine between 2001 and 2004 at Hospice Ward of St. Vincent's Hospital. Results: The median of baseline morphine equivalent daily dose was 615 mg, whereas the median dose of initial epidural morphine was 16 mg. The median of morphine daily equivalent daily dose dropped from 615 mg to 274 mg in one week after epidural morphine infusion therapy (P-value=0.000). The median survival from the time of the first catheter insertion was 35 days. In 6 patients, the catheter was removed due to complications, however the catheter was reinserted in 3 patients. Conclusion: Cancer pain management by epidural morphine infusion is very effective method with low rate of severe complication.

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Effect of surgical site instillation after laparoscopic urologic surgery (비뇨기과 복강경 수술 후 국소마취제 점적의 효과)

  • Hwang, Yong;Shin, Sangyol;Oh, Tae Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제19권7호
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    • pp.200-206
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    • 2018
  • The aim of this study was to evaluate the effect of Ropivacaine on pain following laparoscopic surgery. Between March 2015 and June 2017, all 97 patients with renal mass who elected to receive laparoscopic nephrectomy were reviewed, retrospectively. Normal saline (0.9%) was used as a control in 45 patients while Ropivacaine was used for local anesthesia in the instillation group (n=52). Pain score (visual analog scale) of the shoulder and upper abdominal area between the two groups was significantly different between recovery time and 24 h (p<0.05), with no significant differences between 48 and 72 h (both p>0.05). In the instillation group, pain score of shoulder and abdominal pain in the two groups according to the amount of CO2 used was not significantly different between recovery time and 24, 48, and 72 h (all p>0.05). Ropivacaine reduced shoulder and upper abdominal pain that occurred within 24 h after surgery. Effective pain control with Ropivacaine is needed in the early postoperative period when a large amount of CO2 is used in laparoscopic surgery.

The Effects of Stretching Exercise to Musculoskeletal pain in the Community-Dwelling Farmers (일개 지역 농부에서 근골격계 통증에 대한 스트레칭 운동의 효과)

  • Chong, Bok-Hee;Kim, Jeong-Ja;Yang, Chung-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제12권10호
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    • pp.4523-4530
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    • 2011
  • This study aimed to evaluate the effects of stretching management on musculoskeletal joint pain in community indwelling elderly farmers. The study included 28 residents who lived in a rural community. All participants were assigned randomly to either the stretching group (n=13, $59.67{\pm}4.77$ year-old) or the control group (n=15, $61.44{\pm}10.41$ year-old). Respondents were interviewed by means of a structured questionnaire. Pain severity of 6 body areas caused by symptoms of work-related musculoskeletal disorders and pain severity on day time variations were measured by the visual analogue scale on a self-assessed questionnaire. The stretching group was administered stretching therapy (45 min, 2 sets, warming up and cool down, main exercise; total 19 stretching kinds of subset 5 fields) for 12 times for 4 weeks. There were no significant difference between the two groups in general social and pain characteristics. After 4 weeks of stretching, the stretching group showed significant improvements at almost all joint pain scores except arm/elbow, and day time variation scores of pain compared to both baseline scores, and with control group scores. These results showed that stretching therapy is one of the most useful modalities to manage musculoskeletal pain in community-based elderly farmers.

Changes in the Sensory Function after Transcranial Direct Stimulation on Dorsolateral Prefrontal Cortex Area (배외측전전두엽피질 영역에 경두개직류전류자극이 감각기능에 미치는 영향)

  • Min, Dong-Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제16권1호
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    • pp.445-452
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    • 2015
  • Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

Meta-analysis of the effects of Lavender Aromatherapy on pain (라벤더향기요법이 통증에 미치는 효과에 대한 메타분석)

  • Park, Yang-Sook;Lee, Mi-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제20권5호
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    • pp.300-310
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    • 2019
  • This study is a systematic review of randomized experimental and non-randomized studies on the effects of lavender scent therapy on pain and a meta-analysis to provide evidence-based data. The data included in the meta-analysis are 18 studies published from 2000 to 2018, with interventional subjects being surgical, maternal, arthritis and dialysis patients, and the types of interventions were massage, application, hot-pack, and taking medication. RESULTS: The effect size (Hedges' g) for pain was -0.16 [95% CI:-1.40: -0.72], which was statistically significant. The effect size according to intervention type was -1.36 [95% CI: -1.96, -0.77], local application -1.11 [95% CI:-1.57-0.66], inhalation -1.05 [95% CI:-1.54, -0.56 ], and massage -0.92 [95% CI:-1.62, -0.23], all of which were statistically significant. To explore the possible causes of heterogeneity ($I^2=88%$), meta-ANOVA was conducted with covariates of intervention type or study design, and the results revealed it was statistically insignificant (intervention type Q=0.25, df=3, p=.968, study design Q=0.22, df=1, p=.642).