• Title/Summary/Keyword: 통증조절

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Two Cases of Opioid-Induced Hyperalgesia in Cancer Patients Treated with Opioids for Pain Management (아편유사제를 사용한 암환자에서 발생한 통각과민 2례)

  • Hong, Sukchul;Kwon, Jung Hye;Han, Su Jung
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.100-104
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    • 2019
  • Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.

Analgesic Effects of Triptolide via Peripheral and Central Administration in Rat Model of Inflammatory Orofacial Pain (Triptolide의 말초와 중추투여에 의한 흰 쥐의 안면부 통증경감효과)

  • Kim, Yun-Kyung;Choi, Ja-Hyeong;Lee, Hyun-Jung;Son, Yoo-Jin;Yoon, So-Yeong;Lee, Jung-Hwa;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.424-429
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    • 2015
  • The aim of this study was to investigate whether peripheral or central administration of triptolide is involved in pain modulation in inflammatory orofacial pain. The inflammatory orofacial pain was induced by the injection of 5% formalin into right vibrissa pad of rats. The pain behavioral response was measured the number of grooming or scratching on the orofacial area for 9 successive 5 minutes intervals. Triptolide was administrated into the identified vibrissa pad (12.5, 25, $50{\mu}g/50{\mu}l$) or intracisternal space (0.01, 0.1, $1{\mu}g/10{\mu}l$) 10 min before formalin injection. The nociceptive responses were reduced in the 2nd phase (11~45 minutes), particularly 20, 30 minutes after fomalin injection following administration of triptolide into vibrissa pad (25, $50{\mu}g/50{\mu}l$). Intracisternal ($1{\mu}g/10{\mu}l$) administration of triptolide alleviated the formalin-induced pain behaviors in the 2nd phase, especially 25~40 minutes after formalin injection. Triptolide could be a promising analgesic agent in the treatment of inflammatory orofacial pain.

Comparison of the Postoperative Pain Control Effects of a Buprenorphine Transdermal Patch on Total Knee Arthroplasty Surgery Patients according to Its Applied Sites: Retrospective Case-Control Study (슬관절 인공관절 전치환술 환자에서 부프레노르핀 경피 패치의 적용부위에 따른 수술 후 통증 조절 효과 비교: 후향적 환자-대조군 연구)

  • Kim, Ok-Gul;Lee, Sang-Wook;Kim, Hyun-Min
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.527-533
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    • 2020
  • Purpose: This study compared the effects of a buprenorphine transdermal patch (BTDP) on the chest and knee for pain control after total knee arthroplasty (TKA). Materials and Methods: A retrospective case-control study was conducted from August 2018 to August 2019 on 231 patients who underwent TKA. Two hundred cases were selected considering age, sex, and body mass index. Before and after applying the BTDP, the Numeric Rating Scale (NRS), adverse effects and compliance were measured. All measurements in the chest application group (group A=100) and knee application group (group B=100) were compared. Results: NRS was similar in rest between the groups treated with BTDP, but at two days and three days afternoon, five, six, and seven days postoperatively in group B, the NRS was significantly lower than that of group A. The adverse effects of the central nervous system and gastrointestinal system after applying BTDP were significantly lower in group B than in group A. No significant differences in adverse effects of the cardiovascular system and skin were observed between the two groups. Regarding the maintenance of BTDP, group B was significantly higher than group A. Conclusion: The direct application of BTDP after TKA to painful knee joints showed excellent results in early postoperative pain control and can be a useful method for increasing patient compliance by reducing the frequency of adverse effects.

Sex Differences in the Pain Control by the Peripheral Opioid (성별에 따른 말초 opioid의 통증조절)

  • Bae, Sung-Jae;Kim, Wan-Su;Kang, Soo-Kyung;Auh, Q-Schick;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.339-356
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    • 2013
  • This study was designed to evaluate the sex differences in the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group each from male (n=20) and female (n=20); saline injection group (n=5), lidocaine injection group (n=5), morphine 1.5 mg injection group (n=5) and morphine 3 mg injection group (n=5). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The male and female were significantly different statistically morphine 3 mg group in visual analogue scale evaluation. (male: p<0.05, female: p<0.05) 2. The male and female were more significantly different statistically morphine 3 mg group than morphine 1.5 mg group in McGill pain questionnaire evaluation. (male: p<0.001, female: p<0.01) 3. The male were significantly different statistically morphine 3 mg group in pain drawing evaluation and pressure pain threshold evaluation. (PD: p<0.001, PPT: p<0.05) Therefore, it was revealed that the morphine 3 mg injection for masticatory muscle pain was effective to pain control male patients and more effect than female patients in the objective pain evaluation.

The Effect of pain control and improve function of knee applied to osteoarthritis by carbon surface heating (퇴행성 관절염 환자에게 적용한 탄소면상발열체가 통증조절과 슬관절 기능 향상에 미치는 효과)

  • Son, Min-Young;Lee, Byung-Hoon;Oh, Kyeong-Ae;Park, Jong
    • Journal of Digital Convergence
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    • v.11 no.9
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    • pp.247-254
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    • 2013
  • This study was to investigate the effects of pain control and improvement function to far infrared ray of carbon surface heating element applied on elderly women with knee osteoarthritis. The subjects for this study were forty-five subjects with osteoarthritis, who were divided convenice sampling into 3 groups, control(15 female, no intervention), ceramic far infrared ray(15 female, applied ceramic far infrared rays) and carbon surface-heating(15 female, applied carbon surface-heating) after treatment measuring VAS, PPT and K-WOMAC. These results represent decreased pain and improved function by applied carbon surface heating element and ceramic far infrared ray on osteoarthritis knee. Therefore, carbon surface heating element will be a good treatment for osteoarthritis.

Thoracoscopic Splanchnicectomy for Relief of Intractable Pain in Pancreatic Cancer - 2 case reports - (췌장암 환자의 난치성 통증 해소를 위한 흉강경하 내장신경절제술 - 2예 보고 -)

  • Kim, Jae-Jun;Wang, Young-Pil;Park, Jae-Kil;Suh, Jong-Hui;Moon, Seok-Whan;Kim, Young-Du
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.785-788
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    • 2009
  • Many patients with upper abdominal organ cancers, including pancreatic cancer, suffer from severe pain, and various methods and techniques have been used for relieving this pain. We present here two cases of patients with pancreatic cancer and they were both successfully relieved of their abdominal pain by performing video-assisted thoracoscopic sympathectomy and splanchnicectomy. This minimally invasive procedure offers promise in carefully selected patients with severe pain from pancreatic cancer and other conditions.

Effect of Peripheral Opioid Receptor on Masticatory Muscle Pain Control (말초 opioid 수용체에 의한 저작근 통증의 조절 효과)

  • Ko, Seok-Ho;Kang, Soo-Kyung;Auh, Q-Schick;Kim, Eun-Cheol;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.161-174
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    • 2013
  • This study was designed to evaluate the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group; saline injection group (n=10), lidocaine injection group (n=10), morphine 1.5 mg injection group (n=10) and morphine 3 mg injection group (n=10). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The subjective pain evaluation were significantly different statistically in morphine 3 mg group after 48 hour. (VAS: p<0.01, MGQ: p<0.001, PD: p<0.05) 2. The objective pain evaluation were significantly different statistically in morphine 1.5 mg group after 1 hour. (PPT: p<0.01, PPTol: p<0.05) 3. The morphine 3 mg group were more significantly different than lidocaine group and morphine 1.5 mg group statistically in the McGill pain questionnaire evaluation. (1h: p<0.01, 24h: p<0.01, 48h: p<0.001) Therefore, it was revealed that the morphine 3 mg injection was effective to pain control for masticatory muscle pain patients within 48 hours and more effect than lidocaine injection.

Efficacy and Safety of $Ultracet^{(R)}$ in Ambulatory Patients with Cancer Pain (암환자의 통증치료에 대한 $Ultracet^{(R)}$의 유효성과 안전성)

  • Lee, Hyo-Jin;Jin, Sun-Ah;Yun, Gak-Won;Yang, Yung-Joon;Park, Nam-Whan;Chun, Jae-Min;Park, Nam-Sook;Yun, Hwan-Jung;Jo, Deog-Yeon;Kim, Sam-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.101-105
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    • 2006
  • Purpose: We aimed to investigate the efficacy and side effects of $Ultracet^{(R)}$ in relieving cancer pain in setting. Methods: Sixty-one cancer patients over 18 years old, who had cancer pain with or without medication, were enrolled. Pain and other variables were evaluated before and after treatment with $Ultracet^{(R)}$ for 2 weeks, using Korean version of Brief Pain Inventory. Results: Of 61 patients with assessable efficacy data, the maximum pain intensity(PI) experienced in a day were $5.18{\pm}1.41\;and\;4.82{\pm}1.94$, before and after treatment with$Ultracet^{(R)}$ respectively (P=0.113). The minimum PI experienced in a day were $1.2{\pm}1.05\;and\;0.87{\pm}1.35$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.038). The average PI experienced in a day were $3.61{\pm}1.01\;and\;3.15{\pm}1.73$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.022). The current PI were $3.63{\pm}1.25\;and\;2.85{\pm}1.94$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.003). Regarding the quality of life, only mood changed for the better in 49 patients who were treated with $Ultracet^{(R)}$ alone ($1.98{\pm}1.73\;and\;1.35{\pm}1.15$, before and after treatment respectively; P=0.046). There were five (8.2%) adverse events associated with $Ultracet^{(R)}$ treatment. Conclusion: $Ultracet^{(R)}$ seems effective and safe in ambulatory patients with cancer pain.

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Nonpharmacologic Pain Relief with Oral 25% Dextrose or/and Pacifier for Newborn Infants (신생아에서 비약물적 통증조절을 위한 25% 경구 포도당과 인공 젖꼭지 사용의 효과)

  • Kim, Min-Kyung;Kim, In-Ah;Jung, Min-Hee;Han, Myung-Ki;Park, Kie-Young;Kim, Bong-Seong;Jin, Hyun-Seong
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.353-358
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    • 2011
  • Purpose: The goal of this study was to compare the efficacy of oral 25% dextrose treatment or/and pacifier for analgesia in healthy newborns during intramuscular injection of a hepatitis B vaccine. Methods: A prospective, randomized, partially blinded, clinical trial was performed in 132 healthy newborns. They were assigned randomly to 4 treatment groups: control group (2 mL distilled water), dextrose group (2 mL 25% dextrose), pacifier group, dextrose+pacifier group (pacifier coating with 25% dextrose) during intramuscular injection of hepatitis B vaccine. For all groups, Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) scores were evaluated before the injection, during the injection, and at 2 minutes after the injection. Pain scores were compared among the 4 groups. Results: Maternal and neonatal characteristics were similar among the 4 groups. 25% dextrose treatment led to lower NIPS pain scores during injection (6.4${\pm}$0.9 vs. 5.5${\pm}$1.7, P=0.01) and after injection (1.6${\pm}$2.0 vs. 0.6${\pm}$0.9, P=0.01) and NFCS pain scores after injection (1.5${\pm}$2.3 vs. 0.7${\pm}$0.8, P=0.04) than control group. The number of neonates who feel the pain (indication of scores: NIPS${\geq}$4, NFCS${\geq}$3) decreased (9 (23.1%) vs. 0 (0%), P=0.04 via NIPS, 7 (17.9%) vs. 0 (0%), P=0.02 via NFCS). However, all treatment groups did not decreased PIPP scores, compared with the control group. Conclusion: Oral 25% dextrose is effective than distilled water or using pacifier with or without 25% dextrose in reducing pain during intramuscular injection of hepatitis B vaccinations. Further study based on this preliminary study need about nonpharmacologic management of pain in newborns.