• Title/Summary/Keyword: 통증평가법

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The Study For Clinical Measurement of Pain (통증(痛症)의 임상적평가법(臨床的評價法)에 관한 고찰(考察))

  • Shin, Seung-Uoo;Chung, Seok-Hee;Lee, Jong-Soo;Shin, Hyun-Dae;Kim, Sung-Soo
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.25-46
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    • 2000
  • Pain can be evaluated by experimental methods and clinical methods, but due to subjective characteristics of pain, clinical methods are generally used. The clinical pain measurement tools are divided into unidimensional and multidimensional assessment tools. The former include Visual Analogue Scale, Verbal Rating Scale, Numerical Rating Scale, Pain Faces Scale, and Poker Chip Tool and the latter include McGill Pain Questionnaire, MMPI, Pain Behavior Scale, Pain disability index, and Pain Rating Scale. Unidimensional pain scales mainly measure the intensity of pain on the basis of the patient's self report and their simple construction and ease of use enable the invesgator to assess acute pain. Multidimensional pain scales are used to evaluate subjective, psychological and behavioral aspects of pain and because of its comprehensive and confidential properties they are applied to chronic pain. Patient's linguistic and cognitive abilities are major factors to restrain accurate assessment of pain. Although behavioral patterns and vital sign are inferior to self-report in the measurement of pain, they can be useful indexes in those situations. When deciding on a pain-assessment tool, the investigator must determine which aspect of pain he or she wishes to evaluate on the characteristics of the group of patients, their backgrounds, and their communication skills. Making the proper choice will facilitate the acquisition of meaningful data and the formulation of valid conclusions.

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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The Effect of Psychological Factors on Postoperative Pain in Gastric Tumor Patients after Endoscopic Submucosal Dissection (내시경 점막하 박리법을 시술 받은 위종양 환자에서 심리적 요인이 시술 후 통증에 미치는 영향)

  • Lee, Joon-Hyub;Jeon, Han Ho;Lee, San;Lee, Hyeok;Oh, Seung-Taek;Chang, Jhin Goo;Im, Woo Young;Park, Jaesub;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.68-75
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    • 2018
  • Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

Evaluation of Masticatory Efficiency and Oral Health Related Quality of Life in Temporomandibular Disorder Patients (측두하악장애 환자에서 저작 효율 및 구강건강관련 삶의 질 평가)

  • Lee, Yong-Seung;Byun, Young-Sub;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.135-147
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    • 2010
  • In this study, the objective masticatory efficiency of two groups of temporomandibular disorder patients, pain and sound groups, was compared with that in a normal group using the MAI (mixing ability Index). The subjective chewing ability was evaluated using questionnaires, such as the Food Intake Ability Index (FIA) and Visual Analogue Scale (VAS). The Oral Health Impact Profile (OHIP)-49K of the patients was also examined to measure the oral health-related quality of life. The results were as follows: 1. The MAI, FIA and VAS in the pain group were significantly lower than in the normal and sound groups. This shows that the chewing efficiency of the pain group was lower than the normal and sound groups (P<0.05). However, there was no significant difference between the sound and normal groups. 2. The OHIP-49K for the oral health-related quality of life showed a significant increase in both the pain and sound groups compared with normal group. This means that the oral health-related quality of life was lower in both the pain and sound groups. 3. There was a correlation between the MAI, FIA and VAS (P<0.01) in all subjects (71 persons). The OHIP-49K was associated with the FIA and VAS. 4. There was a correlation between the FIA and VAS (P<0.05) in the sound group but no correlation in the other groups. 5. There was a correlation between the FIA and VAS in all groups. 6. The VAS was increased significantly in the pain group according to the level of pain reduction after treatment (P<0.05). However, there was no significant increase in the MAI, even though there was an improvement in masticatory efficiency. In addition, there was no difference in the FIA and OHIP-49K according to the level of pain reduction after treatment. In this study, it is believed that pain is a main factor decreasing the masticatory efficiency in patients with temporomandibular disorders. Moreover, TMJ sounds decrease the quality of life but do not decrease the masticatory efficiency. Therefore, it is important to control the pain in order to improve the masticatory efficiency in temporomandibular disorder patients. Moreover, managing both pain and sound can improve the quality of life.

Characteristics of Pain Threshold and Pain Experience in Elderly Patients with Dementia (노인 치매 환자의 통증 역치 및 통증 경험의 특성)

  • Bang, Hyeon-Cheol;Park, Ki-Chang;Kim, Min-Hyuk;Lee, Yeong-Bok;Roh, Hyun-Jean
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.140-146
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    • 2013
  • Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

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Effect of Ischemic Compression on Sternomastoidcleido Muscle on Chronic pain in Upper Trapezius Muscle (목빗근에 대한 허혈성 압박법이 위등세모근의 만성 통증에 미치는 영향)

  • Sim, Ji-Hun;Park, Tae-Sung;Kang, Jong-Ho
    • Journal of Convergence for Information Technology
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    • v.11 no.12
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    • pp.194-200
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    • 2021
  • Recently, incorrect and unhealthy postures have become increasingly prevalent due to reasons such as smartphone use. Consequently, imbalanced muscle contraction occurs. In particular, if the oblique muscle is contracted, the accessory nerve will be compressed, causing ischemic pain in the upper trapezius muscle. To investigate the effect on pain in the upper trapezius muscle, this study applied the ischemic compression method to the accessory nerve capture point at the 1/3-point of the oblique cervical muscle. In this study, the ischemic compression method was applied to eight women twice a week for four weeks, and pain was evaluated before, immediately after, and three weeks after application. The visual analogue scale, McGill Pain Questionnaire, and pressure dynamometer were used to evaluate subjects' pain. As a result of this study, it was confirmed that the pain was significantly reduced after treatment, and that the pain reduction was still effective three weeks after completion of the intervention, indicating that the intervention on the accessory nerve compression point on the oblique cervical muscle was both effective and long-lasting for pain reduction in the upper trapezius muscle. Future studies should increase the number of subjects to check not only pain reduction in the upper trapezius muscle, but also improvement of neck function.

Role of Samultang in Formalin-induced Orofacial pain (포르말린으로 유발된 안면부 통증조절에서 사물탕의 역할)

  • Kim, Yun-Kyung;Hyun, Kyung-Yae;Park, Min-Kyoung;Lee, Min-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.9
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    • pp.5594-5601
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    • 2014
  • The aim of this study was to evaluate the analgesic effects of Samultang by measuring the anti-inflammatory and antioxidative activities in formalin-induced orofacial pain. The anti-inflammatory and anti-oxidative effects were measured by western blot analysis for p38 MAPK(Mitogen-activated protein kinases), iNOS(induceble nitric oxide synthase) and NOX4(nicotinamide adenine dinucleotide phosphate4) in a rat's brain and medulla oblongata. Samultang significantly attenuated the increased formalin-induced nociceptive response and inhibited the p38 MAPK and iNOS that led to inflammatory pain. In addition, this study indicated that Samultang possess antioxidative effects through the blockade of NOX4. These findings suggest that Samultang plays an important role in the peripheral processing of inflammatory pain in the orofacial area.

2-Step Needle Insertion Technique to Reduce Pain in Children during Local Anesthesia (소아환자의 국소마취 시 통증을 줄이기 위한 2단계 주사바늘 자입법)

  • Park, Suyoung;Lee, Sangho;Lee, Nanyoung;Jih, Myeongkwan
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.99-108
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    • 2020
  • This study was performed to evaluate the effectiveness of the 2-step needle insertion technique to reduce pain during local anesthesia in children. Local anesthesia was performed bilaterally using conventional technique and a 2-step technique, and to compare the degree of pain using the 2-step with that using the conventional technique during local anesthesia using a pain scale. The pain scores were significantly different between the conventional technique and the 2-step insertion technique at 5.82 ± 2.14 and 2.57 ± 2.09, respectively (p < 0.001). The subjective degree of pain based on gender, age, and Frankl's behavior rating scale was significantly lower in the 2-step insertion technique (p < 0.001). Subjective pain levels in the area of maxilla and mandible, anterior and posterior parts were lower in the group treated using the 2-step insertion technique (p < 0.001). The 2-step insertion technique is a simple and effective way to reduce pain during local anesthesia not only in children with a positive attitude to dental treatment, but also in children with negative attitudes, and is thought to be more effective if combined with application of topical anesthesia or distraction.

Anti-Inflammatory and Antioxidative Effects of Acaiberry in Formalin-Induced Orofacial Pain in Rats (흰쥐의 악안면 통증에서 아사이베리의 항염증 및 항산화 효과)

  • Kim, Yun-Kyung;Hyun, Kyung-Yae;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.14 no.2
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    • pp.240-247
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    • 2014
  • Acaiberry (Euterpe oleracea Mart.) is widely diffused in amazon and is known that has high antioxidant capacity and potential anti-inflammatory activities. The aim of this study was to evaluate analgesic effects of acaiberry in formalin-induced orofacial pain through p38 mitogen-activated protein kinases (p38 MAPK) and nicotinamide adenine dinucleotide phosphate 4 (NOX4) pathway. Rats were divided into 5 groups (n=6); formalin (5%, $50{\mu}L$), formalin after saline (vehicle) or acaiberry (16, 80, 160 mg/kg, intraperitoneally). The nociceptive response was investigated all of groups, p38 MAPK or NOX4 were analysed at dose of 80 mg/kg of acaiberry in rat's medulla oblongata and adrenal gland. Results indicated that acai berry produced analgesic effect in a dose-dependent manner and significantly reduced formalin-induced nociceptive response at 15~40 min. Acaiberry (80 mg/kg) decreased the increased p38 MAPK activation and NOX4 expression in medulla oblongata and adrenal gland. Based on these results, acaiberry is believed to be useful for modulation of orofacial pain and its treatments because of its anti-inflammatory and antioxidative effects.

Arthroscopic Shaving Cystectomy of Popliteal Cyst by using Posteromedial Portal (관절경적 후내측 도달법을 이용한 슬와 낭종의 절삭 절제술)

  • Kwak, Kyoung-Duck;Ahn, Sang-Min;Baek, Seung-Il;Jung, Chan-Jong;Roh, Jae-Su
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.153-158
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    • 2006
  • Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

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