• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.95-108
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• 2005

Objective : In the present study, the effect of electroacupuncture (EA) applied to several acupoints and non-acupoint in CFA-induced knee arthritis was examined. Methods : A common source of persistent pain in humans is arthritis. Arthritis was induced by injection of CFA $125\;{\mu}l$ into knee joint cavity under enflurane anesthesia. The rat subsequently showed swelling of the ankle and a reduced stepping force of the affected limb for the next several days. The reduced stepping force of the limb was presumably due to a painful knee. EA was applied to either of $LR_2,\;LI_4$, or non-acupoint on the contralateral forelimb for 30 min under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next 4 h. Results : EA applied to $LR_2$ point produced a significant improvement of stepping force of the affected foot lasting for at least 2 h. However, neigher $LI_4$ point nor non-point produced any significant increase of weight bearing force. The improvement of stepping pressure was interpreted as an analgesic effect. The analgesic effect was specific to the acupuncture point since the analgesic effect on CFA-induced knee arthritic pain model could not be mimicked by EA applied to a point, $LI_4$ or non-acupoint. In addition, both NO production and iNOS protein expression increased by arthritis were suppressed by EA applied to $LR_2$ point. Conclusion : These data suggest that EA produces a potent analgesic effect in the rat model of CFA-induced knee arthritis. This analgesic effect is produced by applying EA to an acupoint at opposite side from the painful area in a stimulus point-specific way.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.337-344
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• 2021

Background: The primary indication for using long-acting anesthetics in dentistry is extensive dental procedures that require pulpal anesthesia beyond 90 min and management of postoperative pain. Ropivacaine is an amide local anesthetic that is available at various concentrations with inherent vasoconstrictive properties at low concentrations. Ropivacaine has a 75% greater margin of safety than bupivacaine. Ropivacaine can be a good alternative to bupivacaine as a local anesthetic in dental implant surgery as it provides a longer duration of both pulpal and soft tissue anesthesia after mandibular nerve block and lowers CNS and cardiovascular toxicity. This study aimed to evaluate and compare the clinical efficacy of ropivacaine and lignocaine for implant surgery anesthesia. Methods: Fifteen patients with bilateral edentulous sites indicated for implant placement were recruited for this study. Patients aged 20-60 years of both sexes were randomly recruited. Thirty implant placements were performed in the test and control groups using ropivacaine and lignocaine with adrenaline as local anesthetics, respectively. Results: The results were analyzed statistically. The duration of anesthesia was significantly higher in the test group than in the control group. Ropivacaine was found to be superior to lignocaine in terms of the quality of anesthesia. The comparison of mean visual analog scale scores showed ropivacaine to have better anesthetic and analgesic effects than the control group. Conclusion: Ropivacaine 0.75% provides a significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreased intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other intraoral surgical procedures that require a longer duration of anesthesia and analgesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.69-81
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• 2023

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

• Journal of the Korea Convergence Society
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• v.7 no.5
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• pp.43-49
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• 2016

The purpose of this study was done to develop a nursing activity index for postoperative patient using Patient-controlled Analgesia(PCA). The study was developed in two steps: $1^{st}$ step) nursing activity index was developed through literature review and focus-group interview. $2^{nd}$ step) the nursing activity was ratified and Intervention Content Validity(ICV) was tested. Subjects were consisted of 5anesthesiologists, 6adult/fundamental nursing professors and 1acute pain management Clinical Nurse Specialist. We identified 12 items of nursing activity for postoperative patient using PCA. The Intervention Content Validity(ICV) score for each item ranged from 0.92 to 1.0. The nursing activity index for postoperative patient using PCA would be very useful in facilitating the nursing practice.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.233-240
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• 2020

Background: Palatal injection of local anesthetics is the most painful injection. To obviate the need for palatal injections, local anesthetic agents with diffusibility are being investigated. Hence the present study was designed to analyze the anesthetic efficacy of 2% lidocaine hydrochloride (HCl) with 1:100,000 adrenaline and 4% articaine hydrochloride (HCl) with 1:100,000 adrenaline using single buccal infiltration for the extraction of maxillary premolars. Methods: A prospective, double-blind, crossover, randomized clinical study was performed on 60 consecutive systemically healthy patients with an age range of 15-30 years, requiring extraction of asymptomatic bilateral maxillary premolars for orthodontic purposes. They received 1ml buccal infiltration of 4% articaine HCl with 1:100,000 adrenaline on one side and 2% lidocaine HCl with 1:100,000 adrenaline on the other side. The extraction procedure on either side was scheduled 14 days apart. Parameters assessed were the time of onset of anesthesia, intraoperative discomfort, hemodynamic parameters, and the duration of analgesia. Analysis of the data was done using the Mann-Whitney test, the Wilcoxon test, the Kruskal-Wallis ANOVA test, and the chi-square test. Statistical significance was established at P < 0.05. Results: Articaine showed a faster time of onset and longer duration of analgesia than lidocaine. However, the difference in the intraoperative discomfort and hemodynamic parameters was statistically insignificant. Conclusion: Within the limitations of the study, it can be concluded that the extraction of maxillary premolars can be performed with a single buccal infiltration of 2% lidocaine HCl with 1:100,000 adrenaline, which is one of the most commonly used local anesthetic agent.

• Korean Journal of Veterinary Research
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• v.51 no.4
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• pp.303-307
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• 2011

Awareness effect of aquapuncture with dexamethasone on GV-26 was studied in tiletamine/zolazapam anesthetized six healthy crossbred dogs using a randomized cross-over experimental study design. After anesthesia by tiletamine/zolazapam, 0.1 mg dexamethasone was injected on GV-26 at 20 min in the experimental group. For the control group, 0.1 mg dexamethasone was injected on the quadriceps femoralis. A significant difference was evident in the sedation score between groups at 60 and 90 min (p < 0.05). A significant difference was also evident in the analgesia score at 50 and 60 min (p < 0.05). At 90 min, all dogs in the experimental group responded strongly to pain (p < 0.01). Head up time, sternal recumbent time, standing time, and walking time was shorter in the experimental group, but the difference from the control group was statistically significant only for head up time and walking time (p < 0.05). GV-26 acupuncture with dexamethasone is useful for awareness effects after anesthesia.

• YAKHAK HOEJI
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• v.43 no.3
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• pp.404-410
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• 1999

Administration of capsaicin produces acute pain and subsequent long-lasting antinociception. The antinociceptive action site of capsaicin is primarily small afferent nerve fibers. However, the effect of capsaicin on the neural activity of dorsal horn neurons are not well understood. The goal of the present experiment was to study the action of capsaicin on activity of dorsal horn neurons using c-fos immunoreactivity in the spinal cord. Intradermal injection of formalin in the hindpaw produced inflammation in the foot pad and increased the number of cells exhibiting Fos-like immunoreactivity (FLI) in the dorsal horn of the spinal cord, suggesting the hyperalgesia because of the apparent inflammation. Intradermal injection of capsaicin prior to formalin injection significantly reduced the number of cells exhibiting FLI induced by formalin and increased the paw-withdrawal latency, suggesting the hypoalgesic effect of capsaicin. Coadministeration with capsaicin of capsazepine and ruthenium red, antagonists of capsaicin receptor reversed the reduction of formalin-induced FLI by capsaicin. he antagonists also partially antagonized the antinociceptive effect of capsaicin in the paw-withdrawal test. These results further suggest that capsaicin reduces prsponses of dorsal horn neurons to the inflammatory nociceptive stimuli in the periphery. Thus, the reduction of FLI subserves the neural mechanisms underlying analgesia produced by capsaicin.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.211-216
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• 1999

Background: Transdermal fentanyl patch (TDFP) is a simple, noninvasive analgesic with continuous effect. The aim of this study was to evaluate the postoperative analgesic effect of TDFP. Methods: Sixty healthy patients undergoing cesarean section were divided into 3 groups. Postoperative pain was controlled with different methods; Group I: application of TDFP-$25{\mu}g/hr$, Group II: intramuscular injection of ketoprofen; Group III: continuous epidural block. Pain scores (numerical rating scale, NRS), number of patients who needed additive ketoprofen injections and side effects were recorded at 8, 20, 32, 44 hours postoperatively. Results: There was no significanant difference in pain score between Group I and Group II. The numbers of patients who need additive ketoprofen injections were lower in group I than group II. Pruritis (25%), nausea/vomiting (10%), leg numbness (40%) was experienced in group III, but not in Group I & II. Conclusions: TDFP-$25{\mu}g/hr$ for postoperative pain control is simpler and more convinient than intramuscular injection of analgesics.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.188-190
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• 1999

Background: The goal of this study was to evaluate the effects of gabapentin on postherpetic neuralgia. Gabapentin is a known anti-seizure medication, whose cellular mechanism of action is not well understood. Unlike other anticonvulsant, gabapentin has the advantage of a low toxicity and favorable side effect profile. If has been recently recommended for use in treatment of neuropathic pain. Methods: Twelve patients with a diagnosis of postherpetic neuralgia were prescribed gabapentin after failure of routine therapeutic regimens. The dose of gabapentin ranged 300~1800 mg per day, in three divided doses. If initial dose was ineffective and no side effects were noted, the dosages was increased by 300 mg a day in divided doses, to the maximum level for 2 weeks. Patients were evaluated for analgesia using visual analogue scale (VAS) pain score (0; no pain, 10; worst possible pain) and possible side effects. Results: A significant decrease in pain scores with gabapentin were noted. There were several mild side effects such as dizziness, somnolence, dry mouth, constipation and facial edema, without need of special treatment. Conclusions: Gabapentin may be a useful adjunct for treating intractable postherpetic neuralgia with a minimal side effects.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.21-25
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• 2007

Background: Intrathecal sildenafil has produced antinociception by increasing the cGMP through inhibition of phosphodiesterase 5. Spinal opioid receptor has been reported to be involved in the modulation of nociceptive transmission. The aim of this study was to examine the role of opioid receptor in the effect of sildenafil on the nociception evoked by formalin injection. Methods: Rats were implanted with lumbar intrathecal catheters. Formalin testing was used as a nociceptive model. Formalin-induced nociceptive behavior (flinching response) was observed. To clarify the role of the opioid receptor for the analgesic action of sildenafil, naloxone was administered intrathecally 10 min before sildenafil delivery, and formalin was then injected 10 min later. Results: Intrathecal sildenafil produced dose-dependent suppression of flinches in both phases during the formalin test. Intrathecal naloxone reversed the analgesic effect of sildenafil in both phases. Conclusions: Sildenafil is active against the nociceptive state that's evoked by a formalin stimulus, and the opioid receptor is involved in the analgesic action of sildenafil at thespinal level.