• The Korean Journal of Pain
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• v.26 no.3
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• pp.255-264
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• 2013

Background: We investigated the effects of pre-emptive administration of ketamine and norBNI on pain behavior and the expression of DREAM, c-Fos, and prodynorphin proteins on the ipsilateral side of the rat spinal cord at 2 and 4 hours after formalin injection. Methods: Eighty-four male Sprague Dawley rats were divided into 4 major groups consisting of control rats (C) (n = 12), rats given only formalin injections (F) (n = 24), and rats treated with pre-emptive administration of either ketamine (K+F) (n = 24) or norBNI (N+F) (n = 24). The non-control groups were further divided into subgroups consisting of rats that were sacrificed at 2 and 4 hours (n = 12 for each group) after formalin injection. Pain behavior was recorded for 1 hour. After 2 and 4 hours, the rats were sacrificed and the spinal cords (L4-L5 sections) were removed for immunohistochemistry and Western blot analysis. Results: The pain behavior response was reduced in the K+F group compared to the other groups during the second phase of the formalin pain response. We detected an increase in the nuclear DREAM protein level in the K+F group at 2 and 4 hours and a transient decrease in the N+F group at 2 hours; however, it increased at 4 hours after injection. Fos-like immunoreactivity (FLI) and Prodynorphin-like immunoreactivity (PLI) neurons decreased in the K+F group but increased in the N+F group at 2 hours after injection. While FLI decreased, PLI increased in all groups at 4 hours after injection. Conclusions: We suggest that NMDA and kappa opioid receptors can modulate DREAM protein expression, which can affect pain behavior and protein transcriptional processes at 2 hours and bring about either harmful or protective effects at 4 hours after formalin injection.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.47-53
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• 2017

Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.1-8
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• 2023

Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-in^TM) and the classic needle method during treatment-required infiltration anesthesia in children. Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05. Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750). Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-in^TM system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.77-81
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• 1997

Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.284-286
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• 2015

Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.376-378
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• 2015

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

• Journal of Korean Academy of Nursing
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• v.18 no.3
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• pp.257-268
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• 1988

The purpose of this study was to compare the effect of the Z-track intramuscular injection technique with the effect of the stand and intramuscular injection technique on the severity of discomfort and leasions at the injection site. The subjects of the study were 20 patients with only early tuber culosis excluding another abnormalities (a akin rash, allergy to topical use of alcohol, jaundice, edema, neurosensory abnormality, coagulation defects, obesity and thin). Data collection was done from Feb. 1 to March 15, 1988 by means of Korean Pain Measurement Tool, Visual Analogue Scale, and Objective measures of injection site lesions. The results of this study were as follows ; 1) Hypothesis 1 ; “The severity of subject discomfort is less following administration of the Z-track intramuscular injection technique than following administra tion injection technique.” was not sopported 2) Hypothesis 2 ; “The degress of severity subject discomfort is less following administration of the Z-track intramuscular injection technique than following administra tion of the standard intramuscular injection technique.” was not supported. 3) Hypothesis 3 ; “The severity of injection site lesions is less following administra tion of the Z-track intramuscular injection technique than following administration of the standard intramuscular injection techniques.” was not supported. 4) The terms that were selected included factor II (mild-moderate pain) of Ratio Scale Measuring Pain using Korean Pain Terms. In conclusion ; it was found that there was not a difference from the severity of subject discomfort between two groups, but the degress of severity of subject discomfort about following administration of the Z-t-rack intramuscular injection was tended to be declined. Therefore further studies suggest that the Z-track intramuscular injection technique can decrease the severity of discomfort in persons receiving frequently intramuscular injections. First of all, it is necessery to be developed an effective tool of discomfort measurement for the intramuscular injection in Korean.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.127-131
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• 2014

Skeletal muscles which are the largest part of human body may develop pain and dysfunction. The myofascial pain syndrome that has trigger points as a unique characteristic is a major cause of morbidity. Trigger points are focal, hyperirritable painful areas located in a taut band of skeletal muscle. They produce local area pain and a referred pattern pain and often accompany chronic joint dysfunction. Various modalities are used to inactivate trigger points in myofascial pain syndrome. Trigger-point injection has been shown to be one of the most effective treatment modality to provide prompt relief of symptoms. This review article presents general concept of myofascial pain syndrome and technique of trigger point injection.

• The Journal of Korean Medicine
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• v.23 no.2
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• pp.97-107
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• 2002

Objective : Acupuncture is a method used to treat many kinds of pain in oriental cultural medicine. Especially when hetero-segmental area acu-points are stimulated, the therapeutic effects of pain control have more critical properties than other methods of acupuncture. However, the mechanism of pain control by acupuncture is contradictory so far. The present study examined the effects of electroacupuncture (EA) applied to the acu-point of the hetero-segmental area on modulation of formalin-induced pain in Sprague-Dawley rats. Methods : In order to apply EA to acu-points in the plantar area of right forepaws, a pair of Teflon-coated stainless steel wires were implanted in HT 7 (Shin-Moon) and PC 7 (Dae-Reung) 7 days before the behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\;}\mu\textrm{l}$) into the lateral plantar region of the left hind paw. EA was delivered by a constant DC current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. c-Fos protein expression was measured in the lumbar spinal cord at 2 hr and 4 hr after formalin injection. Results : Behavioral responses including favoring, flinching and biting occurred in the biphasic pattern, such as the 1st phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited the behavioral responses. Injection of formalin expressed c-Fos protein on the ipsilateral dorsal horn neurons in L3 - L5 and the expression was sustained more than 4 hrs after formalin injection. However, EA decreased c-Fos protein expression at dorsal horn neurons in the lumbar spinal cord till 4hrs after formalin injection. Conclusions : These results suggest that EA modulates formalin-induced pain and this inhibitory action may be elicited by the descending inhibitory system.

• Child Health Nursing Research
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• v.12 no.2
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• pp.215-222
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• 2006

Purpose: This study was done to identify the effects of the distraction generated by character stamp and stickers on reduction of intravenous injection pain. Method: This study was conducted using a quasi experimental non-equivalent control group non-synchronized design. 60 preschool children who admitted to a Pediatric Department in a C University Hospital were selected as subjects. Convenience assignment was used. The two groups were homogeneous on characteristics. Results: In the experimental group, objective pain(t=3.666, p=.001), subjective pain (t=3.415, p=.001) and perceived pain by the mother(t=2.528, p=0.014) decreased after intravenous injections than the control group. There were no statistical significant differences in pulse rate or fear between the experimental and the control group.　Conclusion: These findings indicate that using character stamp and stickers could be considered as an independent nursing intervention for intravenous injection pain reduction in preschooler.