• Journal of Dental Anesthesia and Pain Medicine
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• 제23권5호
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• pp.273-280
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• 2023

Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

• Perspectives in Nursing Science
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• 제11권2호
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• pp.144-152
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• 2014

Purpose: The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children. Methods: A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0. Results: Younger patients showed higher pain response than older patients (F=33.87, p<.001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation. Conclusion: A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.36-39
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• 2011

Objective : To evaluate the efficacy of scalene injection in patients with thoracic outlet syndrome. Methods : We selected 142 patients diagnosed with thoracic outlet syndrome between January 2005 and October 2009. We performed a series of scalene injection with conservative treatment in all cases. Patients rated their pain degrees using a visual analogue scale. We also evaluated the time to return to everyday life and work, and patients' functional capacity. Results : There were no complications or instances of inadvertent somatic or sympathetic ganglionic blockade after scalene injection. Overall, 111 patients (76.5%) experienced improved symptoms after the first set of scalene injection and 128 patients (88.2%) improved after scalene injection followed by conservative treatment. Of the 68 patients who returned to work during the study period, 54 returned within 1 week, and 62 within 2 weeks. Of those who returned to work, 61 reported nearly full functional capacity. We found that scalene injection was more effective in cases of thoracic outlet syndrome related to trauma than in those related to work-related repetitive stress. Conclusion : In patients with thoracic outlet syndrome, scalene injection effectively reduces pain. We recommend scalene injection as an adjunct to conservative treatment.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.109-114
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• 2019

Background: Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF. Methods: We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA. Results: Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels. Conclusion: During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.48-55
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• 2023

Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

• Clinical Pain
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• 제18권1호
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• pp.16-23
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• 2019

Objective: To evaluate the effectiveness of dynamic balance exercise after intra-articular injection of hyaluronic acid (HA) therapy in elderly patients with unilateral knee osteoarthritis. Method: 30 patients with unilateral knee osteoarthritis were enrolled in this study. The patients were randomly divided into two groups: dynamic balance exercise after HA injection group (group A) and only HA injection group (group B). Both groups administered intra-articular HA injection and group A patients continued 20-session exercises for 4 weeks. The assessments were measured before injection and 4 weeks after treatment using the visual analog scale (VAS) for pain, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for physical function, Berg balance scale (BBS), and computerized dynamic posturography using SMART Balance Master system for balance function. Results: In both groups, significant improvements in VAS, WOMAC and balance function were observed. Compared between groups, group A showed significant improvements compared to group B in WOMAC and balance function. Conclusion: It is suggested that dynamic balance exercise may result in improved balance function and physical function in elderly patients with unilateral knee osteoarthritis.

• The Korean Journal of Pain
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• 제29권2호
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• pp.96-102
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• 2016

Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.193-197
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• 1998

Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

• The Korean Journal of Pain
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• 제34권3호
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• pp.262-270
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• 2021

Background: Transient receptor potential vanilloid 1 (TRPV1) is a non-selective cation channel implicated in pain sensation in response to heat, protons, and capsaicin (CAPS). It is well established that TRPV1 is involved in mechanical allodynia. This study investigates the effect of Ononis spinosa (Fabaceae) in CAPS-induced mechanical allodynia and its mechanism of action. Methods: Mechanical allodynia was induced by the intraplantar (ipl) injection of 40 ㎍ CAPS into the left hind paw of male Wistar rats. Animals received an ipl injection of 100 ㎍ O. spinosa methanolic leaf extract or 2.5% diclofenac sodium 20 minutes before CAPS injection. Paw withdrawal threshold (PWT) was measured using von Frey filament 30, 90, and 150 minutes after CAPS injection. A molecular docking tool, AutoDock 4.2, was used to study the binding energies and intermolecular interactions between O. spinosa constituents and TRPV1 receptor. Results: The ipsilateral ipl injection of O. spinosa before CAPS injection increased PWT in rats at all time points. O. spinosa decreased mechanical allodynia by 5.35-fold compared to a 3.59-fold decrease produced by diclofenac sodium. The ipsilateral pretreatment with TRPV1 antagonist (300 ㎍ 4-[3-Chloro-2-pyridinyl]-N-[4-[1,1-dimethylethyl] phenyl]-1-piperazinecarboxamide [BCTC]) as well as the β2-adrenoreceptor antagonist (150 ㎍ butoxamine) attenuated the action of O. spinosa. Depending on molecular docking results, the activity of the extract could be attributed to the bindings of campesterol, stigmasterol, and ononin compounds to TRPV1. Conclusions: O. spinosa alleviated CAPS-induced mechanical allodynia through 2 mechanisms: the direct modulation of TRPV1 and the involvement of β2 adrenoreceptor signaling.

• Clinical Pain
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• 제20권2호
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• pp.99-104
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• 2021

Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.