• Clinical Pain
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• v.19 no.1
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• pp.16-22
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• 2020

Objective: Recent studies have shown that repetitive peripheral magnetic stimulation (rPMS) reduces pain in various conditions. This pilot study aimed to investigate the effects of rPMS depending on the pain characteristics. Method: Adult patients aged 19~85 years evaluated at our institution between September 1, 2017 and February 28, 2018 for subacute to chronic musculoskeletal pain equivalent to a numeric rating scale of 3 or higher for at least one month were enrolled. Pain scores as determined using a numeric rating scale at baseline and at the end of treatment were set as the primary outcome. Additionally, we classified the pain into nociceptive, intermediate, or neuropathic pain using the PainDETECT questionnaire and compared the responsiveness to rPMS according to the type of pain. Results: The average pain scores significantly decreased after the 2-week rPMS treatment in all enrolled subjects (p<0.001). There was no statistically significant difference in pain reduction between groups divided by PainDETECT questionnaire. Conclusion: This study suggests that rPMS could safely relieve various types of pain.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.517-529
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• 2019

Introduction: Although shift work is an inevitable form of labor in modern society, it has been identified as a cause of many ailments, such as cancer and musculoskeletal disorders. Meanwhile, previous studies have also shown that musculoskeletal disorders account for a large proportion of total industrial accidents and a high prevalence rate of these ailments has been found in shift workers. Methods: Among the respondents to the 5th Korea Working Conditions Survey(KWCS) 3,916 shift workers(2,658 of whom have not experienced musculoskeletal pain and 1,258 who have experienced musculoskeletal pain) were asked how the work regularity of shift workers affected musculoskeletal pain. Results: The results of a dichotomous logistic regression by correcting the demographic characteristics of the study subjects showed a lower prevalence of musculoskeletal pain in the 'High' regularity group compared to the 'Intermediate' regularity group for the criterion 'Regularity of Time Fixation'. A lower prevalence of musculoskeletal pain was shown in the 'High' and 'Moderate' regularity group compared to the 'Very Low' regularity one. Conclusions: Based on these findings, it was found that musculoskeletal pain occurs less when the work regularity of shift workers is 'Very high' or 'Intermediate', and the effect of working regularity on musculoskeletal pain varies for each shift type of work. It is deemed that more precise observation and understanding are required when managing the working environment of shift workers, and further study of regarding this issue is needed.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.192-196
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• 2006

Background: Epidural opioids are commonly used for postoperative analgesia. However, the side effects of epidural opioids include respiratory depression, sedation, pruritus, nausea, vomiting and urinary retention. Meperidine, due to its intermediate lipid solubility and local anesthetic properties, permits postoperative analgesia. The aim of this study was to compare meperidine alone to meperidine coupled with bupivacaine, and to determine the effects of epidural meperidine without bupivacaine, when used for epidural analgesia following hepatectomy abdominal surgery. Methods: Patients received thoracic epidural analgesia with meperidine alone (3.5 mg/ml in saline) or with additional bupivacaine (0.15%) for 2 days after surgery. Postoperative pain was assessed using a visual analog scale (VAS) pain score 2 days after the operation, with the incidence and dose supplementation also evaluated. Postoperative side effects were assessed using a 3 grade system. Results: No significant difference was found between the two groups in terms of age and weight, or in the pain scores, side effects, incidence and dose supplementation. Conclusions: 3.5 mg/ml epidural meperidine at a dose of 2 ml/hr provides effective postoperative analgesia.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.181-186
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• 2005

Background: Hydromorphone has an intermediate lipid solubility range that falls between morphine and fentanyl. Lipophilic activity during opioid epidural administration is important in relation to both the side effects and analgesic efficacy. The purpose of this study was to compare epidural hydromorphone and fentanyl when concomitantly infused with bupivacaine in patients undergoing a thoracotomy. Methods: Seventy-seven thoracotomy patients, with patient-controlled epidural analgesia (PCEA), were blindly allocated into two groups [group F (n = 34); 0.1% bupivacaine and fentanyl $5{\mu}g/ml$, group H (n = 34); 0.1% bupivacaine and hydromorphone $16{\mu}g/ml$)]. The basal PCEA rate and demand dose were 4 ml/hr and 3 ml, respectively. The visual analogue scale (VAS) for pain, and pruritus, sedation and nausea were measured at 6, 12 and 24 hours after the operation. Results: There were no significant differences in the VAS pain scores and the incidences of pruritus, nausea and sedation between the two groups. The total infused volume after 24 hours was lower in H compared to that of F group (P < 0.05). Conclusions: We conclude that epidural hydromorphone or fentanyl administration has a similar analgesic efficacy and shows similar incidences of side effects, when concomitantly infused with bupivacaine, in the management of acute pain following a thoracotomy.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.1
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• pp.59-70
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• 2004

The purpose of this study were to determine the changes between pre, during, intermed, post of each two groups of 16 persons and to compare the effect of transcutaneous electrical nerve stimulation(TENS) at shenmen of auricular point on experimental pressure pain and tactile threshold measured at both ulnar styloid process and medial malleoli. Sixteen healthy adult men and women, aged 20 to 28 years, were assigned randomly to eight of one groups. Control group received TENS to exception of auricular point. Experimental group received TENS to shenmen of auricular point. Experimental pressure pain and tactile pain threshold at the both ulnar styloid process and medial malleoli was determined with algometer and von frey filament before 10 minute, during 10 minute, intermediate and post 30 min of treatment. In pressure pain and tactile threshold showed a statistically significant increase(p<0.05) ipsilateral and contralateral of treatment group. These results suggest that TENS at shenmen of auricular point has the capability to higher pressure pain and tactile threshold in whole body.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.194-201
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• 2024

Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.71-77
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• 2010

Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.98-102
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• 2006

The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

• The Korean Journal of Health Service Management
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• v.9 no.2
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• pp.89-102
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• 2015

Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.514-550
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• 1996

There are many theory in acupuncture mechanism, so we must know the detail contents. and then we can use the acupuncture as we know. the follow article will be helpful in this part. 1. Spinal cord are role in intermediate part in somatosensorypathway also in acupuncture stumulating tract 2. Acute pain pathway started in laminae I, V of gray colmn, next are the spinothalamic tract(trigeminal spinothalamic tract in above neck part) and then go to the specific thalamic nucleus. but chronic pain in laminae II, III, VI, VII, next are spinoreticular tract(trigeminal spinoreticular tract in the neck part) and finally to the nonspecific thalamic nucleus. 3. Thalamus is very important area in somatosensory stimuation including acupuncture stumulating sensory also as a pain control center. but except this, there are Hypothalamus, Limbic system Cerebral cortex and Cerebellum as intermediator. as we Know hypothalamus is related to the emotional analgesic system with a limbic system. 4. A ${\delta$ fiber has relationship in Acute, sharp and initial pain, contrary this C fiber is related with Chronic, dull and last pain. 5. In Acupuncture mechanism of pain analgesia, there are two theory, one is gate control theory as large fiber another is stimuation produced analgesia as small diameter fier. 6. In DNIC, the stimulation sources are mechanical, thermal, heating, pain and acupuncture stimulation etc. we call these as a Heterotopic Noxious Stimulation. 7. In DNIC, SRD(Subnucleus reticularis dorsalis)is core nucleus in pain imtermediated analgesic mechanism. 8. Takeshige insisted nonacupuncture point dependent analgesic mechanism and acupuncture point dependent analgesic mechanism. and protested that Stimulation acupuncture piing evoke blocking nomacupuncture point analgesic pathway.