• Title/Summary/Keyword: Nociceptive Pain

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Anti-nociceptive Activity of Methanol Extracts from Ligularia stenocephala (곤달비 메탄올 추출물의 진통 효과)

  • Cha, Dong Seok;Jeon, Hoon
    • Korean Journal of Pharmacognosy
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    • v.44 no.1
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    • pp.70-74
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    • 2013
  • Ligularia stenocephala has been widely used as a traditional medicine for the treatment of lots of diseases such as asthma, arthritis, and jaundice. In this study, we evaluated the anti-nocicepitve activities of methanolic extract of L. stenocephala (MLS) using various pain models including thermal nociception as well as chemical nociception methods. MLS showed significant increase in latency time in the tail immersion test and hot-plate test. In addition, the number of acetic acid-induced abdominal constrictions was decreased by MLS. MLS also attenuated paw licking time in the formalin test. The combination test using naloxone revealed that the anti-nociceptive properties of MLS was not associated with opioid receptor activation. The present results demonstrate that MLS may possibly used as valuable analgesic agent for the treatment of nociceptive pain.

All about pain pharmacology: what pain physicians should know

  • Kim, Kyung-Hoon;Seo, Hyo-Jung;Abdi, Salahadin;Huh, Billy
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.108-120
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    • 2020
  • From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

Anti-nociceptive Effect of Curcuma longa Extract on Acetic Acid induced Pain Model (강황 에탄올 추출물 및 그 분획물의 초산 유발에 의한 통증억제 효과)

  • Yoon, Won Ho;Lee, Keyong Ho
    • Korean Journal of Pharmacognosy
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    • v.46 no.3
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    • pp.229-233
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    • 2015
  • The anti-nociceptive effect of an ethanol extract and its various solvent fractions from Curcuma longa Linne ethanol extract was studied using the writhing test in mice. Different fractions by various solvent extraction from Curcuma longa Linne ethanol extract were administered orally 1 hr or time-course (0.5, 1, 2 and 5 hr) before intraperitoneal injection of acetic acid. After treatment with 30% ethanol extract and n-butanol fraction, CB-1, at a dose of 250 mg/kg, the significant writhing responses were 87.5 ± 13.4 (inhibition rate 31%, p<0.01) and 75.1 ± 11.1 (inhibition rate 41%, p<0.01) lower than the control group. At the dose of CB-1 50 mg/kg and 250 mg/kg, CB-1 showed a similar activity comparing to diclofenac of 10 mg/kg. A time-course experiment was performed, which involved oral administration of CB-1 (250 mg/kg) at 0, 0.5, 1, 2, and 5 hr before acetic acid intraperitoneal injection. The most effective time of CB-1 was 30 min before treatment and persisting until 2 hr. This study showed that Curcuma longa Linne has anti-nociceptive properties comparable with those of diclofenac, which suggests promise for the treatment of intractable visceral pain in humans. Major components of the active fraction are identified as curcumin, cyclocurcumin and demethoxycurcumin.

Vitamin E Potentiates the Anti-nociceptive Effects by Intraperitoneal Administration of Lidocaine in Rats

  • Kim, Hye-Jin;Yang, Hae-Ji;Kim, Sun-Hyong;Kim, Dan-A;Kim, Seong-Ju;Park, Han-na;Ju, Jin-Sook;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.41 no.4
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    • pp.191-197
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    • 2016
  • The present study was to evaluate effects of vitamin E on intravenous administration of lidocaine-induced antinociception. Experiments were carried out using male Sprague-Dawley rats. Orofacial formalin-induced nociceptive behavioral responses were used as the orofacial animal pain model. Subcutaneous injection of formalin produced significant nociceptive scratching behavior. Intraperitoneal injection of 5 and 10 mg/kg of lidocaine attenuated formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. Intraperitoneal injection of 1 g/kg of vitamin E also attenuated the formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. However, low dose of vitamin E (0.5 g/kg) did not affect the nociceptive behavioral responses produced by subcutaneous injection of formalin. The present study also investigated effects of intraperitoneal injection of both vitamin E and lidocaine on orofacial formalin-induced behavioral responses. Vehicle treatment affected neither formalin-induced behavioral responses nor lidocaine-induced antinociceptive effects. However, intraperitoneal injection of 0.5 g/kg of vitamin E enhanced the lidocaine-induced antinociceptive effects in the 2nd phase compared to the vehicle-treated group. Intraperitoneal injection of naloxone, an opioid receptor antagonist, did not affect antinociception produced by intraperitoneal injections of both vitamin E and lidocaine. These results suggest that treatment with vitamin E enhances the systemic treatment with lidocaine-induced antinociception and reduces side effects when systemically treated with lidocaine. Therefore, the combined treatment with vitamin E and lidocaine is a potential therapeutic for chronic orofacial pain.

Effect of Spinally Administered Ginseng Total Saponin on Capsaicin-Induced Pain and Excitatory Amino Acids-Induced Nociceptive Responses

  • Nah Jin-Ju;Choi Seok;Kim Yoon-Hee;Kim Seok-Chang;Nam Ki-Yeul;Kim Jong-Keun;Nah Seung-Yeol
    • Journal of Ginseng Research
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    • v.23 no.1 s.53
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    • pp.38-43
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    • 1999
  • Ginseng total saponins (ginsenosides) are biologically active main ingredients of Panax ginseng. In present study, we have investigated whether pretreatment of ginsenosides inhibited capsaicin-induced pain at the spinal level, in the view that capsaicin causes substance P (SP) release from primary afferents. Ginsenosides relieved capsaicin-induced pain in a dose-dependent manner. The $ED_{50}$ of the effect was 43 (20-93, $95\%$ C.I.) ${\mu}g/mouse$. We investigated excitatory amino acids-induced nociceptive responses in mice, because these agents are also involved in nociceptive transmission in the spinal cord. Coadministration of ginsenosides with N-methyl-D-aspartate (NMDA) or kainate via i.t. inhibited NMDA- but not kainate-induced pain behaviors. The $ED_{50}$ for the inhibition of NMDA-induced pain by ginsenosides was 37 (21-66, $95\%$ C.I.) ${\mu}g/mouse$. These results suggest that the ginsenosides-induced antinociception results from blocking of pain transmitter-induced nociceptive information at the spinal level.

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Tapentadol: Can It Kill Two Birds with One Stone without Breaking Windows?

  • Chang, Eun Jung;Choi, Eun Ji;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.153-157
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    • 2016
  • Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

Effects of cyanocobalamin and its combination with morphine on neuropathic rats and the relationship between these effects and thrombospondin-4 expression

  • Duzenli, Neslihan;Ulker, Sibel;Sengul, Gulgun;Kayhan, Buse;Onal, Aytul
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.66-77
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    • 2022
  • Background: Thrombospondin-4 (TSP4) upregulates in the spinal cord following peripheral nerve injury and contributes to the development of neuropathic pain (NP). We investigated the effects of cyanocobalamin alone or in combination with morphine on pain and the relationship between these effects and spinal TSP4 expression in neuropathic rats. Methods: NP was induced by chronic constriction injury (CCI) of the sciatic nerve. Cyanocobalamin (5 and 10 mg/kg/day) was administered 15 days before CCI and then for 4 and 14 postoperative days. Morphine (2.5 and 5 mg/kg/day) was administered only post-CCI. Combination treatment included cyanocobalamin and morphine, 10 and 5 mg/kg/day, respectively. All drugs were administered intraperitoneally. Nociceptive thresholds were detected by esthesiometer, analgesia meter, and plantar test, and TSP4 expression was assessed by western blotting and fluorescence immunohistochemistry. Results: CCI decreased nociceptive thresholds in all tests and induced TSP4 expression on the 4th postoperative day. The decrease in nociceptive thresholds persisted except for the plantar test, and the increased TSP4 expression reversed on the 14th postoperative day. Cyanocobalamin and low-dose morphine alone did not produce any antinociceptive effects. High-dose morphine improved the decreased nociceptive thresholds in the esthesiometer when administered alone but combined with cyanocobalamin in all tests. Cyanocobalamin and morphine significantly induced TSP4 expression when administered alone in both doses for 4 or 14 days. However, this increase was less when the two drugs are combined. Conclusions: The combination of cyanocobalamin and morphine is more effective in antinociception and partially decreased the induced TSP4 expression compared to the use of either drug alone.

Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

  • Maeda, Kazumasa;Sonohata, Motoki;Kitajima, Masaru;Kawano, Shunsuke;Mawatari, Masaaki
    • Hip & pelvis
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    • v.30 no.4
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    • pp.226-232
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    • 2018
  • Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

The Anti-nociceptive and Anti-inflammatory Effect of Achyranthes Japonica Nakai

  • Park Hi-Joon;Lee Ji-Suk;Hong Mi-Sook;Kim Chang-Ju;Kim Jin-Woo;Lee Hye-Jung;Lim Sabina
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.8-14
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    • 2004
  • Objective : Achyranthes japonica Nakai (AJ) has been classified as a herb that activates blood flow and clears the stagnated blood. In this study, we evaluated its anti-nociceptive and anti-inflammatory activity in animals to clarify the effect of AJ on pain or inflammation. Methods : ICR mice and Sprague-Dawley rats were pretreated with an ethanolic extract of AJ with two dosages of 200 mg/kg (p.o.) and 400 mg/kg (p.o.). Nociceptive responses of acute pain were determined by hotplate and tail-flick tests. The effects of AJ on inflammation were evaluated by flexion/extention test and mechanical hyperalgesia test in models induced by both carrageenan and Complete Freund's Adjuvant (CFA). Results : AJ showed significant analgesic effects in both hotplate and tail-flick tests at the dose of 400 mg/kg. It also produced a significant inhibition of carrageenan-induced paw edema and CFA induced arthritis in rats at the dose of 400 mg/kg. Conclusion : We have demonstrated the analgesic and anti-inflammatory properties of an 80% ethanolic extract of AJ in animals. This suggests the application of AJ in relief of pain or inflammatory disease.

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Antinociceptive Effects of Intraperitoneal and Intrathecal Vitamin E in the Rat Formalin Test

  • Kim, Myoung-Joong;Hong, Boo-Hwi;Zhang, En-Ji;Ko, Young-Kwon;Lee, Won-Hyung
    • The Korean Journal of Pain
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    • v.25 no.4
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    • pp.238-244
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    • 2012
  • Background: Vitamin E is widely known to be one of the reactive oxygen species (ROS) scavengers and a drug that can easily be obtained, and it has been shown to attenuate the pain responses induced by various causes in animal pain models. Thus, this experiment was conducted to assess the antinociceptive effects of vitamin E by comparing intraperitoneal and intrathecal injections in rats subjected to the formalin test. Methods: After the intraperitoneal and intrathecal injections of vitamin E were carried out, respectively (IP: 500 mg/kg, 1 g/kg, and 2 g/kg, IT: 3 mg/kg, 10 mg/kg, and 30 mg/kg), the formalin test was perfumed. As soon as 5% formalin was injected into left hind paw, the number of flinches induced by pain was measured at 5-minute intervals for 1 hour. Results: Formalin injected into the left hind paw induced biphasic nociceptive behavior in all animals. Intraperitoneal injection of vitamin E diminished the nociceptive behavior in a dose-dependent manner during the early and late phase. Intrathecal vitamin E diminished nociceptive behavior dose dependently during the late phase but showed no significant difference in the early phase. Conclusions: Vitamin E attenuated acute nociception when it was injected systemically, while both systemic and intrathecal injection produced analgesia in a rat model of formalin-induced hyperalgesia.