• The Korean Journal of Pain
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• v.12 no.1
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• pp.21-26
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• 1999

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of central nervous system (CNS) and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative low dose epidural bupivacaine and morphine could affect postoperative pain, changes plasma cortisol, and serum glucose. Methods: Thirty patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. General anesthesia was induced in all patients and after that, epidural blocks were done except the control group (n=10) patients. Preoperative block group (n=10) received 0.5% bupivacaine 50 mg and morphine 2 mg epidurally as a bolus before operation and followed by 0.1% bupivacaine $5\;mghr^{-1}$ and morphine $0.2\;mghr^{-1}$ for 10 hours. Postoperative block group (n=10) received the same doses of bupivacaine and morphine under the same method postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative pain by visual analogue scores (VAS), analgesic requirement (first requirement time, total amounts used), side effects, plasma cortisol level and serum glucose level were compared. Results: Until postoperative 6 hrs, VAS of control group was higher than those of the epidural groups. No difference was observed in VAS between the two epidural groups. First analgesics requirement time and total amounts of used analgesics were not different between the two epidural groups, but first analgesic requirement time of preoperative block group was significantly prolonged compared with control group. Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Low dose preoperative epidural bupivacaine and morphine could not reduce postoperative pain, plasma cortisol level and serum glucose level compared with postoperative block group.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.244-250
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• 1995

Many clinical and laboratory experiments have been developed to prevent or decrease post-operative pain. One of these methods is pre-operative administration of opioid. Recently there have been differing and debatable results reported of pre-operative treatment for post-operative pain management. It was our study to determine whether pre-operative epidural fentanyl prevented central facilitation or wind up of spinal cord from nociceptive afferent input through c-fibers. We evaluated the effect of epidural fentanyl 50 mcg 10 minutes before operation and 10 minutes before the end of surgery. 28 parturient women for Cesarean Section were randomly allocated to receive the epidural fentanyl either at 10 minutes before operation (Group 1, n=14) or 10 minutes before the end of surgery (Group 2, n=14). All of the 28 parturient women were anesthetized with epidural block using (22 ml of) 2% lidocaine supplemented with light general anesthesia ($N_2O$ 2 L/min-$O_2$, 2 L/min), we controlled post-operative pain with epidural PCA(patient controlled analgesia) infusion of meperidine and 0.07% bupivacaine. The action duration of epidural fentanyl from the end of surgery to the first requirement of analgesics with epidural PCA were not significantly different between the two groups. No significant differences between two groups were observed in VAS pain score at 1, 2, 3, 6, 12, 24, and 48 hours after the operation. The number of self administration of narcotics with PCA during 48 hours after surgery were the same between the two groups. The hourly infusion rates of demerol were the same. Pre-operative administration of fentanyl was not clinically effective compared to administration just before the end of surgery for postoperative pain control.

• Biomedical Science Letters
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• v.25 no.3
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• pp.247-255
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• 2019

Curcuma longa L. (C.L), Curcuma aromatica Salisb. (C.A) and Zingiber officinale Rosc. (Z.O) of Zingiberaceae plants which are well known as effects of natural anti-oxidant, anti-cancer and anti-inflammatory. We examined that the Zingiberaceae plants are involved in development and modulation of orofacial pain in rats. Male, 7- to 8-week-old, Sprague-Dawley rats weighing 240~280 g were used in this study. Experiments were performed using acute pain model that was caused by the injection of 5% formalin into the right vibrissa pad. The number of scratching or rubbing to the injection site was recorded for 9 consecutive 5-minute intervals following injection of formalin. The experimental groups were acute orofacial inflammatory pain; control group (formalin, 5%), vehicle group (5% formalin after sodium carboxymethyl cellulose), single administration group, single mixed administration group, repeated administration group. The experiments were performed various concentrations of Zingiberaceae plants extract. Therefore, oral administration of C.L, C.A, and Z.O (p.o., concentrations of 12.5, 25 mg/mL) in orofacial inflammatory pain model substantially decrease the nociceptive behavior in a concentration dependent manner. And it tended to decrease at low concentration (12.5 mg/mL) of single mixed and repeated administration more than single administration. This result means that Zingiberaceae plants extract affects the modulation of acute orofacial inflammatory pain. Thus, Zingiberaceae plants extract may be a potential therapeutic treatment for orofacial inflammatory pain.

• Journal of Oral Medicine and Pain
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• v.37 no.1
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• pp.1-7
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• 2012

Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.240-247
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• 2014

Acaiberry (Euterpe oleracea Mart.) is widely diffused in amazon and is known that has high antioxidant capacity and potential anti-inflammatory activities. The aim of this study was to evaluate analgesic effects of acaiberry in formalin-induced orofacial pain through p38 mitogen-activated protein kinases (p38 MAPK) and nicotinamide adenine dinucleotide phosphate 4 (NOX4) pathway. Rats were divided into 5 groups (n=6); formalin (5%, $50{\mu}L$), formalin after saline (vehicle) or acaiberry (16, 80, 160 mg/kg, intraperitoneally). The nociceptive response was investigated all of groups, p38 MAPK or NOX4 were analysed at dose of 80 mg/kg of acaiberry in rat's medulla oblongata and adrenal gland. Results indicated that acai berry produced analgesic effect in a dose-dependent manner and significantly reduced formalin-induced nociceptive response at 15~40 min. Acaiberry (80 mg/kg) decreased the increased p38 MAPK activation and NOX4 expression in medulla oblongata and adrenal gland. Based on these results, acaiberry is believed to be useful for modulation of orofacial pain and its treatments because of its anti-inflammatory and antioxidative effects.

• Molecules and Cells
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• v.20 no.3
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• pp.315-324
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• 2005

Pain is an unpleasant sensation experienced when tissues are damaged. Thus, pain sensation in some way protects body from imminent threat or injury. Peripheral sensory nerves innervated to peripheral tissues initially respond to multiple forms of noxious or strong stimuli, such as heat, mechanical and chemical stimuli. In response to these stimuli, electrical signals for conducting the nociceptive neural signals through axons are generated. These action potentials are then conveyed to specific areas in the spinal cord and in the brain. Sensory afferent fibers are heterogeneous in many aspects. For example, sensory nerves are classified as $A{\alpha}$, $-{\beta}$, $-{\delta}$ and C-fibers according to their diameter and degree of myelination. It is widely accepted that small sensory fibers tend to respond to vigorous or noxious stimuli and related to nociception. Thus these fibers are specifically called nociceptors. Most of nociceptors respond to noxious mechanical stimuli and heat. In addition, these sensory fibers also respond to chemical stimuli [Davis et al. (1993)] such as capsaicin. Thus, nociceptors are considered polymodal. Recent advance in research on ion channels in sensory neurons reveals molecular mechanisms underlying how various types of stimuli can be transduced to neural signals transmitted to the brain for pain perception. In particular, electrophysiological studies on ion channels characterize biophysical properties of ion channels in sensory neurons. Furthermore, molecular biology leads to identification of genetic structures as well as molecular properties of ion channels in sensory neurons. These ion channels are expressed in axon terminals as well as in cell soma. When these channels are activated, inward currents or outward currents are generated, which will lead to depolarization or hyperpolarization of the membrane causing increased or decreased excitability of sensory neurons. In order to depolarize the membrane of nerve terminals, either inward currents should be generated or outward currents should be inhibited. So far, many cationic channels that are responsible for the excitation of sensory neurons are introduced recently. Activation of these channels in sensory neurons is evidently critical to the generation of nociceptive signals. The main channels responsible for inward membrane currents in nociceptors are voltage-activated sodium and calcium channels, while outward current is carried mainly by potassium ions. In addition, activation of non-selective cation channels is also responsible for the excitation of sensory neurons. Thus, excitability of neurons can be controlled by regulating expression or by modulating activity of these channels.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.235-240
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• 1998

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of CNS and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative intravenous morphine could affect postoperative pain and change plasma cortisol and serum glucose levels. Methods: Thirty eight patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. Control group (n=11) did not received intravenous morphine, preoperative group (n=13) received intravenous morphine (0.1 mg/kg as a bolus 10 min before operation and followed by 1.5 mg/hr for 10 hours), postoperative group (n=14) received the same doses and method of intravenous morphine of preoperative group postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative visual analogue scores (VAS), analgesic requirement (first request time, total amounts used), side effects, plasma cortisol and serum glucose levels were compared. Results: VAS were different between control group and the other two goups, but were not different between preoperative and postoperative group. Total amounts of used fentanyl were not different among groups, but first request time were significantly delayed in the preoperative group compared with the other two groups ($66.2{\pm}33.9$ vs $39.0{\pm}15.4$ and $45.0{\pm}14.9$ min respectively, p<0.05). Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Above dosage of preoperative and postoperative morphine has analgesic effect, but could not block surgical stress induced plasma cortisol and serum glucose increase.

• The Korean Journal of Pain
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• v.24 no.3
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• pp.131-136
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• 2011

Background: Pregabalin is an anticonvulsant and analgesic agent that interacts selectively with the voltage-sensitive-$Ca^{2+}$-channel alpha-2-delta subunit. The aim of this study was to evaluate whether the analgesic action of intrathecal (IT) pregabalin is associated with KATP channels in the rat formalin test. Methods: IT PE-10 catheters were implanted in male Sprague-Dawley rats (250.300 g) under inhalation anesthesia using enflurane. Nociceptive behavior was defined as the number of hind paw flinches during 60 min after formalin injection. Ten min before formalin injection, IT drug treatments were divided into 3 groups: normal saline (NS) $20\;{\mu}l$ (CON group); pregabalin 0.3, 1, 3 and $10\;{\mu}g$ in NS $10\;{\mu}l$ (PGB group); glibenclamide $100\;{\mu}g$ in DMSO $5\;{\mu}l$ with pregabalin 0.3, 1, 3 and $10\;{\mu}g$ in NS $5\;{\mu}l$ (GBC group). All the drugs were flushed with NS $10\;{\mu}l$. Immunohistochemistry for the $K_{ATP}$ channel was done with a different set of rats divided into naive, NS and PGB groups. Results: IT pregabalin dose-dependently decreased the flinching number only in phase 2 of formalin test. The log dose response curve of the GBC group shifted to the right with respect to that of the PGB group. Immunohistochemistry for the $K_{ATP}$ channel expression on the spinal cord dorsal horn showed no difference among the groups 1 hr after the formalin test. Conclusions: The antinociceptive effect of pregabalin in the rat formalin test was associated with the activation of the $K_{ATP}$ channel. However, pregabalin did not induce $K_{ATP}$ channel expression in the spinal cord dorsal horn.

• Advances in Traditional Medicine
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• v.7 no.5
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• pp.501-508
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• 2008

Anti-nociceptive and anti-inflammatory effects of Clematidis Radix (CR)-distillates were investigated in three different pain animal models. Highly purified distillate of CR was injected to Zusanli (ST36) acupoint, called CR herb-acupuncture in the Korean traditional medicine. In tail flick latency test, the CR herb-acupuncture treatment did not show a significant effect of relieving acute phasic pain. To investigate the anti-inflammatory effect of CR herb-acupuncture, inflammatory pain was induced by subcutaneous injection of formalin to the plantar tissue or intra-articular injection of carrageenan to the tibio-tarsal joint in the rats. And the medicinal effect of CR herb-acupuncture was evaluated by analyzing pain behavior such as licking or biting behavior, or by measuring weight distribution ratio between two foot and ankle circumference. In the rat formalin test, the analgesic effect of CR herb-acupuncture was more pronounced in the late phase (for 20 min after the early phase) than in the early phase (for the first 10 min post formalin injection). It also significantly alleviated the carrageenan-induced monoarthritis, in terms of weight distribution ratio and ankle edema. These results revealed that CR herb-acupuncture was effective to treat the inflammatory pain and could be used as an analgesic treatment with an antiinflammatory effect.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.874-883
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• 2007

The aqueous extract of Chungsimyeonja-eum has been used to treat palpitation, anemia, chronic fatigue, hypertension, and stroke. It also possesses various pharmacological effects including hypotensive, blood circulating, sedative, anti-inflammatory, diuretic, and anti-stress activities. In the present results, the latency time of plantar test was decreased in the immobilization stress and incusion pain-induction group. However the paw withdrawal latency values were increased in the immobilization stress and incision pain-induction groups after treatment with the aqueous extract of Chungsimyeonja-eum. The c-Fos expression in the paraventricular nucleus (PVN), and 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase (TPH) in the dorsal raphe were enhanced in the immobilization stress and incision pain-induction groups. However, the treatment with the aqueous extract of Chungsimyeonja-eum suppressed the immobilization stress and incision pain-induced increase of c-Fos, 5-HT, and TPH expressions. Here in this study, we have demonstrated the protective effects of Chungsimyeonja-eum on immobilization and incision pain-induced stress. The present study revealed that Chungsimyeonja-eum treatment diminishes immobilization and pain stress.