• The Journal of Korean Medicine
• /
• v.16 no.1 s.29
• /
• pp.36-50
• /
• 1995

Acupuncture is so effective and simple to use in the pain and dysfunction syndrome of TMD. Acupuncture treatment is a point-specific. So, the selection of acupuncture point is very important. According to the traditional meridian theory, we select the points; local points around TMJ and mastication muscles(ST6, ST7, GB20, GB21) and remote point(LI4). And if there is another pain, one or two other points are added. Both neural and humoral mechanism play an important role in acupuncture analgesia. The discovery of spinal gate mechanisms shows somatic stimulation can induce pain inhibition. Humoral mechanism has been established from the discovery of opioid receptors and endogenous opioids. Acupuncture induces a relaxation in the patient, which further decreases the muscle tension.

• The Korean Journal of Pain
• /
• v.11 no.1
• /
• pp.109-112
• /
• 1998

The sympathetic nervous system has been implicated as an important factor contributing to causalgia. Basis on reports of presence of opioid receptors in sympathetic autonomic ganglia, including human stellate ganglion, we administered morphine in stellate ganglion block for a patient with causalgia. The patient suffering from brachial plexus injury treated with stellate ganglion block in conjunction with physical therapy. Stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine, or 0.25% bupivacaine 8 ml, with morpine 1 mg. Patient's symptoms were dramatically improved after 13 stellate ganglion blocks.

• Journal of Acupuncture Research
• /
• v.23 no.4
• /
• pp.149-162
• /
• 2006

Objectives : The aim of this study is to evaluate the analgesic effect of electroacupuncture on Jogsamni (ST36) in the collagen-induced arthritis rats and investigate the role played by opioid receptor subtypes $({\mu},\;{\delta},\;{\kappa})$ in the antinociceptive effect of electroacupuncture (EA) In the thermal hyper algesia test. Methods : Immunization of male Sprague-Dawley rats with bovine type H collagen emulsified in incomplete Freund's adjuvant, followed by booster injection 2 weeks later induced collagen-induced arthritis (CIA). The thermal hyperalgesia was evaluated weekly with tail flick latency (TFL). In the fourth week after first immunization, EA stimulation (2 Hz, 0.07 mA, 0.3 ms) was delivered into Jogsamni (5736) for 20 minutes. Analgesic effect was evaluated by using the tail flick latency (TFL) after intraperitoneal injection of normal saline, naloxone, naltrindole and nor-binaltorphimine respectively to CIA rats. Results : The results were as follows; 1. The TFL were gradually decreased in CIA as time elapsed after e immunization of arthrogenic collagen and the maximum value was reached between the third to fifth week. 2. EA stimulation on 5736 inhibited chronic inflammatory pain induced by CIA. 3. The analgesic effect of EA was inhibited by pretreatment of ${\mu}-receptor$ antagonist (naloxone),${\delta}-receptor$ antagonist (naltrindole) and ${\kappa}-receptor$ antagonist (nor-binaltorphimine) respectively. Conclusion : Electroacupuncture has an analgesic effect on the CIA rat and has an antinociception mediated by 8, 5, H receptors.

• Korean Journal of Acupuncture
• /
• v.25 no.2
• /
• pp.43-55
• /
• 2008

Objectives : The acupuncture has been in the classic arsenal of Oriental medicine over inflammatory diseases. Its physiological mechanism is not fully understood but being known better everyday. We reviewed several papers to describe current concepts over anti-inflammatory mechanism of acupuncture. Methods : Some computerized literature searches were done using the key words of 'acupuncture' AND 'Anti-inflammatory' in Medline via Pubmed between March 2007 and December 2007. Only rationally-designed studies were picked among practically associated materials. A well-known hypothesis on acupunctural physiology was adapted for integration. Result : 18 studies were selected. 17 studies were laboratory experiment and 1 was a clinical study. Data was classified into some comprehensive categories. Author's opinion was added at the end of each category. Study results supported the hypotheses on acupunctural physiology; Acupuncture has some influences on autonomic nerve system(ANS). And it stimulates several receptors from target cells like macrophage, and finally inhbits cytokines like TNF-${\alpha}$, IL-1${\beta}$ andIL-10 which are inflammation-mediated. Acupuncture increases the opioid releasing therefore relieves inflammation. And acupuncture inhibits cyclooxgenase(COX) but its mechanism is controversial until now. Conclusion : Current concepts over anti-inflammatory mechanism of acupuncture are as follows. Acupucture suppresses inflammation by stimulation of ANS, increasing of opioid releasing and inhibition of COX. But more studies are needed to fully describe the anti-inflammatory effect of acupuncture.

• The Korean Journal of Pain
• /
• v.13 no.1
• /
• pp.49-54
• /
• 2000

Background: Evidence has accumulated that opioids can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. Bupivacaine has a potent analgesic effect with early peak onset in the postoperative period. The combination of intrapelvic bupivacaine and morphine has been suggested as an ideal analgesic after endoscopic pelvic surgery. Methods: Sixty patients scheduled for endoscopic pelvic surgery under general anesthesia were allocated randomly to three groups. Group 1 received normal saline 20 ml, group 2 received morphine 5 mg in normal saline 20 ml, and group 3 received morphine 5 mg in 0.25% bupivacaine 20 ml into the pelvic cavity. Postoperative pain was assessed using the visual analogue scale at 1, 2, 4, 8, and 24 hours after the intrapelvic instillation. Supplemental analgesic requirements, vital signs, and side effects were recorded for 24 hours. Results: Intrapelvic morphine and bupivacaine produced significant analgesia after endoscopic pelvic surgery. The patients in group 3 had lower pain scores than those in the group 1 and 2 at 1, 2 and 4th hours. There were no significant differences in the pain scores at 8 hours and 24 hours postoperatively between group 2 and 3. Supplemental analgesic requirements were significantly greater in the groups 1 and 2 than the group 3 for 24 hours. No significant side effects occurred. Conclusion: The intrapelvic instillation of morphine and bupivacaine is effective for the postoperative pain control in patients undergoing endoscopic pelvic surgery.

• The Korean Journal of Pain
• /
• v.29 no.3
• /
• pp.153-157
• /
• 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.

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

• Advances in Traditional Medicine
• /
• v.7 no.5
• /
• pp.549-555
• /
• 2008

Bupleuri radix (Umbelliferae), the dried root of Bupleurum Chinense DC, has been clinically used to mitigate pain sensation. The descending pain control system consists of three major components, and modulation of pain in the periaqueductal gray is the most extensively studied descending pain control system. However, the relation of Bupleuri radix on the descending pain control system has not been clarified. In the present study, modulation of the aqueous extract of Bupleuri radix on glycine-induced ion current in the acutely dissociated periaqueductal gray neurons was investigated by using nystatin-perforated patch-clamp technique under voltage-clamp condition. In the present results, the glycine-induced ion current was significantly suppressed by 0.1 mg/ml Bupleuri radix, while treatment with $10^{-5}\;M$ naltrexone, opioid receptor antagonist, alleviated Bupleuri radix-induced inhibition on glycine-induced ion current. The present study showed that the aqueous extract of Bupleuri radix may activate descending pain control system through inhibition on glycine-induced ion current in the periaqueductal gray neurons and this effect is mediated by opioid receptors.

• Korean Journal of Acupuncture
• /
• v.35 no.1
• /
• pp.27-35
• /
• 2018

Objectives : The purpose of this study was to investigate the analgesic effect of electroacupuncture(EA) and radio-frequency warm needling(RFWN) stimulation in acupoint combination on ankle sprained pain in rats. Methods : The lateral ligaments of the Sprague-Dawley rats ankle were injured surgically resulting in sprain, of which was divided into EA, RFWN treatment groups and control group without treatment. The level of pain was measured through foot weight bearing force ratio followed by calculating pain relief. To stimulate proximal or distal area in ankle sprain, combination of proximal acupoints(GB34-GB39) and distal acupoints(GB39-GB42) from sprain area were applied, respectively, to either EA or RFWN stimulation. In addition, naltrexone or phentolamine was injected intraperitoneally before the stimulation to observe the pathway of analgesic effects. Results : In the proximal combination of GB34-GB39, EA and RFWN significantly increased pain relief compared to the control group (p<0.05). However, in distal combination with GB39-GB42, both EA and RFWN stimulation did not relieve pain due to ankle sprains. In the combination of GB34-GB39, the analgesia of EA was inhibited by blockade of the ${\alpha}$-adrenoceptor receptor. The analgesia of RFWN was inhibited by blockade of the ${\alpha}$-adrenoceptor receptor as well as ${\mu}$-opioid receptor. Conclusions : We observed that the proximal combination was effective in relieving pain when the treatment by acupoint combination was applied to the ankle sprain pain. Also, it was confirmed that this analgesia was also related to the pathways of ${\mu}$-opioid receptors and/or ${\alpha}$-adrenoceptors.

• Molecules and Cells
• /
• v.41 no.5
• /
• pp.454-464
• /
• 2018

Crosstalk between G-protein signaling and glutamatergic transmission within the brain reward circuits is critical for long-term emotional effects (depression and anxiety), cravings, and negative withdrawal symptoms associated with opioid addiction. A previous study showed that Regulator of G-protein signaling 4 (RGS4) may be implicated in opiate action in the nucleus accumbens (NAc). However, the mechanism of the NAc-specific RGS4 actions that induce the behavioral responses to opiates remains largely unknown. The present study used a short hairpin RNA (shRNA)-mediated knock-down of RGS4 in the NAc of the mouse brain to investigate the relationship between the activation of ionotropic glutamate receptors and RGS4 in the NAc during morphine reward. Additionally, the shRNA-mediated RGS4 knock-down was implemented in NAc/striatal primary-cultured neurons to investigate the role that striatal neurons have in the morphine-induced activation of ionotropic glutamate receptors. The results of this study show that the NAc-specific knock-down of RGS4 significantly increased the behaviors associated with morphine and did so by phosphorylation of the GluR1 (Ser831) and NR2A (Tyr1325) glutamate receptors in the NAc. Furthermore, the knock-down of RGS4 enhanced the phosphorylation of the GluR1 and NR2A glutamate receptors in the primary NAc/striatal neurons during spontaneous morphine withdrawal. These findings show a novel molecular mechanism of RGS4 in glutamatergic transmission that underlies the negative symptoms associated with morphine administration.