Neuropathic pain originating from multiple condition of nerve cell injury is common, but is difficult to treat. Even though many drugs such as anti-convulsants, anti-depressants, NSAIDs, opioids have been used, their clinical analgesic action were not satisfactory due to occur severe side effects. Gabapentin was introduced in 1994 as a novel antiepileptic drug and has been used to treat partial seizure. After 1995 gabapentin treatment for reflex sympathetic dystrophy (RSD) started, 45% of the reports about the analgesic efficacy of gabapentin were restricted to the treatments of non-epileptic pain syndrome. This drug is preferred to treat neuropathic pain because of a lower incidence of its side effects than those of other anti-convulsants and anti-depressants. For evaluating it's analgesic efficacy, the changes in the patients' subjective pain intensity was measured by the score on the visual analogue scale (VAS) and patient's objective pain intensity by measuring the skin temperature via infrared thermography were investigated respectively. Side effects of gabapentin were look into. We observed successful relief of neuropathic pain in the three patients which included post-herpetic neuraligia, complex regional pain syndrome (CRPS) and diabetic neuropathic pain, and the side effects of gabapentin were at acceptable levels.
Background: Although early reviews of clinical findings were mostly negative, there is still a widespread belief for the efficacy of preemptive analgesia among clinicians. In this study, we evaluated whether the preemptive use of ketamine decreases post operative pain in patients undergoing appendectomy. Methods: In double-blind, randomized clinical trials, 80 adult male patients undergoing an operation for acute appendicitis were studied. Patients were randomly assigned to two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In the control group, 0.5 mg/kg of normal saline was injected. The pain intensity was assessed at time 0 (immediately after arousal) and 4, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). Results: Eighty patients (40 for both groups) were enrolled in this study. For all of the evaluated times, the VAS score was significantly lower in the ketamine group compared to the control. The interval time for the first analgesic request was $23.1{\pm}6.7$ minutes for the case group and $18.1{\pm}7.3$ minutes for the control (P = 0.02). The total number of pethidine injections in the first 24 hours postoperatively was $0.6{\pm}0.6$ for the case group and $2.0{\pm}0.8$ for the controls (P = 0.032). There were no drug side effects for the case group. Conclusions: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.
The purpose of this study was to determine reliability and validity of the Neck Disability Index (NDI) now in use for the first time in neck pain patients of Korea. Fifty subjects (26 males and24 female) with neck pain enrolled in the study. They completed a standardized self-administered questionnaire that include pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. Reliability was determined by intra-class correlation coefficient (ICC) and Cronbach's alpha by internal consistency. Validity was examined by correlating the NDI scores to the Visual Analog Scale (VAS) score. The Test-retest reliability of the translated versions of the NDI was good ICC (2,1) = .90 (95%CI .85 .95). Cronbach's alpha value for NDI was found to be .95 and this was statistically significant (p<.05). The criterion-related validity coefficients was .72 (p<.01). We conclude that the Korean version of NDI has shown to be a reliable and valid instrument for the assessment of neck pain.
Purpose: The purpose of this study was to examine the effect on plasma beta endorphin concentration level and the influences on pain score of transcutaneous electrical nerve stimulation (TENS) mediation to patients During a prostate needle biopsy. Methods: TENS was administered to only the experimental group. The electric current was given in high frequency (40-100 pps) and low intensity ($2-50{\mu}s$) from the waiting room stage until the end of the procedure. The average time spent was 35 minutes. Following 10 minutes of retention in the rectum, there was a biopsy. In two groups, the pain score was assessed twice when vas pain penetrated into the rectum, during the needle biopsy. The Beta endorphin concentration level was assessed through blood gathering 2 times in the Nuclear Medicine Labs before and after the test. Results: There was not much difference in pain levels from both groups when a microscope probe penetrated into the rectum and in the time when tissues were collected. However, the average overall pain level was reduced during those two procedures. The plasma beta endorphin level was increased in the TENS medicated group compared with the unmedicated group after the procedures were completed. Conclusion: The research indicates that TENS was desirable to be considered as a non-invasive method for controlling pain.
Park, Sung-Hoon;Kim, Seong-Kyu;Shin, Im-Hee;Kim, Hyung-Gun;Choe, Jung-Yoon
The Korean Journal of Physiology and Pharmacology
/
제13권1호
/
pp.33-37
/
2009
Anti-inflammatory factor(AIF) is a water soluble extract of three herbs, Panax notoginseng(Burk.) F. H. Chen, Rehmannia glutinosa Libosch and Eleutherococcus senticosus. The present study aimed to investigate the safety and efficacy of herb extracts, AIF, on Korean knee osteoarthritis patients for six weeks. Fifty seven patients with knee osteoarthritis, ranging from 43 to 73 years of age, who fulfilled the "American College of Rheumatology"(ACR) classification of idiopathic osteoarthritis of knee and radiographic criteria were randomly selected and enrolled for the study. After initial screening and resting period, two capsules each of AIF(Each capsule contains; 400 mg) and similar identical placebo were administered twice a day to both groups. Pain intensity at second, fourth, and sixth weeks of study as well as one week after discontinuation of drugs was assessed by using 100 mm visual analogue scale(VAS). Changes in the Korean version of the Western Ontario and McMaster Universities(K-WOMAC) index score were compared at the initiation and completion of the study. VAS assessed by patients were significantly reduced(at visit 2; $54.64{\pm}14.72$, at visit 4, $37.32{\pm}16.58$, p<0.001) after AIF administration. Results showed an improvement in the physical function of K-WOMAC scale which was significantly higher(p=0.013) in AIF than placebo group, and decreases of total K-WOMAC score were also significantly higher(p=0.030) in AIF groups than placebo group. No serious adverse effect was observed, and there was no difference in incidence of adverse effect between AIF and placebo groups. In this population of Korean patients with knee osteoarthritis, AIF was found to be safe, tolerable and effective for symptomatic improvement of pain and physical function.
The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.
Purpose : The purpose of this study was to compare the effects of Joing Mobilization and Group back Pain Exercise Program on the disability level and the pain of flexibility and the back muscle strength in the hearing impairment patients with Low back pain. Methods : The subjects of this study were 12 patients, 8 males and females. They visited clinic for physical treatment within 6 months after onset of low back pain. One group was applied with Joing Mobilization and other group was with Group back Pain Exercise Program. The patient were treated special program 3 times session weekly. And treatment 2 times session was 15min with physiotherapy weekly. The muscle strength was measured by Cybex 660, the level of disability by Oswestry low back pain disability scale, the intensity of pain by visual analogue scale (VAS). The data was analysed by paired T-test and independent T-test. Results : The results of this study were summarized as follow : 1. The Oswestry disability score of experimental and control group were significantly decreased and there was no difference in the Oswestry disability score change between joint mobilization group and back pain exercise group. 2. The pains in anterior, postrior, lift lateral and right lateral bending and in rotation of back pain exercise group were significantly increased compared with those of joint mobilization group. 3. The flexors and extensors peak torque of back pain exercise group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of the joint mobilization group. There was no significant difference in extensors and flexors peak torque at $30^{\circ}$/sec, $60^{\circ}$/sec between two group. The results showed that the back pain exercise group were effective in decreasing disability score and pain of trunk activity, increasing trunk extension and flexion peak torque. Conclusion : It is suggested theat the back pain exercise program could be an essential factor for the effective intervension to the hearing impairment patients suffere from low back pain.
Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.
Background: The advances in surgical technology, anesthesia and perioperative care have made it possible to perform laparoscopic cholecystectomy on an outpatient basis. This study was conducted to assess the analgesic effect and the adverse events of different dosing methods when using transdermal fentanyl patches (TDFPs) after laparoscopic cholecystectomy. Methods: Sixty patients who were to undergo laparoscopic cholecystectomy under general anesthesia were divided into two groups. Group 1: 2 TDFPs that released $12{\mu}g/h$ were applied after the induction of anesthesia and these 2 patches were removed after 24 hours. Group 2: 2 TDFPs that released $12{\mu}g/h$ were applied after the induction of anesthesia and one patch was removed after 7 hours and the other patch was removed after 24 hours. The intensity of the postoperative pain was assessed by using a visual analogue scale (VAS) and assessing the adverse events, including dizziness, pruritus and nausea/vomiting, were recorded for 48 hours postoperatively. Results: The VAS score of postoperative pain was not significantly different between the two groups at all times. The incidence of dizziness in groups I and II was 10 and 3, respectively, and the incidence of nausea/vomiting in group I and II was 4 and 0, respectively. The incidences of dizziness and nausea/vomiting in group II were significantly lower than those of group I (P<0.05). Conclusions: A dosing method that removes half of the TDFPs ($24{\mu}g/h$) after 7 hours of application caused a lower incidence of dizziness and nausea/vomiting without any significant difference of postoperative analgesic efficacy, as compared to leaving on both the TDFPs (24$\mu$g/h) for 24 hours after laparoscopic cholecystectomy.
Purpose : The purpose of this study was to find out The effect of Low back pain on the total pattens of Proprioceptive neuromuscular facilitation(PNF). Methods : The subjects of the study were 62 low back pain patients. They were divided into two groups: 31 in the experimental group and 31 in the control group. the experimental group performed modalities and PNF total patterns three times for a week. the control group performed only modalities and ROM exercise three times for a week. Back muscle strength was measured by a back muscle strength measuring machine, the intensity of pain was measured by the Visual Analogue Scale (VAS), and the level of disability was measured by Oswestry low back pain disability index. Study measurements were compared before and after 6 weeks exercise program. The two groups of subjects were assessed by utilizing two different balance measurement: Static standing balance was measured by balance performance monitor (BPM) and Dynamic standing balance was measured by one leg standing(OLS). The scale for static standing balance was measured by using, sway area, sway path, max velocity. Results : The results of this study were as follow: 1) The score on visual analogue scale shows statistically significant increase on PNF group of post test(p<.05). 2) The score on Oswestry low back pain disability index. shows statistically significant decrease on PNF group of post test(p<.05). 3) The change sway area was statistically significant on pre-test and post-test(p<.05). 4) The change sway path was statistically significant on pre-test and post-test(p<.05). 5) The change max velocity was statistically significant on pre-test and post-test(p<.05). 6) The score on one leg standing shows statistically significant increase on PNF group of post test(p<.05). Conclusion : These results of this study indicated that Proprioceptive Neuromuscular Facilitation Total patterns which performed for six weeks had a statistically significant influence on low back pain. If the exercise for muscle strength is performed along with therapeutic stabilizing exercise, a better effect can be expected on low back pain. We hope that this study will provide a basic data for further research with a bigger group and on a long-term effect.
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