• 제목/요약/키워드: opioid

검색결과 449건 처리시간 0.03초

슬관절경 수술 후 관절강 내 주입한 Bupivacaine 및 Morphine이 통증에 미치는 영향 (Postoperative Analgesic Effect of Intraarticular Bupivacaine or Morphine After Arthroscopic Knee Surgery)

  • 김세연
    • Journal of Yeungnam Medical Science
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    • 제10권2호
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    • pp.445-450
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    • 1993
  • 전신 흡입 마취로 슬관절경 수술을 받은 건강한 환자 60명을 대상으로 슬관절경내 Morphine 3 mg을 주입한 군(20명)과 0.25% Bupivacaine 20 ml을 주입한 군(20명)과 약제를 주입하지 않은 대조군(20명)의 통증 정도를 술후 1, 2, 4, 6, 12, 24시간 동안 Visual Analogue Pain Scale을 이용하여 비교 평가하여 다음과 같은 결론을 얻었다. 1) 슬관절강내 0.25% Bupivacaine 20 ml을 주입한 군에서 술후 첫 1, 2시간 동안 통계학적으로 의의있는 통증 점수를 나타내었다. 2) 슬관절강내 Morphine 3 mg을 주입한 군에서는 술후 4시간부터 통계학적으로 의의있는 통증 점수가 나타난 뒤 실험이 끝날 때까지 지속적인 진통효과를 나타내었다. 3) 구역, 구토, 소양증, 뇨정체, 호흡억제 등의 전신적인 부작용은 나타나지 않았다. 이상과 같이 소량의 Morphine을 관절강내 주입함으로써 술후 통증을 감소시켜 진통제의 사용량을 줄일 수 있었다.

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우유속 락토페린의 NMDA 수용체를 통한 진통효과 (Effect of NMDA Receptor on Analgesic Effect of Bovine Milk-derived Lactoferrin (BLF))

  • 전용준;윤재석;임화경;박기숙;나한광;김동섭;김주일;윤여창;최기환
    • 약학회지
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    • 제49권5호
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    • pp.370-374
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    • 2005
  • Lactoferrin is a multifunctional protein that is found in milk, neutrophils, and other biological fluids, and its receptors have also been identified in the central nervous system. Recently, it was reported that bovine milk-derived lacto­ferrin (BLF) produced analgesia via a $\mu$-opioid receptor-mediated response in the spinal cord. However the precise mech­anism of this analgesic effect is remains unclear. In Randall-Selitto paw pressure study, each single administration of morphine (10 mg/kg) and BLF (50, 100 and 200 mg/kg) induced analgesia, however, NMDA receptor antagonist MK-801 (0.1, 0.2 and 0.3 mg/kg), inhibited analgesia induced by BLF (100 mg/kg). Intracerebroventricular infusion (I.C.V.) of N­methyl-D-aspartic acid (NMDA) ($0.3\;{\mu}g/8.0\;{\mu}l/hr/day$), as a NMDA receptor agonist, reversed inhibition of MK-801 (0.3 mg/kg) on analgesia induced by BLF (100 mg/kg). These results suggest that BLF have analgesic effect, through NMDA recep­tor activation.

Evaluation of the Bioequivalence of Two Brands of Naltrexone 50 mg Tablet in Healthy Volunteers

  • Baek, In-Hwan;Yun, Hwi-Yeol;Kang, Won-Ku;Kwon, Kwang-Il
    • 한국임상약학회지
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    • 제16권1호
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    • pp.69-74
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    • 2006
  • 날트렉손은 ${\mu}-opioid$ 수용체에 특이적이고 선택적으로 길항작용을 나타내어 마약이나 마약성 진통제의 강한 의존성 치료에 쓰일 뿐만 아니라, 알코올 의존성 치료에도 쓰이는 약물이다. 본 연구는 날트렉손 제제인 레비아 정 (50 mg tablet, 제일약품) 을 대조약으로 하여 시험약인 명인 제약의 트락손 50 mg정의 생물학적 동등성 평가를 하기 위해 22명의 건강한 지원자를 모집하였다. 지원자를 두 군으로 나누어 1정씩 투여하였고 $2{\times}2$ 교차시험을 실시하였다. 날트렉손의 혈장 중의 농도를 정량하기 위하여 발리데이션된 LC/MS/MS를 사용하였다. 채혈 시간은 투약 전 및 투약 후 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 9, 12 시간에 걸쳐 시행하였다. 생물학적 동등성을 판정하기 위한 파라미터로 12시간까지의 혈장 중 농도 곡선 하 면적$(AUC_{12hr})$과 최고 혈중 농도 $(C_{max})$를 사용하였다. $AUC_{12hr}$의 평균은 $43.45ng{\cdot}hr/ml$ (시험약)과 $43.31ng{\cdot}hr/ml$ (대조약) 으로 관찰되었고, $C_{max}$의 경우 각각 12.01 ng/m1 (시험약)과 12.27 ng/ml (대조약)으로 관찰되었다. $AUC_{12hr}$의 경우 로그변환 한 평균치 차의 90%의 신뢰구간이 log0.95-log1.07이었고, $C_{max}$의 경우 log0.87-log1.14로 계산되어 두 항목 모두 log0.8-log1.25이어야 한다는 식품의약품 안전청과 FDA의 기준을 모두 만족시켰다. 이상의 결과를 종합하면 시험약 트락손 정 50mg 은 대조약 레비아 정 50 mg에 대하여 생물학적으로 동등한 것으로 판정되었다.

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활동기록기를 이용한 주기성사지운동증 환자의 치료 반응 평가:증례 보고 (Actigraphic Evaluation of Treatment Responses in Periodic Limb Movements in Sleep Patient:A Case Study)

  • 신홍범;김의중
    • 수면정신생리
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    • 제12권2호
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    • pp.139-143
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    • 2005
  • 주기성사지운동증의 치료에는 도파민 효현제, 벤조다이아제핀, 오피오이드 등 다양한 약물이 쓰이고 있고, 임상적 치료 효과도 약물에 따라 다르다는 보고가 많다. 야간 수면다원검사는 주기성사지운동증을 진단하는 표준적인 방법이지만, 치료 반응 평가를 위해 사용되기에는 어려움이 있다. 저자들은 주기성사지운동증을 벤조다이아제핀계의 클로나제팜과 도파민 효현제인 프라미펙솔을 이용하여 치료하고 그 경과를 활동기록기를 이용하여 평가한 증례가 있어 보고한다. 기존 연구에서 밝혀진 바와 같이 클로나제팜은 수면의 질을 개선시키는 효과는 있으나 사지운동의 횟수를 줄이지는 못하였다. 프라미펙솔은 사지운동의 횟수를 줄였지만, 수면의 질을 개선 시키지는 못하였다. 활동기록기는 주기성사지운동증의 치료 반응 평가에 유용하게 사용될 수 있을 것으로 생각된다.

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만성통증이 유발된 흰쥐에서 관찰된 침진통효과의 세로토닌성 기전 (Activation of spinal Serotonergic Receptor Contributes to Electroacupuncture Analgesia in Rat with Chronic Pain)

  • 박동석;신홍기;이경희
    • 대한한의학회지
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    • 제26권3호
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    • pp.239-248
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    • 2005
  • Objectives : Electroacupuncture (EA)-induced analgesia has been known to be mediated through the activation of opioid, noradrenergic and serotonergic receptors. However, little study on serotonergic mechanism has been performed in an animal model of chronic pain. The present study was designed to elucidate the type of serotonergic receptors responsible for EA analgesia in the chronic pain model. Methods : In rats with complete Freund's: adjuvant-induced inflammation and spinal nerve injury, spinal wide dynamic range (WDR) cell responses to graded electrical stimulation of afferent C fiber were recorded before and after spinal application of selective 5-hydroxytryptamine (5-HT) receptor antagonists. EA stimulation (2Hz, 0.5msec, 3mA) was applied to the contralateral Zusanli point for 30 min. Results : In both models of chronic pain, WDR cell responses were greatly inhibited after EA stimulation. EA-induced inhibition of WDR celt responses was significantly attenuated by spinal application of non-selective 5-HT receptor antagonist, dihydroergocristine Of 5-HT receptor antagonists tested, 5-HT1A (WAY 100635) and 5-HT2 (LY53857) receptor antagonists strongly reduced an ability of EA stimulation to inhibit WDR cell responses. However, 5-HT1B (GR55562) and 5-HT3 (LY278584) receptor antagonists also had weak but significant blocking action on EA-induced inhibitory effect on chronic pain. Conclusions : Dorsal hem cell responses, afferent C fiber stimulation, chronic pain, electroacupuncture, serotonergic receptors.

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Percutaneous Sacroplasty : Effectiveness and Long-Term Outcome Predictors

  • Lee, Jaehyung;Lee, Eugene;Lee, Joon Woo;Kang, Yusuhn;Ahn, Joong Mo;Kang, Heung Sik
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.747-756
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    • 2020
  • Objective : To evaluate the effectiveness and long-term outcome predictors of percutaneous sacroplasty (PSP). Methods : This single-center study assessed 40 patients with sacral insufficiency fractures using the short-axis technique under C-arm flat-panel detector computed tomography (CT). Two radiologists reviewed the patients' magnetic resonance and CT images to obtain imaging findings before PSP and determine technical success, respectively. The short-term outcomes were visual analog scale score changes and opioid usage reductions. Long-term outcomes were determined using telephone interviews and the North American Spine Society (NASS) patient-satisfaction index at least one year after PSP. Results : Technical success was achieved without any significant complications in 39 patients (97.5%). Telephone interviews were possible with 12 patients and failed in 10 patients; death was confirmed in 18 patients. Fifteen patients (50%) re-visited the hospital and received conservative treatment, including spinal injections. Nine patients reported positive satisfaction (NASS patient-satisfaction index 1 or 2), while the negative satisfaction group (NASS patient-satisfaction index 3 or 4, n=3) showed a higher incidence of compression fractures at the thoracolumbar spine level (66.7% vs. 22.2%) and previous spinal injection history (66.7% vs. 33.3%). The poor response group also showed higher incidences of facet joint arthrosis (100% vs. 55.6%), central canal stenosis (100% vs. 22.2%), neural foraminal stenosis (33.3% vs. 22.2%), scoliosis (100% vs. 33.3%), and sagittal malalignment (100% vs. 44.4%). Conclusion : PSP was effective for sacral insufficiency fractures and showed good long-term outcomes. Combined compression fractures in the thoracolumbar spine and degenerative lumbar pathologies could be possible poor outcome predictors.

Adjuvant 유발(誘發) 관절염(關節炎)에 대(對)한 전침자극(電針刺戟)의 진통효과(鎭痛效果) 및 그 기전(機轉)에 관(關)한 연구(硏究) (The study on the analgesic effect and its mechanism of electroacupuncture in the rat model of adjuvant-induced arthritis)

  • 백용현;최도영;박동석
    • Journal of Acupuncture Research
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    • 제20권3호
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    • pp.117-130
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    • 2003
  • To study the analgesic and effect and its mechanism of eletroacupunture(EA) on the chronic inflammatory pain 50 rats were induced with arthralgesia by injecting complete freund's adjuvant(CFA). Two weeks after the injection of CFA, EA stimulation(2Hz, 0.07mA, 0.3ms) was delivered to Jogsamni($ST_{36}$) for 20 minutes. Analgesic effect was evaluated by using the tail flick latency(TFL) and the analgesic mechanism was observed by applying TFL with the pretreatment with naloxone and yohimbine. The results were as follows ; 1. TFL level for the model of adjuvant-induced arthritis decreased as time went by and it induced the hyperalgesia. 2. EA stimulation delivered to Jogsamni($ST_{36}$) for 20 minutes in the rat model of adjuvant-induced arthritis brought analgesic effect and its effect had lasted for 40 minutes after the stimulation. 3. The analgesic effect of Jogsamni($ST_{36}$) EA in the rat model of adjuvant-induced arthritis was blocked by pretreatment with naloxone(2mg/kg,i.p). This result suggests that the EA effect on the chronic inflammatory pain can be related to the endogenous opioid mechanism. 4. The analgesic effect of Jogsamni($ST_{36}$) EA in the rat model of adjuvant-induced arthritis was blocked by pretreatment with naloxone(2mg/kg,i.p). This result suggests that the EA effect on the chronic inflammatory pain can be related to the ${\alpha}_2$-adrenergic mechanism.

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Cerebroprotective Effect of Nociceptin on Transient Focal Cerebral Ischemia in Rats

  • Lee Seung Yoon;Lee Won Suk;Choi Chang Hwa
    • 대한의생명과학회지
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    • 제11권2호
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    • pp.201-209
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    • 2005
  • This study aimed to investigate the cerebroprotective effect of nociceptin on transient focal cerebral ischemia in Sprague-Dawley rats by determining the changes in regional cerebral blood flow (rCBF) and the infarct size. Right middle cerebral artery (MCA) was occluded for 2 hours, and thereafter was followed by reperfusion by an intraluminal monofilament technique. An open cranial window was made on the right parietal bone for determination of continuous changes in rCBF by laser-Doppler flowmetry. The infarct size was morphometrically determined using the 2,3,5-triphenyltetrazolium chloride technique. In normal rats, nociceptin ($0.01\~100\;nmol/kg$, Lv.) increased rCBF and decreased cerebral arterial resistance in a dose-dependent manner. Systemic arterial blood pressure was little affected by nociceptin at the doses of 0.01 and 0.1nmol/kg, but dose-dependently reduced at the doses of 1 nmol/kg or more. In transient cerebral ischemic rats, nociceptin ($0.01\~0.1$ nmol/kg, i.p.) significantly attenuated the postischemic cerebral hyperemia, and progressively increased rCBF. The improving effect of nociceptin on the postischemic rCBF response was markedly blocked by pretreatment with $[Nphe^1]nociceptin(1-13)NH_2$ (1 nmol/kg, i.p.), a selective nociceptin receptor antagonist, but not by naloxone ($3{\mu}mol/kg$, i.p.), a selective opioid receptor antagonist. The cerebral infarct size was significantly reduced by nociceptin ($0.01\~0.1$ nmol/kg) administered i.p. 5 min after MCA occlusion in transient cerebral ischemia of 2-hour MCA occlusion and 22-hour reperfusiion. It is suggested that nociceptin improves the postischemic cerebral hemodynamics and thereby has a cerebroprotective effect in transient focal cerebral ischemia.

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전침자극이 만성통증을 억제하는 아드레날린성 기전에 대한 연구 ($\alpha_2$-Adrenoceptors are Implicated in the Electroacupuncture-induced Analgesia of Experimental Chronic Pain)

  • 신홍기;이경희;박동석
    • 대한한의학회지
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    • 제25권3호
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    • pp.67-77
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    • 2004
  • Objectives : Many studies have reported that acupuncture analgesia was mediated through the activation of peripheral and central opioid receptors. However, there has been little electrophysiological study on the adrenergic mechanism of acupuncture analgesia in chronic inflammatory and neuropathic pain. The present study was undertaken to elucidate the role of adrenoceptors in the production of acupuncture analgesia in the chronic pain model. Methods : In the rat with chronic inflammation and nerve injury, dorsal horn cell (DHC) responses to afferent C fiber stimulation were used as a pain index and changes in electroacupuncture (EA) analgesia were recorded before and after intravenous administration of selective adrenoceptor antagonists. EA stimulations (2Hz, 0.5msec, 3mA) were applied to the contralateral Zusanli point for 30 min. Results : EA stimulation induced long-lasting inhibition of DHC responses in the rat with chronic inflammation and nerve injury. In both models of inflammation and neuropathic pain, α-adrenoceptor antagonist (phentolamine) significantly attenuated an inhibitory effect of EA on DHC responses. Selective α2-adrenoceptor antagonist (yohimbine) also had a similar suppressive action on DHC responses to that of phentolamine. However, β-adrenoceptor antagonist (propranolol) did not have any inhibitory effect on DHC responses in either model of chronic pain. Conclusions : These experimental findings suggest that in rats with chronic pain, EA stimulation with low frequency and high intensity produced an analgesic effect which was mediated through an activation of α2-adrenoceptors.

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Analgesic Effects of Toad Cake and Toad-cake-containing Herbal Drugs -Analgesic effects of toad cake-

  • Inoue, Eiji;Shimizu, Yasuharu;Masui, Ryo;Usui, Tomomi;Sudoh, Keiichi
    • 대한약침학회지
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    • 제17권1호
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    • pp.74-79
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    • 2014
  • Objectives: This study was conducted to clarify the analgesic effect of toad cake and toad-cake-containing herbal drugs. Methods: We counted the writhing response of mice after the intraperitoneal administration of acetic acid as a nociceptive pain model and the withdrawal response after the plantar surface stimulation of the hind paw induced by partial sciatic nerve ligation of the mice as a neuropathic pain model to investigate the analgesic effect of toad cake and toad-cake-containing herbal drugs. A co-treatment study with serotonin biosynthesis inhibitory drug 4-chloro-DL-phenylalanine methyl ester hydrochloride (PCPA), the catecholamine biosynthesis inhibitory drug ${\alpha}$-methyl-DL-tyrosine methyl ester hydrochloride (AMPT) or the opioid receptor antagonist naloxone hydrochloride was also conducted. Results: Analgesic effects in a mouse model of nociceptive pain and neuropathic pain were shown by oral administration of toad cake and toad-cake-containing herbal drugs. The effects of toad cake and toad-cake-containing herbal drugs disappeared upon co-treatment with PCPA, but not with AMPT or naloxone in the nociceptive pain model; the analgesic effect of toad-cake-containing herbal drugs also disappeared upon co-treatment with PCPA in the neuropathic pain model. Conclusion: Toad cake and toad-cake-containing herbal drugs have potential for the treatments of nociceptive pain and of neuropathic pain, such as post-herpetic neuralgia, trigeminal neuralgia, diabetic neuralgia, and postoperative or posttraumatic pain, by activation of the central serotonin nervous system.