• Title/Summary/Keyword: opioid analgesic

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Anti-nociceptive activity of Corylopsis gotoana (히어리의 진통(鎭痛) 효능(效能))

  • Park, Zi Won;An, Soon Young;Yun, Sun Hwa;Shin, Youn Chel;Yang, Woo In;Lee, Se Youn;Cha, Dong Seok;Jeon, Hoon
    • Korean Journal of Pharmacognosy
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    • v.50 no.4
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    • pp.272-276
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    • 2019
  • Corylopsis gotoana has been widely used as a traditional medicine for the treatment of lots of disease including cold, edema and vomiting. However pharmacological and phytochemical studies on the C. gotoana are extremely limited. Here in this study, the author investigated the anti-nociceptive effects of the methanolic extract of Corylopsis gotoana (MCG) using various pain models. In the present study, MCG exhibited strong and dose-dependent anti-nociceptive activities on various experimental pain models including thermal nociception and chemical nociception, compared to positive control such as tramadol and indomethacin. In addition, the result from combination test using naloxone, analgesic activity of MCG was slightly reduced, indicating that MCG acts as a partial opioid receptor agonist. These results demonstrated that MCG has potent analgesic potential and thus it may be possibly used as a valuable anti-nociceptive agent.

The Analgesic Effects of Epidural Morphine on Cancer-related Pain (경막외 Morphine의 암성통증에 대한 진통효과)

  • Park, Jin-Woo
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.189-193
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    • 1989
  • The analgesic effects of epidural morphine were evaluated on various types of cancer-related pain in forty-eight adult patients. Epidural morphine injections were given via an epidural catheter introduced to an epidural level corresponding to the pain area. Pain relief was classified as excellent, fair, or poor by subjective scoring and by the subsequent need for systemic analgesics. Thirty-two patients of all the patients became pain-free. In sixteen patients, pain relief was complete only for one or two of various types of pain with a certain dose of epidural morphine, The best result was obtained when the pain was continuous and originated from deep somatic structures. Based on the results, the ranking order of different types of cancer pain with regard to their susceptibility to epidural morphine was as follows: 1) Continuous somatic pain 2) Continuous visceral pain 3) Intermittent somatic pain 4) Intermittent visceral pain The differential effects of epidural morphine on cancer-related pain may suggest that various types of noxious stimuli involve different kinds of opioid receptors which differ in affinity to morphine, and that there are some pain-mediating systems which function independently of opioid mechanisms.

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Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

  • Liang, Xiao;Zhou, Weilong;Fan, Yuchao
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.487-500
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    • 2021
  • Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions: Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

Antinociceptive Effect of the Stem of Polygonum multiflorum

  • Lee, Se-Youn;Kim, Jin-Kyu;Kim, Jong-Soo;So, Un-Ki;Oh, Chan-Ho;Jeon, Hoon
    • Natural Product Sciences
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    • v.17 no.3
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    • pp.256-260
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    • 2011
  • Polygoni multiflori Ramulus, the stem of Polygonum multiflorum Thunb., has been widely used as a traditional medicine for the treatment of many diseases. Presently, antinociceptive tests of the butanolic fraction of P. multiflorum (SPB) were performed using several thermal and chemical pain models. SPB had strong and dosedependent antinociceptive activities, both thermal and chemical, compared to the reference drugs Tramadol and Indomethacin. In combination with naloxone, the analgesic activity of SPB was unchanged indicating that the antinociceptive activity of SPB was not due to action as an opioid receptor agonist. The present results indicate the potential of SPB as an analgesic agent for pain control.

Rediscovery of Nefopam for the Treatment of Neuropathic Pain

  • Kim, Kyung Hoon;Abdi, Salahadin
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.103-111
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    • 2014
  • Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the nonsedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain.

Antinociceptive effect of intrathecal sec-O-glucosylhamaudol on the formalin-induced pain in rats

  • Kim, Sang Hun;Jong, Hwa Song;Yoon, Myung Ha;Oh, Seon Hee;Jung, Ki Tae
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.98-103
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    • 2017
  • Background: The root of Peucedanum japonicum Thunb., a perennial herb found in Japan, the Philippines, China, and Korea, is used as an analgesic. In a previous study, sec-O-glucosylhamaudol (SOG) showed an analgesic effect. This study was performed to examine the antinociceptive effect of intrathecal SOG in the formalin test. Methods: Male Sprague-Dawley rats were implanted with an intrathecal catheter. Rats were randomly treated with a vehicle and SOG ($10{\mu}g$, $30{\mu}g$, $60{\mu}g$, and $100{\mu}g$) before formalin injection. Five percent formalin was injected into the hind-paw, and a biphasic reaction followed, consisting of flinching and licking behaviors (phase 1, 0-10 min; phase 2, 10-60 min). Naloxone was injected 10 min before administration of SOG $100{\mu}g$ to evaluate the involvement of SOG with an opioid receptor. Dose-responsiveness and ED50 values were calculated. Results: Intrathecal SOG showed a significant reduction of the flinching responses at both phases in a dose-dependent manner. Significant effects were showed from the dose of $30{\mu}g$ and maximum effects were achieved at a dose of $100{\mu}g$ in both phases. The ED50 value (95% confidence intervals) of intrathecal SOG was 30.3 $(25.8-35.5){\mu}g$ during phase 1, and 48.0 (41.4-55.7) during phase 2. The antinociceptive effects of SOG ($100{\mu}g$) were significantly reverted at both phases of the formalin test by naloxone. Conclusions: These results demonstrate that intrathecal SOG has a very strong antinociceptive effect in the formalin test and it seems the effect is related to an opioid receptor.

A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty

  • You, Di;Qin, Lu;Li, Kai;Li, Di;Zhao, Guoqing;Li, Longyun
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.271-287
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    • 2021
  • Background: Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. Methods: We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Conclusions: Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

Contralateral Heterotropic Electroacupuncture Modulates Formalin Induced Pain in the Rat (거자법에 의한 전침자극이 백서의 formalin 유발 통증에 대한 억제기전)

  • 류영수
    • The Journal of Korean Medicine
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    • v.24 no.2
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    • pp.193-203
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    • 2003
  • Objectives : In this study, we investigated the effect and pathway of contralateral heterotropic electroacupuncture (EA) on pain induced by fonualin in rats. Methods : Acu-points in the right forepaws, HT 7 and PC 7 were stimulated with 3~4mA, 2ms, and 10Hz after 5% formalin (50ul) s.c. injection to the left hind paw. In addition, it was investigated whether the dorsolateral funiculus (DLF), known to be related the descending inhibition, mediates analgesic effects of the contralateral heterotropic EA or whether administration of naltrexone, an opioid antagonist, blocks the effect of EA. Results : The results showed that contralateral heterotropic electroacupuncture (EA) inhibited late phase (63.311.7%) of pain induced by fonualin in the behavioral test, but sham-EA had little effect on pain behavior (85.616.8%) and no analgesic effects after transection of the dorsolateral funiculus (95.718.7%). The pretreatment of naltrexone (10mg/kg, i.p.) could not inhibit the analgesic effects of EA on formalin-induced pain behavior (70.713.1%). Also,EA suppressed formalin injection induced expression of cFos like protein (cFL) in the dorsal homo but not sham-EA. Suppressed expressions of cFL in the spinal cord were eliminated after transection of the ipsilateral dorsolateral funiculus at T10-11 leve1s. However, pretreatment of naltrexone could not prevent the suppressive expressions of cFL at the spinal cord. Conclusions : These results suggest that the analgesic effect of contralateral heterotropic electroacupuncture may be modulated through the dorsolateral funiculus constituting the descending inhibition.

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The study on the analgesic effect and its mechanism of electroacupuncture in the rat model of adjuvant-induced arthritis (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))

  • Baek, Yong-hyeon;Choi, Do-young;Park, Dong-seok
    • Journal of Acupuncture Research
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    • v.20 no.3
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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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Effects of Electroacupuncture on Memory Modulation (전기 침 자극의 기억 조절 효과)

  • Lee, Sang-Kwan;Kim, Min-Soo;Ahn, Ryun-Sup;Kim, Moon-Soo;Sung, Kang-Keyng
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1543-1548
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    • 2007
  • Recent experiments investigating the analgesic or anti-stress effects of electro-acupuncture provide extensive evidence that opioid or stress hormone system is involved in those effects, respectively. It has been also suggested that opioid or stress hormones modulate long-term memory consolidation or retrieval in animals and human subjects. This article reviews the possibilitythat electroacupuncture can modulate memory consolidation or retrieval. The release of serum cortisol is enhanced or reduced by high-frequency or low-frequency electroacupuncture, respectively. Also the release of beta endorphin and enkephalin is enhanced by low-frequency electroacupuncture and the release of dynorphin is enhanced by high-frequency electroacupunture. The memory consolidation is enhanced by post-training injection of Glucocorticoids, Naloxone or Dynorphin. So this review suggests strongly that memory consolidation can be modulated by electroacupuncture.