• Title/Summary/Keyword: pain relief effect

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Comparison of Fentanyl-Based Rapid Onset Opioids for the Relief of Breakthrough Cancer Pain: Drug Price Based on Effect Size

  • Seongchul Kim;Hayoun Jung;Jina Park;Jinsol Baek;Yeojin Yun;Junghwa Hong;Eunyoung Kim
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.43-50
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    • 2023
  • Background and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion: The rapid onset opioids that fit the patient's breakthrough cancer pain pattern have the best cost-effectiveness.

The Effects of a Forceful Transforaminal Epidural Steroid Injection on Radicular Pain: A Preliminary Study

  • Byun, Jong Min;Park, Hahck Soo;Woo, Jae Hee;Kim, Jin
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.334-338
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    • 2014
  • Background: Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. Methods: Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. Results: There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). Conclusions: A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective.

The rate of Happycaine's pain relief when scaling (스켈링 시 구강마취액(해피카인)의 통증완화 정도)

  • Kang, Yoon-Joo;Lim, Jin-Hee;Song, Ji-Na;Kim, Ji-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.3
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    • pp.495-501
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    • 2012
  • Objectives : Today, one of the most basically used procedures to dental patients is scaling for removing tartar. The purpose of this study is the effect of Happycaine during scaling for pain relief. Methods : This study was used self-questionnaire from 202 patients. SPSS 18.0 vision program was used for data analysis. Group A was used Happycaine, but group B wasn't used Happycaine. The degree of pain relief depending on use of Happycaine, was analyzed by Independent-two-sample t-test. Emotion and reaction during scaling was analyzed by mean and standard deviation. The results were as follows. Results : 1. 52.5% participants answered 'require scaling' and 12.9% answered 'required scaling very much'. so 65.4% participants recognized the need of scaling. 2. According to the experience of Happycaine during scaling, differences in pain was by Likert 5 pints scale, Group B's pain was higher than Group A's(p=0.000). 3. According to the experience of Happycaine during scaling, the mean of panic from Group B was a little higher than Group A(p=0.036). In case of cold symptom during scaling, Group B was significantly different(p=0.011). In Group B, pain from dental hygienists was significantly different (p=0.000). Group A was interested in Happycaine use in future scaling(p=0.004). Conclusions : As a result of this study, we recommend Happycaine during scaling in order to decrease mental burden and pain for patients.

Development and Effect of Pain Management Protocol for Nursing Home Patients with Dementia (노인 간호 요양시설에서의 치매환자 통증관리 프로토콜 개발 및 효과)

  • Chang, Sung-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.1
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    • pp.29-43
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    • 2007
  • Purpose: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. Method: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. Results: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. Conclusion: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.

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A Case Report of Abdominal Pain Relief in a Patient with Metastatic Colorectal Cancer Treated with Korean Medicine (한의학적 치료로 호전된 전이성 대장암 환자의 복통에 대한 증례보고)

  • Yoon, Mi-jung;Kim, Na-yeon;Choi, Hong-sik;Kim, Seung-mo;Kim, Kyung-soon
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.687-694
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    • 2021
  • Objectives: The aim of this case report is to present abdominal pain relief in a patient diagnosed with colorectal cancer with several organ metastases. Methods: The patient was treated with herbal medicine, acupuncture, and moxibustion. The effect of the treatment was measured by a numeric rating scale (NRS). Results: The NRS of the patient's abdominal pain was reduced after Korean medicine treatment. Conclusions: This case report suggests that Korean medicine may be effective for treating abdominal pain in cancer patients. However, additional study is needed to confirm interactions between Korean medicine and the control of abdominal pain.

High Frequency Circuit Design using Feedback Control with Body Load Fluctuation for Pain Relief Therapy (통증 완화 치료기용 인체 부하 변동에 따른 피드백 제어가 가능한 고주파 회로 설계)

  • Park, Chul-Won;Won, Chul-Hee
    • The Transactions of the Korean Institute of Electrical Engineers P
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    • v.62 no.1
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    • pp.45-49
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    • 2013
  • High frequency system has been used for the purpose of skin care and obesity treatment, by high-frequency energy is applied to the human body generates deep heat. Conventional high frequency system could not selection control by depending on the body load fluctuations. Such as burns and side effects have been reported by system instability and then therapeutic effect is insufficient. During treatment, objective information about the status of the patient was no. Because of treatment methods are subjective, and so tailored treatments were impossible. In this paper, high frequency medical system with sinusoidal frequency characteristics without distortion of the Push pull switching scheme for pain relief therapy was designed. And control circuit that was designed by feedback using the output changes according to the body-load fluctuation. Last, power circuit for efficient control the heat generated from the hardware was proposed.

The Effects of Microcurrent Treatment and Ultrasound Treatment on the Pain Relief and Functional Recovery after Total Knee Replacement (미세전류치료와 초음파치료가 슬관절전치환술 후 통증경감과 기능회복에 미치는 영향)

  • Cho, Woon-Su;Kim, Yong-Nam;Kim, Yong-Seong;Hwang, Tae-Yeon;Jin, Hee-Kyung
    • The Journal of Korean Physical Therapy
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    • v.24 no.2
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    • pp.118-126
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    • 2012
  • Purpose: The purpose of this study was to investigate pain relief and functional recovery after total knee replacement. Methods: The treatment was performed by dividing individuals into a control group ($n_1=5$), ultrasound treatment group ($n_2=5$), and micro-current treatment group ($n_3=5$). The control group applied the hot pack for 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, and Continuous Passive Movement (CPM) for 40 minutes. The ultrasound therapy group applied the frequency of 1 MHz, intensity of 1.0 $W/cm^2$ for five minutes following the same treatment as the control group. The micro-current therapy group applied the intensity of 25 ${\mu}A$, and pulsation frequency 5 pps for 15 minutes following the same treatment as the control group. After treatment, Visual Analogue Scale (VAS), Korean Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), Berg Balance Scale (BBS), Range of Movement (ROM) and wound length was measured. Results: VAS showed significant effect in the control group and micro-current therapy group during the treatment period. According to the treatment of K-WOMACK, BBS, ROM, and Healing wounds showed main effects between groups. Conclusion: According to the results of this study, data showed improvement of pain relief, wound healing effects, and range of motion recovery. Thus, these selected treatments were effective after total knee replacement. In other words, electrical treatment continues to influence pain relief and functional recovery after total knee replacement.

The Effect of the Combined Analgesia of Epidural and Cryoanalgesia after Thoracotomy Surgery (개흉술 후 냉각요법과 경막외 Fentanyl 병용요법의 비교)

  • Shin, Jin-Woo;Choi, In-Cheol;Ha, Seung-Ill;Sim, Ji-Yeon;Lee, Cheong;Park, Seung-Ill;Yun, Chang-Seob
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.68-75
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    • 2001
  • Background: Thoracotomy is the operation that produces the most postoperative pain, necessitating the highest requirements for postoperative analgesics. The common methods of treating postthoracotomy pain are the use of thoracic epidural analgesia, intemittent or continuous intercostal nerve blocks, intravenous narcotics and cryoanalgesia. We designed to assess the analgesic effect of epidural analgesia, cryoanalgesia and the combined analgesia in thoracic surgery. Methods: A prospective study was carried out in 59 patients undergoing elective thoracotomy for parenchymal disease. Patients were randomized into three groups: C (cryoanalgesia), CE (cryoanalgesia and thoracic epidural analgesia), E (epidural analgesia). All patients had standard anesthesia with endotracheal intubation using a double lumen endotracheal tube, and one-lung ventilation. Subjective pain relief was assessed on a visual analog scale. Analgesic requirements, complications and the degree of satisfaction were evaluated during the 7 days following surgery. Results: Subjective pain relief was significantly better in Group CE and Group E in comparison with Group C (P < 0.05). Cryoanalgesia provided a better pain score on the 6th and 7th POD than the early postoperative periods. Analgesic requirements were higher in Group C than in the Group CE and Group E during the first POD. The incidence of side effects was similar in Group CE and Group E. Conclusions: If we can reduce the concentration of fentanyl and local anesthetics in combined analgesia of epidural and cryoanalgesia, the disadvantages of each method would be overcome and would be a better method of postthoracotomy pain control.

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Clinical effect of preoperative intravenous non-steroidal anti-inflammatory drugs on relief of postoperative pain in patients after laparoscopic cholecystectomy: Intravenous ibuprofen vs. intravenous ketorolac

  • Gyeong Geon Lee;Joon Seong Park;Hyung Sun Kim;Dong Sup Yoon;Jin Hong Lim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.251-256
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    • 2022
  • Backgrounds/Aims: Postoperative pain management is a key to enhanced recovery after surgery. The aim of this study was to evaluate clinical effect of preoperative intravenous (IV) non-steroidal anti-inflammatory drugs (NSAIDs) on relief of postoperative pain in patients after laparoscopic cholecystectomy. Methods: This single center, retrospective study was conducted between September 2019 and May 2020. A total of 163 patients were divided into two groups: Ibuprofen group (preoperative IV ibuprofen, n = 77) and Ketorolac group (preoperative IV ketorolac, n = 86). The primary outcome was postoperative pain score measured immediately in the recovery room. Results: There was no difference in demographic characteristics between the two groups of patients. Postoperative pain score measured immediately in the recovery room was significantly higher in the Ibuprofen group than in the Ketorolac group (mean value: 5.09 vs. 4.61; p = 0.027). The number of patients who needed analgesics immediately in the recovery room was also higher in the Ibuprofen group than in the Ketorolac group (28 [36.4%] vs. 18 [20.9%]; p = 0.036). Conclusions: In this study, preoperative IV injection with ketorolac reduced postoperative pain and analgesic requirement in the recovery room more effectively than that with ibuprofen. However, both showed similar effects on peak pain and pain at discharge. Numbers of patients requiring additional analgesics were also similar between the two groups.

Effect of arthrocentesis on the clinical outcome of various treatment methods for temporomandibular joint disorders

  • Kim, Chang-Woo;Lee, Sung-Jae;Kim, Euy-Hyun;Lee, Dong-Keon;Kang, Mong-Hun;Song, In-Seok;Jun, Sang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.44.1-44.7
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    • 2019
  • Background: We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results: We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion: The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.