• The Korean Journal of Pain
• /
• v.25 no.1
• /
• pp.38-42
• /
• 2012

Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.

• Biomolecules & Therapeutics
• /
• v.19 no.1
• /
• pp.84-89
• /
• 2011

The present study was undertaken to determine whether combined treatment with prokinetic trimebutine and mosapride has a synergic effect on gastrointestinal motility and visceral pain associated with gastrointestinal dysfunction. To develop effective gastroprokinetic agents with greater potencies than trimebutine or mosapride for the treatment of gastrointestinal tract disease, a mixture of trimebutine and mosapride was designed and prepared. In the present study, treatment with trimebutine alone showed a dose-dependent effect on propelling movements of normal small and large intestine in mice, whereas mosapride effected only small intestine motility. Co-administration of trimebutine with mosapride, a well-established prokinetic drug, produced a synergistic influence on normal small intestine motility, but demonstrated an unclear effect on large intestine motility, with a slight tendency to reduce the propelling time. In a stress model, the small and large intestine motilities were significantly decreased. The reduction of intestine motility was restored to a normal level and the restoring effect was more pronounced in the combined treatment with trimebutine plus mosapride than treatment with trimebutine or mosapride alone. Furthermore, treatment with trimebutine plus mosapride significantly decreased acute visceral pain which was not controlled by trimebutine or mosapride alone. These data suggest that combination therapy with trimebutine plus mosapride has a synergic effect on small and large intestine motility and visceral pain control in gastrointestinal disorders.

• The Korean Journal of Pain
• /
• v.34 no.4
• /
• pp.479-486
• /
• 2021

Background: Prior studies have reported that 40%-90% of the patients with celiac plexus-mediated visceral pain benefit from the neurolytic celiac plexus block (NCPB), but the predictive factors of response to NCPB have not been evaluated extensively. This study aimed to identify the factors associated with the immediate analgesic effectiveness of NCPB in patients with intractable upper abdominal cancer-related pain. Methods: A retrospective review was performed of 513 patients who underwent NCPB for upper abdominal cancer-related pain. Response to the procedure was defined as (1) a decrease of ≥ 50% or ≥ 4 points on the numerical rating scale (NRS) in pain intensity from the baseline without an increase in opioid requirement, or (2) a decrease of ≥ 30% or ≥ 2 points on the NRS from the baseline with simultaneously reduced opioid consumption after NCPB. Logistic regression analysis was performed to determine the factors associated with successful responses to NCPB. Results: Among the 513 patients included in the analysis, 255 (49.8%) and 258 (50.2%) patients were in the non-responder and responder group after NCPB, respectively. Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] = 0.644, P = 0.035), history of upper abdominal surgery (OR = 0.691, P = 0.040), and celiac metastasis (OR = 1.496, P = 0.039) were the independent factors associated with response to NCPB. Conclusions: Celiac plexus metastases, absence of diabetes, and absence of prior upper abdominal surgery may be independently associated with better response to NCPB for upper abdominal cancer-related pain.

• The Korean Journal of Pain
• /
• v.19 no.2
• /
• pp.292-295
• /
• 2006

The diagnosis of chronic abdominal pain due to abdominal cutaneous nerve entrapment can be elusive. Tenderness in patients with abdominal pain is naturally assumed to be of either peritoneal or visceral origin. Studies have shown that some patients suffer from prolonged pain in the abdominal wall and are often misdiagnosed, even after unnecessary and expensive diagnostic tests, including potentially dangerous invasive procedures, and treated as having a visceral source for their complaints, even in the presence of negative X-ray findings and atypical symptoms. Abdominal cutaneous nerve entrapment syndrome is rarely diagnosed, which is possibly due to failure to recognize the condition rather than the lack of occurrence. The accepted treatment for abdominal cutaneous nerve entrapment syndrome is a local injection, with infiltration of anesthetic agents coupled with steroids. Careful history taking and physical examination, in conjunction with the use of trigger zone injections, can advocate the diagnosis of abdominal cutaneous nerve entrapment and preclude any unnecessary workup of these patients. Herein, 3 cases of abdominal cutaneous nerve entrapment syndrome, which were successfully treated with local anesthetics and steroid, are reported.

• The Korean Journal of Pain
• /
• v.32 no.2
• /
• pp.79-86
• /
• 2019

Background: The use of aroma oils dates back to at least 3000 B.C., where it was applied to mummify corpses and treat the wounds of soldiers. Since the 1920s, the term "aromatherapy" has been used for fragrance therapy with essential oils. The purpose of this study was to determine whether the essential oil of Eucalyptus (EOE) affects pain pathways in various pain conditions and motor coordination. Methods: Mice were subjected to inhalation or intraperitoneal injection of EOE, and its analgesic effects were assessed by conducting formalin, thermal plantar, and acetic acid tests; the effects of EOE on motor coordination were evaluated using a rotarod test. To determine the analgesic mechanism, 5'-guanidinonaltrindole (${\kappa}$-opioid antagonist, 0.3 mg/kg), naltrindole (${\delta}$-opioid antagonist, 5 mg/kg), glibenclamide (${\delta}$-opioid antagonist, 2 mg/kg), and naloxone (${\mu}$-opioid antagonist, 4, 8, 12 mg/kg) were injected intraperitoneally. Results: EOE showed an analgesic effect against visceral pain caused by acetic acid (EOE, 45 mg/kg); however, no analgesic effect was observed against thermal nociceptive pain. Moreover, it was demonstrated that EOE did not have an effect on motor coordination. In addition, an anti-inflammatory effect was observed during the formalin test. Conclusions: EOE, which is associated with the ${\mu}$-opioid pain pathway, showed potential effects against somatic, inflammatory, and visceral pain and could be a potential therapeutic agent for pain.

• Journal of Acupuncture Research
• /
• v.20 no.1
• /
• pp.74-84
• /
• 2003

Objective : We investigated association between excessiveness and deficiency of the visceral and twelve merdians and low back pain, by checking Yangdorak. Methods : Clinical studies were done 62 patients who were treated with low back pain to Dept. of Acupuncture & Moxibustion, Hospital of Oriental Medicine in Semyung University from August 2, 2002 to August 20, 2002. We divided low back pain patients into lumbar vertebra strain, herniated nucleous pulposus(H.N.P.) degenerative spondylosis(D.J.D) and tested the potentiality of skin resistance(Yangdorak) to them. Results: 1. H.N.P. groups were more than another groups in comparing with the States over Physiological Limits and the and excessiveness of merdians. 2. In degenerative spondylosis groups, excessiveness of the F3(kidney) was to be superior. In H.N.P. groups deficiency of the H5(triple energiger) was to be superior. In lumbar vertebra strain groups, deficiency of the H5(triple energiger) and excessiveness of the F2(Liver) was to be very superior. Conclusions: We could investigate the relationship of the excessiveness and deficiency of the visceral and twelve merdians to low back spain patients by checking Yangdorak. Specially, Deficiency of the H5(triple energiger) and H4(Small intestine) may be helpful in diagnosis H.N.P..

• The Journal of Korean Medicine
• /
• v.29 no.2
• /
• pp.32-40
• /
• 2008

Background: Angelica dahurica has been used in various clinical cases. Its taste is hot and its property is warm, dry and nonpoisonous. Its efficacy is to remove wind-damp, cure swelling and edema, exhaust pus, stop itching, rhinitis and leukorrhea. Object: To test through experiment Angelica dahurica's analgesic and anti-inflammatory efficacy. Method: Inject acetic acid as a pain-inducing substance to the mice and measure visceral pain bywrithing reflex. Inject carrageenan that is an edema-inducing substance to the rat's paw and measure volume of edema. Take thermal pain to mice with plantar test and measure paw withdrawal latency. Normal group is non Angelica dahurica-treated group and treated group is Angelica dahurica-treated group. Results: In acetic acid-induced visceral model, treatment with Angelica dahurica suppressed writhing reflex significantlyand dose-dependently. In carrageenan-induced paw edema model, treatment with Angelica dahurica suppressed carrageenan-induced paw edema. In plantar test model, no significant effect on the withdrawal latency of thermal stimulation-induced nociception was observed. Conclusion: Angelica dahurica has analgesic and anti-inflammatory efficacy.

• Clinical and Experimental Pediatrics
• /
• v.49 no.2
• /
• pp.129-135
• /
• 2006

Chronic recurrent abdominal pain is a common manifestation in children. Functional abdominal pain is the most common cause of chronic abdominal pain and can be diagnosed properly by the physician without the requirement of specific evaluation when there are no alarm symptoms or signs. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia, according to the Rome II criteria for pediatric functional gastrointestinal disorders. New concepts on the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, gastrointestinal dysmotility, inflammation, autonomic dysfunction, genetic predisposition, and triggering factors including psycho-social stress.

• Journal of Sasang Constitutional Medicine
• /
• v.26 no.1
• /
• pp.55-63
• /
• 2014

Objectives This research was performed to establish the clinical practice guideline(CPG) for Lesser Yin Symptomatology of Soeumin disease. Methods Dongeui suse bowon(sinchuk edition), textbook for Sasang constitutional medicine, Clinical guidebook for Sasang constitutional medicine, and standardization reports on Sasang constitutional medicine and papers concerning symptomatology of Soeumin Disease, especially Lesser Yin Symptomatology was collected and classified. Additionally experts' conference was held to make agreement on the conflicting issues on a regular basis. Results & Conclusions There was no concerning paper on Lesser Yin Symptomatology. Experts' agreement was needed to establish the CPG. Lesser Yin pattern can be classified into 2 groups; Lesser Yin severe pattern and Lesser Yin critical pattern. There are Lesser Yin pattern accompanied abdominal pain and bowel irritability pattern and Lesser Yin pattern accompanied green tinged watery diarrhea pattern in Lesser Yin severe pattern. There are Visceral syncope pattern and Exuberant yin repelling yang pattern in Lesser Yin critical pattern. Lesser Yin symptomatology has several symptoms like abdominal pain and diarrhea, thirst, oral discomfort, chest discomfort, whole body pain, articular pain and coldness of hands and feet. Additionally there are abdominal pain and diarrhea in Lesser Yin symptomatology accompanied abdominal pain and bowel irritability pattern, there is green tinged watery diarrhea in Lesser Yin pattern accompanied green tinged watery diarrhea pattern and if this symptoms exacerbate, delirious speech and constipation can occur. There are restlessness and coldness on hands and feet in Visceral syncope pattern and severe restlessness and coldness on hands and feet and symptom which the patient cannot drink water in Exuberant yin repelling yang.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.109-113
• /
• 1996

Even in the absence of any specific abnormal pathologic findings of the gastrointestinal tract, many patients still suffer from : fullness, anorexia and postprandial abdominal pain. As these symptoms are similar to visceral origin pain, many physicians focus on the discovery of pathologic abnormality of the gastrointestinal tract. At our Yoido Pain Clinic, after diagnosing myofascial pain syndrome, we treated 64 patients by trigger point injection and physical therapy on abnormal abdominal muscle, from June 1993 to April 1995. Most patients' conditions improved after these treatments.