Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Sex Differences in the Pain Control by the Peripheral Opioid

성별에 따른 말초 opioid의 통증조절

  • Bae, Sung-Jae (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Kim, Wan-Su (Department of Periodontology, Dental College, Wonkwang University) ;
  • Kang, Soo-Kyung (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Auh, Q-Schick (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Hong, Jung-Pyo (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Chun, Yang-Hyun (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University)
  • 배성제 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 김완수 (원광대학교 치과대학 치주과학교실) ;
  • 강수경 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 어규식 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 홍정표 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 전양현 (경희대학교 치의학전문대학원 안면통증구강내과학교실)
  • Received : 2013.10.21
  • Accepted : 2013.10.31
  • Published : 2013.12.30
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Abstract

This study was designed to evaluate the sex differences in the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group each from male (n=20) and female (n=20); saline injection group (n=5), lidocaine injection group (n=5), morphine 1.5 mg injection group (n=5) and morphine 3 mg injection group (n=5). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The male and female were significantly different statistically morphine 3 mg group in visual analogue scale evaluation. (male: p<0.05, female: p<0.05) 2. The male and female were more significantly different statistically morphine 3 mg group than morphine 1.5 mg group in McGill pain questionnaire evaluation. (male: p<0.001, female: p<0.01) 3. The male were significantly different statistically morphine 3 mg group in pain drawing evaluation and pressure pain threshold evaluation. (PD: p<0.001, PPT: p<0.05) Therefore, it was revealed that the morphine 3 mg injection for masticatory muscle pain was effective to pain control male patients and more effect than female patients in the objective pain evaluation.

이 연구에서는 말초 opioid 수용체를 이용한 저작근 통증 조절 시 성별 효과의 차이를 확인하고자 RDC/TMD로 진단된 지원자 남성 20명, 여성 20명을 saline 주사군, lidocaine 주사군, morphine 1.5 mg 주사군, morphine 3 mg 주사군 각각 5명씩 배정하였다. 통증부위에 주사 전, 주사 후 1시간, 24시간, 48시간에 각각 주관적인 통증 평가인 시각유추척도평가, 맥길통증설문지 평가, 통증부위표시평가 그리고 객관적인 통증 평가인 압력통증역치평가와 압력통증한계평가를 실시하였다. 검사 후 평가된 자료를 통계 처리하여 다음과 같은 결과를 얻었다. 1. 시각유추척도평가에서는 남녀 모두가 morphine 3 mg군에서 통계학적으로 유의성 있는 효과가 있었다. (male: p<0.05, female: p<0.05) 2. 맥길통증설문지 평가에서는 남녀 모두가 morphine 1.5 mg군 보다 morphine 3 mg군에서 더 통계학적으로 유의성 있는 효과가 있었다. (male: p<0.001, female: p<0.01) 3. 통증부위표시평가와 압력통증역치평가에서는 남성이 morphine 3 mg군에서 통계학적으로 유의성 있는 효과가 있었다. (PD: p<0.001, PPT: p<0.05) 이상의 연구 결과로 저작근 통증을 조절하기 위해서 morphine 3 mg을 통증부위에 주사한 경우 객관적인 통증 평가에서 여성 환자보다 남성 환자에게 더 효과가 있다는 것을 알 수 있었으며, 앞으로 시간에 따른 그리고 용량에 따른 남녀 치료효과의 차이에 관한 연구가 더 필요 할 것으로 생각된다.

Keywords

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