• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.1
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• pp.29-34
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• 2008

배경: 신경병증성 통증은 스테로이드, 아편유사제 등의 진통제에 잘 반응하지 않는다. 하지만 염증성 매개물질들이 신경병증성 통증의 발생에 관여한다는 보고가 있다. 특히 선택적 COX2 억제제인 celecoxib의 신경병증성 통증에 대한 효과에 관해서 상반된 연구결과가 존재한다. 본 연구는 신경병증성 통증 모델인 척추신경 결찰모델을 이용 기계적, 냉각 이질통 및 온도감각 과민현상의 발현에 celecoxib이 미치는 영향을 관찰하여 celecoxib의 항통각효과를 확인하고자 하였다. 방법: 30마리의 쥐를 이용 척추신경을 결찰하여 신경병증성 통증을 유도하였다 celecoxib (1, 10, 100, and 300 mg/kg)을 경구 투여하였고 총 30마리 중 12마리의 쥐에서 열, 기계적자극에 대해서 통각과민, 냉각자극에 의해 이질통이 발생하였다. 약물 투여 후 30, 60, 120, 180분 후 von Frey, 냉각자극검사, Hargreaves검사를 시행하여 쥐의 행동변화를 관찰하였다. 결과: 신경결찰 후 5일 후에 celecoxib의 용량에 관계없이 열, 기계적 자극에 의한 통각과민, 냉각 자극에 대한 이질통을 감소시키지 않았다(P > 0.05). 또한 celecoxib투여에 의한 장기간의 항 통각효과는 관찰되지 않았다(P > 0.05). 결론: celecoxib을 경구로 투여하였을 때 장기간 유지된 신경병증성 통증 흰쥐에서 약의 투여용량, 투여기간에 따른 항 통각작용은 관찰되지 않았다. 따라서 조직 손상후 발생된 장기간의 신경병증성 통증에 있어서 celecoxib은 효과가 없는 것으로 사료된다.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.100-104
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• 2019

Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.80-84
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• 1992

49세 여자 환자가 경부 추간판 탈출증의 치료를 받기위하여 전신 마취하에 우측의 추궁 절제술과 전방 추체간 접합술을 받고난 즉시 회복실에서 부터 양측 상지에 작열통이 발생하였다. 환자는 양측 상지에 전형적인 작열통의 증상인 allodynia, 통각 과민(hyperalgesia), 통각 이상 과민증 (hyperpathia)을 보였으며 특히 우측 상지에는 심한 부종을 보이고 있었다. 환자는 일련의 성상 신경절 차단과 disposable $Daymate^{TM}$ portable elastomeric infusor를 이용한 연속적 상완신경총 차단으로 작열통이 완치되었다.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.1
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• pp.73-83
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• 2007

This study aims to examine the effects on nociceptive neuron excitability by application of electroacupuncture in rat with inflammation. It used 20 rats for experiment, divided them into control group, electroacupuncture group (EA group), caused hyperalgesia by injecting ${\lambda}$-carrageenan into hindpaw and conducted treatment three times for experimental period. Change of NFR(reaction time, RMS) showed no significant differences among EA group showed significant differences compared to control group from 48 hours. This study showed that EA group had an effect on nociceptive neurone excitability. Therefore, it is considered that electroacupuncture for pain control will be very desirable.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.181-194
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• 2004

The aim of this study was to investigate the effects of TENS and cold application on secondary thermal hyperalgesia in rats induced by muscle pain. Muscle pain was induced in male Sprague-Dowley rats by intra-muscular injection of gastrocnemius with $3\%$ carrageenan. The paw withdrawal latency(PWL) and tail flick test(TFT) to heat were used to detect secodary thermal hyperalgesia induced by the muscle pain. PWL and TFT were quantified before and 4, 10, and 24 h after induction of muscle pain and after application of TENS(100Hz, $100{\mu}s$, sensory intensity) and cold($4^{\circ}C$). TENS and cold significantly reduced the PWL and TFT to heat stimuli when compared with controls receiving no TENS and cold(p<.05). These results suggested that application of TENS and cold attributed to decrease secodary thermal hyperalgesia in rat induced by muscle pain.

• YAKHAK HOEJI
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• v.48 no.5
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• pp.285-290
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• 2004

The purpose of this study is to prove how magnetic field (MF) acts on sympathetic neuro-transmissions using thermal response. Mice were divided into two groups and each one was exposed to MF (20 G, 24 hrs) or sham. Every vehicle or drugs were treated a half hour before the thermal response test. The pain threshold was lowered by MF (20 G, 24 hrs) alone. This reduction of pain threshold by MF was not blocked by a single treatment of $\alpha$-receptor antagonist (prazosin), $\alpha$$_2$-receptor agonist (clonidine, guanabenz), $\beta$$_1$-receptor antagonist (atenolol) or $\beta$$_1$,$\beta$$_2$-receptor antagonist (propranolol). But administration of $\alpha$$_2$-receptor antagonist (yohimbine) completely inhibited the decrease in pain threshold by MF. Moreover, it increased by high dose of yohimbine over normal condition. These results suggest that MF acts on sympathetic nerve terminal to induce hyperalgesia, in which pre-synaptic az receptor might be involved.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.243-250
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• 2012

Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

• The Journal of Korean Physical Therapy
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• v.18 no.2
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• pp.25-34
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• 2006

Purpose: This study conducted quantitative sensory test and nociceptive flexion reflex(NFR) measurement to examine degree of pain depending on polarity of high voltage pulsed current(HVPC) of hyperalgesia site in hyperalgesia rat by local thermal injury. mechanical pain threshold, thermal pain threshold and root mean square of NFR were measured. Methods: This study was conducted with control group I of hyperalgesia rat at hind paw by thermal injury and experimental groups divided into cathodal HVPC group II, anodal HVPC group III and alternate HVPC group IV. It measured pain threshold and root mean square(RMS) of NFR and obtained the following results. Results: Mechanical pain threshold of hyperalgeisa site was significantly increased at groups II, III and IV applying HVPC group compared to control group, but there was no difference among HVPC groups. Thermal pain threshold of hyperalgesia site showed a significant increase in group II. Group III showed significant difference after 4 days of hyperalgesia. RMS of NFR at hyperalgeisa site was significantly reduced in group II after 2 days of hyperalgesia. Group III showed significant decrease after 5 and 6 days of hyperalgesia. Conclusion: Consequently it was found that application of HVPC of hyperalgesia site increased pain threshold at hyperalgesia site by mechanical stimuli and thermal stimuli. NFR by electrical stimuli was similar to pain threshold by mechanical stimuli. Effects by polarity of HVPC showed the greatest reduction of hyperalgesia when cathodal electrode was used.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.171-176
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• 1999

Background: Effect of nitric oxide on the hyperalgesia induced by inflammation is controversial. From our previous experiment, NOS inhibitor, L-NAME given during the induction period decrease mechanical hyperalgesia occured by Freund's complete adjuvant induced inflammation. In addition, we attempted to analyze the effects of L-NAME on mechanical hyperalgesia after the development of inflammation by Freund's complete adjuvant in rat paw. Methods: Male Sprague Dawley rats were divided into four groups; control (normal saline), and three different doses of L-NAME (0.1 mg, 1 mg, 10 mg). Inflammation was induced in rats by injecting 0.15 ml of Freund's complete adjuvant (FCA) intraplantarly. Rats showed typical hyperalgesia within twelve hours after injection and maintained this for about one week. Tests were done 2 days after injection of FCA. After the baseline test either L-NAME or saline was injected under light halothane anesthesia. Effect of L-NAME on hyperalgesia was assessed by measuring mechanical hyperalgesia at 15, 30, 60, 90, 120 minutes. Same experients were repeated on normal rats. Results: When injected at the site of inflammation, L-NAME caused dose dependent decrease in mechanical hyperalgesia. However, normal rats also showed increased mechanical threshold after L- NAME injection. Conclusions: Although L-NAME reduces FCA induced mechanical hyperalgesia, this result may solely be due to inhibition of nitric oxide production and need to be further determined.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.455-460
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• 2007

Majority of toothache is caused by abnormality of pulpal or periodontal tissues. However, there are numerous nonodontogenic sources that may be responsible for pain felt in the tooth. Nonodontogenic toothache may result from muscle, maxillary sinus, neuropathic, neurovascular, even cardiac and psychogenic problems. Myofascial pain is one of the most common abnormality characterized by palpation of a hard band which acts as the trigger point that causes stiffness and fatigue of the muscle, referral pain in tooth, tension-type headache, and hyperalgesia. Masseter muscle particularly induce referral pain in maxillary and mandibular molars. This case reported the treatment of the pain in right mandibular molar originated from myofascial pain of the right masseter. The pain is improved by general and reversible treatments such as muscle exercise, physical therapy, and medication. Nonodontogenic toothache should undergo proper differential diagnosis in order to avoid unnecessary dental treatments, such as endodontic, periodontic treatment, and tooth extraction, which would fail to alleviate the symptom of the patient.