• Journal of Dental Anesthesia and Pain Medicine
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• 제23권5호
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• pp.273-280
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• 2023

Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

• 한국자원식물학회:학술대회논문집
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• 한국자원식물학회 2023년도 임시총회 및 춘계학술대회
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• pp.61-61
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• 2023

Zanthoxylum piperitum has been used as a spice or various folk remedies since ancient times, and studies on antibacterial, anti-inflammatory and analgesic effects have been reported. In this study, a raw material standardization study was conducted for the industrialization of Z. piperitum. First, optimal conditions for drying methods were established for the standardization of raw materials for Z. piperitum, and optimal conditions were established through content analysis using quercitrin, an marker compound, by obtaining samples every month. As for the drying method of Z. piperitum, it was confirmed that cold air drying was the best. It was analyzed that the marker compound content was highest in July. Next, for functional and toxicity evaluation of Z. piperitum, anti-oxidant, anti-inflammatory and immune enhancing efficacy and cytotoxicity were evaluated. Cytotoxicity of Z. piperitum was not observed, and it was confirmed that although it had an antioxidant and anti-inflammatory effect, it had no immuneenhancing effects. In addition, a study was conducted on the change in the efficacy of Z. piperitum using lava seawater, and as a result of the study, it was confirmed that the efficacy was superior when lava seawater was simultaneously treated. In conclusion, this study suggested the standardization of raw materials through the analysis of the marker compounds and the functional evaluation of Z. piperitum, and it can be used as basic data for future industrialization.

• 셀메드
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• 제13권14호
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• pp.17.1-17.23
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• 2023

Menopause is a physiological phase experienced by all women as part of normal aging known as menopause. Per se, menopause is not a disease, but hormonal imbalance may lead to menopausal symptoms in some women. The unani physician described that in Sinn-i-Inḥiṭāṭ/ Sinn al-Yās, Burūdat (coldness) increases lead to Ihtibās al-Tamth (amenorrhea) that can occur naturally. Besides, Khilt Dam (blood) production decreases from the liver, slight production occurs, tends towards Burūdat. Therefore, at this age, Ihtibās al-Tamth is associated with Alāmāt Sinn al-Yās(menopausalsymptoms) including weight gain, loss of appetite, hirsutism, fatigue, headache, backache, arthralgia, neck pain, general myalgia, nervousness, anxiety, depression, and insomnia. The traditional Unani manuscripts are enriched with knowledge for the management of Alāmāt Sinn al-Yās. Consequently, an extensive exploration of classical texts concerning the management of Alāmāt Sinn al-Yās was undertaken. Moreover, PubMed, Scopus, Google Scholar, and other indexing databases were thoroughly explored for evidence-based approaches to managing menopausalsymptoms. The principle management as per Unani texts is to treat the cause of Alāmāt Sinn al-Yās. Unani medicines with emmenagogue, anti-inflammatory, analgesic, cardioprotective, and neuroprotective properties are beneficial for the amelioration of Alāmāt Sinn al-Yās. Unani Herbs such as Asgandh, Aslusūs, Khārkhasak, Tagar, Shuneez, Ustukhuddus, Zafran, and Majūn Najāh possess properties and are proven scientifically for their efficacy in Alāmāt Sinn al-Yās. Hence, the substantiation and preservation of traditional knowledge assume paramount importance in facilitating prospective research and proving invaluable in the modern era. Moreover, the conduct of randomized controlled trials, systematic reviews, and meta-analyses becomes imperative.

• Hip & pelvis
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• 제35권2호
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• pp.63-72
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• 2023

The aim of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) for comparison of the effectiveness of pericapsular nerve group (PENG) block with that of other analgesic techniques for reduction of postoperative pain and consumption of opioids after total hip arthroplasty (THA). A search of records in the PubMed, Embase, and Cochrane Library, and ClinicalTrials.gov databases was conducted in order to identify studies comparing the effect of the PENG block with that of other analgesics on reduction of postoperative pain and consumption of opioids after THA. Determination of eligibility was based on the PICOS (participants, intervention, comparator, outcomes, and study design) criteria as follows: (1) Participants: patients who underwent THA. (2) Intervention: patients who received a PENG block for management of postoperative pain. (3) Comparator: patients who received other analgesics. (4) Outcomes: numerical rating scale (NRS) score and opioid consumption during different periods. (5) Study design: clinical RCTs. Five RCTs were finally included in the current meta-analysis. Significantly lower postoperative opioid consumption at 24 hours after THA was observed in the group of patients who received the PENG block compared with the control group (standard mean difference=-0.36, 95% confidence interval -0.64 to -0.08). However, no significant reduction in NRS score at 12, 24, and 48 hours after surgery and opioid consumption at 48 hours after THA was observed. The PENG block showed better results for opioid consumption at 24 hours after THA compared with other analgesics.

• 대한한방부인과학회지
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• 제37권1호
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• pp.23-39
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• 2024

Objectives: Primary dysmenorrhea (PD) is defined as abdominal pain during menstruation period in the absence of an identifiable pathological lesion. Corydalis tuber (CT) is an herbal medicine that has an excellent effect in relieving pain and convulsions. The purpose of this study is to observe the effect of Corydalis tuber aqueous extracts (CTe) on primary dysmenorrhea. Methods: The rats were injected with estradiol benzoate subcutaneously for 10 days (2.5 mg/kg on the first and 10th days, and 1 mg/kg from the 2~9th day). Oxytocin 1 U/kg was treated by peritoneal injection 1 hour after the last 10th injection of estradiol benzoate. CTe 400, 200 and 100 mg/kg were administered orally, once a day for 10 days at 30 minutes after each estradiol benzoate treatment. The results of CTe were compared to those of IND 5 mg/kg orally treated rats. Results: As results of estradiol benzoate and oxytocin administration, noticeable decreases of body weights and gains, uterus weights were observed with congestion and enlargement of the uterus at gross inspections, and increases of abdominal writhing responses, uterus MDA levels, GSH contents, SOD and CAT activities. However, these oxidative stress mediated PD signs were dose-dependently decreased by 10 consecutive days of oral administration of three different doses of CTe 400, 200 and 100 mg/kg as comparable to those of IND 5 mg/kg in CTe 200 mg/kg. Conclusions: CTe had a significant improvement effect on primary dysmenorrhea in the PD rat model induced by estrogen benzoate and oxytocin.

• Journal of Chest Surgery
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• 제57권3호
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• pp.291-299
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• 2024

Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods. Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME). Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01). Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.119-128
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• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• The Korean Journal of Pain
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• 제37권3호
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• pp.233-246
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• 2024

Background: Ferrostatin-1 and liproxstatin-1, both ferroptosis inhibitors, protect cells. Liproxstatin-1 decreases morphine tolerance. Yet, ferrostatin-1's effect on morphine tolerance remains unexplored. This study aimed to evaluate the influence of ferrostatin-1 on the advancement of morphine tolerance and understand the underlying mechanisms in male rats. Methods: This experiment involved 36 adult male Wistar albino rats with an average weight ranging from 220 to 260 g. These rats were categorized into six groups: Control, single dose ferrostatin-1, single dose morphine, single dose ferrostatin-1 + morphine, morphine tolerance (twice daily for five days), and ferrostatin-1 + morphine tolerance (twice daily for five days). The antinociceptive action was evaluated using both the hot plate and tail-flick tests. After completing the analgesic tests, tissue samples were gathered from the dorsal root ganglia (DRG) for subsequent analysis. The levels of glutathione, glutathione peroxidase 4 (GPX4), and nuclear factor erythroid 2-related factor 2 (Nrf2), along with the measurements of total oxidant status (TOS) and total antioxidant status (TAS), were assessed in the tissues of the DRG. Results: After tolerance development, the administration of ferrostatin-1 resulted in a significant decrease in morphine tolerance (P < 0.001). Additionally, ferrostatin-1 treatment led to elevated levels of glutathione, GPX4, Nrf2, and TOS (P < 0.001), while simultaneously causing a decrease in TAS levels (P < 0.001). Conclusions: The study found that ferrostatin-1 can reduce morphine tolerance by suppressing ferroptosis and reducing oxidative stress in DRG neurons, suggesting it as a potential therapy for preventing morphine tolerance.

• The Korean Journal of Pain
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• 제37권3호
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• pp.188-200
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• 2024

This review explores the essential methodologies for effective postoperative pain management, focusing on the need for thorough pain assessment tools, as underscored in various existing guidelines. Herein, the strengths and weaknesses of commonly used pain scales for postoperative pain-the Visual Analog Scale, Numeric Rating Scale, Verbal Rating Scale, and Faces Pain Scale-are evaluated, highlighting the importance of selecting appropriate assessment tools based on factors influencing their effectiveness in surgical contexts. By emphasizing the need to comprehend the minimal clinically important difference (MCID) for these scales in evaluating new analgesic interventions and monitoring pain trajectories over time, this review advocates recognizing the limitations of common pain scales to improve pain assessment strategies, ultimately enhancing postoperative pain management. Finally, five recommendations for pain assessment in research on postoperative pain are provided: first, selecting an appropriate pain scale tailored to the patient group, considering the strengths and weaknesses of each scale; second, simultaneously assessing the intensity of postoperative pain at rest and during movement; third, conducting evaluations at specific time points and monitoring trends over time; fourth, extending the focus beyond the intensity of postoperative pain to include its impact on postoperative functional recovery; and lastly, interpreting the findings while considering the MCID, ensuring that it is clinically significant for the chosen pain scale. These recommendations broaden our understanding of postoperative pain and provide insights that contribute to more effective pain management strategies, thereby enhancing patient care outcomes.

• The Korean Journal of Pain
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• 제37권3호
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• pp.218-232
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• 2024

Background: Cynara scolymus has bioactive constituents and has been used for therapeutic actions. The present study was undertaken to investigate the mechanisms underlying pain-relieving effects of the hydroethanolic extract of C. scolymus (HECS). Methods: The antinociceptive activity of HECS was assessed through formalin and acetic acid-induced writhing tests at doses of 50, 100 and 200 mg/kg intraperitoneally. Additionally, naloxone (non-selective opioid receptors antagonist, 2 mg/kg), atropine (non-selective muscarinic receptors antagonist, 1 mg/kg), chlorpheniramine (histamine H₁-receptor antagonist, 20 mg/kg), cimetidine (histamine H₂-receptor antagonist, 12.5 mg/kg), flumazenil (GABA_A/BDZ receptor antagonist, 5 mg/kg) and cyproheptadine (serotonin receptor antagonist, 4 mg/kg) were used to determine the systems implicated in HECS-induced analgesia. Impact of HECS on locomotor activity was executed by open-field test. Determination of total phenolic content (TPC) and total flavonoid content (TFC) was done. Evaluation of antioxidant activity was conducted employing 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay. Results: HECS (50, 100 and 200 mg/kg) significantly indicated dose dependent antinociceptive activity against pain-related behavior induced by formalin and acetic acid (P < 0.001). Pretreatment with naloxone, atropine and flumazenil significantly reversed HECS-induced analgesia. Antinociceptive effect of HECS remained unaffected by chlorpheniramine, cimetidine and cyproheptadine. Locomotor activity was not affected by HECS. TPC and TFC of HECS were 59.49 ± 5.57 mgGAE/g dry extract and 93.39 ± 17.16 mgRE/g dry extract, respectively. DPPH free radical scavenging activity (IC₅₀) of HECS was 161.32 ± 0.03 ㎍/mL. Conclusions: HECS possesses antinociceptive activity which is mediated via opioidergic, cholinergic and GABAergic pathways.