• Title/Summary/Keyword: Enhanced Pain

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Bupivacaine-induced Vasodilation Is Mediated by Decreased Calcium Sensitization in Isolated Endothelium-denuded Rat Aortas Precontracted with Phenylephrine

  • Ok, Seong Ho;Bae, Sung Il;Kwon, Seong Chun;Park, Jung Chul;Kim, Woo Chan;Park, Kyeong Eon;Shin, Il Woo;Lee, Heon Keun;Chung, Young Kyun;Choi, Mun Jeoung;Sohn, Ju Tae
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.229-238
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    • 2014
  • Background: A toxic dose of bupivacaine produces vasodilation in isolated aortas. The goal of this in vitro study was to investigate the cellular mechanism associated with bupivacaine-induced vasodilation in isolated endothelium-denuded rat aortas precontracted with phenylephrine. Methods: Isolated endothelium-denuded rat aortas were suspended for isometric tension recordings. The effects of nifedipine, verapamil, iberiotoxin, 4-aminopyridine, barium chloride, and glibenclamide on bupivacaine concentration-response curves were assessed in endothelium-denuded aortas precontracted with phenylephrine. The effect of phenylephrine and KCl used for precontraction on bupivacaine-induced concentration-response curves was assessed. The effects of verapamil on phenylephrine concentration-response curves were assessed. The effects of bupivacaine on the intracellular calcium concentration ($[Ca^{2+}]_i$) and tension in aortas precontracted with phenylephrine were measured simultaneously with the acetoxymethyl ester of a fura-2-loaded aortic strip. Results: Pretreatment with potassium channel inhibitors had no effect on bupivacaine-induced relaxation in the endothelium-denuded aortas precontracted with phenylephrine, whereas verapamil or nifedipine attenuated bupivacaine-induced relaxation. The magnitude of the bupivacaine-induced relaxation was enhanced in the 100mM KCl-induced precontracted aortas compared with the phenylephrine-induced precontracted aortas. Verapamil attenuated the phenylephrine-induced contraction. The magnitude of the bupivacaine-induced relaxation was higher than that of the bupivacaine-induced $[Ca^{2+}]_i$ decrease in the aortas precontracted with phenylephrine. Conclusions: Taken together, these results suggest that toxic-dose bupivacaine-induced vasodilation appears to be mediated by decreased calcium sensitization in endothelium-denuded aortas precontracted with phenylephrine. In addition, potassium channel inhibitors had no effect on bupivacaine-induced relaxation. Toxic-dose bupivacaine-induced vasodilation may be partially associated with the inhibitory effect of voltage-operated calcium channels.

Rt $S_1$ Root Block during Rt $L_5$ Root Block in the Lumbar Radiculopathy (요부 신경질환에서 우측 $L_5$ 신경근 차단시 보여진 우측 $S_1$ 신경근 차단)

  • Kim, Jong-Lul;Yoon, Keon-Jung;Kang, Jun-Goo;Kim, Kyung-Hee;Lim, Chung-Hyuck;Lee, Myung-Woo;Park, Kyu-Ho;Choi, Hae-Sung
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.307-310
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    • 1998
  • Selective lumbosacral radiculography and nerve root block techniques are very useful in determining the nerve root involved. We have done the lumbar root block to 61-year-old female who had suffered from low back pain radiating to right lower leg which was not relieved by epidural steroid injection two times. $L_5$ root block was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we injected contrast medium (Isovist$^{(R)}$ - 300, Schering, Germany). After we injected 1.5 cc isovist, the S1 root was figured but L5 root was not figured. When we reinjected 1.5 cc isovist, $S_1$ root was enhanced and $L_5$ root was slightly visible due to severe disc bulging and lateral spinal stenosis.

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Various pain stimulations cause an increase of the blood glucose level

  • Sim, Yun-Beom;Park, Soo-Hyun;Kang, Yu-Jung;Jung, Jun-Sub;Ryu, Ohk-Hyun;Choi, Moon-Gi;Suh, Hong-Won
    • Animal cells and systems
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    • v.16 no.5
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    • pp.385-390
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    • 2012
  • The relationship between pain stimulation and the blood glucose level was studied in ICR mice. We examined the possible change of the blood glucose level after the pain stimulation induced by acetic acid injected intraperitoneally (i.p.),, formalin injected subcutaneously (s.c.) into the hind paw, or substance P (SP), glutamate, and proinflammatory cytokines (TNF-${\alpha}$ and IFN-${\gamma}$) injected intrathecally (i.t.). We found in the present study that acetic acid, formalin, SP, TNF-${\alpha}$, and IFN-${\gamma}$ increased the blood glucose level. The blood glucose level reached at maximal state 30 min and returned to normal level 2 h after the pain stimulation in a fasting group. Furthermore, acetic acid, formalin, SP, TNF-${\alpha}$, and IFN-${\gamma}$ caused the elevation of the blood glucose level in D-glucose-fed group only in an additive manner. However, i.t. injection of glutamate did not alter the blood glucose level in a fasting group. In contrast, i.t. injection of glutamate enhanced the blood glucose level in the D-glucose-fed group. Our results suggest that the blood glucose level appears to be differentially regulated by various pain stimulation induced by acetic acid, formalin, SP, glutamate, and pro-inflammatory cytokines.

A Case Report inculding Pharmacopuncture Therapy at Lumbar Facet joints for a Patient with Lumbar Disc Herniation with Lower Back Pain and Leg Radiating Pain that Worsen during Pregnancy (요추 후관절 약침 치료를 병행한 임신 중 요통 및 하지방사통이 악화된 요추 추간판 탈출증 환자 증례 보고)

  • Kim, Su-Jin;Kim, Sun-A;Kim, Min-Kyung;Lee, Si-Won;Kyung, Da-Hyun;Bae, Ji-Eun;Kwon, Yong-Su;Huh, Hyo-Seung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.93-103
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    • 2021
  • Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.

Effects of Scalp Nerve Block on the Quality of Recovery after Minicraniotomy for Clipping of Unruptured Intracranial Aneurysms : A Randomized Controlled Trial

  • Seungeun Choi;Young Hoon Choi;Hoo Seung Lee;Kyong Won Shin;Yoon Jung Kim;Hee-Pyoung Park;Won-Sang Cho;Hyongmin Oh
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.652-663
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    • 2023
  • Objective : This study compared the quality of recovery (QoR) after minicraniotomy for clipping of unruptured intracranial aneurysms (UIAs) between patients with and without scalp nerve block (SNB). Methods : Patients were randomly assigned to the SNB (SNB using ropivacaine with epinephrine, n=27) and control (SNB using normal saline, n=25) groups. SNB was performed at the end of surgery. To assess postoperative QoR, the QoR-40, a patient-reported questionnaire, was used. The QoR-40 scores were measured preoperatively, 1-3 days postoperatively, at hospital discharge, and 1 month postoperatively. Pain and intravenous patient-controlled analgesia (IV-PCA) consumption were evaluated 3, 6, 9, and 12 hours and 1-3 days postoperatively. Results : All QoR-40 scores, including those measured 1 day postoperatively (primary outcome measure; 155.0 [141.0-176.0] vs. 161.0 [140.5-179.5], p=0.464), did not significantly differ between the SNB and control groups. The SNB group had significantly less severe pain 3 (numeric rating scale [NRS]; 3.0 [2.0-4.0] vs. 5.0 [3.5-5.5], p=0.029), 9 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.048), and 12 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.035) hours postoperatively. The total amount of IV-PCA consumed was significantly less 3 hours postoperatively in the SNB group (2.0 [1.0-4.0] vs. 4.0 [2.0-5.0] mL, p=0.044). Conclusion : After minicraniotomy for clipping of UIAs, SNB reduced pain and IV-PCA consumption in the early postoperative period but did not improve the QoR-40 scores.

Stimulation of the Immune Response by Herbal Formulas for Wind-Cold and Heat Pain Symptom (대표적인 풍한열(風寒熱)에 의한 통증 치료 처방의 면역 활성화 비교 연구)

  • Jung, Da-Young;Ha, Hye-Kyung;Lee, Ho-Young;Lee, Jin-Ah;Lee, Jun-Kyoung;Huang, Dae-Sun;Shin, Hyeun-Kyoo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.616-623
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    • 2010
  • Three herbal formulas (Bangpungtongsung-san, Ohyaksungi-san, and Ojeok-san) for wind-cold and heat pain symptom were applied to investigate the immunological activities on antigen (Ag)-specific or Ag-non-specific immune responses in murine macrophage cell line (RAW 264.7) and ovalbumin (OVA)-immunized mice. This study was carried out in nitric oxide (NO) synthesis in RAW 264.7 cells and cellular proliferation in mouse splenocytes according to three herbal formulas. C57BL/6 mice were immunized intraperitonially with OVA/aluminium ($100\;{\mu}g/200\;{\mu}g$/mouse) on day 1, 8, and 15. Three herbal formulas were administrated to mice orally for 3 weeks from day 1. On day 22, OVA-, lipopolysaccharide (LPS)-, and concanavalin A (Con A)-stimulated splenocyte proliferation and antibodies (OVA-specific antibodies of the IgG, lgG1, and total IgM classes) in plasma were measured. Ohyaksungi-san increased NO synthesis in RAW 264.7 cells. Ojeok-san and Ohyaksungi-san significantly enhanced cellular proliferation by LPS and Con A in splenocytes from OVA-immunized mice (p<0.001). Three herbal formulas for wind-cold and heat pain symptom also significantly enhanced plasma OVA-specific IgG, IgG1, and total IgM levels compared with the OVA/Alum group. These results suggested that three herbal formulas for wind-cold and heat pain symptom could be used as stimulator of immune response.

Effects of Auricle Electric Stimulation on Pain, Gait and Balance in the Old Aged with Knee Joint Disease (외이전기자극이 슬관절질환 노인의 통증과 보행 및 균형에 미치는 영향)

  • Seo, Sam-Ki;Cho, Woon-Su;Lee, Jeong-Woo;Kim, Yong-Nam;Jung, Jin-Kyue;Hwang, Tae-Yeun
    • The Journal of Korean Physical Therapy
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    • v.20 no.2
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    • pp.11-17
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    • 2008
  • Purpose: This study examined the application of electric stimulation to the auricle acupoint (frequency 2 Hz, stimulation level: noxious) with 30 elderly people over 65 years that received treatment in a rural hospital to determine the influence of pain, gait and balance in the aged with knee joint disease. Methods: The subjects were divided into three groups; the degenerative joint diseases (DJD) group (1 male, 9 females), the total knee replacement (TKR) group (1 male, 9 females) and the control group (1 male, 9 females). Auricualr electrical stimulation (AES) was applied with low frequency, high intensity transcutaneous electrical nerve stimulation for 10 seconds per each point. Results: 1. For the change of pain according to AES, there was interaction in the resting period (p<0.001) and gait (p<0.001) and pain of the DJD group and TKR group was decreased. 2. The range of motion (ROM) of the knee joint showed a significant difference in interaction for each group of elderly people (p<0.001) and the ROM for the DJD group and TKR group of elderly people was increased. 3. In the analysis of gait speed changes, there was a significant difference in interaction for each group of elderly people (p<0.001) and for gait speed in the DJD group and TKR group of elderly people. 4. It was found in the change of static balance that there was a significant difference in interaction for each group of elderly people (p<0.01) and balance capacity in the DJD group and TKR group of elderly people was increased. Conclusion: The aged with knee joint disease have pain, and a decreased function of gait and balance. AES was an excellent treatment for control of pain, and an excellent treatment to enhanced joint functions. AES was useful for improving gait and balance due to decreased pain.

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Analgesic Effects of Triptolide and N-nitro-L-arginine Methyl Ester in Rat's Temporomandibular Joint Pain Model (흰 쥐의 측두하악관절 통증모델에서 Triptolide와 N-nitro-L-arginine Methyl Ester의 통증조절효과)

  • Kim, Yun-Kyung;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.15 no.6
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    • pp.800-806
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    • 2015
  • The aim of this study was to investigate whether intracisternal administrations of triptolide and N-nitro-L-arginine Methyl Ester (L-NAME) are involved in the regulation of temporomandibular joint (TMJ) pain. The TMJ pain was induced by the injection of 5% formalin ($30{\mu}l$) into TMJ capsule of rats. The pain behavioral responses was recorded the number of grooming or scratching on the left TMJ area for 9 successive 5 minutes intervals. Triptolide and L-NAME were administrated intracisternally 10 minutes before formalin injection. The intra-articular injection of formalin produced a biphasic pattern of pain response (first phase: 0~10 minutes and second phase: 11~45 minutes). The intracisternal administration of triptolide ($1{\mu}g/10{\mu}l$) and L-NAME ($0.1{\mu}g/10{\mu}l$) suppressed the TMJ pain behavior in each experiment. Co-administration of two drugs was shown the enhanced effect than the analgesic effect by single-administration of triptolide ($1{\mu}g/10{\mu}l$). The triptolide could be a useful analgesic agent for the treatment of TMJ pain, and it is expected to reduce the substantial amount of it via co-administration of synthetic chemical compound and natural products.

The Effects of Upper Limb Neuro Dynamic Treatment on the Pain, Grip Strength and Nerve Conduction Velocity of Patients with Carpal Tunnel Syndrome (상지역동학 치료가 수근관 증후군 환자의 통증, 악력, 신경전도속도에 미치는 효과)

  • Yu, Seong-Hun;Park, Sung-Doo;Kim, Tae-Won;Song, Hyun-Seung;Kim, Jin-Young
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.18 no.1
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    • pp.49-56
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    • 2012
  • Background: When applying the upper limb neurodynamic treatment ULNT1 and upper limb neurodynamic treatment ULNT2, The object of this study evaluates the pain and grip strength, nerve conduction velocity and tries to present the treatment that is effective in the carpal tunnel syndrome through the comparison of effect between tests. Methods: The ULNT1 (n=10) and ULNT2 (n=10) was applied to the carpal tunnel syndrome in patient of 20 subject for 10 time 5 set during 4 weeks. Both groups received conventional physical therapy (hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Results: The ULNT1 showed the difference which the result of this study significantly in the median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude, grip strength and pain. ULNT2 showed the difference significantly in median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude and pain. Conclusions: If it implements by applying the traditional physiotherapy and ULNT1 and ULNT2 to the carpal tunnel syndrome subjects according to the subject state and function, the remedial value can be more enhanced.

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Impact of KTO Method on the shoulder pain reduction (KTO(Korea Traditional Osteopathy)를 이용한 동결견 통증 완화 연구)

  • Kang, Cheol-Ho;Byun, Sang-Joon;Hong, Seong-Gyun
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.415-419
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    • 2012
  • Frozen shoulder was diagnosed with this study 14 patients were enrolled. Patients who volunteer to visit the configuration is more than six months and pain were studied in a chronic illness. Frozen shoulder to patients based on these results the effect of KTO treatment is a diet that is valid for a unified model and the exact effect can be enhanced, be combined with other treatments and therapies are deemed necessary. When applied to patients with Frozen shoulder KTO with an increased range of motion of the shoulder can result in a reduction of pain.