• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.61-71
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• 2016

Purpose: This study was designed to evaluate the comparison between the subjective and the objective evaluation of pain control effect in masticatory muscle pain depending on time and dose change. Methods: The patients were recruited to this study and diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Experimental group were divided into three groups; saline injection group (n=10), morphine 1.5 mg injection group (n=10), and morphine 3.0 mg injection group (n=10). Evaluation list was the subjective pain evaluation (visual analogue scale, McGill pain questionnaire) and the objective pain evaluation (pressure pain threshold [PPT], pressure pain tolerance [PTO]). The subjective and the objective pain evaluation were performed at the times of just before injection, 10 minutes, 30 minutes, 1 hour, 24 hours, and 48 hours after injection. Then, data were statistically analyzed. Results: The results were as follows: 1) There is no statistically significant difference between the results of the subjective and the objective pain evaluation with regard to the short-term (within 1 hour) analgesic effect of morphine sulfate. 2) However, after 1 hour of injection, while the subjective pain evaluation score still decreased, the objective pain evaluation didn't show significant changes in PPT and PTO (1 hour, p<0.05; 24 hours, p<0.01; 48 hours, p<0.001). 3) In comparison to changes in the dose, the McGill pain questionnaire was the most statistically effective method among the subjective pain evaluations (1.5 mg, p<0.05; 3 mg, p<0.01). Conclusions: Therefore, it was revealed that the subjective pain evaluation was more effective to evaluate long-term pain control, and that the McGill pain questionnaire could be an effective way to evaluate pain control depending on dose changes. It requires further investigations with time and dose extension.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.293-296
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• 2009

Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.

• Journal of Oral Medicine and Pain
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• 제37권3호
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• pp.169-182
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• 2012

이 연구는 Morphine을 이용한 저작근통증의 조절 효과를 확인하기 위해서 시행되었으며, 경희대학교 치과대학병원 구강내과에 내원한 환자 중 RDC/TMD로 진단된 지원자를 saline 주사군, lidocaine 주사군, morphine 주사군 각각 10명씩 배정하였다. 통증부위에 주사 전, 주사 후 10분, 30분, 60분에 각각 주관적인 통증 평가인 시각유추척도검사, 맥길통증설문지검사 그리고 통증부위표시검사와 객관적인 통증 평가인 압력통증역치검사와 압력통증한계검사를 실시하였다. 검사 후 평가된 자료를 통계 처리하여 다음과 같은 결과를 얻었다. 1. 주관적인 통증 평가와 객관적인 통증 평가 모두 집단 내 효과가 있었다. (p<0.001) 2. 주관적인 통증 평가인 통증부위표시검사(p<0.001)에서 집단 간 효과가 있었다. 3. 객관적인 통증 평가인 압력통증역치검사(p=0.025)에서 집단 간 효과가 있었다. 4. 주관적인 통증 평가인 통증부위표시검사는 morphine 주사군(p=0.001)이 saline 주사군에 비해서 효과가 있었다. 이상의 연구결과로 저작근에 통증이 있는 환자에게 morphine 주사 시 60분 이내에는 주관적인 평가에서 통증 조절 효과가 있었으며, 향후 시간 연장에 따른 지속적인 추가 연구가 필요 할 것으로 생각된다.

• The Korean Journal of Pain
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• 제20권1호
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• pp.1-7
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• 2007

Pain is one of the most common causes of disability and work loss. However, patients with chronic pain have not been regarded as impaired persons in the Republic of Korea because of a lack of objective findings in those patients and difficulties in validating their genuine suffering and quantitative evaluation of pain. Here, the difficulties in the evaluation of impairment in chronic pain patients are discussed. In addition, guidelines for rating impairment in chronic pain patients, which are under development by the Korean Academy of Medical Sciences, are introduced.

• 대한한방내과학회지
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• 제24권2_4호
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• pp.995-1006
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• 2003

Objective: The purpose of this study is to see whether pain in cancer patients is decreased by Eriobotryae Folium Fomentation. Methods: We examined the change in pain among six cancer patients, prescribing Eriobotryae Folium Fomentation. As for evaluating methods, we used the case history of pain, the direct evaluation of pain, the indirect evaluation of pain. The direct evaluation of pain is subdivided by the language expression, the non-language expression, and Visual analog scale(VAS). The indirect evaluation of pain is subdivided by the condition of walking, mood and the condition of sleep. Results: After two weeks, any remarkable pain decrease is not observed in both of the direct evaluation and indirect evaluation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.119-127
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• 2020

This study was conducted to determine how precooling reduces the subjective reported pain and objective pain and to evaluate the effectiveness of precooling the injection site before administration of local anesthesia in children. Electronic databases (PubMed, Ovid SP, Cochrane Central Register of Controlled Trials) were searched for publications from 1980 to 2020. Studies were screened for titles and abstracts, followed by full-text evaluation of included reports. Six studies were included in this systematic review. The primary outcome evaluated was the pain perception or the subjective pain reported by the child receiving the injection. The secondary outcome evaluated was objective pain evaluated in each study. Among 5 studies that evaluated child reported pain scores on a visual analogue scale (VAS), 4 studies reported lower scores in the precooling group and one study reported a higher VAS score in the precooling group than in children treated with 20% benzocaine topical anesthesia. Among 6 studies that evaluated the pain reaction of children by Sound Eye Motor (SEM) score, 4 studies reported a lower SEM score in the precooling group, one study reported no significant difference between the precooling and control groups, and one study reported higher SEM scores in the precooling group than in children treated with 20% benzocaine topical anesthesia. Within the limits of this systematic review, evidence suggests that precooling the injection site with ice can be an effective adjunct to topical anesthesia in reducing both subjective and objective pain during local anesthesia administration in children.

• The Korean Journal of Pain
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• 제23권1호
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• pp.28-34
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• 2010

Background: An independent medical examination (IME) is a critical process for awarding reparation for injury. However, conducting an IME in pain medicine is very difficult, not only because pain is a subjective symptom, but also because there are no proper objective methods to demonstrate it. This study was conducted to compare IME reports and the court decisions on the disability status of the patients. Methods: We analyzed 79 IME reports and 25 corresponding court decisions on the disability status of patients. The diagnoses, causal relationships between the patients' status and the trauma, McBride's degree of disability, the American Medical Association's impairment ratings, the estimated annual cost for future treatment, and the necessity of care-giving were compared and analyzed. Results: The diagnoses in the 79 cases were complex regional pain syndrome (CRPS) type I (58 cases), CRPS type II (7 cases), peripheral neuropathy (5 cases), myofascial pain syndrome (4 cases), herniated intervertebral disc (2 cases), and fibromyalgia (1 case). The types of accidents were road traffic accidents (50 cases), military injuries (14 cases), industrial accidents (11 cases), and others (4 cases). The IME reports and the court decisions stated considerably different McBride's degrees of disability (P = 0.014). However, there was no significant difference in the estimated cost for future treatment between the IME reports and the court decisions (P = 0.912). Conclusions: IME reports should be accurate, fair, and based on objective findings. Feedback on IMEs from the court decisions is helpful for reference use.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.327-335
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• 2023

Background: Pain control is a crucial aspect of pediatric dentistry for patient management. Thermo-mechanical devices (Buzzy^TM Pain Care Labs, USA) work on the concept of vibration and cooling and have shown promising results in pain control during local anesthesia in pediatric dentistry. On the other hand, audio distraction has also been used for pain management. The amount of pain endured is determined by the patient's perception and attentiveness. Thus, if audio function is added to the thermomechanical device it might increase its efficiency. Hence, the present study aimed to compare pain on injection using a thermo-mechanical device with and without audio during inferior alveolar nerve block (IANB) injection in children aged 5-10 years old. Methods: Twenty-eight children aged between 5 and 10 indicated for IANB were included in this randomized study. Children who were undergoing the dental procedure were divided into 2 groups, with 14 children in each group. The study group was the thermo-mechanical device with audio distraction; the control group was the thermo-mechanical device without audio distraction. IANB was administered. Subjective pain evaluation was performed using the Wong-Baker Faces Pain Rating Scale (WBFPR) and objective pain evaluation was done using the Faces, Leg, Activity, Consolability, Cry (FLACC) scale. Results: The outcome depicted a significant reduction in pain on injection for both objective and subjective evaluations in the thermo-mechanical device with an audio distraction group. Conclusions: Less pain on injection was observed, when a thermo-mechanical device was used with audio distraction for IANB procedures.

• 근관절건강학회지
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• 제19권2호
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• pp.173-183
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• 2012

Purpose: The purpose of this study was to analyze nursing records for pain management in intensive care unit (ICU) patients. Methods: Nursing process for pain management were analyzed retrospectively by 180 ICU patients' nursing records. Instruments consisted of 3 questionnaires (pain assessment, intervention, and evaluation). Results: For assessment, there was different pain intensity between cancer patients (7.95) and non-cancer patients (7.20). Also pain intensity was lower in PCA group (5.08) than in PCA with PRN group (8.27). Common pain site was surgical areas, along with 17 kinds of words expressed for pain, and mean of pain intensity was 7.47 by numeric rating scales (NRS). For intervention, the patients received pharmacologic interventions (99.4%) such as narcotic analgesics (38.3%) intermittently (70.5%) without side effects (94.4%). For evaluation, mean of pain intensity was decreased to 3.14, but a few patients (12.8%) experienced pain over 5 points despite the intervention. Nurses evaluated the degree of pain relief after the intervention in 87.2% of patients. Conclusion: Nurses do assess patients' pain by using objective tool, intervene, and evaluate for effective pain management. Nurses should make an individual approach and record all nursing activities for pain management.

• Journal of Acupuncture Research
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• 제19권2호
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• pp.137-148
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• 2002

Objective : The low back pain was the main reason of receiving acupuncture treatment. Despite its widespread prevalence, objective data assessing the pain and the results of various forms of treatment were difficult to find in korea. In order to compare the value of different types of treatment, it was necessary to use standard and meaningful forms of assessment. Methods : Pain and functional disability scales for low back pain were reviewed for contents, measurement properties and current methodological issues. Results and Conclusions : 1. The SF-36 Bodily Pain Scale and the Graded Chronic Pain Scale were commonly used for the standard pain scale. 2. The Oswestry Disability Questionnaire and the Roland-Morris Disability Questionnaire were commonly used for the standard function scale. 3. When evaluated, there was no definite answer to the results of the treatment. In the literature, the responsiveness of the Roland-Morris Disability Questionnaire ranged from 2 to 8 points but clinically, the ranges should be minimally changed from 2 to 3 points. 4. In the future, scale for low back pain should be standardized in multiple dimension so that the computerized adaptive testing by Item Response Theory could be widely used.