• The Korean Journal of Pain
• /
• 제18권2호
• /
• pp.124-132
• /
• 2005

Background: This study was performed to evaluate the dose-related effects of naloxone on morphine analgesia in the rat formalin test, and observe the correlation of pain behavior and spinal c-fos expression induced by a formalin injection. Methods: Fifty rats were divided into five groups; control, morphine (morphine pre-treated, intra-peritoneal injection of 0.1 mg of morphine 5 min prior to formalin injection), and three naloxone groups, which were divided according to the administered dose-ratio of naloxone to morphine 20 : 1 ($5{\mu}g$), 10 : 1 ($10{\mu}g$), and 1 : 1 ($100{\mu}g$) representing the low-, medium-, and high-dose naloxone groups, respectively, were injected intra-peritoneally 16 min after a formalin. A fifty ul of 5% formalin was injected into the right hind paw. All rats were observed for their pain behavior according to the number of flinches during phases 1 (2-3, 5-6 min) and 2 (1 min per every 5 min from 10 to 61 min). The spinal c-fos expression was quantitatively analyzed at 1 and 2 hours after the formalin injection using a real-time PCR. Results: The morphine pre-treated (morphine and three naloxone) groups during phase 1, and the morphine, low- and medium-dose naloxone groups during phase 2, showed significantly less flinches compared to those of the control (P < 0.05). In the three naloxone groups, the numbers of flinches were transiently reduced following the naloxone injection in the low- and medium-dose groups compared to those of the morphine group (P < 0.05). The duration of the reduced flinches was longer in the medium-dose group (P < 0.05). The high-dose group revealed immediate increases in flinches immediately after the naloxone injection compared to those of the morphine, low- and medium-dose groups (P < 0.05 for each). The spinal c-fos expression showed no significant patterns between the experimental groups. Conclusions: Our data suggest that relatively low-dose naloxone (1/20 to 1/10 dose-ratio of morphine) transiently potentiates morphine analgesia; whereas, high-dose (equal dose-ratio of morphine) reverses the analgesia, and the spinal c-fos expression does not always correlate with pain behavior in the rat formalin test.

• 성인간호학회지
• /
• 제19권1호
• /
• pp.66-77
• /
• 2007

Purpose: This study was performed to evaluate the effectiveness of a pain assessment education program developed for nurses. Methods: Research design of this study was nonequivalent control group quasi-experimental study. Subjects for this study were 56 nurses for control group, and 53 nurses for experimental group. The experimental group participated in pain assessment education program. Data were collected before and 6 months after the program and analyzed using the SPSS 12.0 program. Results: The results of this study were as follows: In pretest, there were no significant differences in general characteristics, knowledge of pain, attitude toward pain and pain assessment behaviors. In post test, the experimental group had significantly higher scores of pain knowledge scores and pain assessment behaviors than control group. However, attitude toward pain remained unchanged. Conclusion: According to the results, pain assessment education program was effective in improving pain knowledge and pain assessment behavior.

• The Korean Journal of Pain
• /
• 제29권3호
• /
• pp.153-157
• /
• 2016

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

• The Korean Journal of Pain
• /
• 제23권2호
• /
• pp.109-115
• /
• 2010

Background: The pathophysiological and neurochemical changes following spinal injury are not yet elucidated. This study was designed to evaluate the morphological changes of the dorsal horn of the spinal cord and profiles of pain behaviors following intraspinal injection of NMDA in rats. Methods: Rats were randomized into three groups: a sham-operated control group and groups where the rats received 10 mM or 100 mM N-methyl-D-aspatate (NMDA) injected into their spinal dorsal horn. Following injection, hypersensitivity to cold and mechanical stimuli and excessive grooming behaviors were assessed serially for four weeks. Morphological changes of the spinal cord were evaluated four weeks after intraspinal injection. Results: Few animals in the NMDA groups developed hypersensitivity to cold and mechanical stimuli. The number of groomers and the severity of excessive grooming were significantly higher in the 100 mM NMDA group than those values of the control and 10 mM NMDA groups. The size of the neck region (lamina III-IV) was significantly smaller in the 100 mM NMDA group than in the control and 10 mM NMDA groups. Conclusions: In conclusion, intraspinal injection of NMDA in rats leads to the pathological sequela in the spinal cord and to excessive grooming behavior. These results support the use of NMDA and excessive grooming behavior after excitotoxic SCI as a model to study chronic pain after SCI.

• 대한간호학회지
• /
• 제22권1호
• /
• pp.5-16
• /
• 1992

The purposes of this study were : 1) to evaluate validity of a pain rating scale using the level of correlation between the Korean Pain Rating Scale(KPRS), Short -Form KPRS(SKPRS) and the Graphic Rating Scale(GRS). 2) to identify sensitivity of the scale using pain behavior of patients with chronic pain. Of the 2025 patients with chronic pain who visited the orthopedic and neurosurgical out - patients departments of 11 university hospitals in various districts of Korea, 520 subjects were selected through convenient sampling and responded to the questionnaires by mail. The results of the study can be summarized as follows : 1. The mean pain score measured by the KPRS was 444,85 : the mean sensory score was 209.47, the mean affective score, 147.63 and the mean miscellaneus score. 87.75. The mean pain score measured by the GRS was 20.11 : the mean sensory intensity score, 10.54. and the mean distress score, 9.57. 2. The average number of hours of rest during the day was 3.3, the average score of discomfort in carrying out ADL was 99, the average frequency of pain relieving practices was 3.0, the average number of pain sites was 3.6. 3. The most sensitive scale to differentiate each group was the GRS, the KPRS and SKPRS were less sensitive than the GRS. 4. The intercorrelation between the KPRS total score and the GRS score(.500) as well as that of the SKPRS score were highly correlated(.652), but intercorrelation between the SKPRS score and the GRS score(.172) was not high. Based on the above results, it was found that the SKPRS must be studied further to obtain validity.

• 재활간호학회지
• /
• 제15권1호
• /
• pp.30-38
• /
• 2012

Purpose: The purpose of this study was to understand the degree of pain belief in musculoskeletal patients, and to identify the correlation with chronic pain, pain coping and pain disability. Methods: A total of 203 inpatients or outpatients with chronic pain in orthopedics agreed voluntarily to participate in this study and answer a questionnaire. Data were analyzed using SPSS/WIN 17.0 program with descriptive statistics, t-test, ANOVA, Scheffe test, Pearson's correlation coefficient, and simple linear regression. Results: The degree of pain belief in this study showed statistically significant differences depending on their age, education, job, health status, and pain duration. Among the variables correlating with pain belief in this study, there were positive correlations between pain and pain disability, pain and passive coping, pain belief and passive coping, pain belief and pain, pain belief and pain disability. The strongest correlation was passive coping and pain disability. Conclusion: From the results of this study, we concluded that it is necessary to develop the nursing intervention which can help reducing negative pain belief in patients with chronic musculoskeletal pain. Also we need to enhance the ways of coping to active or chronic pains for controlling them effectively.

• 대한한의학회지
• /
• 제28권3호통권71호
• /
• pp.261-272
• /
• 2007

Objectives : This study was conducted to determine the analgesic effect of Acanthopanax sessiliflorus using the model of neuropathic pain and formalin-induced pain. Methods : A model of neuropathic pain was made by injuring the tibial nerve and sural nerve while the common peroneal nerve was maintained. After 2 weeks, the Acanthopanax sessiliflorus was orally administered to rats. The author performed behavioral teststo try out mechanical allodynia using von frey filament and cold allodynia using acetone, which are calculated by counting withdrawal response on foot. Thirty minutes after the Acanthopanax sessiliflorus injection in the abdominal cavity, the formalin test was performed. 2% formalin in a volume of $20{\mu}l$was injected subcutaneously into the plantar surface of the hindpaw with 26-G needle. To access formalin-induced pain behavior, paw licking time was measured every 5 min. Results : The Acanthopanax sessiliflorus 400mg/10ml/kg group showed significant decrease the withdrawal response of mechanical allodynia using von frey filament in the 10min, 30min, 60min and 120min increments compared with the control group. There were no significant differences in each group in the withdrawal response of cold allodynia using acetone. The Acanthopanax sessiliflorus group showed significant decrease in the formalin-induced pain behavior in the 15min, 20min and 25min increments compared with the control group. Conclusions : The Acanthopanax sessiliflorus may have a significant analgesic effect on the general pain as well as nerve injury pain.

• The Journal of Korean Physical Therapy
• /
• 제25권1호
• /
• pp.36-41
• /
• 2013

Purpose: To investigate whether the long-term use of a cane induces pain in the unaffected lower limb of stroke patients. Methods: A total of 107 stroke patients with chronic hemiparesis were recruited in this study and classified into two groups; a cane-use group (n=49) and non-cane-use group (n=58). The existence of pain in the unaffected lower limb was assessed on a visual analog scale in the hip, knee, and ankle joint, and the University of Alabama pain behaviors scale (UAB pain behavior scale) used to measure the intensity of pain. In addition, the Motricity Index (MI) was tested in the upper and lower extremities. Results: The proportion of pain in each joint of the lower limb was significantly higher in the cane-use group, compared to the non-cane-use group (p<0.05). In addition, significant differences were observed on the UAB pain behavior scale between the two groups. The lower MI score was significantly lower in the cane-use group, compared with the control group. However, no difference was observed in MI scores of the upper limb between the two groups. Conclusion: These findings reveal that long-term cane usage can induce pain in the unaffected lower limb of stroke patients. We suggest careful consideration when prescribing a cane, depending on functional ability in hemiparetic patients, and recommend continuous evaluation for pain in the affected lower limb.

• Clinical and Experimental Pediatrics
• /
• 제53권8호
• /
• pp.790-794
• /
• 2010

Purpose: The purpose of this study was to test the efficacy of treating the pain among newborn infants associated with a medical procedure with sucrose with regard to overall physiological and behavioral stability. Methods: 103 newborn infants were enrolled in this study. The control group (n=63) did not receive any treatment. The experimental group (n=40) received 2 mL of 24% sucrose solution two minutes before a routine heel stick. The pain was assessed by measurements of physiological changes [e.g. pulse rate, oxygen saturation, salivary cortisol (hydrocortisone)] and behavioral changes [e.g. crying time, and the neonatal infant pain scale (NIPS) for neonates]. Results: There were no differences among the groups with respect to physiological changes associated with the pain from the procedure. However, there were significant group differences in behavioral changes to the pain. In the control group, the median crying time was 13 seconds, while in the experimental group, the median crying time was 3.5 seconds ($P$=.000). In the control group the median NIPS score was 4, while in the experimental group the median NIPS score was 2 ($P$=.000). Conclusions: These findings suggest that sucrose can be an effective method for the management of stress responses in infants with regard to behavior. However, this treatment had no significant physiological effects.

• 대한한의학회지
• /
• 제24권2호
• /
• pp.193-203
• /
• 2003

Objectives : In this study, we investigated the effect and pathway of contralateral heterotropic electroacupuncture (EA) on pain induced by fonualin in rats. Methods : Acu-points in the right forepaws, HT 7 and PC 7 were stimulated with 3~4mA, 2ms, and 10Hz after 5% formalin (50ul) s.c. injection to the left hind paw. In addition, it was investigated whether the dorsolateral funiculus (DLF), known to be related the descending inhibition, mediates analgesic effects of the contralateral heterotropic EA or whether administration of naltrexone, an opioid antagonist, blocks the effect of EA. Results : The results showed that contralateral heterotropic electroacupuncture (EA) inhibited late phase (63.311.7%) of pain induced by fonualin in the behavioral test, but sham-EA had little effect on pain behavior (85.616.8%) and no analgesic effects after transection of the dorsolateral funiculus (95.718.7%). The pretreatment of naltrexone (10mg/kg, i.p.) could not inhibit the analgesic effects of EA on formalin-induced pain behavior (70.713.1%). Also,EA suppressed formalin injection induced expression of cFos like protein (cFL) in the dorsal homo but not sham-EA. Suppressed expressions of cFL in the spinal cord were eliminated after transection of the ipsilateral dorsolateral funiculus at T10-11 leve1s. However, pretreatment of naltrexone could not prevent the suppressive expressions of cFL at the spinal cord. Conclusions : These results suggest that the analgesic effect of contralateral heterotropic electroacupuncture may be modulated through the dorsolateral funiculus constituting the descending inhibition.