• 제목/요약/키워드: Pain evaluation

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말초 opioid 수용체에 의한 저작근 통증의 조절 효과 (Effect of Peripheral Opioid Receptor on Masticatory Muscle Pain Control)

  • 고석호;강수경;어규식;김은철;홍정표;전양현
    • Journal of Oral Medicine and Pain
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    • 제38권2호
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    • pp.161-174
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    • 2013
  • 이 연구는 저작근 통증 환자에게 Morphine을 주사하였을 때의 조절 효과를 확인하기 위해서 시행되었으며, 경희대학교 치과대학병원 구강내과에 내원한 환자 중 RDC/TMD로 근막통증으로 진단된 환자들이 지원하였다. 실험군은 총 네 군으로 구성되었으며 saline 주사군, lidocaine 주사군, morphine 1.5mg 주사군, morphine 3.0 mg 주사군에 각각 10명씩 배정하였다. 통증부위에 주사 전, 주사 후 1시간, 24시간, 48시간에 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 통증평가에서 morphine 3 mg 군은 48시간 후 통계학적으로 유의성 있는 효과가 있었다.(VAS: p<0.01, MGQ: p<0.001, PD: p<0.05) 2. 객관적인 통증평가에서 morphine 1.5 mg 군은 1시간 후 통계학적으로 유의성 있는 효과가 있었다.(PPT: p<0.01, PPTol: p<0.05) 3. 맥길통증설문지에서 lidocaine 군, morphine 1.5 mg 군 그리고 morphine 3 mg 군은 모두 처치 후 1시간부터 효과가 있었으나 상대적으로 morphine 3 mg 군에서 통계학적으로 유의성 있게 더 큰 효과가 있었다.(1h: p<0.01, 24h: p<0.01, 48h: p<0.001) 이상의 연구 결과로 저작근에 통증이 있는 환자에게 morphine 주사 시 주관적인 평가에서 48시간 후 통증 조절 효과가 있었고, morphine 3 mg이 더 효과가 있었으며, 향후 시간 연장에 따른 지속적인 추가 연구가 필요 할 것으로 생각된다.

암 병동 간호사를 위한 통증모니터링 프로그램 개발 및 효과 (Implication and Evaluation of Pain Monitoring Program for Oncology Nurses)

  • 김연희;공성화;최진선;정지영;전명희
    • 한국간호교육학회지
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    • 제12권2호
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    • pp.196-204
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    • 2006
  • Purpose: This study was purposed to identify the effect of pain monitoring program for improving the knowledge, attitude and assessment ability of cancer pain in oncology nurses. Methods: In this study pain monitoring program was developed based on the literature, and constructed it with various teaching method including several group lectures, workshop, focus group and implementation at the clinical practices. In order to test the effect of this program, contrast group, pretest-post test quasi-experimental design was designed. 46 oncology nurses randomly assigned to either control or experimental group. The tool used are 32 item scale for the evaluation of the nurses' knowledge, attitude toward pain modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The pain monitoring program for the oncology nurses was statistically significant for improving the level of the knowledge about and attitude toward pain management, and pain assessment behavior. Conclusion: More sensitive multiple measurement tool for the attitude toward pain management needs to be developed. Nurses need more knowledge and effective attitude toward cancer pain management. Pain monitoring program in this study is effective to improve the quality of pain management.

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요통에 대한 휘담식 수기요법의 임상 적용 (Clinical application of Whidam's Su-Gi therapy to Low back pain)

  • 안훈모;장성진;강한주
    • 대한의료기공학회지
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    • 제21권1호
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    • pp.13-21
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    • 2022
  • Objective : This report aimed to provide an introduction to the clinical application of Whidam's Su-Gi therapy to low back pain. Methods : Whidam's Su-Gi therapy for low back pain consisted of manual therapy according to upward and downward evaluations. Upward evaluation items include SLR, hip joint LOM, legs raising together, raising knee and turning left and right, and waist raising. Downward evaluation items include spinal alignment in sitting position, shoulder part tension, and cervical part tension. After performing the manual therapy according to the evaluation at each stage, the pain and dysfunction are reevaluated to confirm the negative and proceed to the next step. Conclusions : The clinical application of Whidam's Su-Gi therapy to low back pain is a method of interpreting and approaching low back pain disease with the theory of attraction pathology according to the principle of ChoGi-therapy(調氣療法).

Secondary Trigeminal Neuralgia Caused by Pharyngeal Squamous Cell Carcinoma - A Case Report -

  • Kim, Min Seok;Ryu, Yong Jae;Park, Soo Young;Kim, Hye Young;An, Sangbum;Kim, Sung Woo
    • The Korean Journal of Pain
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    • 제26권2호
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    • pp.177-180
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    • 2013
  • Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

측두하악장애환자의 교합교정에 관한 장기평가 (Long-term Evaluation of Occlusal Adjustment in Patients with Temporomandibular Disorders)

  • Myung Yun Ko;Ki Hong Kwon;Jeom Il Choi
    • Journal of Oral Medicine and Pain
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    • 제11권1호
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    • pp.29-35
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    • 1986
  • 18 TMD patients who received occlusal adjustment in PNUH though Jan.1984 to 1985 were followed up for short-term(2-6yrs.) and long-term(1-2yrs.) evaluation. The obtained results were as follows : 1. Pain index showed gradual decrease after occlusal adjustment and significant change on long-term evaluation. 2. Noise index had no significant change throughout the all follow-up evaluation. 3. Opening limitation index showed gradual decrease after occlusal adjustment and significant change on both long-term and short-term evaluation. 4. Maximum comfortable opening exhibited more and more increase and significant change on long-term evaluation.

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Psychological Aspects of Burning Mouth Syndrome

  • Kim, Cheul
    • Journal of Oral Medicine and Pain
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    • 제40권1호
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    • pp.3-9
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    • 2015
  • The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.

신경병증성 통증 증후군의 관리를 위한 부가적 진통제로서의 Paroxetine (Paroxetine, as an Adjuvant Analgesic for the Management of Neuropathic Pain Syndrome)

  • 한태형;은종신;이상민;신백효
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.201-209
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    • 1998
  • Background: Tricyclic antidepressants (TCA) have been used for various pain syndromes for their analgesic effects. They, however, often have anticholinergic side effects and therefore search for more selective drugs with fewer side effects is justified. Paroxetine, a selective serotonin reuptake inhibitor devoid of autonomic side effects, was evaluated for its role as an analgesic adjuvant in the management of neuropathic pain. Method: According to individual diagnostic group as diabetic neuropathy, postherpetic neuralgia, central pain syndrome and cancer related plexopathy, 10 patients per each group were equally accumulated. Patients have been stabilized in their analgesic regimen at least four weeks prior to enrollment into study. TCA, if taken, was discontinued for two weeks for wash out period. Baseline four point verbal pain intensity score was obtained and oral administration of paroxetine 20 mg was initiated. At two weeks follow-up visit, pain intensity scores, pain improvement scores judged by family, drug efficacy, tolerability and overall evaluation were assessed. The incidence of side effects were also obtained. Result: After two weeks of treatment, pain intensity scores decreased in 77.5% of patients and no patients experienced aggravation. These findings were objectively reflected in pain improvement scores judged by family members. But, the number of nonresponders was different among groups. In drug efficacy, tolerability and overall evaluation, the proportions of patients who scored as excellent or good were 75%, 80% and 80% respectively. Incidence of side effects was 27.5%, but the side effects spontaneously disappeared after discontinuation of medication. Conclusion: Paroxetine, a selective serotonin reuptake inhibitor, appears to be effective as adjuvant analgesic for the management of various neuropathic pain syndromes.

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요통의 양도락 진단 및 평가에 관한 문헌 고찰 (A Review Study on Ryodoraku Diagnosis and Evaluation of Low Back Pain)

  • 송민호;양수진;이채원;이병렬;권정남
    • 대한한의학회지
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    • 제35권3호
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    • pp.116-124
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    • 2014
  • Objectives: This study aimed to evaluate Ryodoraku diagnosis and evaluation of low back pain reported in Korean, Japanese, Chinese and English. Methods: Using web search on five Korean databases, two Japanese, one Chinese and one English, we selected studies on Ryodoraku diagnosis and evaluation of low back pain. Results: Our initial search returned 26 Korean studies, 17 Japanese, 2 Chinese and 1 English. From them, we found 14 studies suitable for the purpose of this study. In general low back pain, studies showed that F4 (bladder) was the most frequently suggested abnormal Ryodoraku. In specific low back pain, Ryodoraku had no recognizable relation to disease-specific low back pain, but abnormal Ryodoraku of F2 (liver) and F5 (gall bladder) was frequently observed. More foot Ryodoraku showed abnormal than hand Ryodoraku. Conclusions: The diagnostic values of Ryodoraku for F2 (liver), F4 (bladder), H5 (triple energizer), F3 (kidney), and F5 (gall bladder) can be good diagnostic references, and future studies should be conducted on the aspect of differentiation of symptoms and signs.

정상근과 근막 유발점이 활성화된 근육의 초음파 영상의 비교 (Comparison of Ultrasonography Images on Normal Muscle and Myofascial Trigger Points Activated Muscle)

  • 김명훈;김수현;김현진
    • The Journal of Korean Physical Therapy
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    • 제25권2호
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    • pp.76-80
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    • 2013
  • Purpose: The objective of this study was to offer primary clinical data examining whether change of imaging structure and quantitative evaluation of muscle activity on myofascial trigger points can lead to implementation of an analytical technique for evaluation of myofascial pain diagnoses. In addition, we examined the effect of a variety of mediation techniques, in order to examine neuromuscular physiological characteristics of myofascial trigger points muscle by comparing differences in pressure pain threshold and ultrasound imaging. Methods: Participants in the study included 30 adults in their twenties. The subjects were divided into the normal and myofascial trigger points groups. Clinical outcomes were evaluated by pressure pain threshold for pain and ultrasound imaging was performed for evaluation of the structural characteristics of muscle. Independent t-test was used for statistical analysis. Results: The two groups showed statistical significance in the change in pressure pain threshold (p<0.05). Findings of ultrasound imaging analysis showed no significant differences, increased muscle thickness was observed (p>0.05). Findings of ultrasound imaging analysis showed significant differences, increased muscle echodensity was observed (p<0.05). Findings on ultrasound imaging analysis showed significant differences, increased muscle white area index was observed (p<0.05). Conclusion: From these results, active myofascial trigger points muscle showed quality deterioration on ultrasound imaging. Thorough evaluation of imaging structure and physiological characteristics can be useful quantitative analytical techniques for diagnosis of myofascial pain syndrome and a primary factor reflected in physical therapy intervention.