• Title/Summary/Keyword: pain relief

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The Effect of Transforaminal Epidural Block with Hyaluronidase and Triamcinolone (Hyaluronidase를 사용한 경추간공 경막외 차단의 효과)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myoung Hee
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.176-180
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    • 2005
  • Background: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. Methods: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. Results: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. Conclusions: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.

Percutaneous T2 and T3 Radiofrequency Sympathectomy for Complex Regional Pain Syndrome Secondary to Brachial Plexus Injury: A Case Series

  • Chen, Chee Kean;Phui, Vui Eng;Nizar, Abd Jalil;Yeo, Sow Nam
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.401-405
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    • 2013
  • Complex regional pain syndrome secondary to brachial plexus injury is often severe, debilitating and difficult to manage. Percuteneous radiofrequency sympathectomy is a relatively new technique, which has shown promising results in various chronic pain disorders. We present four consecutive patients with complex regional pain syndrome secondary to brachial plexus injury for more than 6 months duration, who had undergone percutaneous T2 and T3 radiofrequency sympathectomy after a diagnostic block. All four patients experienced minimal pain relief with conservative treatment and stellate ganglion blockade. An acceptable 6 month pain relief was achieved in all 4 patients where pain score remained less than 50% than that of initial score and all oral analgesics were able to be tapered down. There were no complications attributed to this procedure were reported. From this case series, percutaneous T2 and T3 radiofrequency sympathectomy might play a significant role in multi-modal approach of CRPS management.

Effects of a Postpartum Back Pain Relief Program for Korean Women

  • Oh, Hyun-Ei;Lee, Young-Sook;Shim, Mi-Jung;Kim, Jin-Sun
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.163-170
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    • 2007
  • Purpose. Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. Methods. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). Results. At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. Conclusions. A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.

The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.346-368
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    • 2021
  • Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

Postoperative Epidural Pain Control Evaluation of 1,054 Patients Undergoing Cesarean Section (제왕절개술후 경막외 통증조절경험 1,054예)

  • Yang, Soo-Jung;Yoon, Oh-Joon;Park, Kyung-Soo;Lee, Jae-Heu
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.91-95
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    • 1998
  • Background: Quality of postoperative care may be improved by management of postoperative pain. Epidural anesthesia and analgesia have several advantages over general anesthesia and parenteral analgesics in managing the postoperative pain. We retrospectively reviewed records of obstetrical patients who underwent the cesarean sections under epidural anesthesia to evaluate perioperative analgesic use, side effects, and complications. Methods: All patients received epidural anesthesia consisting of 0.25% bupivacaine, 2% lidocaine and 100 ${\mu}g$ fentanyl, followed by epidural analgesia with 0.1% bupivacaine and 12.5 ${\mu}g$/ml fentanyl at rate of 2 ml/hr for 48 hours. Patients' records were reviewed for: medications administered for pain relief, incidence of nausea and vomiting and pruritus, and presence of respiratory or cardiovascular depression. Results: Over 18 months, 1,054 patients' records were reviewed. Average age was 27.8 years (18~43 years). 768 patients (72.9%) received no additional drugs for the pain relief. Intramuscular analgesics, ketoprofens, were one time administered to 247 patients (23.4%), 39 patients (3.7%) received two more dosages. The time of administration was $8.3{\pm}4.3$ hours postoperatively. Antiemetics, for example, low-dose droperidol, were administerd one time for 160 patients (15.2%), 5 patients (0.5%) received two or more administrations. The medication was administered $5.1{\pm}4.2$ hours postoperatively. Drugs for relief of pruritus, low-dose naloxone, were administered one time for 108 patients (10.2%), 10 patients (0.9%) received 2 or more dosages. The time of administration was $6.3{\pm}4.2$ hours postoperatively. None of the patients experienced cardiovascular nor respiratory (<8 breath/min) depression. Conclusions: Postoperative continuous epidural analgesia in combination with bupivacaine and fentanyl is an effective method of providing postoperative analgesia with low incidence of side effects.

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Pharmacoeconomics Evaluation of Morphine, MS Contin and Oxycodone in the Treatment of Cancer Pain

  • Zhang, Wen-Zhou;Yu, Wei-Jiang;Zhao, Xiu-Li;He, Bao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8797-8800
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    • 2014
  • Objective: To analyze cost-effectiveness of morphine, MS contin and oxycodone in the treatment of cancer pain, providing guidance for rational drug use in the clinic. Methods: Confirmed by histology, a total of 171 patients with various cancers who required analgesic treatment were selected and divided into 3 groups, 57 cases for each group, given morphine, MS contin and oxycodone, respectively. If there appeared a poor short-term effect or aggravated sudden pain during the treatment, a short-acting morphine injection was given and adverse reactions were processed by symptomatic treatment. The pain relief rate and adverse reactions of groups were observed and pharmacoeconomics evaluation was undertaken. Results: The pain relief rates with morphine, MS contin and oxycodone were 89.5%(51/57), 91.2%(52/57) and 93.0%(53/57), respectively, with no difference samong groups (${\chi}^2=4.4489$, P=0.6162). The occurrence rates of adverse reactions were 59.7%(34/57), 54.4%(31/57) and 43.9%(25/57), again with no significant variation (P>0.05). The ratios of cost-effectiveness (C/E) for the 3 groups were $14.6{\pm}7.21$, $15.0{\pm}7.44$ and $16.1{\pm}8.10$. When the price of 3 kinds of analgesics was reduced by 10%, the ratios of cost-effectiveness were $12.2{\pm}6.53$, ($13.4{\pm}6.08$ and $14.5{\pm}6.74$ but there was no differences when compared with before the price adjustment (t=1.86, P=0.0651; t=1.30, P=0.1948; t=1.17, P=0.2453). Conclusion: Morphine, MS contin and oxycodone give similar pain relief and adverse reaction rates but of all, morphine is the preferred drug for the treatment of cancer pain from the perspective of pharmacoeconomics.

A Study on Pain relief effects and Allergic responses for the Osteoarthritis of the knee joint Between Sweet Bee Venom and Bee Venom Pharmacopuncture. (Sweet Bee Venom과 봉약침의 퇴행성 슬관절염에 대한 통증감소효과와 Allergy 반응 비교연구)

  • Na, Won-Min;Lee, Sung-Young;Jang, Eun-Ha;Moon, Hyung-Cheol;Kim, Seong-Min;Yoon, Chang-Ho;Jun, Bong-Hwan;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.10 no.2 s.23
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    • pp.47-55
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    • 2007
  • Objectives : To verify pain relief effects and allergy inhibitory action for the osteoarthritis of the knee joint in Sweet Bee Venom in which allergy causing enzyme is removed. Methods : We randomly allocated 36 participants to treatment group Sweet Bee Venom and Bee Venom. Outcomes on pain reduction were measured by 100mm VAS(Visual Analog Scale). And we recorded into details allergic responses during Pharmacopuncture treatment. Results : Whole body condition and pain rate through VAS measurement were improved significantly in 2 weeks. We could get difference in pain score of two Pharmacopuncture groups significantly in 2 weeks. BV group showed superior reduction in pain compared to the Sweet BV group. But we could not get difference in whole score of two pharmacopuncture groups significantly. On the other hand other allergic responses such as edema, itchiness, pain were significantly lower in the Sweet BV group.

Comparison of Fentanyl-Based Rapid Onset Opioids for the Relief of Breakthrough Cancer Pain: Drug Price Based on Effect Size

  • Seongchul Kim;Hayoun Jung;Jina Park;Jinsol Baek;Yeojin Yun;Junghwa Hong;Eunyoung Kim
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.43-50
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    • 2023
  • Background and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion: The rapid onset opioids that fit the patient's breakthrough cancer pain pattern have the best cost-effectiveness.

Effects of Local Anesthetic Cream on Pain Relief in Newborns During Venipuncture (신생아의 정맥천자시 통증 완화를 위한 국소마취 크림 적용 효과)

  • Kim, Hae-Won;Ahn, Hye-Young
    • Child Health Nursing Research
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    • v.17 no.4
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    • pp.215-221
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    • 2011
  • Purpose: Newborns routinely experience pain associated with invasive procedures such as blood sampling, venipuncture, heelstick, or venous cannulation. This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of local anesthetic cream during venipuncture. Methods: Participants were 70 newborns hospitalized in the nursery. Informed Consent was obtained from parents of the newborns. Venipuncture for regular blood sampling was carried out for a test on 2 groups; the experimental, placebo group. The neonatal infant pain scale (NIPS), and duration of crying were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. Results: There were significant differences in pain behavior during venipuncture (t=-4.752, p<.001), immediately after sampling (t=-5.591, p<.001), 3 minutes after puncture (t=-2.469, p=.017), and in duration of crying (t=-3.005, p=.004). Conclusion: Results show that local administration of EMLA cream before venipuncture causes a reduction in neonatal pain response, indicating that the EMLA cream has the effect of pain relief.

Changes in Pain, Muscle Strength and Flexibility according to Pinch Lift and Rubbing Manual Therapy and Stretching Application for Low Back Pain (스트레칭과 PMT 적용에 따른 요통환자의 통증, 근력, 유연성의 변화)

  • Paek, Yun Woong;Min, Soon;Lee, Byung Hoon;Shin, Myeong Gi
    • Journal of Korean Biological Nursing Science
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    • v.16 no.1
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    • pp.1-7
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    • 2014
  • Purpose: This research was implemented for men in their thirties who have lower back pain to observe general activity disorder patterns during pinch lift and rubbing manual therapy (PMT) and stretching application. Methods: Participants were divided into three groups: The PMT Group used applied pinch lift and rubbing manual therapy; the STR Group used applied stretching; and the CON Group was the control group. Participants for each group received treatments that were conducted three times a week for a total five weeks. Measures of pain utilized Visual Analogue Scale (VAS) [INCOMPLETE SENTENCE]. Results: There were significant differences between the PMT Group and the CON Group as well as the STR Group and the CON Group for pain, muscle strength and flexibility. There was a significant difference in pain between the PMT Group and the STR Group. Conclusion: As a result, it is inferred that PMT and stretching positively influenced recovery with regards to pain, muscle strength and flexibility relief; however PMT is more effective for pain relief than stretching.