• Journal of Physiology & Pathology in Korean Medicine
• /
• v.21 no.2
• /
• pp.548-553
• /
• 2007

In general, cancer pain is neither fully recognized nor adequately treated. The inadequate pain control is due to failure of accurate assessment of cancer pain. This study was aimed to understand various characters of cancer pain and investigate available assessment scales which have been designed for, or frequently used with people with cancer pain. A total of 23 articles were selected from two different databases. The selected articles were analyzed according to three aspects of initial assessment, patient self-report and assessment of the outcomes of pain management. The characters of cancer pain is complex and includes physical, psychosocial, and spiritual dimension. Also, subjective pain can be classified into at least four specific factors, such as pain intensity, pain affect, pain relief, and pain quality. Based on various classification, the pain assessment scales can be divided into unidimensional or multidimensional. Among the more commonly used clinical tools are numeric rating scales, verbal rating scales, visual analog scales, and picture scales. Above all, in order to assess cancer pain objectively, the clinician must select appropriate assessment instruments which reflect pain definition and clinical purpose.

• The Korean Journal of Pain
• /
• v.12 no.1
• /
• pp.123-127
• /
• 1999

Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

• Journal of muscle and joint health
• /
• v.19 no.2
• /
• pp.173-183
• /
• 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.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.214-217
• /
• 2005

Spinal cord stimulation (SCS) was first attempted by Shearly et al for the relief of intractable pain. A spinal cord stimulator has traditionally been used for failed back surgery syndrome (FBSS) angina pectoris, complex regional pain syndrome (CRPS) and ischemic pain in the extremity. However, the complications associated with the use of a spinal cord stimulator, such as wound infection, hematoma, lead migration and device malfunction; make its long term application difficult. Here, our experience of an interesting case, in which intractable right leg pain was controlled using a spinal cord stimulator placed in the left epidural space, is reported, with a review of the literature.

• The Korean Journal of Pain
• /
• v.14 no.1
• /
• pp.118-122
• /
• 2001

Complex regional pain syndrome type I of vascular origin is difficult to detect unless the classic symptoms and signs exist and/or overt extremity trauma has precipitated the pain. The diagnosis is confirmed by relief of pain following a sympathetic nerve blockade. A 36-year-old woman with arterial occlusive disease of the right lower extremity presented with burning pain and hyperesthesia after sprain had occurred which was accompanied by motor weakness of right ankle. A lumbar sympathetic ganglion blockade with 2% lidocaine 10 ml and triamcinolone 80 mg produced prompt improvement of the pain and motion.

• Asian Oncology Nursing
• /
• v.12 no.1
• /
• pp.77-83
• /
• 2012

Purpose: This study was designed to describe outcomes of pain management, to identify pain intensity, pain management and barriers to pain management, and to test correlation among the variables in cancer patients who are registered in public health centers. Methods: By using a descriptive survey design, 3 instruments were used to collect data: the Numeric Rating Scale for pain, the Barriers Questionnaire-Korean version, and a one-item self-report tool about patient satisfaction. A sample of 190 patients with cancer was recruited from a public health center. Results: The mean rating for pain during the past 24 hours was mild and the mean score of barriers to pain management was 3.20. Patients were satisfied with pain management but they also had concerns it. A negative correlation was found among pain severity, pain relief and satisfaction of pain management. However, there was not significant correlation between the patient-related barriers to pain management and other variables. Conclusion: These results suggest that the intervention for cancer patients should focus not only on patient-related barriers to pain management, but also address health-care system related barriers.

• Physical Therapy Rehabilitation Science
• /
• v.2 no.1
• /
• pp.27-30
• /
• 2013

Objective: Low back pain is a primary of source of dysfunction and economic costs. Gluteus medius muscle co-activation and activity pattern change caused the low back pain. Active release technique (ART) is a patented, non-invasive, soft tissue treatment process that both locates and breaks down the scar tissue and adhesions. The purpose of this study was to assess the effects on chronic low back pain using ART on gluteus medius so that suggest usable treatment method for treating chronic low back pain. Design: One group pretest-posttest design. Methods: Twelve patients with chronic low back pain were participated in this study. Subjects in ART group were received 2 times a week for 3 weeks treatments with either ART on gluteus medius muscle trigger points. Outcome measures were conducted by pain intensity with a pain visual analogue scale and pressure pain threshold on gluteus medius. Results: Completion of the intervention, the visual analogue scale was decreased in ART group (p<0.05). Also pressure pain threshold was decreased in ART group (p<0.05). Conclusions: Our results suggest that the response to ART may be usable to treat low back pain. ART was presented to reduce pain level of low back in people with chronic low back pain. Further study is required to management for low back pain due to gluteus medius and more ART study.

• The Korean Journal of Pain
• /
• v.21 no.3
• /
• pp.229-232
• /
• 2008

Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.226-228
• /
• 1996

Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. The pain is usually spasmodic in nature and most commonly encountered in patients with carcinoma of the rectum or other pelvic organs. In 1988, Bristowand Foster reported that patients with severe spasmodic painful tenesmus were relieved with chemical sympathectomy. In 1990, Plancarte introduced block of Ganglion impar. This technique is proposed as an alternative means of managing localized perineal pain of sympathetic origin. Ganglion impar block was performed on a 54-year-old female patient when analgesic or psychotropic drugs failed to control the symptoms of post-traumatic severe spasmodic painful tenesmus. Postoperatively, patient was free of tenesmoid pain for only 7 days. We then performed neurotomy by RF lesion generator which provided complete pain relief.

• The Korean Journal of Pain
• /
• v.26 no.1
• /
• pp.3-13
• /
• 2013

Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.