• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.9-17
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• 2023

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

• Journal of Oral Medicine and Pain
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• v.40 no.3
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• pp.89-95
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• 2015

All living organisms have a biological clock that orchestrates every biological process and function, and this internal clock operates following a circadian rhythm. This biological clock is known to influence various clinical indicators such as blood pressure and body temperature. Also, the fluctuation of signs and symptoms of diseases including pain disorders are affected by circadian rhythm. It has been reported that the pain intensity of various somatic and neuropathic pain disorders show unique pain patterns that depend on the passage of time. The generation of pain patterns could be explained by extrinsic (e.g., physical activity, tactile stimulation, ambient temperature) and also intrinsic factors (neural and neuroendocrine modulation) that are related to the circadian rhythm. It is important to recognize and identify the individual pain pattern in pain therapy to approve treatment outcome. Moreover, chronotherapeutics which considers pain patterns and pharmacokinetics in context of the circadian rhythm could produce greater analgesia in response to medication. However, only a limited number of studies handle the issue of pain patterns according to circadian rhythm and chronotherapeutics in the orofacial region. The present review intends to reflect on the most recent and relevant data concerning the bidirectional relation between pain disorders of the orofacial region and circadian patterns.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.333-339
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• 2009

Objective : Few studies on the clinical spectrum of automated pressure-controlled discography (APCD)-defined positive discs have been reported to date. Thus, the present study was undertaken to analyze clinical parameters critical for diagnosis of discogenic pain and to correlate imaging findings with intradiscal pressures and pain responses in patients with APCD-positive discs. Methods : Twenty-three patients who showed APCD-positive discs were selected for analysis. CT discogram findings and the degrees of nuclear degeneration seen on MRI were analyzed in comparison to changes of intradiscal pressure that provoked pain responses; and clinical pain patterns and dynamic factors were evaluated in relation to pain provocation. Results : Low back pain (LBP), usually centralized, with diffuse leg pain was the most frequently reported pattern of pain in these patients. Overall, LBP was most commonly induced by sitting posture, however, standing was highly correlated with L5/S1 disc lesions (p<0.01). MRI abnormalities were statistically correlated with grading of CT discogram results (p<005); with most pain response observed in CT discogram Grades 3 and 4. Pain-provoking pressure was not statistically correlated with MRI grading. However, it was higher in Grade 3 than Grade 4. Conclusion : APCD-positive discs were demonstrated in patients reporting centralized low back pain with diffuse leg pain, aggravated by sitting and standing. MRI was helpful to assess the degree of nuclear degeneration, yet it could not guarantee exact localization of the painful discs. APCD was considered to be more useful than conventional discography for diagnosis of discogenic pain.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.96-100
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• 1998

Bakground: At our institution, We have controlled pain during vaginal delivery with epidural block since 1986. We designed a questionaire for parturients to analyze the degree of satisfaction of epidural block. Method: The self-questionaire were sent to parturients(N=200), who had epidural block to control labor pain during vaginal delivery. The questionaire covered topics dealing with motivation, fear, satisfaction and complications, of epidural block. Results: Motivation by an experienced person was 72.5%(145 parturients), fear of epidural block was 66%(132 parturients), and satisfactory response was 84%(168 parturients). Parturients who knew the role of anesthesiologist numbered 105(52.5%). Scarcely, 46 parturients displayed confidence for safety of fetus; 111 parturients experienced more than one complications. But special therapy for complications were not necessary. Conclusions: Publicity through mass-media and direct contact will improve the recognition and merit of epidural block by parturients as well as the role of the department of anesthesiology.

• 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.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.327-335
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• 2022

Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.18-26
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• 2008

Background: Because genetic manipulation is commonly accomplished in mice, mouse models for pain have advanced our understanding of the mechanisms of persistent pain. The purpose of this experimental study is to develop a mouse model for understanding incision induced postoperative pain. Methods: A longitudinal incision was made at the hindpaw of male DBA/2 mice. The withdrawal frequency(WF) from applications of von Frey filaments and the response frequency (RF) to blunt mechanical stimulation were examined in an incision group and a control grouP. The withdrawal latency (WL) to radiant heat and a pain score based on weight bearing were also measured. Tests were performed 1 day before incision, and 2 hours, 1-3 days, 5 days and 7 days after incision. Results: The WF for the strongest filament was $35.0{\pm}9.1%$ before incision and this increased to $100.0{\pm}0%$ at 2 hours and to $65.0{\pm}9.1%$ at 7 days after incision. The RF to the blunt stimulus was $4.1{\pm}4.1%$ before incision and $100.0{\pm}0.0%$ at 2 hours and $42.8{\pm}10.8%$ at 7 days after incision. The WL was $6.6{\pm}0.5sec$ before incision and $2.4{\pm}0.3sec$ at 2 hours and $5.9{\pm}0.6sec$ at 7 days after incision. The pain score increased from $1.1{\pm}0.8$ to $7.4{\pm}1.5$ at 2 days after incision. Conclusions: A mouse model of acute postoperative pain was developing by making a surgical incision in the mouse hindpaw. Mechanical hyperalgesia and allodynia lasting for several days demonstrate that this model has similarities to the human post-operative pain state. Future studies will allow us to further investigate the genetic and molecular mechanisms of incisional pain.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.35-42
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• 2014

Background: Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods: Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results: More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions: Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.

• The Korean Journal of Physiology
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• v.21 no.1
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• pp.79-90
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• 1987

The present experiment was performed in 35 normal male volunteers to evaluate the effect of electroacupuncture on the human nociception more clearly and to demonstrate the effect of different parameters of electrical stimulation through acupuncture needles. The threshold of the pain(Tp) and the nociceptive flexion reflex(Tr), the threshold for intolerable pain(Tip) and that for obtaining maximal reflex response(Tmr) were studied before and after electroacupuncture performed on the acupoints of tsusanli and hsuanchung. 1) For the pricking pain, electroacupuncture with intermittent stimulation induced a significant decrease in Tp which recovered after removal of the needles. There was no significant change in other thresholds. 2) For the dull pain, electroacupuncture with intermittent stimulation produced a significant increase in Tp which continued after removal of the needles. But there was no signifcant change in Tip. Electroacupuncture with continuous stimulation induced a slight increase in Tp. 3) After resting without electroacupuncture, Tp and Tip of the dull pain were slightly decreased. These results suggest that electroacupuncture had no significant analgesic effect on the pricking pain induced by electrical stimulation of the foot skin. However, electroacupuncture with intermittent stimulation had significant analgesic effect on the weak dull pain and it had slightly greater analgesic effect than electroacupuncture with continuous stimulation.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.442-444
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• 2005

Objective : There were few reports about statistically significant factor which contribute to low back pain[LBP] after microscopic discectomy. We analyzed the result of percutaneous radiofrequency neurotomy[PRN] for low back pain after microscopic discectomy in lumbar disc herniation. Methods : Forty four patients with LBP after microscopic discectomy who were treated by one level microscopic discectomy from January 2003 to March 2004 were included in this study. They were divided into two groups by the presence of preoperative LBP into preoperative back pain group [group I] and postoperative back pain group [group II]. Radiofrequency procedures were performed in the usual manner, targetting the medial branch of L4, L5 and Sl. Pain relief was estimated at 1 week, 1 month and 6 months following the procedure, using the visual analogue scale. Above 50% pain relief was defined as the positive response. Results : Positive responders were 16 patients [73%] at 1 week, 12 patients [55%] at 1 month, and 7 patients [32%] at 6 months after PRN in group I. In Group II, 18 patients, 15 patients and 13 patients responded positively after 1 week, 1 month and 6 months after PRN, respectively. Conclusion : PRN is an effective treatment for newly developed low back pain after microscopic discectomy. There was no morbidity in our series, but long-term follow up is necessary.