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Lee SH, Hwang SH, Moon YK, Bae HM, Moon DE. Assessment of Clinical Outcome of Lumbar Transforaminal Foraminoplasty in Patients with Lumbar Spinal Stenosis. Pain Physician 2021; 24:E1119-E1128. [PMID: 34704721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lumbar spinal stenosis (LSS), a common spinal disorder that negatively affects quality of life, is a disabling condition accompanied by back pain, leg pain, and claudication. Lumbar foraminal stenosis (LFS) is often accompanied by lumbar central stenosis (LCS) and conservative treatment is often ineffective. A surgical approach, including a minimally invasive technique, is usually recommended for the conservative treatment of refractory conditions. To achieve effective decompression of LSS, a specially designed new instrument for lumbar transforaminal foraminoplasty (TFFP) can be considered before opting for surgical treatment. OBJECTIVE To evaluate the clinical outcomes and safety of TFFP with a specially designed instrument. STUDY DESIGN Retrospective design. SETTING This research was conducted in a hospital outpatient surgical center. METHODS The medical records of 112 patients who underwent TFFP from December 1, 2018 to January 1, 2020, were reviewed. Outcome measures were obtained using the numeric rating scale for pain (NRS pain), Oswestry Disability Index (ODI), and walking distance without pain for functional ability at preprocedure and 1, 3, and 6 months postprocedure. The clinical data and radiologic findings were analyzed to evaluate correlations between predictive factors and efficacy of TFFP. RESULTS Among 112 patients who underwent TFFP, 110 were accessed and analyzed. The percentage of successful responders was 59.1%, 73.6%, and 74.5 % of 110 patients at one, 3, and 6 months, respectively. The NRS pain score, ODI, and duration of walking without radicular pain were improved significantly at the one-, 3-, and 6-month follow-up periods (all P < 0.001). No serious adverse events occurred during this study. LIMITATIONS The limitations of this study include the possibility of bias due to nonrandomized patient selection. CONCLUSION TFFP using the Foramoon® device (Mcarekorea, Seongnam-si, Gyeonggi-do, Republic of Korea) appeared to be effective for managing patients with LFS and LCS, who were refractory to conservative care.
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Affiliation(s)
- Sung Hyun Lee
- Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Ha Hwang
- Department of Anesthesia and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Kwan Moon
- Department of Orthopedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Hyun Min Bae
- Department of Anesthesia and Pain Medicine, The Moon Pain Clinic, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesia and Pain Medicine, The Moon Pain Clinic, Seoul, Korea
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Han YJ, Lee MN, Cho MJ, Park HJ, Moon DE, Kim YH. Contrast Runoff Correlates with the Clinical Outcome of Cervical Epidural Neuroplasty Using a Racz Catheter. Pain Physician 2016; 19:E1035-E1040. [PMID: 27676674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Epidural neuroplasty using a Racz catheter has a therapeutic effect. Studies have found no correlation between foraminal stenosis and the outcome of epidural neuroplasty, which is thought to depend on contrast runoff. OBJECTIVE To examine the correlation between the contrast spread pattern and pain reduction in cervical epidural neuroplasty using a Racz catheter. STUDY DESIGN Retrospective study. SETTING An interventional pain-management practice in a university hospital. METHODS Fluoroscopic images were reviewed retrospectively. The spread of contrast from the neural foramen to a nerve root was called contrast runoff. If the contrast did not spread in this manner, then there was no contrast runoff. We defined successful epidural neuroplasty as a 50% or greater reduction from the pre-procedure numeric rating scale (NRS) score for total pain, and an at least 40% reduction in the neck pain and disability scale (NPDS) score. RESULTS This study reviewed 169 patients. Among the patients who had a contrast runoff pattern, the epidural neuroplasty was rated as successful in 96 (74.4%), 97 (75.2%), 86 (66.7%), and 79 (61.2%) cases one, 3, 6, and 12 months after the procedure, respectively. When there was no contrast runoff, the epidural neuroplasty was successful in 12 (30%), 12 (30%), 10 (25%), and 10 (25%) cases at one, 3, 6, and 12 months after the procedure (P < 0.001). Logistic regression of the contrast spread pattern and predicting successful epidural neuroplasty gave similar results. Patients with a contrast runoff pattern had odds ratios of 6.788, 7.073, 6.000, and 4.740 at one, 3, 6, and 12 months, respectively (P < 0.001). LIMITATIONS This study lacked a control group, and the patients were not classified by their diagnosed disease, such as spinal stenosis, herniated nucleus pulposus, and post-spinal surgery syndrome. CONCLUSIONS Cervical epidural neuroplasty with a contrast runoff pattern had a higher success rate. Contrast runoff should be observed during neuroplasty, even in the presence of foraminal stenosis. KEY WORDS Cervical spinal pain, contrast, contrast runoff, epidural neuroplasty, percutaneous adhesiolysis, Racz catheter.
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Affiliation(s)
- Yun-Joung Han
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Myoung No Lee
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Min Ji Cho
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Dong Eon Moon
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Young Hoon Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
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Park J, Park HJ, Moon DE, Sa GJ, Kim YH. Radiologic Analysis and Clinical Study of the Upper One-third Joint Technique for Fluoroscopically Guided Sacroiliac Joint Injection. Pain Physician 2015; 18:495-503. [PMID: 26431125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Sacroiliac intraarticular injection by the traditional technique can be challenging to perform when the joint is covered with osteophytes or is extremely narrow. OBJECTIVE To examine whether there is enough space for the needle to be advanced from the L5-S1 interspinous space to the upper one-third sacroiliac joint (SIJ) by magnetic resonance image (MRI) analysis as an alternative to fluoroscopically guided SIJ injection with the lower one-third joint technique, and to determine the feasibility of this novel technique in clinical practice. STUDY DESIGN MRI analysis and observational study. SETTING An interventional pain management practice at a university hospital. METHODS We analyzed 200 axial T2-weighted MRIs between the L5 and S1 vertebrae of 100 consecutive patients. The following measurements were obtained on both sides: 1) the thickness of fat in the midline; 2) the distance between the midline (Point C) and the junction (Point A) of the skin and the imaginary line that connects the SIJ and the most medial cortex of the ilium; 3) the distance between the midline (Point C) and the junction (Point B) of the skin and the imaginary line that connects the SIJ and the L5 spinous process; 4) the distance between the SIJ and midline (Point C) on the skin, or between the SIJ and the midpoint (Point C') of the line from Point A to Point B; and 5) the angle between the sagittal line and the imaginary line that connects the SIJ and the midline on the skin. The upper one-third joint technique was performed to establish the feasibility of the alternative technique in 20 patients who had unsuccessful sacroiliac intraarticular injections using the lower one-third joint technique. RESULTS The mean distances from the midline to Point A and to Point B were 21.9 ± 13.7 mm and 27.8 ± 13.6 mm, respectively. The mean distance between the SIJ and Point C (or Point C') was 81.0 ± 13.3 mm. The angle between the sagittal line and the imaginary line that connects the SIJ and the midline on the skin was 42.8 ± 5.1°. The success rate of sacroiliac intraarticular injections with the upper one-third joint technique was 90% (18/20). LIMITATIONS This was an observational study and lacked a control group. CONCLUSIONS Sacroiliac intraarticular injections with the upper one-third joint technique are advisable when it is hard to perform them with the lower one-third joint technique.
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Affiliation(s)
- Junghyun Park
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | | | | | - Gye Jeol Sa
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
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Moon DE, Park HJ, Kim YH. Assessment of clinical outcomes of cervical epidural neuroplasty using a Racz-catheter and predictive factors of efficacy in patients with cervical spinal pain. Pain Physician 2015; 18:E163-E170. [PMID: 25794215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Epidural neuroplasty using the Racz catheter has a therapeutic effect in patients with cervical disc herniation and central stenosis who do not respond to fluoroscopically guided epidural injections. OBJECTIVE To evaluate the clinical outcomes of cervical epidural neuroplasty in patients with posterior neck and upper extremity pain and to demonstrate correlations between predictive factors and unsuccessful results of cervical epidural neuroplasty. STUDY DESIGN Observational study. SETTING An interventional pain management practice in a university hospital. METHODS Outcome measures were obtained using the numeric rating scale (NRS) for total pain, neck pain, arm pain, and sleep disturbance; and the neck pain and disability scale (NPDS); as well as opioid consumption at preprocedure, one month, 3, 6, and 12 months after procedure. Successful epidural neuroplasty was defined as 50% or greater reduction from the preprocedure NRS for total pain, and at least a 40% reduction in the NPDS. We obtained clinical data and radiologic findings to evaluate correlations between predictive factors and efficacy of epidural neuroplasty. RESULTS Of the 169 patients, successful outcomes were observed in 108 patients (63.9%) at one month following the procedure, in 109 patients (64.5%) at 3 months, in 96 patients (56.8%) at 6 months, and in 89 patients (52.7%) at 12 months. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament were significantly associated with unsuccessful outcomes as measured by NRS and NPDS (P < 0.05). LIMITATIONS Limitations of this evaluation include the lack of a placebo group. CONCLUSIONS Cervical epidural neuroplasty may be an effective treatment for pain reduction and functional improvement in patients with cervical spinal pain who did not respond to conservative treatment, and may decrease surgical demand. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament are associated with unsuccessful outcomes of epidural neuroplasty.
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Kim YH, Park HJ, Moon DE. Ultrasound-guided Pararadicular Injection in the Lumbar Spine: A Comparative Study of the Paramedian Sagittal and Paramedian Sagittal Oblique Approaches. Pain Pract 2014; 15:693-700. [DOI: 10.1111/papr.12249] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/07/2014] [Accepted: 07/13/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Young Hoon Kim
- Department of Anesthesiology and Pain Medicine; College of Medicine; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine; College of Medicine; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine; College of Medicine; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
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Jin EH, Zhang E, Ko Y, Sim WS, Moon DE, Yoon KJ, Hong JH, Lee WH. Genome-wide expression profiling of complex regional pain syndrome. PLoS One 2013; 8:e79435. [PMID: 24244504 PMCID: PMC3828360 DOI: 10.1371/journal.pone.0079435] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 09/23/2013] [Indexed: 11/20/2022] Open
Abstract
Complex regional pain syndrome (CRPS) is a chronic, progressive, and devastating pain syndrome characterized by spontaneous pain, hyperalgesia, allodynia, altered skin temperature, and motor dysfunction. Although previous gene expression profiling studies have been conducted in animal pain models, there genome-wide expression profiling in the whole blood of CRPS patients has not been reported yet. Here, we successfully identified certain pain-related genes through genome-wide expression profiling in the blood from CRPS patients. We found that 80 genes were differentially expressed between 4 CRPS patients (2 CRPS I and 2 CRPS II) and 5 controls (cut-off value: 1.5-fold change and p<0.05). Most of those genes were associated with signal transduction, developmental processes, cell structure and motility, and immunity and defense. The expression levels of major histocompatibility complex class I A subtype (HLA-A29.1), matrix metalloproteinase 9 (MMP9), alanine aminopeptidase N (ANPEP), l-histidine decarboxylase (HDC), granulocyte colony-stimulating factor 3 receptor (G-CSF3R), and signal transducer and activator of transcription 3 (STAT3) genes selected from the microarray were confirmed in 24 CRPS patients and 18 controls by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). We focused on the MMP9 gene that, by qRT-PCR, showed a statistically significant difference in expression in CRPS patients compared to controls with the highest relative fold change (4.0±1.23 times and p = 1.4×10−4). The up-regulation of MMP9 gene in the blood may be related to the pain progression in CRPS patients. Our findings, which offer a valuable contribution to the understanding of the differential gene expression in CRPS may help in the understanding of the pathophysiology of CRPS pain progression.
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Affiliation(s)
- Eun-Heui Jin
- Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Korea
- * E-mail: (EHJ); (WHL)
| | - Enji Zhang
- Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Youngkwon Ko
- Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Woo Seog Sim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Eon Moon
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Keon Jung Yoon
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University, Daejeon, Korea
| | - Jang Hee Hong
- Department of Phamacology, College of Medicine, Chungnam National University, Daejeon, Korea
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Korea
| | - Won Hyung Lee
- Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea
- Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Korea
- * E-mail: (EHJ); (WHL)
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Affiliation(s)
- Eun-Jeong Cho
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Kim ED, Kim YH, Park CM, Kwak JA, Moon DE. Ultrasound-guided Pulsed Radiofrequency of the Third Occipital Nerve. Korean J Pain 2013; 26:186-90. [PMID: 23614084 PMCID: PMC3629349 DOI: 10.3344/kjp.2013.26.2.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/13/2022] Open
Abstract
A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.
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Affiliation(s)
- Eung Don Kim
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Abstract
PURPOSE Levodopa is the most effective anti-Parkinsonian agent. It has also been known to exhibit analgesic properties in laboratory and clinical settings. However, studies evaluating its effects on neuropathic pain are limited. The aim of the present study was to examine the anti-allodynic effects of levodopa in neuropathic rats. MATERIALS AND METHODS Sprague-Dawley male rats underwent the surgical procedure for L5 and L6 spinal nerves ligation. Sixty neuropathic rats were randomly divided into 6 groups for the oral administration of distilled water and levodopa at 10, 30, 50, 70, and 100 mg/kg, respectively. We co-administered carbidopa with levodopa to prevent peripheral synthesis of dopamine from levodopa, and observed tactile, cold, and heat allodynia pre-administration, and at 15, 30, 60, 90, 120, 150, 180, and 240 min after drug administration. We also measured locomotor function of neuropathic rats using rotarod test to examine whether levodopa caused side effects or not. RESULTS Distilled water group didn't show any difference in all allodynia. For the levodopa groups (10-100 mg/kg), tactile and heat withdrawal thresholds were increased, and cold withdrawal frequency was decreased dose-dependently (p<0.01). In addition, levodopa induced biphasic analgesia. Different dosage of levodopa did not impact on the rotarod time (p>0.05). CONCLUSION Levodopa reversed tactile, cold and heat allodynia in neuropathic rat without any side effects.
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Affiliation(s)
- Hue Jung Park
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwan Seok Joo
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Young Hoon Kim
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ou-Kyoung Kwon
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jaemin Lee
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Sung Kim
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Bae HM, Park YJ, Kim YH, Moon DE. Stevens-johnson syndrome induced by carbamazepine treatment in a patient who previously had carbamazepine induced pruritus - a case report -. Korean J Pain 2013; 26:80-3. [PMID: 23342214 PMCID: PMC3546217 DOI: 10.3344/kjp.2013.26.1.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 10/16/2012] [Accepted: 10/16/2012] [Indexed: 11/05/2022] Open
Abstract
Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction. In addition, we strongly recommend gradual titration when initiating treatment with carbamazepine.
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Affiliation(s)
- Hyun Min Bae
- Department of Anesthesiology and Pain Medicine, Catholic Medical Center, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Yoo SH, Lee DH, Moon DE, Song HK, Jang Y, Kim JB. Anatomical investigations for appropriate needle positioning for thoracic paravertebral blockade in children. J Int Med Res 2013; 40:2370-80. [PMID: 23321195 DOI: 10.1177/030006051204000636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Clinicians hesitate to perform thoracic paravertebral blockade (TPVB) in children due to the potential high risk of adverse effects. No paediatric anatomical guidelines for TPVB exist. This study aimed to estimate the appropriate depth and distance for safe needle positioning in children. METHODS The depth (D) from the skin to the paravertebral space and the distance (A) from the spinous process to the needle entry point on the skin were measured using chest computed tomography (CT) in children aged between 1 and 9 years. Correlations between age, gender, weight, height, body mass index (BMI) and each of the anatomical measurements were analysed. RESULTS Each measurement correlated significantly with age, weight and height, but not with BMI (n = 373 children). Measurements A and D could be calculated by: A = 13.56 + (0.33 × age [years]) + (0.06 × weight [kg]) + 0.47 × (gender [female = 0, male = 1]); and D = 17.49 - (0.35 × age [years]) + (0.55 × weight [kg]). CONCLUSION These anatomical guidelines for TPVB are recommended to help prevent anaesthetic complications such as pneumothorax, when ultrasonography and CT are unavailable.
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Affiliation(s)
- S H Yoo
- Department of Anaesthesia and Pain Medicine, Soonchunhyang University Hospital Cheonan, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
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Park HJ, Kim YH, Koh HJ, Park CS, Kang SH, Choi JH, Moon DE. Analgesic effects of dexmedetomidine in vincristine-evoked painful neuropathic rats. J Korean Med Sci 2012; 27:1411-7. [PMID: 23166426 PMCID: PMC3492679 DOI: 10.3346/jkms.2012.27.11.1411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 09/12/2012] [Indexed: 11/20/2022] Open
Abstract
Dexmedetomidine, which is a selective α2-adrenoceptor agonist, was recently introduced into clinical practice for its analgesic properties. The purpose of this study was to evaluate the effects of dexmedetomidine in a vincristine-evoked neuropathic rat models. Sprague-Dawley rats were injected intraperitoneally with vincristine or saline (0.1 mg/kg/day) using a 5-day-on, 2-day-off schedule for 2 weeks. Saline and dexmedetomidine (12.5, 25, 50, and 100 µg/kg) were injected to rats developed allodynia 14 days after vincristine injection, respectively. We evaluated allodynia at before, 15, 30, 60, 90, 120, 180, and 240 min, and 24 hr after intraperitoneal drug (normal saline or dexmedetomidine) injection. Saline treatment did not show any differences for all the allodynia. Maximal paw withdrawal thresholds to mechanical stimuli were 3.0 ± 0.4, 9.1 ± 1.9, 13.0 ± 3.6, 16.6 ± 2.4, and 24.4 ± 1.6 g at saline, 12.5, 25, 50, and 100 µg/kg dexmedetomidine injection, respectively. Minimal withdrawal frequency to cold stimuli were 73.3 ± 4.2, 57.1 ± 6.8, 34.3 ± 5.7, 20.0 ± 6.2, and 14.3 ± 9.5 g at saline, 12.5, 25, 50, and 100 µg/kg dexmedetomidine injection, respectively. Dexmedetomidine shows a dose-dependent antiallodynic effect on mechanical and cold stimuli in vincristine-evoked neuropathic rat models (P < 0.05).
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Affiliation(s)
- Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Young Hoon Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Jung Koh
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chul-Soo Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung-hee Kang
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong-Ho Choi
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Park JS, Kim YH, Jeong SA, Moon DE. Ultrasound-guided Aspiration of the Iatrogenic Pneumothorax Caused by Paravertebral Block -A Case Report-. Korean J Pain 2012; 25:33-7. [PMID: 22259714 PMCID: PMC3259135 DOI: 10.3344/kjp.2012.25.1.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 11/22/2011] [Accepted: 11/23/2011] [Indexed: 11/08/2022] Open
Abstract
Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.
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Affiliation(s)
- Jin Suk Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Choi HS, Kim YH, Han JW, Moon DE. A new technique for inferior hypogastric plexus block: a coccygeal transverse approach -a case report-. Korean J Pain 2012; 25:38-42. [PMID: 22259715 PMCID: PMC3259136 DOI: 10.3344/kjp.2012.25.1.38] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 11/15/2011] [Accepted: 11/17/2011] [Indexed: 11/17/2022] Open
Abstract
Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.
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Affiliation(s)
- Hong Seok Choi
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Moon DE, Lee DI, Lee SC, Song SO, Yoon DM, Yoon MH, Kim HK, Lee YW, Kim C, Lee PB. Efficacy and tolerability of pregabalin using a flexible, optimized dose schedule in Korean patients with peripheral neuropathic pain: a 10-week, randomized, double-blind, placebo-controlled, multicenter study. Clin Ther 2011; 32:2370-85. [PMID: 21353106 DOI: 10.1016/j.clinthera.2011.01.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2010] [Indexed: 01/01/2023]
Abstract
BACKGROUND Clinical trials from various countries have reported the efficacy of pregabalin for reducing peripheral neuropathic pain. OBJECTIVE This study assessed the efficacy and tolerability of pregabalin in Korean patients with neuropathic pain. METHODS This was a Phase III, 10-week, randomized, double-blind, placebo-controlled, multicenter study. Patients aged ≥ 18 years with neuropathic pain (diabetic peripheral neuropathy, postherpetic neuralgia, or posttraumatic neuropathic pain) were enrolled and randomly assigned (2:1 ratio) to pregabalin (150-600 mg/d) or matching placebo. Randomization was performed using a proprietary telerandomization system. The primary end point was the difference in week 8 least squares (LS) mean Daily Pain Rating Scale (DPRS) score (rated once daily from 0 ["no pain"] to 10 ["worst possible pain"]) between pregabalin and placebo, calculated using the average of the last 7 available DPRS scores. Secondary efficacy measures included the following: the proportion of responders whose DPRS scores were reduced by ≥ 30% or ≥ 50% versus baseline, the Daily Sleep Interference Scale (DSIS; 11-point scale, scored daily), the Euro Quality of Life assessment (EQ-5D; 2 items scored separately), the Medical Outcomes Study (MOS) Sleep Scale (12 items each scored separately), the Hospital Anxiety and Depression Scale (HADS; 2 items scored from 0 to 21), the Patient Global Impression of Change (PGIC) and the Clinical Global Impression of Change (CGIC; each scored on a 7-point scale), and tolerability assessments. Adverse events and vital signs were monitored throughout the study with laboratory measurements, physical examinations, neurologic examinations, and 12-lead ECG tests. Data were analyzed using ANCOVA or Cochran-Mantel-Haenszel test, and P < 0.05 was considered statistically significant. RESULTS The treatment groups (n = 162 pregabalin; n = 78 placebo) were well matched at baseline (pregabalin: 51.2% [83/162] female; mean [SD] age, 59.7 [10.8] years; weight, 63.6 [9.3] kg; placebo: 59.0% [46/78] female; mean age, 61.3 [12.9] years; weight, 62.0 [9.5] kg). All patients were Korean. The mean doses at end point were 480 mg/d for pregabalin and 513 mg/d for the placebo equivalent. Most patients received concomitant drug treatments during the study: 79.6% (129/162) in the pregabalin group and 92.3% (72/78) in the placebo group. The mean DPRS score at end point was significantly lower in the pregabalin group than in the placebo group (LS mean difference, -0.50; 95% CI, -1.00 to 0.00; P = 0.049). In total, 26.1% (42/161) of pregabalin-treated patients reported ≥ 50% improvement in mean DPRS scores from baseline, compared with 14.3% (11/77) for placebo (P = 0.041 between groups). The LS mean change in the DSIS from baseline to end point favored pregabalin (-0.51; 95% CI, -0.96 to -0.07; P = 0.024). Significant improvements were also recorded for overall MOS sleep interference score (difference in LS means, -0.65; P = 0.018) and HADS anxiety subscale score (-0.85; P = 0.038). Other secondary assessments (eg, EQ-5D, HADS depression subscale, PGIC, and CGIC) did not reach significance. A higher proportion of patients reported treatment-related adverse events with pregabalin (43.8% [71/162]) than with placebo (29.5% [23/78]). Dizziness (21.0% [34/162]), somnolence (13.6% [22/162]), face edema (6.2% [10/162]), peripheral edema (6.2% [10/162]), and weight gain (5.6% [9/162]) were the most commonly reported adverse events in the pregabalin group. CONCLUSION Flexible-dose pregabalin (150-600 mg/d for 8 weeks) was associated with a significant, although modest, reduction in mean DPRS score; an improvement in anxiety and subjective sleep; and generally good tolerability compared with placebo in these Korean patients with neuropathic pain due to diabetic peripheral neuropathy, postherpetic neuralgia, or posttraumatic neuropathic pain.
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Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Korea, Seoul, Korea
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Kim W, Kim JS, Lim SC, Kim YI, Moon DE. Reversible Posterior Leukoencephalopathy Syndrome After Cervical Transforaminal Epidural Steroid Injection Presenting as Transient Blindness. Anesth Analg 2011; 112:967-70. [DOI: 10.1213/ane.0b013e31820bff7e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cho SK, Heiby EM, McCracken LM, Moon DE, Lee JH. Daily functioning in chronic pain: study of structural relations with posttraumatic stress disorder symptoms, pain intensity, and pain avoidance. Korean J Pain 2011; 24:13-21. [PMID: 21390174 PMCID: PMC3049972 DOI: 10.3344/kjp.2011.24.1.13] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 01/27/2011] [Accepted: 01/28/2011] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. METHODS Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. RESULTS The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. CONCLUSIONS Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.
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Affiliation(s)
- Sung Kun Cho
- Department of Psychology, College of Medicine, Chung-Ang University, Seoul, Korea
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Abstract
Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain. The usual approach to treat mild to moderate pain is to start with a nonopioid analgesic. If this is inadequate, and if there is an element of sleep deprivation, then it is reasonable to add an antidepressant with analgesic qualities. If there is a component of neuropathic pain or fibromyalgia, then a trial with one of the gabapentinoids is appropriate. If these steps are inadequate, then an opioid analgesic may be added. For moderate to severe pain, one would initiate an earlier trial of a long term opioid. Skeletal muscle relaxants and topicals may also be appropriate as single agents or in combination. Meanwhile, the steps of pharmacologic treatments for neuropathic pain include (1) certain antidepressants (tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors), calcium channel α2-δ ligands (gabapentin and pregabalin) and topical lidocaine, (2) opioid analgesics and tramadol (for first-line use in selected clinical circumstances) and (3) certain other antidepressant and antiepileptic medications (topical capsaicin, mexiletine, and N-methyl-d-aspartate receptor antagonists). It is essential to have a thorough understanding about the different pain mechanisms of chronic pain and evidence-based multi-mechanistic treatment. It is also essential to increase the individualization of treatment.
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Affiliation(s)
- Hue Jung Park
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee MH, Yang KS, Kim YH, Jung HD, Lim SJ, Moon DE. Accuracy of live fluoroscopy to detect intravascular injection during lumbar transforaminal epidural injections. Korean J Pain 2010; 23:18-23. [PMID: 20552068 PMCID: PMC2884208 DOI: 10.3344/kjp.2010.23.1.18] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 12/21/2009] [Accepted: 12/24/2009] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Complications following lumbar transforaminal epidural injection are frequently related to inadvertent vascular injection of corticosteroids. Several methods have been proposed to reduce the risk of vascular injection. The generally accepted technique during epidural steroid injection is intermittent fluoroscopy. In fact, this technique may miss vascular uptake due to rapid washout. Because of the fleeting appearance of vascular contrast patterns, live fluoroscopy is recommended during contrast injection. However, when vascular contrast patterns are overlapped by expected epidural patterns, it is hard to distinguish them even on live fluoroscopy. METHODS During 87 lumbar transforaminal epidural injections, dynamic contrast flows were observed under live fluoroscopy with using digital subtraction enhancement. Two dynamic fluoroscopy fluoroscopic images were saved from each injection. These injections were performed by five physicians with experience independently. Accuracy of live fluoroscopy was determined by comparing the interpretation of the digital subtraction fluoroscopic images. RESULTS Using digital subtraction guidance with contrast confirmation, the twenty cases of intravascular injection were found (the rate of incidence was 23%). There was no significant difference in incidence of intravascular injections based either on gender or diagnosis. Only five cases of intravascular injections were predicted with either flash or aspiration of blood (sensitivity = 25%). Under live fluoroscopic guidance with contrast confirmation to predict intravascular injection, twelve cases were predicted (sensitivity = 60%). CONCLUSIONS This finding demonstrate that digital subtraction fluoroscopic imaging is superior to blood aspiration or live fluoroscopy in detecting intravascular injections with lumbar transforaminal epidural injection.
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Affiliation(s)
- Min Hye Lee
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Lim SJ, Park HJ, Lee SH, Moon DE. Ganglion impar block with botulinum toxin type a for chronic perineal pain -a case report-. Korean J Pain 2010; 23:65-9. [PMID: 20552077 PMCID: PMC2884216 DOI: 10.3344/kjp.2010.23.1.65] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Revised: 11/26/2009] [Accepted: 12/17/2009] [Indexed: 11/05/2022] Open
Abstract
Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.
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Affiliation(s)
- Su Jin Lim
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Yang KS, Kim YH, Park HJ, Lee MH, Kim DH, Moon DE. Sacral nerve stimulation for treatment of chronic intractable anorectal pain -a case report-. Korean J Pain 2010; 23:60-4. [PMID: 20552076 PMCID: PMC2884202 DOI: 10.3344/kjp.2010.23.1.60] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 12/21/2009] [Accepted: 12/29/2009] [Indexed: 11/05/2022] Open
Abstract
Despite recent methodological advancement of the practical pain medicine, many cases of the chronic anorectal pain have been intractable. A 54-year-old female patient who had a month history of a constant severe anorectal pain was referred to our clinic for further management. No organic or functional pathology was found. In spite of several modalities of management, such as medications and nerve blocks had been applied, the efficacy of such treatments was not long-lasting. Eventually, she underwent temporary then subsequent permanent sacral nerve stimulation. Her sequential numerical rating scale for pain and pain disability index were markedly improved. We report a successful management of the chronic intractable anorectal pain via permanent sacral nerve stimulation. But further controlled studies may be needed.
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Affiliation(s)
- Kyung Seung Yang
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Kim YS, Park HJ, Kim TK, Moon DE, Lee HJ. The effects of Ginkgo biloba extract EGb 761 on mechanical and cold allodynia in a rat model of neuropathic pain. Anesth Analg 2009; 108:1958-63. [PMID: 19448231 DOI: 10.1213/ane.0b013e31819f1972] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Neuropathic pain is chronic pain that is caused by an injury to the peripheral or central nervous system. The symptoms of neuropathic pain are continuing pain, hyperalgesia, and allodynia. Ginkgo biloba extract is an oriental herbal medicine that has various pharmacological actions. We examined the effect of Ginkgo biloba extract, EGb 761, on the mechanical and cold allodynia in a rat model of neuropathic pain. METHODS Male Sprague-Dawley rats were prepared by tightly ligating the left L5 and L6 spinal nerves. All the rats developed mechanical and cold allodynia 7 days after surgery. Fifty neuropathic rats were assigned into five groups for the intraperitoneal administration of drugs. The study was double-blind and the order of the treatments was randomized. Normal saline and EGb 761 (50, 100, 150, and 200 mg/kg) were administered, respectively, to the individual groups. We examined mechanical and cold allodynia at preadministration and at 15, 30, 60, 90, 120, 150, and 180 min after intraperitoneal drug administration. Mechanical allodynia was quantified by measuring the paw withdrawal threshold to stimuli with von Frey filaments of 1.0, 1.4, 2.0, 4.0, 6.0, 8.0, 10.0, 12.0, 15.0, and 26.0 g. Cold allodynia was quantified by measuring the frequency of foot lift with applying 100% acetone. We measured the locomotor function of the neuropathic rats by using the rotarod test to reveal if EGb 761 has side effects, such as sedation or reduced motor coordination. RESULTS The control group showed no differences for mechanical and cold allodynia. For the EGb 761 groups, the paw withdrawal thresholds to mechanical stimuli and withdrawal frequencies to cold stimuli were significantly reduced versus the preadministration values and versus the control group. The duration of antiallodynic effects increased in a dose-dependent fashion, and these were maintained for 120 min at the highest dose (P < 0.05). Only at the highest dose (200 mg/kg) did EGb 761 reduce the rotarod performance time. CONCLUSION We conclude that Ginkgo biloba extract, EGb 761, attenuates mechanical and cold allodynia in a rat model of neuropathic pain, and it may be useful for the management of neuropathic pain.
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Affiliation(s)
- Yee Suk Kim
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Kim DY, Yu MR, Kang SH, Park JM, Moon DE. Pulsed Radiofrequency of the Sphenopalatine Ganglion for Treatment of a Cluster Headache - A case report -. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.2.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dae Young Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mi Ran Yu
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Hee Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Min Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kang SH, Han HJ, Kim WY, Kim DY, Moon DE. Pulsed Radiofrequency of Lumbar Dorsal Root Ganglia for Treatment of Chronic Inguinal Herniorrhaphy Pain - A case report -. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.2.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seung Hee Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyo Jo Han
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Young Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dae Young Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park JJ, Moon DE, Park SJ, Choi JI, Shim JC. Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome - A case report -. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.1.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jung Ju Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Jae Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Il Choi
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Chol Shim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea
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Park HJ, Lee Y, Lee J, Park C, Moon DE. The effects of botulinum toxin A on mechanical and cold allodynia in a rat model of neuropathic pain. Can J Anaesth 2006; 53:470-7. [PMID: 16636031 DOI: 10.1007/bf03022619] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Botulinum toxin type A (BoNT-A) has been used to treat many disorders related to excessive muscle contraction, but there are few studies evaluating its effects on neuropathic pain. The aim of this study was to evaluate the analgesic effects of BoNT-A in a rat model of neuropathic pain. METHODS Male Sprague-Dawley rats were prepared by ligating the left L5 and L6 spinal nerves to produce neuropathic pain. Seventy neuropathic rats were randomly assigned into seven groups. Either normal saline or BoNT-A (10, 20, 30 and 40 U.kg(-1)) was administered to the plantar surface of the affected left hind paw, and BoNT-A (30 and 40 U.kg(-1)) was administered into the unaffected right paw in order to determine the drug-induced systemic effect. Mechanical and cold allodynia were observed at pre-administration, one, three, five, seven and 15 days after drug administration, and were quantified by measuring withdrawal frequencies to stimuli with von Frey filament and 100% acetone, respectively. Rotarod performance was measured to detect drug-induced adverse motor effects. RESULTS The mean minimum withdrawal frequencies to mechanical and cold stimuli were 77 +/- 11 and 90 +/- 4.5%, 46 +/- 5 and 66 +/- 7%, 33 +/- 7 and 62 +/- 7%, 12 +/- 2.9 and 54 +/- 7.3% with 10, 20, 30 and 40 U.kg(-1) BoNT-A respectively (P < 0.05). Doses of 30 and 40 U.kg(-1) BoNT-A resulted in reduced rotarod performance time. CONCLUSION We conclude that peripherally administered BoNT-A reduces mechanical and cold allodynia in a rat model of neuropathic pain.
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Affiliation(s)
- Hue Jung Park
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505 Banpo-Dong, Seocho-Gu, Seoul, Korea, 137-040
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Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, Catholic University College of Medicine, Korea.
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Park BC, Kim BS, Hwang WJ, Lee J, Moon DE. Anatomical Variations Which Can Result in Inadvertent Dural Puncture When Performing Caudal Block: A report of 3 cases. Korean J Anesthesiol 2006. [DOI: 10.4097/kjae.2006.50.3.332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - Bum Soo Kim
- Department of Radiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Jung Hwang
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Korea
| | - Jaemin Lee
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Korea
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Kim WY, Moon DE, Choi JH, Park CM, Han SM, Kim SH. The Effect of Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome. Korean J Pain 2006. [DOI: 10.3344/kjp.2006.19.2.152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Won Young Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Hwan Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Min Han
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shi Hyeon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park SJ, Moon DE, Kim WY, Park JJ, Cho EJ, Yang SW. The Sphenopalatine Ganglion Radiofrequency Thermocoagulation on a Patient of CRPS with Facial Pain and Pruritus -A report of 2 cases-. Korean J Pain 2006. [DOI: 10.3344/kjp.2006.19.2.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seung Jae Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Young Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Ju Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Jeong Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Suk-Woo Yang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Affiliation(s)
- Young Hoon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Chong Min Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea
| | - Jae Won Yoon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea
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Moon DE, Moon YE, Kim SH, Kim ES. Botulinum Toxin Type A Therapy in Chronic Headache Patients. Korean J Pain 2005. [DOI: 10.3344/kjp.2005.18.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Eun Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shi Hyeon Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Sung Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kim SH, Moon DE, Park CM, Ryu KH, Seo KS, You SH. Thoracic Spinal Cord Stimulation and Radiofrequency Thermocoagulation of Lumbar Sympathetic Ganglion in a Patient with Complex Regional Pain Syndrome in the Lower Extremity -A case report-. Korean J Pain 2005. [DOI: 10.3344/kjp.2005.18.2.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Shi Hyeon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Keon Hee Ryu
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Kyung Soo Seo
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Sie Hyun You
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, Cheonan, Korea
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35
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Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea
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36
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Affiliation(s)
- Jae Won Yoon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Young Yang
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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37
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Yoon JW, Moon DE, Lee CW, Ryu KH. Cervical Spinal Cord Stimulation in a Patient with Complex Regional Pain Syndrome in the Upper Extremity -A case report-. Korean J Pain 2004. [DOI: 10.3344/jkps.2004.17.2.243] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jae Won Yoon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chul Woo Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Keon Hee Ryu
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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38
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Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology and Pain medicine, College of Medicine, The Catholic University of Korea, Korea
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39
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Affiliation(s)
- Dong Eon Moon
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jaemin Lee
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Sung Kim
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Whan Moon
- Department of Chest Surgery, School of Medicine, The Catholic University of Korea, Seoul, Korea
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40
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Jang Y, Moon DE, Yoo JH, Lee HJ, Lee JY, Kwon OK. Effects of Oxcarbazepine on Mechanical and Cold Allodynia in a Neuropathic Rat Model. Korean J Anesthesiol 2003. [DOI: 10.4097/kjae.2003.45.3.385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yeon Jang
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joo Hyun Yoo
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Jin Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Young Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ou Kyoung Kwon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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41
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Son UC, Kim MC, Moon DE, Kang JK. Motor cortex stimulation in a patient with intractable complex regional pain syndrome type II with hemibody involvement. Case report. J Neurosurg 2003; 98:175-9. [PMID: 12546368 DOI: 10.3171/jns.2003.98.1.0175] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe the effectiveness of motor cortex stimulation (MCS) in a patient with complex regional pain syndrome (CRPS) Type II, formerly known as causalgia, with hemibody allodynia. During MCS, a subjective sensation of warm paresthesia developed in the painful hand and forearm and spread toward the trunk. Pain and allodynia in the areas associated with this sensation were alleviated significantly. The analgesic effect of stimulation proved to be long lasting and was still present at the 12-month follow up. The authors speculate that MCS might exert its effect through the modulation of thalamic activity in this particular case of CRPS with hemisensory deficit. A central mechanism associated with functional disturbance in noxious-event processing in the thalamus might have an important role in the pathogenesis of the condition.
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Affiliation(s)
- Ung Chul Son
- Department of Neurosurgery, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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42
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Kim HS, Chung DS, Kwon OK, Moon DE, Han YM, Jung HJ, Kim JB, You SH, Min SH. Effect of PaCO2, PETCO2, P(a-ET)CO2 and Regional Cortical Blood Flow on the Prognosis of Craniotomy Patients. Korean J Anesthesiol 2001. [DOI: 10.4097/kjae.2001.41.5.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Hyun SooK Kim
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Dong SuK Chung
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Ou Kyung Kwon
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Young Moon Han
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Hyun Joo Jung
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Jong Bun Kim
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Sie Hyun You
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
| | - Sang Hoon Min
- Department of Anesthesia, The Catholic University of Korea, Uijeongbu, Seoul, Korea
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Lee J, Shim JY, Choi JH, Kim ES, Kwon OK, Moon DE, Choi JH, Bishop MJ. Epidural naloxone reduces intestinal hypomotility but not analgesia of epidural morphine. Can J Anaesth 2001; 48:54-8. [PMID: 11212050 DOI: 10.1007/bf03019815] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Epidural morphine is associated with decreased bowel motility and increased transit time. Low doses of intravenous naloxone reduce morphine-induced pruritus without reversing analgesia, but the effect of epidural naloxone on bowel motility has not been studied. Therefore we evaluated bowel motility and analgesia when naloxone was co-administered with morphine into the epidural space. METHODS Forty-three patients having combined thoracic epidural and general anesthesia for subtotal gastrectomy were randomly assigned to one of two study groups. All received a bolus dose of 3 mg epidural morphine at the beginning of surgery, followed by a continuous epidural infusion containing 3 mg morphine in 100 ml bupivacaine 0.125% with either no naloxone (control group, n = 18) or a calculated dose of 0.208 microg x kg(-1) x hr(-1) of naloxone (experimental group, n = 25) for 48 hr. We measured the time to the first postoperative passage of flatus and feces to evaluate the restoration of bowel function, and visual analog scales (VAS) for pain during rest and movement. Scores were assessed at 2, 4, 8, 16, 24, 36 and 48 hr postoperatively. RESULTS The experimental group had a shorter time to the first postoperative passage of flatus (5 1.9 +/- 1 6.6 hr vs 87.0 +/- 19.5 hr, P < 0.001 ) and feces (95.3 +/- 25.0 hr vs 132.9 +/- 29.4 hr, P < 0.001). No differences were found in either resting or active VAS between the two groups. CONCLUSION Epidural naloxone reduces epidural morphine-induced intestinal hypomotility without reversing its analgesic effects.
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Affiliation(s)
- J Lee
- Department of Anesthesiology, Kangnam Saint Mary's Hospital, Seoul, Korea
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Affiliation(s)
- Jin Hye Min
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Nyeun Kim
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Woo Chung
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Hyun Kim
- Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea
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45
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Affiliation(s)
- Keon Jung Yoon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Sung Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - keon Hee Ryu
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Sung Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Ho Choi
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Ki Lee
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Chung DS, Kim HS, Moon DE, Im KS. Temperature Difference between the Brain and the Axilla according to the Patients Body Temperature. Korean J Anesthesiol 2000. [DOI: 10.4097/kjae.2000.39.5.613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dong Suk Chung
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Sook Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Sil Im
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Moon DE, Lee DH, Han HC, Xie J, Coggeshall RE, Chung JM. Adrenergic sensitivity of the sensory receptors modulating mechanical allodynia in a rat neuropathic pain model. Pain 1999; 80:589-595. [PMID: 10342420 DOI: 10.1016/s0304-3959(98)00252-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study focuses on changes in adrenergic sensitivity in untransected sensory axons that innervate an area of skin made neuropathic by transection of neighboring nerves. The segmental nerve injury model is favorable for this since all axons in the L5 and L6 nerves are transected whereas the L4 axons are intact. Earlier findings are that pain behaviors develop after this injury and that these behaviors are ameliorated by sympathectomy. The present study shows that behavior indicating mechanical allodynia can be rekindled after sympathectomy by intradermal norepinephrine and alpha-2 but not alpha-1 adrenergic ligands and the rekindling can be blocked by alpha-2 but not alpha-1 adrenergic antagonists. By contrast neither intradermal norepinephrine nor other adrenergic agonists or antagonists have any demonstrable effects in the normal or after either neuropathic surgery or sympathectomy alone. These data suggest that the combination of neuropathic surgery and sympathectomy results in an upregulation of active alpha-2 adrenergic receptors on the undamaged sensory axons that provide the remaining sensory innervation to a neuropathic area partially denervated by segmental nerve lesions. These changes on undamaged axons presumably compliment similar changes on the transected axons and, thus play a role in the development of neuropathic pain.
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Affiliation(s)
- Dong Eon Moon
- Marine Biomedical Institute, University of Texas Medical Branch, Galveston, TX 77555-1069, USA Departments of Anatomy and Neurosciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1069, USA Departments of Physiology and Biophysics, University of Texas Medical Branch, Galveston, TX 77555-1069, USA
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48
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Park SS, Moon DE, Kwon OK, Jang Y, Cho EC, Jee SE, Song HK, Jeong DS. The Analgesic Effect of Intrathecal Gabapentin in a Rat Model of Incisional Pain. Korean J Anesthesiol 1999. [DOI: 10.4097/kjae.1999.37.4.704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Soo Seog Park
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Oh Kyoung Kwon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Jang
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Chung Cho
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Eun Jee
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Kyung Song
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Seok Jeong
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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49
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Jang Y, Park SS, Jee SE, Cho EC, Song HK, Moon DE, Min JH, Park CM. Effects of Preemptive Intrathecal Bupivacaine on Postoperative Pain in Rats. Korean J Anesthesiol 1999. [DOI: 10.4097/kjae.1999.36.6.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yeon Jang
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo Seog Park
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Eun Jee
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Chung Cho
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Kyung Song
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Hye Min
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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50
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Lee JM, Moon DE, Park CM, Lee YK, Choi JW, Yang NY, Kim CS, Kim SN. Effects of Cervical Sympathectomy on Mechanical Allodynia and Cold Allodynia in a Rat Model of Neuropathic Pain. Korean J Anesthesiol 1999. [DOI: 10.4097/kjae.1999.36.2.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jai Min Lee
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Eon Moon
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Min Park
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Ki Lee
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Whan Choi
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nae Yun Yang
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Sung Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Nyeun Kim
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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