• Title/Summary/Keyword: Analgesic effect

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Experimental Effects of Mahwangkanghwal-tang(Mahuangqianghuo-tang) on the Adjuvant Arthritis in Rats (마황강활탕(麻黃羌活湯)이 Adjuvant 관절염에 미치는 실험적 효과)

  • Sul, Jae-Uk;Shin, Mi-Suk;Choi, Jin-Bong
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.2
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    • pp.55-65
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    • 2005
  • Objectives : Mahwangkanghwal-tang(Mahuangqianghuo-tang;MKT) is a prescription that treat clinically arthritis. The purpose of this study is to investigate effects of MKT extract on the adjuvant arthritis in pathological rats induced by Freund's complete adjvant($0.2m{\ell}/kg$). Methods : Experimental groups were divided into 4 groups ; Normal group were administered DDW $1.0m{\ell}$ to normal rats for 14 days, Control group were administered DDW $1.0m{\ell}$ to arthritic rats for 14 days, Sample A group were administered MKT $300m{\ell}/kg$ $1.0m{\ell}$ to arthritic rats for 14 days, Sample B group were administered MKT $500m{\ell}/kg$ $1.0m{\ell}$ to arthritic rats for 14 days. The present author observed body weight, inhibitory effect of edema, analgesic effects by hot plate, WBC, RBC, hemoglobin, hematocrit, platelet, total serum protein level and total serum cholesterol level. Results : 1. All sample group were increased body weight compared with control group, sample B group were significantly increased body weighty compared with control group. 2. All sample group significantly inhibited the rated of paw edema compared with control group. 3. All sample group significantly prolongated the escaping time compared with control group, sample B group significantly prolongated the paw licking time compared with control group. 4. All sample group were significantly decreased WBC compared with control group, sample B group were significantly decreased RBC compared with control group. 5. All sample group ware decreased hemoglobin and hematocrit compared with control group. 6. All sample group ware increased total serum cholesterol compared with control group, sample B group were significantly decreased platelet compared with control group. 7. All sample group ware significantly decreased total serum protein level compared with control group. 8. All sample group ware increased total serum cholesterol compared with control group, sample B group were significantly increased total serum cholesterol level compared with control group. Conclusions : We thought that Mahwangkanghwal-tang(Mahuangqianghuo-tang) could be used for curing rheumatoid arthritis, anti-inflammatory effect was somewhat better in much than small dosage.

Effect of Angelicae Gigantis Radix for Inflammatory Response in HaCaT Cells (당귀(當歸) 추출물이 피부 각질형성세포의 염증반응에 미치는 영향)

  • Huh, Jung;Park, Hoyeon;Kim, Eom Ji;Kim, Eun-Young;Sohn, Youngjoo;Jung, Hyuk-Sang
    • The Korea Journal of Herbology
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    • v.37 no.3
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    • pp.9-19
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    • 2022
  • Objectives : Angelicae Gigantis Radix (AG) is a plant of the Ranunculus family. AG have been reported to have various pharmacological effects on human health which include uterine growth promotion, anti-inflammatory, analgesic, and immune enhancement. However, research on dermatitis disease is insufficient. Therefore, we investigated the effects of AG on tumor necrosis factor-α (TNF-α)/interferon-γ (IFN-γ) stimulated HaCaT cell. Methods : To investigate the effect of AG on HaCaT cell, HaCaT cells were pre-treated with AG for 1 hour and then stimulated with TNF-α/IFN-γ. After 24 hours, media and cells were harvested to analyze the inflammatory mediators. Concentration of human interleukin-1beta (IL-1β), monocyte chemoattractant protein-1 (MCP-1), granulocyte-macrophage colony-stimulating factor (GM-CSF), and TNF-α in the media were assessed by ELISA. mRNA expression of human thymus and activation-regulated chemokine (TARC), IL-6, and IL-8 were analyzed by RT-PCR. Additionally, the mechanisms of mitogen-activated protein kinases (MAPKs) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway were investigated by Western blot. Results : The treatment of AG inhibited gene expression levels of IL-6, IL-8, and TARC and protein expression levels of IL-1β, MCP-1, and GM-CSF. Also, AG significantly reduced extracellular signal-regulated kinase (ERK) phosphorylation and NF-κB translocation in TNF-α/IFN-γ stimulated HaCaT cell. Conclusions : Taken together, these results demonstrate that AG can alleviate inflammatory diseases such as atopic dermatitis by regulating the expression of inflammatory cytokines. Also, it suggest that AG may a promising candidate drug for the treatment of inflammatory disease such as atopic dermatitis.

Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice

  • Douglas Lobb;Masoud MiriMoghaddam;Don Macalister;David Chrisp;Graham Shaw;Hollis Lai
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.19-28
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    • 2023
  • Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

Utilizing the Application of High-Intensity Yttrium Aluminum Garnet (YAG) Lasers Focused on Acupoint Irradiation (경혈 조사를 중심으로 본 고출력 Yttrium Aluminum Garnet (YAG) 레이저의 활용)

  • Maeum Lee;Yoomin Choi;Subin Ahn;Gihyang Lee;Eunhee Lee;Myungjin Yim;Hyung-Sik Seo;Eui-hyoung Hwang;Insoo Jang
    • Korean Journal of Acupuncture
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    • v.40 no.4
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    • pp.141-148
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    • 2023
  • Objectives : The purpose of this study is to investigate on the application of the yttrium aluminum garnet (YAG) lasers for acupoints irradiation. Methods : We conducted a systematic search for peer-reviewed studies published from inception to November 2023, in the following electronic databases: PubMed, Scopus, and Web of Science in English, Science ON, Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS) in Korean, and China National Knowledge Infrastructure (CNKI) and Wanfang in Chinese, and Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii) in Japanese. Inclusion criteria were original articles including clinical and experimental studies related with YAG lasers for acupoints including Ashi or meridian sinews. Results : Among the 8 selected studies, there were 7 studies on human subjects and 1 study on animals, 7 studies on Nd:YAG (1,064 nm) laser, and 1 study on Er:YAG (2,940 nm) laser. A total of 16 acupoints were used, 15 of which were in the face and 1 of which was located in the foot. In addition, there were two studies using Ashi. 4 studies looked at the effect of pain relief, 2 studies looked at safety, 1 study looked at changes in blood flow, and 1 study looked at the effect of skin care. There were no reported adverse events, and the YAG laser was confirmed to be safe and effective in pain relief, beautifying the skin, and increasing blood flow. Conclusions : We suggest that high intensity YAG lasers can be applied to laser acupuncture or laser moxibustion. YAG lasers are considered to be worth using for various clinical indications of Korean medicine because of photobiomodulation effects, analgesic action, and deep penetration depth. Further scientific research and clinical evidences should be warranted.

Clinical research of Aqua-acupuncture effects on Rheumatoid arthritis (약침을 이용한 류마토이드 관절염에 대한 임상적 연구)

  • Park, So-Young;Koh, Kang-Hoon;Yoon, Min-Young;Jin, Kyong-Sun;Chang, Byoung-Sun;Km, Il-Du;Cho, Nam-Geun;Lee, Byong-Chul;Lee, Sam-Ro;Moon, Hyung-Cheol;Hwang, Woo-Jun;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.135-146
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    • 2002
  • Background and Purpose : This study shows the clinical effects on treatment with Rheumatoid arthritis using Aqua-acupuncture such as Ursi Fel Bovis Calculus and Cathami Flos that are known for which have anti-inflammatory and analgesic effects. Objective and Methods : This study has been carried out Aqua-acupuncture treatment such as Cathami Flos and Ursi Fel Bovis Calculus twice or three times a week with patients diagnosed as rheumatoid arthritis on 7 criteria of US Rheumatism Academy. Results : 1. If you see the sexual distribution, it shows the rates of male and female 1: 1.83. Age distribution shows as age ascend it shows high. 2. If you see the duration distribution, it shows chronic tendency in order of more than 6 months(63.3%), 2 to 5 months, and I month. 3. If you see the invaded distribution, it shows chronic tendency in order of hand(37 cases), wrist joint(34 cases), knee joint(32 cases), ankle joint(21 cases), elbow joint(16 cases), shoulder joint(14 cases), feet(14 cases), hip joint(9 cases), low back(6 cases), neck(4 cases). 4. Seeing the mean post-therapeutic index among groups on RA factor level distinction, it shows that 0-18(normal range) scored 89.0, 19-50 scored 94.8, 51-80 scored 101.2, 81-100 scored 97.3, 101-140 scored 102.4, above 141 scored 97.5. 5. Seeing the mean post-therapeutic index among groups on CRP level distinction, it shows that 0-0.4(normal range) scored 100, 0.5-1.0 scored 48.6, 1.1-2.0 scored 34.9, 2.1-3.0 scored 35.7, 3.1-4.0 scored 37.1, 4.1-5.0 scored 53.8, above 5.0 scored 70.4. 6. Seeing the mean post-therapeutic index among groups on ESR level distinction, it shows that 0-20(normal range) scored 48.6, 21-40 scored 57.5, 41-60 scored 59.2, 61-80 scored 59.2, above 81 scored 66.0. 7. If you see the satisfactory assesment after Aqua-acupuncture treatment such as Cathami Flos and Ursi Fel Bovis Calculus, Excellent is 11 cases, Good is 14 cases, and Moderate 5 cases. Conclusion : It will be better effects, if herbal medicine, moxibustion, and acupuncture are used together with Cathami Flos and Ursi Fel Bovis Calculus on rheumatoid arthritis as chronic inflammatory disease.

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The influence of ginseng, reserpine, and chlorpromazine on epinephrine-induced and morphine induced hyperglycemiae (인삼(人蔘), reserpine, 및 chlorpromazine이 epinephrine 및 morphine 과혈당(過血糖)에 미치는 영향(影響))

  • Cheong, Dong-Kyun
    • The Korean Journal of Pharmacology
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    • v.1 no.1 s.1
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    • pp.17-36
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    • 1965
  • Besides it's all important analgesic action, morphine has, among others, hyperglycemic effect, though not important clinically, which is believed to be resulted from augmented glycogenolysis in the liver and muscles due to the increased liberation of epinephrine from the adrenal medulla upon the stimulation of the posterior part of hypothalamus. It is known that adrenergic blocking agents are acting inhibitory to this sort of hyperglycemia. Much, however, should as yet be studied for the drugs which affect central nervous system and release of endogenous catecholamine as far as their effects on hyperglycemia are concerned. Much is still not known about the effect of ginseng, which has been highly regarded in the Herb Medicine, as far as it's influence on the blood sugar is concerned. Author investigated the effects of chlorpromazine, reserpine and ginseng on epinephrine induced, and morphine-induced hyperglycemiae. Animals used in this experiment were healthy albino rabbits weighing approximately 2.0 kg of body weight and were all fasted for 24 hours, before the experiment undertaken. Blood sugar determination was carried out by Nelson-Somogy method. Results obtained are summarized as follows; 1. The groups of rabbits administered intravenously with epinephrine 0.02 mg/kg, and 0.05 mg/kg, showed marked and transient hyperglycemia within 15 minutes after injection. The maximal rate of elevation in blood sugar to the control level, were 28% and 57% respectively. The blood sugar returned to the control level within 3 hours. Thus, the hyperglycemic responses were paralleled with epinephrine doses. 2. The hyperglycemic responses by morphine were different according to the doses. The groups of rabbits in which 4 mg/kg of morphine was administered, did not show any hyperglycemic effect, but, in which 10 mg/kg of morphine administered, showed severe hyperglycemic effect, resulting in the maximal level within 2 hours after injection. The maximal rate of increasing in blood sugar ,level was 88%. Compared .with epinephrine-injected groups, morphjne-injected groups showed more persistent hyperglycemic effect, but returned to control blood sugar .level in 6 hours after injection. 3. The intravenous injection of chlorpromazine 2 mg/kg and 8 mg/kg evoked a slight, and persistent hyperglycemia. The maximal rate of increasing in blood sugar level were 15% and 23% respectively. These hyperglycemia gradually returned to the normal level in 5 or 6 hours after injection. Thus, the intensity of response was paralleled with the dose of chlorpromazine. 4. The intravenous injection of reserpine 0.2 mg/kg and 0.5mg/kg, showed the most persistent but steady elevation of blood sugar level in this experiments, resulting in the maximal level in 5 hours after injection. The maximal rate of increasing of blood sugar level were 18% and 39% respectively. 5. The blood sugar level from 24 hours to 30 hours after intraperitoneal administration of reserpine 1.0mg/kg, did not show statistically significant difference, compared with control groups. 6. The oral administration of ginseng extract 15 ml/kg did not. show any :change in blood sugar level. 7. The intravenous administration of epinephrine 0.05 mg/kg or morphine 4 mg/kg to the group pretreated with ginseng extract 15 ml/kg $20{\sim}30$ minutes before the experiment, evoked more marked hyperglycemic effect than the non-pretreated group. 8. The intravenous administration of epinephrine 0.02 mg/kg, morphine 4 mg/kg, or morphine 10 mg/kg to the groups pretreated with reserpine 0.2 mg/kg or 0.5 mg/kg $20{\sim}30$ minutes before experiment, produced more marked and persistent hyperglycemic effects than the groups injected with single epinephrine or morphine injection. 9. When epinephrine 0.05 mg/kg or morphine 10 mg/kg administered intravenously to the groups pretreated with the intraperitoneal administration of reserpine 1 mg/kg 24 hours before experiment morphine-induced hyperglycemia was inbibited, but epinephrine-induced hyperglycemia was augmented. 10. When epinephrine 0.05mg/kg or morphine 10 mg/kg administered intravenously to the groups pretreated with chlorpromazine, 2 mg/kg, 4 mg/kg, and 8 mg/kg $20{\sim}30$ minutes before the experiment, morphine-induced hyperglycemia was inbibited, but epinephrine-induced hyperglycemia was more persistent.

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Experimental Study of GuizhiShaoyaoZhimu-Tang on the Rheumatic Pathologic Model Induced by Ajuvant in Rats (계지작약지모탕(桂枝芍藥知母湯)이 Ajuvant 투여로 유발된 풍습성(風濕性) 동물병태모델에 미치는 실험적 연구)

  • Jeong, Hyun-Woo
    • Herbal Formula Science
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    • v.20 no.1
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    • pp.25-40
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    • 2012
  • The purpose of this study explain the experimental effects of Guizhishaoyaozhimu-Tang (桂枝芍藥知母湯) that have clinical efficacy in rheumatoid Arthritis. Materials of present study were Guizhishaoyaozhimu-Tang freeze dried powder (GSZT), Sprague-dawley rats (300 g or so, male), various kinds of needing experimental studis. In order to study the therapeutic effects of GSZT, this Prescription (GSZT 500 mg/kg, 1,000 mg/kg) were administered per oral to the rats with the arthritis induced by Freund's complete adjuvant ($0.2m{\ell}/kg$), several experimental items were measured and compared each other ; that is body weight, rate of edema, analgesic effect by hot plate method, WBC, total protein, TNF-${\alpha}$, IL-10 and expression and localization of H&E, COX-2 staining in synovial tissues from rat with rheumatoid arthritis by immunohistochemical staining using polyclonal COX-2 antibodies. Rats were divided into four groups. Normal group was not treated with Freund's complete adjuvant and treated with DDW 1.0 $m{\ell}$, Control group was treated with Freund's complete adjuvant 0.2 $m{\ell}/kg$ and DDW 1.0 $m{\ell}$, Sample A group was treated with Freund's complete adjuvant 0.2 $m{\ell}/kg$ and GSZT (500 $mg/m{\ell}$) $1.0m{\ell}$, Sample B group was treated with Freund's complete adjuvant 0.2 $m{\ell}/kg$ and GSZT (1,000 $mg/m{\ell}$) 1.0 $m{\ell}$. 0 was day that did not start experiment, 14 was day that confirmed rheumatism induced by Freund's complete adjuvant, 28 was day that completed experiment. The following results were obtained in this study ; Sample A group was increased in body weight, escape time and paw licking time statistical significance compared with Control group, and were decreased in edema, WBC, total protein, TNF-${\alpha}$ with statistical significance compared with Control group. Sample B group was increased in escape time with statistical significance compared with Control group, and were decreased in edema, WBC, total protein with statistical significance compared with Control group. Sample A and Sample B groups were increased in IL-10 compared with Control group, and Sample B group was decreased in TNF-${\alpha}$ compared with Control group. And, Control, Sample A and Sample B groups were showed considerable reduction of positive expression in comparison to Normal group. Especially, Sample B group was most significantly reduction of positive expression than the other groups. From above results, I suggest that GuizhiShaoyaoZhimu-Tang can be used for curing rheumatoid arthritis.

Analgesic Effect of Combination of Ketamine Hcl/Propionyl promazine HCI and Tiletamine HC1/Zolazepam HCl for Scaling in Dog (개의 치석제거를 위한 마취에 있어 Ketamine HCl/Propionyl promazine HCI과 Tiletamine HCl/Zolazepam HCl의 투여효과)

  • Shin Nam-Sik;Choi Youn-Ju;Kwon Soo-Wahn;Han Duk-hwan;Park Hyun-Jong;Kweon Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.10 no.2
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    • pp.221-226
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    • 1993
  • To study effective dossage and administration route for scaling, ketamine HCl/propionyl promazine HCl(ketamine) combination and tiletamine HCl/zolazepam HCl(zoletil) were administered in one hundred six dogs. The dogs were toy poodle, Yorkshire Terrier, Pekingese and Chihuahua. Scaling and polishing time, possible treatment time after the first injection of anesthetics, the number of anethesia added, presence of tongue movement during anesthesia, the presence of swaying sign during recovery and respiration were evaluated. The possible treatment time after the first Injection of anesthetic in toy poodle were 26.3${\pm}$3.0 minutes with intravenous(IM) treatment of ketamine 10mg/kg, and 21.4${\pm}$6.6 minutes with intramuscula(IM) treatment of zoletil 8mg/kg, In Yorkshire Terrier were 19.51: 1.7 minutes with IV treatment of ketamine 10mg/kg. 19.0${\pm}$5.2 minutes IM and 20.8${\pm}$6.1 minutes with IM treatment of zoletil 5mg/kg,24.8${\pm}$3,5 minutes with IM treatment of zoletil 8mg/kg. In pekingese were 27.5${\pm}$2.1 minutes with IM treatment of ketamine 10mg/kg,28.0${\pm}$4.2 minutes with IM treatment of zoletil 8mg/kg. In Chihuahua were 19.5${\pm}$1.9 minutes with IV treatment of ketamine 7mg/kg, 17.5${\pm}$1.7 minutes with IM treatment of ketamine 10mg/kg and 20.3${\pm}$3.8 minutes with IM treatment of zoletil 5mg/kg, 21.2${\pm}$5.5 minutes with IM treatment of zoletil 8mg/kg. Swaying sign was observed in all group during recovery time, espically, in toy poodle and Yorkshire Terrier which administered zoletil 8mg/kg IM showed more severe swaying sign. The present results suggested that injection of zoletil 8mg/kg IM might be relatively effective for scaling in Chihuahua Within 20 minutes treatment for scaling in Yorkshire Terrier and Chihuahua, IM treatment of ketamine 7 to 10mg/kg is recommended.

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Effects of Pain Stimulation on EEG in Dogs Anesthetized withMedetomidine and Tiletamine/Zolazepam (Medetomidine과 Tiletamine/Zolazepam을 병용마취한 개에서 통증자극이 뇌파 변화에 미치는 영향)

  • Choi, Woo-Shik;Jang, Hwan-Soo;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.136-141
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    • 2010
  • The aim of this study is to investigate whether medetomidine (MED) and tiletamine/zolazepam (ZT) combination in dogs provide the sufficient analgesia during the period of the stage of surgical anesthesia determined by the response to the noxious stimuli, which were evaluated by the change of electroencephalogram (EEG) and hemodynamic values. Seven clinically healthy, adult beagle dogs were used. They were used repeatedly at interval of a week, according to a randomized design. This study had 2 experimental groups. In Group 1, dogs received $30\;{\mu}g/kg$ of medetomidine and 10 mg/kg of tiletamine/zolazepam. Both drugs were administered intramuscularly. In Group 2, dogs were medicated with the same method as in Group 1, except the pedal withdrawal reflex test was done. In Group 2, interdigital regions were grasped with a mosquito forceps for 30 seconds, every 5 min from 10 min to 45 min after ZT injection. During all recording stages, the power for each band, mean arterial pressure and heart rates were calculated. On EEG, no significant changes were observed between groups. Although mean arterial pressure and heart rate were increased 10 min after ZT injection, no significant differences were observed between groups. In conclusion, the MED and ZT anesthesia in dogs are seemed to provide a satisfactory analgesic effect during the period of surgical anesthesia based on EEG with pedal withdrawal reflex test.

An Open-Label Trial of the 5% Lidocaine Patches for the Treatment of Chronic Pain (다양한 만성 통증 질환에서 5% 리도카인 패치의 유용성 연구)

  • Moon, Jee Youn;Choi, Jong Bum;Lee, Pyung Bok;Son, He Min;Nam, Francis Sanhgun;Kim, Young Chul;Lee, Sang Chul;Lee, Sang Jin
    • The Korean Journal of Pain
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    • v.22 no.3
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    • pp.216-223
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    • 2009
  • Background: There have been limited reports on the effectiveness of 5% lidocaine patches (L5Ps) for treating a few types of chronic pain. We utilized L5Ps for chronic pain patients with various diagnoses and who had incompletely responded to their current treatment regimen. This study aimed at describing the results of a retrospective review of an open-label L5P trial to assess L5Ps' effectiveness and safety for treating various chronic pain patients. Methods: The chronic pain patients with pain lasting longer than 6-month duration were offered a 2-week L5P treatment trial. The patients were maintained on their other analgesic regimens. The treatment effect was measured according to the change from the baseline visual analog scale (VAS) to the week 2 VAS. After a 2-week trial, the patients were asked if they perceived pain improvement with L5Ps by using a four-item Pain Relief Scale (1 = a lot of relief, 2 = slight relief, 3 = no change, 4 = worse pain). Results: In the combined patient population (n = 177), 2-week treatment with the L5Ps significantly improved the week 2 VAS (P = 0.000). Significant improvement in the VAS was reported by the chronic pain patients with postherpetic neuralgia, intercostal neuralgia, degenerative osteoarthritis at knee joint, and other maladies. A higher proportion of the chronic pain patients reported improving their pain by the L5Ps. Seven patients experienced mild or moderate patch-related adverse events. Conclusions: The L5P provided clinically meaningful pain relief in some refractory chronic pain patients without any severe adverse events.