• Title/Summary/Keyword: Chronic pain

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PECS II block is associated with lower incidence of chronic pain after breast surgery

  • De Cassai, Alessandro;Bonanno, Claudio;Sandei, Ludovica;Finozzi, Francesco;Carron, Michele;Marchet, Alberto
    • The Korean Journal of Pain
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    • v.32 no.4
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    • pp.286-291
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    • 2019
  • Background: Breast cancer is complicated by a high incidence of chronic postoperative pain (25%-60%). Regional anesthesia might play an important role in lowering the incidence of chronic pain; however it is not known if the pectoral nerve block (PECS block), which is commonly used for breast surgery, is able to prevent this complication. Our main objective was therefore to detect any association between the PECS block and chronic pain at 3, 6, 9, and 12 months in patients undergoing breast surgery. Methods: We conducted a prospective, monocentric, observational study. We enrolled 140 consecutive patients undergoing breast surgery and divided them in patients receiving a PECS block and general anesthesia (PECS group) and patients receiving only general anesthesia (GA group). Then we considered both intraoperative variables (intravenous opioids administration), postoperative data (pain suffered by the patients during the first 24 postoperative hours and the need for additional analgesic administration) and development and persistence of chronic pain (at 3, 6, 9, and 12 mo). Results: The PECS group had a lower incidence of chronic pain at 3 months (14.9% vs. 31.8%, P = 0.039), needed less intraoperative opioids (fentanyl $1.61{\mu}g/kg/hr$ vs. $3.3{\mu}g/kg/hr$, P < 0.001) and had less postoperative pain (3 vs. 4, P = 0.017). Conclusions: The PECS block might play an important role in lowering incidence of chronic pain, but further studies are needed.

Does risk of obstructive sleep apnea have interaction with chronic facial pain?

  • Kang, Jeong-Hyun;Lee, Jeong Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.5
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    • pp.277-283
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    • 2022
  • Objectives: The main purpose of the present study was to investigate the associations between the risk of obstructive sleep apnea (OSA) and chronic orofacial pain in a nationally representative sample of the Korean population. Materials and Methods: Data from the 8th wave Korean national health and nutrition examination survey, which was conducted from 2019 to 2020 were analyzed. This study included 5,780 Koreans (2,503 males, 3,277 females) over 40 years of age. The presence of subjective chronic facial pain lasting more than 3 months was evaluated based on a self-reported questionnaire. The risk of OSA was determined using the STOP-BANG questionnaire. Data related to anthropometric and sociodemographic factors; diagnostic history of hypertension, depression, and OSA; level of health-related quality of life and stress awareness; health-related behaviors, including smoking and alcohol drinking; and sleep duration were collected. The participants were classified into two groups according to the presence of chronic facial pain. Results: The level of health-related quality of life and stress awareness showed significant differences between the two groups. The sleep duration on weekends also presented significant differences. No significant differences were observed in the presence of snoring and observed apnea, while participants with chronic facial pain showed significantly higher levels of tiredness between the groups. The risk of OSA evaluated by STOP-BANG questionnaire showed significant differences between groups; however, the risk of OSA seemed to be higher in participants without chronic facial pain. Conclusion: The participants with chronic facial pain demonstrated decreased sleep duration, lower health-related quality of life, and increased stress and tiredness. Even though, the role of OSA in the development of chronic facial pain was inconclusive from the study, it is possible that ethnicity play a role in relationship between OSA and chronic facial pain.

Impact of coronavirus disease 2019 on patients with chronic pain: multicenter study in Korea

  • John, Hyunji;Lim, Yun Hee;Hong, Sung Jun;Jeong, Jae Hun;Choi, Hey Ran;Park, Sun Kyung;Kim, Jung Eun;Kim, Byung-soo;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.209-223
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    • 2022
  • Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain. Methods: Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following: demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors. Results: A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients' decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain. Conclusions: COVID-19 has caused several changes in patients with chronic pain. During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients' increasing pain.

Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases

  • Lee, Ho-Jin;Choi, Eun Joo;Nahm, Francis Sahngun;Yoon, In Young;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.116-124
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    • 2018
  • Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.

The Effects of Traditional Physical Therapy on Pain Reduction and Depression Level of Patients with Chronic Low Back Pain (만성요통 환자의 우울수준과 통증감소에 미치는 전통적 물리치료의 효과)

  • You, Jae-Eung;Jung, Eun-Ha
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.677-683
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    • 2001
  • The object of this study is in the comparison of level of depression between patients with chronic low back pain & normal adult, of the relation between reduction of pain & level of depression and in the examination of the influence of traditional physical therapy against the reduction of pain & level of depression of the patients with chronic low back pain for the new recognition of psychological factors to the physical therapists as well as patients. This study was targeted for 40 patients with chronic low back pain who were diagnosed as lumbar sprain & herniated intervertebral disk and compared & analyzed how traditional physical therapy has an influence to their reduction of pain and level of depression by questioning with visual an analog scale of Beck's depression inventory & pain inventory to them. The results are as follows. 1. Traditional physical therapy has an effect in the reduction of pain of the patients with chronic low back pain. 2. Although traditional physical therapy relieved a little the level of depression of patients with chronic low back pain. there was no evident effect statistically. 3. In the relation between the reduction of pain and level of depression, level of depression also showed somewhat relief according to the reduction of pain and appeared that they have some relationship. However, it's degree was not big. 4. In the comparison of the level of depression between the normal adult and the patient with chronic low back pain, the level of depression of the patient with low back pain are high rather than that of normal adult.

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Factors Influencing on Quality of Life in Aged Women with Chronic Pain (만성통증을 가진 여성노인의 삶의 질 영향 요인)

  • 손정태;서순림
    • Journal of Korean Academy of Nursing
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    • v.32 no.5
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    • pp.735-742
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    • 2002
  • This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. Method: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. Result: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second .Conclusion: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.

Application of purified porcine collagen in patients with chronic refractory musculoskeletal pain

  • Seong, Hyunyoung;Kim, Raing Kyu;Shin, Youngjae;Lee, Hye Won;Koh, Jae Chul
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.395-399
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    • 2020
  • Background: This study aimed to assess the potential efficacy of purified porcine atelocollagen (PAC) for the management of refractory chronic pain due to suspected connective tissue damage. Methods: Patients treated with PAC were retrospectively evaluated. Patients with chronic refractory pain, suspected to have originated from musculoskeletal damage or defects with the evidence of imaging studies were included. Pain intensity, using the 11-point numerical rating scale (NRS), was assessed before the procedure, and 1 month after the last procedure. Results: Eighty-eight patients were finally included for investigation. The mean NRS score was decreased from 5.8 to 4.1 after 1 month of PAC injection (P < 0.001). No independent factor was reported to be directly related to the decrease in NRS score by more than half. Conclusions: Application of PAC may have potential as a treatment option for refractory chronic musculoskeletal pain. PAC might promote tissue recovery, act as a scaffold for repair, or directly reduce inflammation.

Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain

  • Semeru, Gracia Mayuni;Halim, Magdalena S.
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.22-29
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    • 2019
  • Background: The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. Methods: A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). Results: This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. Conclusions: This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.

Successful Treatment of Abdominal Cutaneous Entrapment Syndrome Using Ultrasound Guided Injection

  • Hong, Myong Joo;Kim, Yeon Dong;Seo, Dong Hyuk
    • The Korean Journal of Pain
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    • v.26 no.3
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    • pp.291-294
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    • 2013
  • There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

The Deep Dry Needling Techniques, and Interventional Muscle & Nerve Stimulation (IMS) for the Treatment of Chronic Pain (만성통증 치료에서 Deep Dry Needling의 모델들과 중재적 근육 및 신경자극 요법)

  • Lee, Young Jin;Ahn, Kang;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.1-7
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    • 2006
  • Chronic pain can cause disability, mild to severe suffering and high medical costs. Some unfortunate patient do not improve despite administering conservative treatment and then the various interventional therapies, including oriental medical treatment and/or surgery, and they find themselves in search of a more effective pain relief. Deep dry needling is one of the newer treatment modalities for these patients. The last 10 years have seen a lot of progress in understanding the neural pathways and the type and extent of tissue involvement during chronic pain. This in turn has stimulated the development of new treatment techniques, and deep dry needling is one of them. So, the authors of this paper discuss the individual theories, the characteristics and future directions of several deep dry needling techniques, and we examine the new dry needling technique that has been recently developed in Korea.