• The Korean Journal of Pain
• /
• v.13 no.2
• /
• pp.175-181
• /
• 2000

Background: Pain is often measured using psychophysical scaling techniques. However, all of these methods found their limits, since they were based on the subjective sensations reported by the subjects. It is, therefore, desirable to validate psychophysical pain measures by simultaneously measuring some physiological correlate of nociception. We studied an objective method for measuring pain in human volunteer using R(III) nociceptive flexion reflex. Methods: Four different intensity of electrical stimuli between perception and 1.4 times the R(III) nociceptive flexion threshold were delivered to the sole of the feet in 8 normal volunteers. We measured the flexion reflex activity in the skin over the ipsilateral tibialis anterior muscle and subjects rated each stimulus on a visual analog scale (VAS) Results: Both R(III) nociceptive flexion reflex activity and VAS ratings showed a linear relationship with stimulus intensity and with each other in all volunteers. Conclusions: R(III) nociceptive flexion reflex elicited through electrical stimulation may used as an objective pain measurement, previsionary based on our study paradigm.

• The Korean Journal of Pain
• /
• v.14 no.1
• /
• pp.19-25
• /
• 2001

Background: Transcutaneous electrical nerve stimulation (TENS) has been used widely, but its effects are controversial. This is probably due to the varying intensity and type of pain. We designed a study to assess the effects of the TENS on the RIII nociceptive flexion reflex as the resting pain level and the temporal summation as a repeated, movement related pain in 7 normal volunteer subjects. Methods: High frequency (80 Hz), non-noxious TENS was applied over the left popliteal fossa for 20 minutes. Ipsilateral RIII reflexes induced by single electrical stimulus and temporal summation of pain responses to repeated stimuli (five stimuli at 2 Hz) were recorded before, during (just before stopping), and subsequently at 20 minutes after TENS. Results: R (III) nociceptive flexion reflex activity during and after TENS was more significantly decreased than before treatment. However, the temporal summation threshold was not changed. Conclusions: We conclude that high frequency, non-noxious TENS could be effective on resting pain relief in the same segment but not on the movement related pain.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.4 no.1
• /
• pp.1-12
• /
• 2006

This study conducted RIII reflex measurement to examine degree of pain depending on polarity of high voltage pulsed current of primary and secondary hyperalgesia site in hyperalgesia rat by local thermal injury. Hind paw which was injury site was taken as primary hyperalgeisa site, sole which was injury adjacent site was taken as secondary hyperalgesia site, and mechanical pain threshold, thermal pain threshold and root mean square of RIII reflex were measured. This study was conducted with control group I of hyperalgesia rat at hind paw by thermal injury and experimental groups divided into cathodal high voltage treatment group II, anodal high voltage treatment group III and alternate high voltage treatment group IV, applied active electrode of high voltage pulsed current to hind paw directly, placed reference electrode on the sole of injury adjacent site and applied pulse frequency. It measured RIII reflex and obtained the following results: Root mean square of RIII reflex at primary hyperalgeisa site was significantly reduced in group II after 2 days of hyperalgesia. Group II showed significant decrease after 5 and 6 days of hyperalgesia. Root mean square of RIII reflex at secondary hyperalgesia site showed significant reduction in group II after 6 days of hyperalgesia. Consequently it was found that application of high voltage pulsed current of hyperalgesia site reduced RIII reflex at primary hyperalgeisa site and secondary hyperalgesia site by electrical stimuli. Effects by polarity of high voltage pulsed current showed the greatest reduction of pain threshold when cathodal active electrode was used.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.4
• /
• pp.335-336
• /
• 2021

The oculocardiac reflex is a trigeminal-vagal reflex that manifests as cardiac arrythmias, most often bradycardia. The reflex can be triggered by manipulation of periorbital structures and unintended pressure on the bulbus oculi maxillofacial procedures. In this brief communication, we describe an unusual trigger of the oculocardiac reflex during maxillofacial surgery that resulted in severe bradycardia. This case highlights the need for careful securement of medical devices and attention to surgical technique to avoid undue pressure on draped fascial structures.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.13 no.1
• /
• pp.54-60
• /
• 2006

This study, a quasi-experimental study using a nonequivalent control group pretest-posttest design. conducted a survey on 30 patients test group and control group of IS patients sampling an adjacent population at random - who are operated on the breast cancer and are in the A University Hospital located in Suwon, to examine into the effects of foot reflex zone massage on their pain and sleep satisfaction through the nursing interventions. It gave them a foot reflex zone massage for the total 30 minutes-basic massage 10 minutes and reflex massage 20 minutes required to alleviate their pain day in day out covering a two-month period from the first of July to the first of September 2004. for the purpose of collecting data. It launched into a two-round foot reflex zone massage at 6 and 24 hours since mastectomy through a direct visit at the hospital room to measure pain intensity, physiological index(pulse and blood pressure) and sleep satisfaction of them. The results are as follows. First, it showed that there is all the difference between pain intensity of test group and that of control group. In result, the first hypothesis, pain of test group. which measure at 6(p=.000) and 24 hours(p=.001) since mastectomies, will be bigger than that of control group, was established. Second, it showed that there is all the difference between physiological index of test group and that of control group. In result. the second hypothesis, pulse(p= .025, p= .002), systolic blood pressure(p= .004, p=.012) and diastolic blood pressure(p=.004. p= .003) of test group, which investigate at 6 and 24 hours since mastectomies, will be bigger than that of control group, was established. Third, it showed that there is a significant difference between sleep satisfaction of test group and that of control group(p=.000). In result, the fourth hypothesis, sleep satisfaction of test group. which examine in the morning after mastectomies, will be bigger than that of control group, was established. In the result. a foot reflex zone massage is seen to be effective in the pain reduction and sleep promotion of patients who are operated on breast cancer, and in providing them with more qualitative care by improving confidence between them and nurses through a physical touch. Also, it can be applied to a clinical examination through an independent nursing intervention.

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

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

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.3
• /
• pp.151-155
• /
• 2012

A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.

• The Journal of Korean Medicine
• /
• v.29 no.1
• /
• pp.39-46
• /
• 2008

Background : Acupuncture has been used as a clinical treatment in Oriental medicine for various diseases including pain relief. The descending pain control system of periaqueductal gray (PAG) is a powerful pain control system in mammalians. Expression of c-Fos is used as a marker for stimuli-induced metabolic changes of neurons. Objective : In the present study, the effects of acupuncture on analgesic effect in visceral pain were investigated through the writhing reflex and c-Fos expression in ventrolateral PAG (vlPAG) area using immunohistochemistry in mice. Method : For the writhing test, mice were divided into five groups. Immediately after finishing the behavioral test, the animals were weighed and overdosed with Zoletil. After a complete lack of response was observed, the brains of the mice were dissected into serial coronal sections, and c-Fos immunohistochemistry was performed. Statistical analysis of all data was performed using one-way ANOVA. Result : The present results showed that acupuncture affected the writhing reflex and that Choksamni (zusnali) acupoint and aspirin significantlysuppressed acetic acid treatment-induced increased writhing reflex, and the expression of c-Fos in vlPAG was significantly increased in the acupunctured group. Conclusion : The present study suggests that acupuncture has an antinociceptive effect on acetic acid-induced visceral pain by increase of c-Fos expression in mice. Aspirin also showed analgesic effect, however the mechanism is different from the acupuncture.

• The Korean Journal of Physiology
• /
• v.17 no.2
• /
• pp.169-176
• /
• 1983

It is well known that the acupuncture has been used effectively for the relief of certain types of pain. Although the precise mechanism of action of acupuncture analgesia is unknown, it is generally accepted that their analgesic properties are related to the activation of endogenous opiate system in central nervous system. And it is suggested that pain-relieving properties of acupunture may be related to a stimulation of peripheral nerve underlying the acupuncture point on the skin. However, the efficacy of acupuncture has no relationship between the site of pain and the acupuncture point. Consequently, the present study was undertaken to investigate electroacupuncture analgesia in relation to the site of peripheral nerve stimulation. Cats were decerebrated ischemically and the flexion reflex as an index of pain was elicited by stimulating the sural nerve (20V, 0.5 msec duration) and recored as a compound action potential from the nerve innervated to the posterior biceps femoris muscle in the ipsilateral hindlimb. Bilateral common peroneal nerve and contralateral superficial radial nerve were selected as the site of peripheral nerve stimulation. For the stimulation of peripheral nerve, a stimulus of 20 V intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min respectively. The results obtained are summarized as follows: 1) Both stimulation of contralateral common peronal nerve and contralateral superficial radial nerve did not change the flexion reflex and there were no significant differences between them. 2) Stimulation of ipsilateral common peroneal nerve markedly depress the flexion reflex, the effect being reversed by naloxone application. These results suggest that stimulation of ipsilateral common peroneal nerve has the analgesic effect but both stimulation of contralteral common peroneal nerve and contralateral superficial radial nerve to the pain site where flexion reflex was elicited have no analgesic effect.

• The Korean Journal of Physiology
• /
• v.15 no.2
• /
• pp.67-71
• /
• 1981

Experiments were conducted to test morphine sensitivity of the flexion reflex in the anemic decerebrate cats. Animals were immobilized with gallamine triethiodide(Flxaedil) and were artificially ventilated. The sural nerve was electrically stimulated(20V, 0.5 msec) and the flexion reflex was obtained by recording compound action potentials from the nerve innervated to the semitendinosus muscle. Intravenous injection of morphine $(0.5{\sim}2.0\;mg/kg)$ was found to have following effects on the flexion reflex. 1) Morphine tended to depress the early component of the flexion reflex and the effect was widely variable between animal preparations. 2) Morphine significantly depressed the late component of the flexion reflex, the effect being proportional to the dose of morphine. 3) The morphine effect on the flexion reflex was reversed by a small dose of naloxone hydrochloride$(0.025{\sim}0.1\;mg/kg)$. 4) Naloxone hydrochloride alone did not appear to facilitate the flexion reflex. 5) The main site for the morphine action was found to be the brain stem. From these results and those reported in literatures, we conclude that the late component of the flexion reflex well represents the pain sensation, thus the late component of the flexion reflex can be used as a reasonable subjective index of pain in experimental animals.