Korean Journal of Pain最新文献

{"title":"The cerebrospinal fluid-contacting nucleus CGRP-RAMP1-PKA signaling pathway mediates trigeminal neuralgia and its mechanism.","authors":"Bin Gui, Yang Bai, Yijun Zhang, Weiwei Yan, Zhi Yang, Xinling Wang, Jin Qian, Yu Peng, Licai Zhang","doi":"10.3344/kjp.26029","DOIUrl":"https://doi.org/10.3344/kjp.26029","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is prevalent form of neuropathic pain (NP). Its regulatory circuits and mechanisms remain unclear. The authors' previous work demonstrated that the cerebrospinal fluid-contacting nucleus (CSF-contacting nucleus) participates in the regulation of NP induced by sciatic nerve injury via the brain-CSF circuit. However, whether it mediates NP caused by trigeminal nerve injury has not been reported.</p><p><strong>Methods: </strong>This study used viral retrograde tracing to examine neural projections between the CSF-contacting nucleus and the trigeminal ganglion (TG). Neuronal activity in TN model was assessed using immunofluorescence, and chemogenetic tools were used to test its role in pain behavior. Local calcitonin gene-related peptide (CGRP)-RAMP1-PKA signaling changes and their modulation were analyzed for effects on TN.</p><p><strong>Results: </strong>Retrograde tracing confirmed neural projections between the CSF-contacting nucleus and the TG. In TN model rats, elevated c-Fos expression indicated its activation. Chemogenetic activation induced hyperalgesia in normal rats, whereas its inhibition reduced pain in TN rats. Molecular analyses revealed upregulation of CGRP, RAMP1, and components of the PKA pathway within the nucleus. Pathway inhibition via RAMP1 knockdown or olcegepant administration attenuated pain, with knockdown effect being reversible by cAMP.</p><p><strong>Conclusions: </strong>This study reveals that the CSF-contacting nucleus is activated during TN and participates in central pain regulation through its local CGRP-RAMP1-PKA signaling pathway. Intervening in this pathway effectively modulates pain behavior, suggesting that this nucleus and its signaling system may represent novel therapeutic targets for treating TN. These findings provide experimental evidence for understanding the central mechanisms of TN and developing analgesic strategies.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"cGAS-STING signaling in the anterior cingulate cortex modulates electroacupuncture analgesia in a rat neuropathic pain model.","authors":"Ang Li, Mei Li, Zhen-Ping Hu, Meng-Jing Yang, Hui Zhang, Xu-Wu Xiang, Yong-Xing Yao","doi":"10.3344/kjp.26061","DOIUrl":"https://doi.org/10.3344/kjp.26061","url":null,"abstract":"<p><strong>Background: </strong>The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) signaling pathway is associated with different neurological dysfunctions in the nervous system. Although electroacupuncture (EA) has been proven to alleviate neuropathic pain (NP), its underlying mechanisms remain unclear. The role of the cGAS-STING signaling pathway in the anterior cingulate cortex (ACC) during NP and its potential association with EA-mediated analgesic effects remain unknown.</p><p><strong>Methods: </strong>The authors established an NP model by applying chronic constriction injury (CCI) to the sciatic nerve and evaluated behavioral hyperalgesia using the acetone test score and mechanical threshold. Protein distribution and expression were assessed using immunofluorescence and Western blotting, respectively.</p><p><strong>Results: </strong>cGAS and STING were predominantly expressed in neurons in the ACC of rats, and the total abundance of cGAS and STING was upregulated on both sides of the ACC following CCI. Intra-ACC administration of either RU.521 or C-176 alleviated the pain hypersensitivity caused by CCI. Moreover, EA reduced pain hypersensitivity and inhibited the CCI-induced upregulation of cGAS and STING in the ACC.</p><p><strong>Conclusions: </strong>This study demonstrates that the cGAS-STING signaling pathway is involved in the occurrence and development of NP in the ACC following peripheral nerve injury, and that EA may alleviate NP by suppressing this pathway in rats.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradox or misinterpretation? Re-examining McCaffery's maxim and the International Association for the Study of Pain definition of pain.","authors":"Simon van Rysewyk","doi":"10.3344/kjp.26010","DOIUrl":"https://doi.org/10.3344/kjp.26010","url":null,"abstract":"","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond numeric scales: validity of the EQ-5D-5L pain/discomfort dimension in postoperative pain assessment after minimally invasive colorectal cancer surgery.","authors":"Sooah Cho, Soo-Hyuk Yoon, Ho-Jin Lee, Jae Hyun Park, Min Jung Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong","doi":"10.3344/kjp.26071","DOIUrl":"10.3344/kjp.26071","url":null,"abstract":"<p><strong>Background: </strong>This study examined the validity of the EuroQol-5 Dimension 5-Level (EQ-5D-5L) pain/discomfort dimension for acute postoperative pain assessment.</p><p><strong>Methods: </strong>This retrospective study analyzed prospectively collected data from the Korean Enhanced Recovery After Surgery (K-ERAS) registry, including adults undergoing elective minimally invasive colorectal cancer surgery at a single tertiary center between October 2023 and December 2025. Convergent validity was assessed using Spearman correlations between the EQ-5D-5L pain/discomfort dimension and numeric rating scale (NRS) scores at rest and during coughing on postoperative days (PODs) 1-3. Correlations with other EQ-5D-5L domains were compared using Steiger's Z-test. Known-group validity was evaluated by area under the curve analysis for discrimination between adjacent levels and by comparisons between ERAS and conventional groups using cumulative link mixed models. Responsiveness was assessed using standardized response means.</p><p><strong>Results: </strong>A total of 333 patients were included. The pain/discomfort dimension demonstrated moderate correlations with NRS scores at rest (ρ = 0.44-0.53) and during coughing (ρ = 0.50-0.57) across PODs 1-3 (all <i>P</i> < 0.001), and showed stronger associations with other EQ-5D-5L dimensions than the NRS. It exhibited acceptable discriminative ability without meaningful floor or ceiling effects and responsiveness comparable to the NRS. The dimension also successfully differentiated clinical groups, with lower pain levels observed in the ERAS group.</p><p><strong>Conclusions: </strong>The EQ-5D-5L pain/discomfort dimension has potential as a valid and responsive measure for acute postoperative pain, complementing numeric scales by capturing the functional impact of pain. Further validation in diverse surgical populations is warranted.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"461-471"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propofol attenuates pain hypersensitivity and neuroinflammation in chronic constriction injury rats by regulating miR-1249-3p/VEGFA axis.","authors":"Hailin Zhao, Chuping Peng, Xiumei Zhu, Long Wang, Lu Ye","doi":"10.3344/kjp.25449","DOIUrl":"10.3344/kjp.25449","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain (NP), a disabling chronic condition with limited treatments, is recapitulated in the chronic constriction injury (CCI) rat model. The role of the miR-1249-3p/VEGFA (vascular endothelial growth factor A) axis in propofol-mediated analgesia remains unclear.</p><p><strong>Methods: </strong>AntagomiR-1249-3p, antagomiR-NC (negative control), a VEGFA-targeting siRNA, and si-NC were delivered intrathecally <i>via</i> lentiviral vectors 3 days before CCI. Propofol (15 mg/kg) was intraperitoneally administered for 7 consecutive days after CCI surgery. Behavioral tests assessed mechanical pain threshold and thermal pain threshold (n = 8). Spinal miR-1249-3p and VEGFA expression were detected by reverse transcription-quantitative polymerase chain reaction. Concentrations of tumor necrosis factor-α, interleukin (IL)-6, IL-1β, and IL-18 in the spinal cord were quantified using ELISA. Protein levels of VEGFA, COX2, iNOS, phospho-NF-κB p65, and total NF-κB p65 were detected using Western blotting. The relationship between miR-1249-3p and VEGFA was validated by dualluciferase reporter assay.</p><p><strong>Results: </strong>The expression of miR-1249-3p decreased and VEGFA increased in the spinal cord of CCI rats (all <i>P</i> < 0.001). The luciferase reporter assay demonstrated that miR-1249-3p targets VEGFA (<i>P</i> < 0.001). Propofol treatment upregulated miR-1249-3p (<i>P</i> < 0.001) and downregulated VEGFA (<i>P</i> < 0.001). The antinociceptive effects and suppression of pro-inflammatory markers of propofol were abolished by antagomiR-1249-3p (<i>P</i> < 0.001), and this abolition was rescued by VEGFA knockdown (<i>P</i> < 0.001). Propofol attenuates NP and neuroinflammation in CCI rats via inhibiting the NF-κB pathway through the miR-1249-3p/VEGFA axis.</p><p><strong>Conclusions: </strong>These findings suggest that propofol may reduce behavioral signs of NP and suppress associated neuroinflammation in CCI rats by the miR-1249-3p/VEGFA axis.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"344-360"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain-heart axis in burning mouth syndrome: a neurobiological perspective.","authors":"Takahiko Nagamine","doi":"10.3344/kjp.25311","DOIUrl":"10.3344/kjp.25311","url":null,"abstract":"","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"474-477"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistent analgesic effect of intravenous dexamethasone on rebound pain after brachial plexus block: a causal machine learning approach.","authors":"Boohwi Hong, Yumin Jo, Myungjong Shin, Woolim Min, Woosuk Chung, Chahyun Oh","doi":"10.3344/kjp.25431","DOIUrl":"10.3344/kjp.25431","url":null,"abstract":"<p><strong>Background: </strong>Rebound pain, a sudden increase in pain intensity after resolution of regional anesthesia, remains a major challenge in postoperative patient care. Intravenous (IV) dexamethasone has been proposed as a preventive strategy, but whether its effectiveness varies across patient characteristics remains unclear.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent upper extremity orthopedic surgery under brachial plexus block (BPB). Rebound pain was defined as the occurrence of both severe pain (numeric rating scale ≥ 7) and rescue analgesic administration between 4 and 24 hours after BPB. The association between IV dexamethasone and rebound pain was evaluated using multivariable logistic and generalized random forest (GRF) models.</p><p><strong>Results: </strong>Among the 1,171 patients, 651 (55.6%) received IV dexamethasone. The dexamethasone group had a significantly lower incidence of rebound pain (7.1% <i>vs</i>. 16.9%, <i>P</i> < 0.001) with delayed onset (median 14 <i>vs</i>. 11 hours). IV dexamethasone was an independent protective factor (odds ratio, 0.42; 95% confidence interval [CI], 0.27 to 0.64; <i>P</i> < 0.001). GRF analysis estimated an average treatment effect of -0.09 (95% CI -0.13 to -0.05), corresponding to a 9% absolute risk reduction. Calibration testing demonstrated accurate model (GRF) estimation (mean coefficient, 0.98; <i>P</i> < 0.001) and no statistically detectable heterogeneity in treatment effect (differential coefficient, -0.30; <i>P</i> = 0.713).</p><p><strong>Conclusions: </strong>IV dexamethasone was associated with reduced rebound pain without evidence of meaningful heterogeneity in treatment effect in patients undergoing upper extremity surgery under BPB. These findings suggest a potential preventive role for dexamethasone as an adjunct to perioperative pain management in this population.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"448-460"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of multimodal analgesia using intravenous non-opioid agents on immediate postoperative rescue analgesic use following minor general surgery: a retrospective study.","authors":"Chahyun Oh, Hyunjeong Ki, Jeong Yeon Lee, Boohwi Hong, Chaeseong Lim","doi":"10.3344/kjp.26009","DOIUrl":"10.3344/kjp.26009","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative multimodal analgesia with non-opioid agents is standard in perioperative pain management. However, evidence directly comparing triple, dual, and single agent regimens remains limited.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed adult patients undergoing minor general surgery, setting in which opioids are not routinely employed for postoperative pain management. The primary outcome was the use of rescue analgesics within 4 hours after surgery, comparing triple (acetaminophen [AAP] + nonsteroidal anti-inflammatory drugs [NSAIDs] + nefopam), dual (AAP + NSAIDs, AAP + nefopam, or NSAIDs + nefopam), and single agent regimens. Comparisons among individual dual agent combinations and among individual single agents were performed as secondary analyses. Outcomes were estimated using multivariable regression with inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>Among 5,601 patients included, 37.9% received single, 58.5% dual, and 3.6% triple agent regimens. Rescue analgesic use occurred in 75.1%, 58.8%, and 43.8% of these groups, respectively. After IPTW adjustment, the triple regimen was associated with significantly lower rescue analgesic use compared with dual regimens (odds ratio, 0.48; 95% confidence interval, 0.32-0.70; <i>P</i> < 0.001), with adjusted probabilities of 31.4% (triple), 49.1% (dual), and 67.2% (single). Among dual regimens, the lowest rescue probability was observed with NSAIDs + nefopam (39.7%), followed by AAP + NSAIDs (53.2%), and AAP + nefopam (58.7%).</p><p><strong>Conclusions: </strong>Triple agent intraoperative non-opioid analgesia was associated with the greatest reduction in postoperative rescue analgesic use, with a stepwise benefit observed across single, dual, and triple regimens. These findings support the active use of multimodal non-opioid analgesia in minor general surgery.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"421-433"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggrecan and small leucine-rich proteoglycan fragments correlate with Toll-like receptor-2 mediated inflammation in painful degenerative disc disease.","authors":"Polly Lama, Binod Kr Tamang, Jerina Tiwari, Sagnik Chakraborty, Sukriti Chauhan, Michael A Adams","doi":"10.3344/kjp.25417","DOIUrl":"10.3344/kjp.25417","url":null,"abstract":"<p><strong>Background: </strong>Painful intervertebral disc degeneration is a leading cause of chronic low back pain. Proteolytic cleavage fragments of extracellular matrix components, particularly aggrecan and small leucine-rich proteoglycans (SLRPs), may act as endogenous danger signals activating inflammatory pathways. To determine whether proteolytic fragments of aggrecan and SLRPs correlate with disc degeneration severity and Toll-like receptor-2 (TLR-2) mediated inflammation.</p><p><strong>Methods: </strong>Human disc tissues were analysed from 20 non-degenerated cadaveric controls (Thompson Grades 1-2) and 35 patients with painful degeneration (Pfirrmann Grades 3-5). Western blotting assessed fragmentation of aggrecan and SLRPs (decorin, biglycan, lumican, fibromodulin, chondroadherin). Immunofluorescence localized these molecules in disc sections. Disc cells were cultured under four conditions: unstimulated controls, TLR-2 agonist Pam2CSK4-stimulated controls, cells extracted from degenerated discs, and those treated with the TLR-2 antagonist MMG-11. Cytokine profiles were determined using antibody array.</p><p><strong>Results: </strong>Fragmented peptides of aggrecan and SLRPs (22-45 kDa) were predominantly detected in Pfirrmann Grades 4 and 5 discs. TLR-2 expression was significantly higher in degenerated disc cells versus controls (<i>P</i> < 0.001), further upregulated by Pam2CSK4 and attenuated by MMG-11. Cytokine analysis revealed marked pro-inflammatory shifts in patient discs (interleukin [IL]-6 ↑1.37×, IL-8 ↑1.30×, IL-1β ↑1.25×), while control discs exhibited an anabolic profile with elevated expressions of growth factors (TGF-β, EGF, VEGF).</p><p><strong>Conclusions: </strong>Aggrecan and SLRP fragments were observed alongside TLR-2 mediated inflammatory responses in advanced disc degeneration, suggesting a potential association with tissue catabolism. Targeting TLR-2 signaling may warrant further investigations as a potential therapeutic strategy for painful disc disease.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"330-343"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond opioid dosage: temporal dynamics of intravenous patient-controlled analgesia use captured by electronic device logs-a post hoc analysis of three randomized controlled trials.","authors":"Sooah Cho, Soo-Hyuk Yoon, Ho-Jin Lee","doi":"10.3344/kjp.25376","DOIUrl":"10.3344/kjp.25376","url":null,"abstract":"<p><strong>Background: </strong>Intravenous patient-controlled analgesia (IV-PCA) is widely used for postoperative pain management. However, its temporal usage pattern remains poorly characterized.</p><p><strong>Methods: </strong>This secondary analysis included 332 patients from three randomized controlled trials investigating postoperative analgesia following robot-assisted laparoscopic prostatectomy, video-assisted thoracoscopic surgery, and minimally invasive distal gastrectomy (MIDG). Each trial compared two analgesic strategies, yielding six groups. Only the conventional MIDG group received IV-PCA alone without multimodal analgesia. Hourly fentanyl-based IV-PCA consumption and bolus attempts were obtained from electronic device logs. The primary outcome was the first time when 75% of patients reached an hourly IV-PCA consumption of ≤ 20 μg fentanyl/hr, predefined as the low-utilization threshold. The secondary outcomes included the first time when 75% of patients reached a bolus attempt rate ≤ 1/hr, temporal trajectories of PCA use, delivery-to-demand ratio, and correlations between pain scores and cumulative opioid consumption.</p><p><strong>Results: </strong>The low-utilization threshold was reached within 6-8 hours by 75% of patients in all groups, except for the conventional MIDG group. Similarly, bolus attempts declined to ≤ 1/hr after 7-9 hours postoperatively, again excluding the opioid-only group. Delivery-to-demand ratio was the lowest immediately after surgery and increased over time, showing higher values with multimodal analgesia. Pain intensity correlated significantly, but only weakly, with PCA consumption (r = 0.16-0.24, <i>P</i> < 0.05 for all comparisons).</p><p><strong>Conclusions: </strong>Fentanyl-based IV-PCA use declined rapidly, indicating that its benefit is largely confined to the early postoperative phase and that its duration can be shortened when multimodal analgesia is well established.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"383-396"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}