Korean Journal of Pain最新文献

{"title":"The downsides of artificial intelligence in healthcare.","authors":"Dalmacito Cordero","doi":"10.3344/kjp.23312","DOIUrl":"10.3344/kjp.23312","url":null,"abstract":"","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"87-88"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10764219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813235","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":"Necessity of professional medical illustration for increasing the value of the journal.","authors":"Hyung-Sun Won, Miyoung Yang, Yeon-Dong Kim","doi":"10.3344/kjp.23288","DOIUrl":"10.3344/kjp.23288","url":null,"abstract":"","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"84-86"},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10764217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813234","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":"Cooled radiofrequency ablation of genicular nerves for knee osteoarthritis.","authors":"Myong-Hwan Karm, Hyun-Jung Kwon, Chan-Sik Kim, Doo-Hwan Kim, Jin-Woo Shin, Seong-Soo Choi","doi":"10.3344/kjp.23344","DOIUrl":"10.3344/kjp.23344","url":null,"abstract":"<p><p>Knee osteoarthritis (OA) is a prevalent and debilitating musculoskeletal condition that significantly affects the quality of life of millions of individuals worldwide. In recent years, cooled radiofrequency ablation (CRFA) has become a viable treatment option for knee OA. This review thoroughly evaluated the existing literature on CRFA therapy for knee OA. It delved into the mechanisms behind CRFA, evaluated its clinical efficacy, and investigated potential avenues for future research and application. The insights gained from this review are crucial for healthcare professionals, researchers, and policymakers, offering an updated perspective on CRFA's role as a viable therapeutic option for knee OA.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"37 1","pages":"13-25"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10764214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139059185","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":"Repetitive transcranial magnetic stimulation in central post-stroke pain: current status and future perspective.","authors":"Riva Satya Radiansyah,&nbsp;Deby Wahyuning Hadi","doi":"10.3344/kjp.23220","DOIUrl":"https://doi.org/10.3344/kjp.23220","url":null,"abstract":"<p><p>Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"408-424"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/14/kjp-36-4-408.PMC10551398.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122569","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":"Comparison of the efficacy of genicular nerve phenol neurolysis and radiofrequency ablation for pain management in patients with knee osteoarthritis.","authors":"Gokhan Yildiz, Gevher Rabia Genc Perdecioglu, Damla Yuruk, Ezgi Can, Omer Taylan Akkaya","doi":"10.3344/kjp.23200","DOIUrl":"10.3344/kjp.23200","url":null,"abstract":"<p><strong>Background: </strong>: Genicular nerve neurolysis with phenol and radiofrequency ablation (RFA) are two interventional techniques for treating chronic refractory knee osteoarthritis (KOA) pain. This study aimed to compare the efficacy and adverse effects of both techniques.</p><p><strong>Methods: </strong>: Sixty-four patients responding to diagnostic blockade of the superior medial, superior lateral, and inferior medial genicular nerve under ultrasound guidance were randomly divided into two groups: Group P (2 mL phenol for each genicular nerve) and Group R (RFA 80°C for 60 seconds for each genicular nerve). The numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the effectiveness of the interventions.</p><p><strong>Results: </strong>: RFA and phenol neurolysis of the genicular nerves provided effective analgesia within groups at 1 week, 1 month, and 3 months compared to baseline. There was no significant difference between the groups in terms of NRS and WOMAC scores at all measurement times. At the 3rd month follow-up, 50% or more pain relief was observed in 53.1% of patients in Group P and 50% of patients in Group R. The rate of transient paresthesia was 34.4% in Group P and 6.3% in Group R, and this was significantly higher in Group P.</p><p><strong>Conclusions: </strong>: Neurolysis of the genicular nerves with both RFA and phenol is effective in the management of KOA pain. Phenol may be a good alternative to RFA. Further studies are needed on issues such as dose adjustment to prevent transient paresthesia response.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"450-457"},"PeriodicalIF":3.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/db/kjp-36-4-450.PMC10551393.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160446","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":"Comments on comparing analgesic efficacy of different local blocks after laparoscopic cholecystectomy.","authors":"Xue Gao,&nbsp;Fu-Shan Xue,&nbsp;Xin-Tao Li","doi":"10.3344/kjp.23211","DOIUrl":"https://doi.org/10.3344/kjp.23211","url":null,"abstract":"In a single-center randomized controlled trial including 60 patients who underwent laparoscopic cholecystectomy, Cho et al. [1] compared the postoperative analgesic efficacy of the modified thoracoabdominal nerve block through the perichondral approach (M-TAPA) and subcostal transversus abdominis plane block (TAPB) and showed no significant difference in postoperative pain scores, cumulative analgesic consumption, patient satisfaction with pain control, or incidence of postoperative nausea and vomiting between two techniques. The authors should be congratulated on their excellent work. However, beyond the limitations described in the discussion section, we had several questions about the design and results of this study and wished to get the authors’ responses. First, as an important component of multimodal analgesic strategy, basic analgesics, such as acetaminophen and ketorolac, were intravenously administered during surgery. However, it was unclear why these drugs were not continuously used after surgery. The current protocols for enhanced recovery after surgery for laparoscopic surgery recommend that administration of basic analgesics should be started before or during an operation and regularly executed after surgery, while opioids should only be reserved for rescue analgesia [2]. Even without local blocks, a well-designed multimodal analgesic strategy can also adequately control postoperative pain, keep the patient comfortable, as well as decrease the opioid dose and adverse effects by the synergistic or additive effects of various types of analgesics in the patients undergoing laparoscopic cholecystectomy [3]. Jung et al. [4] demonstrated that even the addition of the bilateral subcostal and lateral TAPB to a standard multimodal analgesic strategy does not improve analgesic outcomes or quality of recovery following laparoscopic cholecystectomy. Second, to keep the patient comfortable, a numeric rating scale (NRS) score of 3 or less is generally considered as satisfactory postoperative pain control [2]. According to figures 3–6 in the article by Cho et al. [1], we noted that the median NRS score of maximum pain intensity during movement within the first 12 hours postoperatively were 5 or more, with large interquartile ranges. Furthermore, a significant proportion of patients had median NRS scores of 4 or more at rest and during coughing and movement within the first 6 hours postoperatively. These results indicate that most patients experienced moderate","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"473-475"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/c3/kjp-36-4-473.PMC10551402.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158567","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":"Towards precision pain management-the case for targeting DRP1 in remifentanil-induced hyperalgesia.","authors":"Ki Tae Jung","doi":"10.3344/kjp.23258","DOIUrl":"10.3344/kjp.23258","url":null,"abstract":"short-acting opioid analgesic, remifentanil also causes opioid-induced hyperalgesia (OIH), as opioids paradoxically can increase sensitivity to painful stimuli [1]. The exact mechanisms behind remifentanil-induced hyperalgesia (RIH) are not entirely understood but have been attributed to various factors. Prevention and treatment for RIH are not easy and unpredictable. Tapering or discontinuation is not universally effective and may not be applicable in acute settings where remifentanil is often used [2]. And while adjuvant therapies such as N-methylD-aspartate (NMDA) receptor antagonists or alpha-2 agonists may have a role in managing OIH, more evidence is required [3,4]. In the last issue of the Korean Journal of Pain, the research of Zhou et al. [5] provided insight into a potential therapeutic strategy for RIH and reinforced the importance of the dynamin-related protein 1 (DRP1)mitochondria-reactive oxygen species (ROS) pathway in pain modulation. Upregulation of DRP1, a key protein involved in mitochondrial fission, can lead to excessive mitochondrial fission, which may contribute to mitochondrial dysfunction [6]. Dysfunctional mitochondria may produce excessive ROS, activating pain pathways [7]. DRP1-mediated mitochondrial fission has been shown to play a role in synaptic plasticity [8]. Given that neural plasticity is one of the essential factors in the development of chronic pain and possibly OIH [9], DRP1 upregulation could be a contributing factor. In this study, antisense oligodeoxynucleotides against DRP1 (AS-DRP1), administered intrathecally, relieved pain behavior due to RIH via downregulation of the DRP1-mitochondria-ROS pathway. By reducing DRP1 expression, hyperactivity of the spinal NR2B subunit of the NMDA receptor associated with neural hyperexcitability was reduced [10,11]. These findings emphasize the role of the DRP1-mitochondria-ROS-NMDA pathway in the development of RIH. Inhibiting DRP1 in the spinal cord with AS-DRP1 may offer an effective treatment or prevention of RIH. Interestingly, the authors used antisense oligodeoxynucleotide (ASO) drug delivery methods. ASOs are short, synthetic strands of DNA or RNA that specifically bind to a designated RNA target [12]. By binding to target mRNA, they can modulate post-transcriptional gene expression, preventing the mRNA from being translated into a pro-","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":" ","pages":"405-407"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/48/kjp-36-4-405.PMC10551392.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286958","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":"The current status of fibromyalgia in Korea: an electronic population health data study in Korea.","authors":"Cheol-Hyeong Lee,&nbsp;Eun Young Lee,&nbsp;Miyoung Yang,&nbsp;Hyung-Sun Won,&nbsp;Yeon-Dong Kim","doi":"10.3344/kjp.23204","DOIUrl":"https://doi.org/10.3344/kjp.23204","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population.</p><p><strong>Methods: </strong>Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study.</p><p><strong>Results: </strong>The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties.</p><p><strong>Conclusions: </strong>The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"458-464"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/1d/kjp-36-4-458.PMC10551395.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153441","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":"The use of artificial intelligence in treating chronic back pain.","authors":"Kenny Do,&nbsp;Eric Kawana,&nbsp;Benjamin Vachirakorntong,&nbsp;Jenifer Do,&nbsp;Ross Seibel","doi":"10.3344/kjp.23239","DOIUrl":"https://doi.org/10.3344/kjp.23239","url":null,"abstract":"Chronic back pain is a debilitating disorder that is believed to be experienced by close to a quarter of the adult population globally [1]. With the recent advancements in technology, artificial intelligence (AI) has played a crucial role in healthcare, such as safely filtering patient information, analyzing medical imaging, providing recommendations for diagnoses, and even acting as virtual assistants for both physicians and patients [2]. One of the ways AI has been used in pain medicine and in helping patients with low back pain is aiding in the diagnoses of various conditions through interpretations of MRI, CT, X-ray, and other imaging modalities. Previous studies have already assessed the accuracy of artificial intelligence in diagnosing low back pain associated with spinal stenosis, disc degeneration, and lumbar arthritis [3]. One systematic review found that through the use of various machine learning models, physicians can use AI to differentiate patients with and without low back pain through the analysis of brain MRI [3]. AI can be used to filter and interpret clinical data, electromyography studies, and even physical motion to diagnose or predict the onset of various low back pain conditions. Some studies in the systematic review reported an accuracy of up to over 90% [3]. AI can be used to not only interpret these imaging modalities, but it can be used to enhance and even reconstruct an entire imaging of the spine as well. AI algorithms can be trained to differentiate between noisy and clear MRI or CT images, where this training can be applied by having the software reconstruct high-quality images [4]. This will allow the radiologists, interventional pain physicians, and even spine surgeons to have a better understanding of the disease at hand and how to best operate on patients. Past studies have even mentioned the use of AI to create completely new images from given data. For example, with a given MRI image, AI can be used to translate the information into a synthetic CT image, allowing physicians to obtain a more comprehensive view of a patient’s spine or nerves [4]. Even something as mundane as labeling the different parts can be completed by AI to save the physician's time. AI can also be effectively used to identify pain using neurophysiology-based methods [5]. Electroencephalography (EEG), a technique that records the brain’s electrical impulses, has been used to identify and even measure pain intensity [5,6]. A systematic review examined 22","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"478-480"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/e5/kjp-36-4-478.PMC10551394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156960","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":"Muscimol as a treatment for nerve injury-related neuropathic pain: a systematic review and meta-analysis of preclinical studies.","authors":"Hamzah Adel Ramawad,&nbsp;Parsa Paridari,&nbsp;Sajjad Jabermoradi,&nbsp;Pantea Gharin,&nbsp;Amirmohammad Toloui,&nbsp;Saeed Safari,&nbsp;Mahmoud Yousefifard","doi":"10.3344/kjp.23161","DOIUrl":"https://doi.org/10.3344/kjp.23161","url":null,"abstract":"<p><strong>Background: </strong>: Muscimol's quick onset and GABAergic properties make it a promising candidate for the treatment of pain. This systematic review and meta-analysis of preclinical studies aimed at summarizing the evidence regarding the efficacy of muscimol administration in the amelioration of nerve injury-related neuropathic pain.</p><p><strong>Methods: </strong>: Two independent researchers performed the screening process in Medline, Embase, Scopus and Web of Science extracting data were extracted into a checklist designed according to the PRISMA guideline. A standardized mean difference (SMD [95% confidence interval]) was calculated for each. To assess the heterogeneity between studies, I² and chi-square tests were utilized. In the case of heterogeneity, meta-regression and subgroup analyses were performed to identify the potential source.</p><p><strong>Results: </strong>: Twenty-two articles met the inclusion criteria. Pooled data analysis showed that the administration of muscimol during the peak effect causes a significant reduction in mechanical allodynia (SMD = 1.78 [1.45-2.11]; <i>P</i> < 0.0001; I² = 72.70%), mechanical hyperalgesia (SMD = 1.62 [1.28-1.96]; <i>P</i> < 0.0001; I² = 40.66%), and thermal hyperalgesia (SMD = 2.59 [1.79-3.39]; <i>P</i> < 0.0001; I² = 80.33%). This significant amendment of pain was observed at a declining rate from 15 minutes to at least 180 minutes post-treatment in mechanical allodynia and mechanical hyperalgesia, and up to 30 minutes in thermal hyperalgesia (<i>P</i> < 0 .0001).</p><p><strong>Conclusions: </strong>: Muscimol is effective in the amelioration of mechanical allodynia, mechanical hyperalgesia, and thermal hyperalgesia, exerting its analgesic effects 15 minutes after administration for up to at least 3 hours.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 4","pages":"425-440"},"PeriodicalIF":2.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/67/kjp-36-4-425.PMC10551397.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155296","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}