• Title/Summary/Keyword: 급성통증관리

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The Approaches to Postoperative Pain Management (술후 통증관리의 접근)

  • Song, Sun-Ok
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.1-7
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    • 1995
  • 효율적인 술후 통증치료를 위해서는 통증치료의 방법과 환자관리면을 동시에 고려하여야 한다. 방법은 상술한 바와 갈이 술후 통증기전에 부합되는 방법들이 예방적으로 적용되어야 하고 아울러 환자 개개인에 맞는 지속적인 균형제통이 시행되어야 한다. 그리고 환자관리면에서는 환자의 통증을 자주 평가하고 그에 동반된 처치 및 간호업무가 수반되어야 한다. 그러므로 술후 통증관리는 진통제에 대한 전문지식을 갖춘 의료인이 적합한 제통방법을 지속적으로 시행하여야 하는데 그러기 위해서는 효율적인 조직체제가 필요하다. 구미각국에서는 여러해 전부터 술후 통증관리가 통증관리센터란 체제하에서 효과적인 급성 통증치료실로 운영되어져 왔으며 현재는 병원의 중심센타로 확립된 실정이다. 우리나라도 국민의료보험이 도입된지 17년이 지났고 환자 위주의 병원환경이 마련되어야 한다는 데에는 대다수의 국민들로부터 공감대가 형성된 현시점에서 이제는 통증관리센터가 설립되어야 한다고 생각된다. 이러한 제안이 기정사실화 되기까지는 많은 논의와 임상결과에 대한 자료들이 있어야 하겠지만 무엇보다도 마취과 의사들의 술후통증관리에 대한 지속적인 관심과 연구가 뒷바침되어야 할 것으로 생각된다.

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Postoperative Pain Management Status led by Nurse of Acute Pain Service (급성통증관리 간호사 주도의 수술 후 통증관리 현황)

  • Kang, Mi Ra;Ryu, Jeong Ok;Kim, Myung Hee;Yun, Hea Shin;Kwon, Jeong Soon
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.296-304
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    • 2020
  • Purpose: This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). Methods: A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with χ2test, and Correlation coefficient. Results: As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. Conclusion: With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies. Therefore, it is suggested that this system is safe and effective for pain management.

지혜 깊어지는 건강 - 40대를 지켜라 - 통풍 환자는 바람만 불어도 엄지발가락이 아프다

  • Seo, Dong-Hyeon
    • 건강소식
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    • v.35 no.2
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    • pp.20-22
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    • 2011
  • 엄지발가락이 따끔거리더니 시간이 지날수록 심한 통증이 찾아와 밤에 잠을 잘 수 없는 고통을 겪는 40대가 많다. 한참 사회생활이 활발한 40대의 특성상 술자리가 많고 외근도 잦아 걷는 일이 다반사인데 신발을 신지 못할 정도의 심각한 통증으로 업무에 지장이 생겨 참다못해 병원에 방문하면 혈액검사를 비롯한 검진을 통해 급성 통풍암을 알게 된다.

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The Convergent Development of Nursing Activity Index for postoperative patient using Patient Controlled Analgesia (자가통증조절기를 사용하는 수술 후 환자를 위한 간호 활동 목록의 융합적 개발)

  • Lee, Yoon-Young
    • Journal of the Korea Convergence Society
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    • v.7 no.5
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    • pp.43-49
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    • 2016
  • The purpose of this study was done to develop a nursing activity index for postoperative patient using Patient-controlled Analgesia(PCA). The study was developed in two steps: $1^{st}$ step) nursing activity index was developed through literature review and focus-group interview. $2^{nd}$ step) the nursing activity was ratified and Intervention Content Validity(ICV) was tested. Subjects were consisted of 5anesthesiologists, 6adult/fundamental nursing professors and 1acute pain management Clinical Nurse Specialist. We identified 12 items of nursing activity for postoperative patient using PCA. The Intervention Content Validity(ICV) score for each item ranged from 0.92 to 1.0. The nursing activity index for postoperative patient using PCA would be very useful in facilitating the nursing practice.

The current evidence for the effectiveness of exercise in low back pain (요통에 대한 운동치료 효과의 최근 연구에 따른 증거)

  • Kim, Tae-Yoon;Jung, Sung-Woog
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.139-158
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    • 2002
  • 컴퓨터를 이용하여 MEDLINE, AMED, CINAHL과 Cochrane Libra를 검색하여 요통환자를 위한 다양한 형태의 운동치료 효과에 대해서 발표된 연구 보고서 중 1991년부터 2001년 사이에 영문으로 출판된 보고서를 중심으로 본 연구에 합당한 주제를 충족시키는 연구 보고서 40편을 선택하였다. 수집된 자료를 통하여 요통 관리의 운동치료 효과에 대하여 연구하였으며 일반적인 요통환자들만을 대상으로 급성, 아급성, 만성단계로 구분하였다. 실험논문은 수정된 rating system을 이용하여 논문의 질 수준과 연구결과를 측정하였으며 고찰 논문과 관찰 연구는 grading system을 사용하여 주요 연구 결과를 측정하였다. 본 연구의 결과는 운동치료가 통증감소와 기능 향상에 효과적임이 증명되었고, 총괄적으로 타당도를 지지하는 정도는 중등도에 해당되었다. 연구보고서들을 scale system을 통해서 세부적으로 분석했을 때, 상급의 연구 방법론적 질을 충족시켰다. 결과에 따르면 급성, 아급성과 만성요통에 대한 운동치료가 효과적이었다라는 확실한 증거를 나타냈다. 본 연구의 결론은 요통환자에 대한 운동치료는 효과적으로 입증되었으며, 특별히 만성요통환자의 경우에 더욱 더 효과적인 것으로 나타났다. 이러한 결론을 더욱 지지하기 위해서는 더 많은 고질의 연구 논문들이 이루어져야 할 것이다.

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Acute Malocclusion and Temporomandibular Disorders (급성 부정교합과 턱관절장애)

  • Byun, Jin-Seok;Lee, Kyung-Eun;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.121-128
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    • 2007
  • If patients complain about sudden ill-fitting occlusal sensation(acute malocclusion), a dentist has to consider many possible causes about that. Acute malocclusion is characterized its sudden onset and mainly can be caused by teeth and its related structure problem. But we always keep on mind that acute malocclusion also can be caused by temporomandibular disorders In this 3 cases of acute malocclusion, evaluating by patient history, clinical and radiographic findings, we diagnosed them as 1. Lateral pterygoid muscle spasm, 2.. Retrodiscitis, 3. Osteoarthritis. Through this non-odontogenic acute malocclusion cases, we emphasize the key of diagnosis is on comprehensive and careful patient history taking and clinical examination.

Current Status of Home-Based Cancer Patients Management in Jeju (제주지역에서의 호스피스.완화의료기관과 보건소의 재가암 관리 현황)

  • Huh, Jung-Sik;Kim, Hyeon-Ju
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.76-80
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    • 2010
  • Purpose: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. Methods: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. Results: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. Conclusion: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.

Effect of Pressure Taping between Tibia and Fibula on Pain, ROM and Strength in Athletes diagnosed with High Ankle Sprain (원위경비인대결합 손상 선수의 경·비간 압박테이핑 적용이 통증, 관절가동범위, 근력에 미치는 영향)

  • Jang, Won-Bong;Oh, Jae-Keun;Yoon, Jin-Ho
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.303-310
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    • 2021
  • This study was conducted to identify the effects of pressure taping between tibia and fibula of High Ankle Sprain athletes on pain, Range of Motion(ROM), and strength and to provide basic data for rehabilitation programs. The subjects of the study were conducted with a total of 10 athletes except for four who gave up who were diagnosed with high ankle sprain, or who were diagnosed with ankle sprain but their physical examinations proved positive. The results showed no significant differences in pain(Visual Analog Scale, VAS). The ROM was significantly increased in inversion(IV) and eversion(EV) in both groups. The Isometric strength was significantly improved in IV(0°, 7°, 14°) and EV(0°) in Taping Group(TG). When taping was applied to athletes with injury to the High Ankle Sprain, ROM and muscle strength improved at the same pain level.

The Prediction Model for Self-Reported Voice Problem Using a Decision Tree Model (의사결정나무 모형을 이용한 주관적 음성장애 예측모형)

  • Byeon, Haewon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3368-3373
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    • 2013
  • The purpose of this study was to analyze the risk factors of self-reported voice problem. Data were from the Korea National Health and Nutritional Examination Survey 2008. Subjects were 3,600 persons (1,501 men, 2,099 women) aged 19 years and older. A prediction model was developed by the use of a exhaustive CHAID (Chi Squared Automatic Interaction Detection) algorism of decision tree model. In the decision tree analysis, pain and discomfort during the last 2 weeks, age, the longest occupation and thyroid disorders was significantly associated with self-reported voice problem. The findings of associated factors suggest potential ways of targeting counseling and prevention efforts to control self-reported voice problem.