• Child Health Nursing Research
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• v.20 no.3
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• pp.142-148
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• 2014

Purpose: This study was done to evaluate the effectiveness of EMLA cream on pain related to venipuncture among children. Methods: In this study, 48 children were evaluated using a sequential measurement for level of pain by Skin Conductance Level (SCL) based on Galvanic Skin Response (GSR), heart rate, and the Visual Analogue Scale (VAS) at four times. Results: The maximum and mean of the SCL were each significantly different between the experimental and control groups and furthermore, the two were also significantly different among observed times. In addition there was a significant interaction between group and time. The children's perceived pain using VAS was not significantly different between the experimental and control groups. There was no significant difference in the heart rate between the experimental and control groups; however, the interaction between group and time was significant. Conclusion: In conclusion, applying topical anesthetic cream to the venipuncture site to reduce pain was effective among the children and therefore it is highly recommended that topical anesthetic cream be applied at the venipuncture site as a nursing intervention to reduce pain when a child has to undergo a venipuncture.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.688-692
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• 2021

Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.41-45
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• 2009

Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.143-147
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• 1998

당뇨병환자의 자가혈당조절에 있어서의 기준이 되는 혈당측정에 있어서 하나의 지침을 제공하기 위해 본 연구는 말초혈관과 상완정맥에서의 혈액을 채취하여 이들 검사물들의 혈당치를 직접적으로 비교했다. 30명의 건강한 한국인 성인 남자(연령 : 평균=30세)로부터, 공복시의 혈액을 세가지의 서로 다른 방법들(우선 손가락 끝에 말초혈관을 울혈이 되도록 한 뒤에, 이후 같은 편의 팔의 상완정맥에서, 마지막으로 다시 처음 검채를 시행했던 바로 그 말초의 천자부위에서 혈액을 짜내는 방법으로.)로 각각의 대상에서 검채하였다. 검사물들의 혈당치는 간편측정용 혈당측정기(Glucocard, KDK Corp., Japan. 1995)로 측정한 결과 상완정맥에서 채취한 혈액의 혈당치(107.58$\pm$21.03mg/dl)가 말초에서 채취한 혈액(울혈 후 : 100.21$\pm$24.03mg/dl, .짜낸 경우 : 97.84$\pm$22.45mg/dl)들 보다 높았다(T=2.86. p=.0081 : T=3.084. p=.0055). 그러나 이 결과는 기타의 연구들에서의 결과와는 일치하지 않았다. 이러한 불일치는 자가혈당측정기가 인슐린 의존형 당뇨환자는 물론이고 비의존성 당뇨환자들의 자가관리에 결정적인 지침이 된다는 점을 고려할 때, 좀 더 통제된 상황에서 더욱 많은 사람을 대상으로 한 임상시험을 통해 자가 혈당측정치에 있어서 기계요인에 대한분석이 이루워질 필요를 시사하고 있다. 또한 동일한 부위에서 서로 다른 방법들(혈관을 울혈을 시킨 천자하여 얻은 경우와 천자 후 그 부위를 짜서 검사물을 얻는 방법)에 의해서 얻어진 혈액의 헐당치 측정 결과 간에 차이가 없는 것으로 나타나서(t=0.72, p=.4791), 일반적으로 혈당치의 측정 시 검채한 양이 부족할 때, 새로이 천자하여 검사를 시행하는 것을 원칙으로 인식하고 있으나 본 연구결과를 볼 때, 이러한 채혈의 방식에 의한 차이는 환자의 안녕의 차원에서 고려하여 필요하다면 간과될 수도 있음을 의미하고 있다.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1120-1125
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• 2002

Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.

• Child Health Nursing Research
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• v.17 no.4
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• pp.215-221
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• 2011

Purpose: Newborns routinely experience pain associated with invasive procedures such as blood sampling, venipuncture, heelstick, or venous cannulation. This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of local anesthetic cream during venipuncture. Methods: Participants were 70 newborns hospitalized in the nursery. Informed Consent was obtained from parents of the newborns. Venipuncture for regular blood sampling was carried out for a test on 2 groups; the experimental, placebo group. The neonatal infant pain scale (NIPS), and duration of crying were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. Results: There were significant differences in pain behavior during venipuncture (t=-4.752, p<.001), immediately after sampling (t=-5.591, p<.001), 3 minutes after puncture (t=-2.469, p=.017), and in duration of crying (t=-3.005, p=.004). Conclusion: Results show that local administration of EMLA cream before venipuncture causes a reduction in neonatal pain response, indicating that the EMLA cream has the effect of pain relief.

• Child Health Nursing Research
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• v.12 no.2
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• pp.253-259
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• 2006

Purposes: Venipuncture is one of the most painful and frequently performed invasive procedure for children by nurses. The purpose of this study was to investigate the effect of EMLA cream(eutectic mixture of local anesthetics: 2.5% lidocaine and 2.5% prilocaine) to decrease venipuncture related pain and anxiety in children. Methods: A randomized, double blinded, placebo-controlled study was conducted. Sixty children scheduled venipuncture were recruited, and randomly allocated to receive either EMLA or a placebo cream 1 hour before venipuncture. Venipuncture was carried out by one nurse investigator. Pain and anxiety was measured by parent, nurse investigator, and nurse observer. Results: Pain in the EMLA group was significantly lower than that of placebo group. However, there was no significant difference in anxiety score between the EMLA and placebo groups. Local side effect of EMLA cream were negligible. Conclusions: EMLA cream was found to be an effective local anesthetic for pediatric venipuncture pain. Further studies should continue to evaluate the facilitators and barriers of EMLA cream application in pediatric nursing practice.

• Korean Journal of Adult Nursing
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• v.20 no.3
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• pp.386-394
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• 2008

Purpose: The purpose of this study was to examine the effect of topical lidocaine cream on pain and anxiety during the AV fistula puncture among hemodialysis patients. Methods: The study employed one group repeated measurement design. The data were collected from 50 hemodialysis patients who received AV fistula puncture. The topical lidocaine cream was applied 30 minutes before the puncture. The data were measured total 3 times (T1=without lidocaine, T2=2% lidocaine, T3=5% lidocaine). Pain was measured by VAS and a behavioral checklist. Anxiety was measured by Korean manual of SCL-90-R. Results: Patients with 5% lidocaine cream reported significantly lower of VAS pain score than those with 2% lidocaine and without lidocaine. Patients with 2% lidocaine cream reported significantly lower of behavioral pain scores than those without lidocaine, but less effective than 5% lidocaine cream. Patients with 2% lidocaine cream reported significantly lower of anxiety scores than those without lidocaine, but less effective than 5% lidocaine cream. Conclusion: Topical application of lidocaine cream for 30 minutes before AV fistula puncture significantly decreased pain and anxiety among hemodialysis patients. Specifically 5% lidocaine was more effective than 2% lidocaine for both pain and anxiety.

• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.679-684
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• 2023

Venous puncture is widely used to obtain blood samples for pathological examination. Because the invasive venipuncture method using a needle is repeatedly performed, the pain suffered by the patient increases, so our research team pre-developed a miniaturized near-infrared (NIR) imaging system in advance. To improve the image quality of the acquired NIR images, this study aims to model the non-local means (NLM) algorithm, which is well known to be efficient in noise reduction, and analyze its applicability in the system. The developed NIR imaging system is based on the principle that infrared rays pass through dichroic and long-pass filters and are detected by a CMOS sensor module. The proposed NLM algorithm is modeled based on the principle of replacing the pixel from which noise is to be removed with a value that reflects the distances between surrounding pixels. After acquiring an NIR image with a central wavelength of 850 nm, the NLM algorithm was applied to segment the final vein area through histogram equalization. As a result, the coefficient of variation of the NIR image of the vein using the NLM algorithm was 0.247 on average, which was an excellent result compared to conventional filtering methods. In addition, the dice similarity coefficient value of the NLM algorithm was improved by 62.91 and 9.40%, respectively, compared to the median filter and total variation methods. In conclusion, we demonstrated that the NLM algorithm can acquire accurate segmentation of veins acquired with a NIR imaging system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.9
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• pp.4065-4072
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• 2012

The purpose of this study was to examine the effect of topical EMLA Cream on venipuncture related pain and anxiety of surgery patient from oct. 27 to nov, 13, 2011, EMLA Cream was applied to the experimental group(n=40) 1hour before the procedure, but was not applied to the control group (n=37). The collected data were analyzed with the SPSS WIN 15.0 program. The percentage, mean and standard deviation were figured statistic, ${\chi}^2$-test, t-test, ANOVA, Correlation analysis were performed. Consequently, Pain in the EMLA applied experimental group was significantly lower than that of the control group. also state anxiety in the experimental group was lower than that of the control group. correlation of pain and anxiety after EMLA was related. EMLA cream was considered to be an effective local anesthetic for preoperative venipuncture on pain and anxiety.