• Title/Summary/Keyword: 통증관리효과

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Efficacy of the Epidural Buprenorphine for Postoperative Pain Control after Upper Abdominal Surgery (상복부 수술후 진통을 위한 경막외 Buprenorphine의 효과)

  • Shin, Kam-Jin;Choe, Huhn;Han, Young-Jin;Kim, Dong-Chan;Song, He-Sun
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.213-219
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    • 1993
  • The use of buprenorphine by epidural route in the prevention of postoperative pain has been controversial. High lipid solubility of buprenorphine caused the same parenteral/epidural analgesic dose ratio, and the analgesic effect of epidural buprenorphine possibly due to systemic absorption, which revealed no advantages of epidural administration against parenteral injection. On the contrary, epidural buprenorphine had longer duration of action and fewer side effects than parenteral buprenorphine, which advocated the epidural use of buprenorphine. We studied the efficacy of epidural buprenorphine by comparing epidural buprenorphine with epidural morphine in terms of latency and the duration of analgesic action, and the incidence of side effects. 0.15mg and 0.3mg of epidural buprenorphine had shorter latency than 2mg of morphine. 0.3 mg of buprenorphine had longer duration of action than 4 mg of morphine. The incidence of nausea and vomiting were slightely higher in buprenorphine group than in morphine group. Voiding difficulty and pruritus were little in buprenorphine group, while the incidence of somnolence was markedly higher in buprenorphine group. Form our results we conclude that epidural buprenorphine may be useful in the treatment of postoperative pain, and but recognize both advantages and disadvantages as compared epidural morphine.

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Economic evaluation of manual therapy for musculoskeletal diseases: a systematic review and narrative synthesis of evidence (근골격계 질환의 수기요법에 관한 경제성 평가: 체계적 문헌 고찰 및 근거 합성 연구)

  • Kim, Chang-Gon;Lee, Jin-Hyun;Kim, Ka-Na;Shin, Byung-Cheul;Ko, Youn-Suk;Park, Tae-Yong;Ha, Won-Bae;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.1-33
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    • 2020
  • 연구 목적 : 본 연구는 근골격계 질환에 대한 수기치료가 갖는 경제적 효과를 체계적으로 평가해 보기 위해 시행되었다. 연구 방법 : 2017년 2월 2일까지 국내외 관련 문헌을 체계적으로 검색 하였으며, 연관된 체계적 고찰 논문의 참고문헌을 조사하였다. 두 명의 연구자가 독립적으로 문헌을 선택하고, 비뚤림 위험 평가 및 경제성 평가 질 평가, 자료 추출을 시행하였다. 연구 결과 : 총 3,327개의 논문을 검토하여 최종적으로 18개의 무작위 대조 연구가 포함되었다. 경제성 평가는 수기요법과 다른 치료방법간의 유효성 비교를 통해 시행되었다. 요부 통증, 견관절 통증 및 외측 상과염 치료에 있어 침치료, 견인치료, 주사치료, 일반의 치료, 척추 안정화 기법 및 통증관리 치료보다 비용 효과적인 것으로 나타났다. 또한 또한, 수기치료는 경항통, 흉통, 고관절염 혹은 슬관절염, 경추신경병증 및 수부손상 치료에 있어 일반적 치료, 물리치료, 자가 치료 프로그램, 견인 치료에 비하여 효과적인 치료인 것으로 확인되었다. 결론 : 18개의 논문 중 10개의 논문에서 근골격계 질환 치료에 있어 수기치료가 경제적으로 효과가 있는 것으로 나타났다. 이러한 결과는 다른 치료방법에 비해 수기요법이 근골격계 질환에 있어서 경제적 가치가 있음을 시사하는 내용이다. 하지만, 근골격계 질환 수기치료의 경제성 평가에 대한 선행 연구는 전반적으로 부족한 실정으로, 보다 정확한 결과를 제시하고 정책결정을 위한 효과적인 제안을 위해서는 체계적인 추가 연구가 필요하다 사료되는 바이다.

Effect of Foot Care Education for Patients with Rheumatoid Arthritis Involving the Feet (족부에 침범한 류마티스 관절염 환자에게 적용한 발 관리 교육의 효과)

  • Kim, Seong Kyong;Kim, Hee Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.1
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    • pp.7-17
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    • 2014
  • Purpose: The purpose of this study was to evaluate effects of foot care education on foot pain, foot care compliance, and disability of daily living for people with rheumatoid arthritis involving the feet. Methods: This study was conducted as a randomized controlled trial. The participants were 49 patients, including 24 in the experimental group and 25 in the control group. The experimental treatment was the provision of foot care education leaflets and 20-minute 1:1 explanations of the content of the leaflet. After 2 weeks, foot care compliance was confirmed by phone call. The experimental effects were assessed by measuring changes in foot pain, foot care compliance, and disability of daily living using a pre test before the foot care education and a post test, 1 month after the foot care education. Results: Foot pain and disability of daily living in the experimental group decreased more than that of the control group. Foot care compliance in experimental group increased more than that of the control group. Conclusion: Results indicate that this foot care education program is an effective intervention to decrease foot pain and the disability of daily living, and increase the foot care compliance in patients with rheumatoid arthritis involving the feet.

Effect of Jang-Gu Program and Self-help Management Program on Depression, Stress, Pain and Body Discomfort in Women with Osteoarthritis (장구치기와 관절염 자조관리교육이 골관절염 여성 환자의 우울, 스트레스, 통증, 신체불편감에 미치는 효과)

  • Jeong, Yeong-Hee;Kim, Jong-Im;Kim, Sun-Ae;Lim, Keum-Ok
    • Journal of muscle and joint health
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    • v.17 no.2
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    • pp.212-221
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    • 2010
  • Purpose: The purpose of this study was to determine the effects of music therapy (Jang-Gu) on depression, stress, pain and body discomfort in women with osteoarthritis. Methods: The study is designed using one group pretest-posttest experimental design. 31 arthritis patients, the subjects of the group participated in the music therapy program. The program was provided for 12 weeks (two times per week). The questionnaires were used to measure the outcome variables before and after the program. Data were analyzed with the SPSS 17.0 using descriptive statistics, paired t-test. Results: Depression, Stress, Pain did not decrease. But body discomfort decreased (p=0.001). Conclusion: Therefore this program was effective in body discomfort and can be a community based self-help management program for arthritis patient.

Effect of the Arthritis Self-management Program on Elderly Women Living Alone in the Community (지역사회 여성 독거노인을 위한 '스스로 관절관리' 프로그램의 적용 효과)

  • Cho, Moo Yong;Kim, Dae Sook
    • Journal of muscle and joint health
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    • v.31 no.1
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    • pp.1-11
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    • 2024
  • Purpose: This study aimed to evaluate the effects of an arthritis self-management program on elderly women living alone in the community. Methods: This study recruited 36 individuals, who participated in the program once a week for six weeks at two community centers. The program consisted of muscle strengthening and flexibility exercises, health education on muscles and joints, and joint dance for aerobic exercise. The data collected were analyzed using the paired t-test and Wilcoxon rank test. Results: After six weeks, participants showed significant improvements in pain (t=3.03, p=.005), difficulties in activities of daily living (t=2.77, p=.010), health-related quality of life (t=-2.63, p=.014), flexibility of right shoulder (z=-2.42, p=.015), and balance (right leg, t=-2.63, p=.036; left leg, z=-2.36, p=.018). Conclusion: The results showed that the arthritis self-management program effectively improved outcomes for elderly women living alone. Thus, this program could be incorporated into various programs for elderly people living alone.

Water Quality and Hydrochemistry of Natural Springs and Community Wells in Daejeon Area (대전지역 자연샘물 및 공동우물의 수질 및 수리화학적 특성)

  • 정찬호;박충화;이광식
    • Economic and Environmental Geology
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    • v.35 no.5
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    • pp.395-406
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    • 2002
  • The sixty natural springs and community wells used as a drinking water in the Daejeon area are mainly located at the parks and the natural green districts. The purpose of this study is to investigate the characteristics of water quality and the contamination of the springs and the wells, and to suggest the management strategy for the springs and wells. For this study, we undertook water quality data from Daejeon City. According to the statistic analysis of water quality data, unacceptable rate as a drinking water was about 28 percent in 1999 and 24.5 percent in 2000, respectively. Major unacceptable factor is coliform, and others are bacteria, yersinia, color, turbidity, Fe and F. The unacceptable rate shows a roughly positive relationship with precipitation, that is, it shows highest rate during a rainy season between June and September. The major contamination source is likely to be the excrement of wild animals around natural springs and wells. Most of springs are vulnerable to the contamination of coliform and bacteria because of short residence time and shallow circulation in subsurface environment. The water samples collected from 31 springs or wells show weak acidic pHs, the electrical conductivity ranging from 63 to 357 $\mu\textrm{S}$/cm, and the hydrochemical types of Na(Ca)-HC0$_3$ and Ca-HC0$_3$. The groundwater samples of low total dissolved solid(TDS) belong to Na(Ca)-HC0$_3$. type, and the groundwater of high total dissolved solid is shifted towards Ca-HC0$_3$ type in the chemical composition. These hydrochemical characteristics indicate that most natural springs is in the early stage of geochemical evolution. The natural springs should be closed during a rainy season, which shows a high contamination rate. We suggest that a protection barrier around the springs should be built to keep wild animals away from the springs.

Effects of the Aroma Roll-on Inhalation Method on Stress, Pain, Depression and Blood Pressure in the Elderly in a Senior Citizen Clubs (아로마 롤온 흡입법이 경로당 이용 노인의 스트레스, 통증, 우울 및 혈압에 미치는 효과 )

  • Eun-Kyoung Han;Soo-Ah Jo;Ga-Eul Park;Ji-Eun Kim;Soo-Yeon Lee;Eun-Kyung Choi;Yeon-Ju Chae;Eun-Bin Oh;Jo-Hyeon Kim;Ha-Young Lee;Ji-Woo Yang;Yeong-Ju Jeong;Soo-Ah Park;Jin-Ah Kwon;Min-Jung Kim;Eun-Seo Choi;Ju-Eon Yang;Ga-Eun Jo;Ji-Woo Yang
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.1
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    • pp.13-23
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    • 2023
  • This study is an experimental study on the single group pre-post test design for the effects of the aroma inhalation method with roll-on on stress, pain, depression and blood pressure of the elderly. 33 elderly people who met the selection criteria participated among the elderly using the senior citizen clubs located in S city, Gyeonggi-do. The data collection period was from November 14, 2022 to December 19, 2022. A questionnaire consisting of stress, pain, depression, and blood pressure was measured before and after the aroma roll-on inhalation intervention. The components of aroma essential oil included Marjoram, Geranium, Peppermint and Orange sweet that were diluted in Jojoba oil which was the carrier oil. The aroma inhalation method with roll-on was carried out 3 times day for 4 weeks. In the result of this study, the aroma inhalation method with roll-on were statistically significant differences in stress(t=2.63, p=.013), pain(t=2.46, p=.019), and systolic blood pressure(t=3.01, p=.005) of the participants. Therefore, aroma roll-on therapy is expected to be available as a useful nursing intervention method for reducing stress, relieving pain, and managing blood pressure in the elderly using the senior citizen clubs.

Development of community-based intensive health care program for the community dwelling elderly (재가노인을 위한 지역사회 중심의 집중건강관리프로그램의 개발과 적용)

  • Song, Mi-Sook;Song, Hyun Jong
    • 한국노년학
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    • v.29 no.1
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    • pp.37-50
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    • 2009
  • The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

The Effect of Postoperative Propacetamol on Acute Pain and Endocrine-Metabolic Response in Gynecological Surgery (부인과 수술 후 통증관리에 있어서 프로파세타몰의 모르핀 절감 및 내분비 대사에 대한 효과)

  • Han, Tae-Hyung;Seo, Jae-Wan;Shin, Baek-Hyo;Son, Jong-Chan
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.170-178
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    • 1997
  • Background: The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetoaminophen, in combination with intravenous morphine PCA were studied in 40 patients after gynecological surgery requiring lower abdominal incision. Methods: Using a double-blind, randomized, parallel-group design, the effects of four(every 6 hr) intravenous injections of 2 g propacetamol(=1 g acetoaminophen) were compared with four injections of placebo(PL) immediately after surgery. Efficacy of cumulative dose of morphine and number of boluses requested was assessed over 24 hours by automated recording on the PCA device. It was assessed on pain scores rated on a ten-point verbal scale along with vital signs, $K^+$, glucose, BUN, creatinine, PT and PTT were measured along with stress hormones(epinephrine, norepinephrine and cortisol). Results: There were no differences in demographic data between two groups. Propacetamol group demonstrated approximately 21% morphine sparing effect compared to placebo group($33.1{\pm}10.4$ mg vs $41.4{\pm}8.0$ mg). No significant differences noted in $K^+$, glucose, BUN, Creatinine, PT and PTT levels. There were significant increases in norepinephrine and cortisol in placebo group postoperatively, compared to preoperative values. At the same time, propacetamol group also showed significant changes in these hormones. Both group revealed high degree of patient satisfaction. Conclusion: Propacetamol showed significant morphine sparing effect to some degree. Side effects were much less in propacetamol group with subsequently high patient satisfaction. The secretion of stress hormone were not blocked by postoperative propacetamol injections. Authors concluded that propacetamol should be considered as an excellent adjuvant analgesics in postoperative pain control in opioid patient controlled analgesia.

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Effects of Preemptive Analgesia by Epidural Bupivacaine and Fentanyl on Postoperative Pain Control in Lower Abdominal Surgery (하복부 수술에서 경막외 Bupivacaine과 Fentanyl에 의한 선행진통법이 술후 통증관리에 미치는 효과)

  • Lee, Jun-Hak;Kim, In-Ryeong;Yoon, Chae-Sik;Chung, Eun-Bae;Lee, Ki-Nam;Moon, Jun-Il
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.185-190
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    • 1997
  • Background: Preemptive analgesia is an antinociceptive treatment that prevents the establishment of altered central processing which amplifies postoperative pain. A controversy exists over the effectiveness and clinical value of preemptive analgesia. We studied whether epidural bupivacaine and fentanyl prior to surgery could possibly affect postoperative pain and analgesic demands, as compared to administration of same at end of surgery. Methods: Forty patients scheduled for lower abdominal surgery were randomly assigned to one of two groups and prospectively studied in a double-blind method. Group 1(n=20) received epidural injection of 15 ml bupivacaine 0.25% with fentanyl 100 y g before surgery while group 2(n=20) received the same injection at the end of their surgery respectively. Postoperative analgesia consisted of basal plus patient-controlled mode of epidural bupivacaine and fentanyl from PCA system. Postoperative visual analog pain scores(VAPS), analgesics consumption, supplementary analgesics requirement and side effects were assessed for 3 postoperative days. Results: There were no significant difference in analgesics requirement and pain scores, at any time, during rest or after movement, in measurement between the groups. Conclusions: We conclude no clinical value of effectiveness in administering epidural bupivacaine-fentanyl before surgery as compared to administration after surgery.

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