• Title/Summary/Keyword: 통증조절장치

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A COMPARISON OF PATIENT-CONTROLLED ANALGESIA (PCA) AND INTRAMUSCULAR ANALGESIA AFTER ORTHOGNATHIC SURGERY (악교정 수술후 근주와 자가통증조절장치(PCA)의 제통효과 비교)

  • Park, Mi-Hwa;Kim, Jae-Hyun;Baek, Sang-Heum;Cha, Duwon;Lee, Sang-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.3
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    • pp.260-265
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    • 2005
  • Patient-controlled analgesia (PCA) has been widely used for postoperative pain control in medical surgery parts. Conventional intramuscular analgesia (IMA) is also effective in postoperative pain control, but it has some disadvantages that depend on patients' perception of pain and the anxiety that they endure caused by the delay of the injection time. This study was conducted to assess the efficacy and postoperative outcomes of intravenous PCA compared to IMA injections in 36 patients (BSSRO). Three factors were compared: amount of pain in PCA and IMA group ; amount of pain according to the sex in PCA and IMA group and the amount of pain according to the analgesia use. Results of this study did not demonstrate a statistically significant difference in any of these, using a p value of 0.05. The results of this study were as follows. : 1. There was no statistically significant difference in VAS pain score between IMA group and PCA group. 2. There was no statistically significant difference according to the sex. 3. There was no statistically significant difference according to the amount of PCA. The history of PCA is about 30 years and many literatures have reported about its effects, complications, methods, advantages and disadvantages. So, this study has some limitations of small sample size to conclude the effects of PCA. But when the decision about the method for postoperative pain control has to be made, it should be made based on patient or physician preference and cost factors rather than on the trend.

Effects of Aromatherapy on Stress, Sleep, Nausea and Vomiting during Patient Controlled Analgesia Treatment of Patients with Hysterectomy (자가통증조절장치 (PCA) 사용자에서 향기흡입법이 자궁적출술 후 스트레스, 수면 및 오심과 구토에 미치는 효과)

  • Choi, JungHee;Kim, Yun Mi
    • Women's Health Nursing
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    • v.19 no.4
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    • pp.211-218
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    • 2013
  • Purpose: The purpose of study was to examine effects of aromatherapy on stress, sleep, nausea and vomiting of women after laparoscopic hysterectomy. Methods: The participants were 60 women who had laparoscopic hysterectomy: experiment group for aromatherapy (n=30) and control group for routine care (n=30). The experimental group received inhalation aromatherapy for 5 minutes, twice; the first was done right after the operation, the second was at 9 pm before sleep on the same day-while the control group had no inhalation. Data were collected from July to September, 2012 at G hospital. Results: The degree of psychological stress was not significantly different between two groups (t=-1.96, p=.054). Yet, there were significant differences between two groups for degree of physiological stress (t=-3.20, p=.002), the level of cortisol (t=-2.01, p=.049), the score of sleep status (t=2.47, p=.016), the score of sleep satisfaction (t=2.43, p=.018), and the score for nausea and vomiting (t=-2.58, p=.012). Conclusion: Inhalation aromatherapy using the mixed oil of lavender, mandarin, and marjoram was effective in decreasing the level of physiological stress, cortisol, and the score for nausea and vomiting, and also allowed the participants to have a better sleep. Therefore, inhalation aromatherapy could be effective in improving the quality of life of these women during recovery.

Patient Controlled Analgesia of Alfentanil after a Total Abdominal Hysterectomy: A Comparison of the Intravenous and Epidural Route (전자궁 적출술 후 자가통증조절장치를 이용하여 정맥과 경막외로 투여된 Alfentanil의 진통효과 비교)

  • Choi, Soo Kyeong;Yoon, Seok Hwa;Lee, Jun Hwa;Hwang, Jae Ha;Jung, Woo Suk;Kim, Yoon Hee;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.169-173
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    • 2007
  • Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.

A COMPARATIVE STUDY ON POST-OPERATIVE ANALGESIC EFFECT FOR PATIENT-CONTROLLED AND INTRAMUSCULAR ANALGESIA IN MANDIBULAR FRACTURE PATIENTS (하악골 골절환자에서 술후 자가통증조절장치와 근주용 진통제의 효과에 관한 비교)

  • Lee, Seok-Jae;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.42-48
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    • 2006
  • Open reduction and rigid internal fixation is the most popular treatment method for maxillofacial fracture patients, and it is unevitable that postoperative pain can be developed. Many surgeons including oral & maxillofacial surgeons have made constant efforts to decrease postoperative pain. This study is a comparison of postoperative analgesia and intramuscular analgesia in patients with mandibular fractures. In this study, twenty-one patients (Experimental group) were randomly selected and they were injected with IV patient-controlled analgesia (PCA; Walkmed$^{(R)}$, USA). For control group another twenty-one patients were injected with intramusclar non-steroid anti-inflammatory drugs (Rheoma$^{(R)}$, Samsung Pharm. Co.). And then, we measured visual analogue scale (VAS) scores from first postoperative day to second day at regular time interval. The following results were uptained; 1. In patient group who with open reduction and rigid internal fixation, there was significant difference of postoperative analgesic effect during the first postoperative day(p<0.05). 2. In patient group with over 90 minutes surgery time, there was significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p<0.05). 3. In patient group with less than 90 minutes surgery time, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 4. In patient group with surgery of open reduction using rigid internal fixation at single fractured site, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 5. In patient group with surgery at two fractured sites, there was significant difference of postoperative analgesic effect during the first postoperative day when compared between experimental group and control group(p<0.05). As mentioned above, it suggest that patient-controlled analgesia is more effective for postoperative pain relief than intramuscular injection in patients with rigid internal fixation by open reduction after mandibular fracture occurred. Especially, it is considered that in patient with more than 90 minutes surgery time or in cases with multiple fractured sites had more effective results with PCA therapy than conventional intramuscular analgesics.

Effect of Abdominal Draw In Maneuver in Sitting Position (앉은자세에서 실시하는 복부드로우인기법의 효과)

  • Kim, Seon-Chil;Kim, Shin-Gyun;Kim, Chang-sook
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.3
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    • pp.207-214
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    • 2017
  • The problem of trunk stability is a major factor in back pain.. Abdominal draw in maneuver(ADIM), One of the trunk stabilization exercises to relieve lumbar instability, is a method of inducing selective contraction of the transverse abdominis associated with anticipatory posture control among the abdominal stabilization muscles. ADIM is usually performed with a visual feedback by applying a pressure biofeedback unit(PBU) under the lumbar at the supine position, which is not functional compared to the sitting position. This study was conducted to investigate the effect of ADIM applied in supine and sitting position on 31 healthy men and women. In each posture, muscle activity was measured by rectal abdominis (RA), external oblique (EO), transverse abdominis (TrA)/internal obilique (IO) and erector spinae (ES) using wireless EMG. In the result, there was no significant difference between RA and EO between the two postures and there was a significant difference between TrA / IO and ES. In both postures, the activity of TrA/IO was higher than that of RA, and the effect of ADIM was shown to be the same, whereas TrA/IO and ES showed higher activity in sitting position. This means that the activity of the muscles involved in the postural stability and lumbar stability is increased further in the sitting position. Therefore, ADIM in sitting, which can be applied more easily in daily life, is useful for improving lumbar stability.

Nocturnal Bruxism and Botulinum Toxin Effect on the Subjects with Masseteric Hypertrophy (야간 이갈이와 교근비대 환자의 보툴리눔 독소 주사 효과)

  • Sohn, Seung-Mahn;Chung, Gi-Chung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.337-346
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    • 2007
  • This study aimed to evaluate a relation of bruxism with clinical effects of botulinum toxin type A(BTX-A) injection. 5 bruxers and 5 nonbruxers with bilateral masseter hypertrophy were participated in this study. After injecting 25 unit of BTX-A(Allergen Inc, $Botox^{(R)}$) into each masseter muscle, the thickness of masseter(Mm) and anterior temporalis(Ta) muscles was measured by ultrasonography and the maximum bite force was evaluated during a 9-month period. Self-estimation on the recovery of occlusal force during mastication was done as well. Regardless of presence of bruxsim, all subjects showed significantly reduced Ms thickness(p<0.001) and maximum bite force at $1^{st}$ molars(p=0.027) with their peak at 3 months after injection, which then started to return. No significant difference was observed in Ta thickness and the bite force at the central incisors. While self-estimated occlusal force was the least at 2 weeks after injection and then rapidly returned to the baseline level with full recovery at the time of 6 to 9 months after injection, the maximum bite force measured by bite force recorder did not recover the original value, particularly in the nonbruxer group. It is assumed that nocturnal bruxism can influence recovery of atrophic masseter and decreased occlusal force due to BTX-A injection. These findings suggest a need of occlusal appliance to control bruxism or clenching habit for longer clinical effect of BTX-A injection.