• Journal of Chest Surgery
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• v.33 no.10
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• pp.792-797
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• 2000

Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

• Medical Lasers
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• v.9 no.1
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• pp.39-43
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• 2020

Background and Objectives Breast reconstruction has the advantage of reducing the loss of the body image of patients after mastectomy surgery, and also improving the quality of the social and sexual life of breast cancer patients. However, in surprising and unfortunate number of patients, acute postoperative pain persists beyond the normal course of postsurgical recovery. We set out to investigate the effect of local dynamical micro-massage (LDM) treatment for achieving pain relief and reducing other postoperative complications. Materials and Methods We performed a retrospective analysis on 58 patients who underwent LDM treatment for postoperative pain management at Soonchunhyang University Bucheon Hospital between February 2017 and June 2019. Those patients who complained of persistent postoperative pain, which was uncontrollable with medication, were treated with LDM. The degree of pain and discomfort with contracture were recorded using numerical rating scale (NRS) scoring system with numbers from 0 to 10 ('none' to 'worst'). Results The median NRS score of pain was reduced by 62.3% from the start to the end of LDM treatment (p<0.001). Further, the NRS score of discomfort with contracture was reduced 66.0% (p<0.001). There was no complication related to the LDM treatment. Conclusion Dual-frequency ultrasound LDM can be an effective therapeutic option for persisting pain after breast reconstruction surgery. It was also effective in improvement of discomfort with contracture and erythema of the surgical wound.

• The Korean Journal of Pain
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• v.32 no.3
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• pp.206-214
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• 2019

Background: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. Methods: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). Results: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB ($33.0{\mu}g$; interquartile range [IQR], $27.0-69.5{\mu}g$) than in the control group ($92.8{\mu}g$; IQR, $40.0-155.0{\mu}g$) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). Conclusions: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.69-79
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• 2021

Objectives The purpose of this study was to verify the effect of integrative Korean medicine on acute postoperative pain after arthroscopic shoulder surgery. Methods This study was conducted in a retrospective observational way. Patients who met the inclusion criteria were divided into integrative Korean medicine-treated group (IKM group) and no integrative Korean medicine treated-group (No IKM group). The primary outcome was the difference in the amount of change in pain intensity. The secondary outcome was the difference in pain intensity, opioid consumption over time, and the number of adverse events after surgery. Results The change of numerical rating scale for pain intensity from baseline to IKM group was 3.09±2.12, while 2.64±1.80 in no IKM group, and the difference of change between two groups was statistically significant (p<0.05). Difference in the use of opioid between two groups over time after surgery was also statistically significant (p=0.000). Conclusions The results of this study suggest that integrative Korean medicine can be effective for acute postoperative pain after arthroscopic shoulder surgery.

• Acute and Critical Care
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• v.33 no.4
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• pp.206-215
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• 2018

Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.68-73
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• 2020

Pain management is an important part of dental practice, and dentists frequently prescribe analgesics to improve clinical outcomes. Dentists should be aware of the pharmacological characteristics of the analgesics commonly used in dentistry and should choose appropriate analgesics to treat and prevent pain associated with inflammation or surgery. In this article, we review the potential benefits and risks of the analgesics frequently used in dental practice and provide a stepwise approach for pain management.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.226-230
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• 2011

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.393-398
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• 1987

Unstable angina pectoris is often premonitory to an acute myocardial infarction. Surgical revascularization in this syndrome is of great potential benefit and relatively low mortality. A patient with unstable angina pectoris is reported. A 65-year-old man complained of dyspnea and pain in the left anterior chest. The pain was brought on by mild exercise, occurred at rest and sleeping time. The pain worsened over a month period and more aggravated in intensity and duration. Physical examination showed no abnormalities except hypertension and laboratory data were within normal limits. His anginal pain was not relived by nitroglycerin ingestion. Preoperative coronary angiograms revealed significant obstruction [>90%] of left anterior descending coronary artery. Aorto-left anterior descending coronary bypass with autogenous saphenous vein used as conduit was performed. The postoperative course was uneventful and he was discharged on 16th postoperative day in a healthy condition.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.77-83
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• 2016

Objectives The aim of this study is to investigate the possibility of making Korean Medicine-Western Medicine collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery. Methods This preliminary Critical Pathway (CP) was composed of 9 Index of vertical axis (assesment, treatment, patient movements, consultation, diet, other, administration, examination, education) and 5 hospitalization periods of horizontal axis through a review of the literature and reference data of medical records. This preliminary CP's Content Validity Index (CVI) survey was carried out by 20 personnel of two different medical institutions from 06, June, 2016 to 15, June, 2016. All data were double-cross checked and analyzed. Results Of those questioned, there were 13 males and 7 females in age, 6 professors, 7 medical residents, 7 nurses in position of 20 personnel. According to the survey, among the 62 contents, 32 contents are above 80 percent agreements, 12 contents were between 70 to 80 percent and 18 contents below 70 percent agreements. Especially, Most contents in treatment index were below fixed validity. Overall Contents Validity in Index, Treatments (72.7%), Diet (100.0%), Other (100.0%), Administration (75.0%) and Examination (100.0%) were in high validity. On the other hands, Assessments (29.4%), Patient movements (0.0%), Consultation (30.0%) and Education (33.3%) were in low position. Conclusions This survey results can be evidence of possibility to develop New Korean Medicine-Western Medicine Collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.157-160
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• 2015

A patient with squamous cell carcinoma on the left mandible presented with symptoms similar to acute coronary syndrome just after surgery. The exact etiology was unclear, but following transthoracic echocardiogram, takotsubo cardiomyopathy was diagnosed. This is a rare, acute, and reversible form of heart failure, and the patient recovered completely within weeks. Related risk factors are believed to include extended surgery times and extended time under general anesthesia. Early recognition, followed by postoperative control of pain and anxiety are crucial to patient recovery.