• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.97-100
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• 2002

Background: Patient-controlled sedation (PCS) has been blown for a safe and effective sedative method on the same pharmacological concepts of patient-controlled analgesia. Many different kinds of infusion devices have been used but they often have too long nominal infusion rate and lockout time. $Perfuser^{\circledR}$ fm (B. Braun, Germany) is a new PCA device with 999.9 ml/hr nominal infusion rate and minimum 1 min lockout time. In this study, the feasibility of propofol PCS using $Perfuser^{\circledR}$ fm was examined in order to provide a safe satisfactory sedation for dental patients. Methods: Eleven healthy patients presenting for oral surgery were studied. Propofol PCS was performed using $Perfuser^{\circledR}$ fm, which was set to deliver a bolus dose of 5 mg with 999.9 ml/hr nominal infusion rate and 1 min lockout time. Propofol loading dose was randomly assigned to a bolus dose ${\times}$ 0, 2, and 3 (initial bolus). Patients were told to press the bolus button as often as they needed to relieve discomfort. Results: Total infused dose of propofol was mean 1.8 mg/kg/hr and D (Delivery)/A (Attempt) ratio was mean 72.8%. All patients was awake and there were no clinically significant intraoperative side effects during the sedation. Almost all patients were very satisfied with this type of PCS. Conclusion: Propofol PCS using $Perfuser^{\circledR}$ fm infusion pump provided good conscious sedation for dental procedures.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.167-178
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• 2013

Oxycodone is a semi-synthetic opioid synthesized from poppy-derived thebaine. It is a narcotic analgesic generally indicated for relief of moderate to severe pain. Although developed in an attempt to improve on the existing opioids, the adverse effects of oxycodone are those that are typically found in opioids. In recent years, the use of the opioid oxycodone has increased markedly and replacing morphine as the first line choice of opioid in several countries. There are formulations for oral immediate, oral extended release and intravenous use. In 2013, intravenous oxycodone was approved for marketing by Ministry of Food and Drug Safety (MFDS), with the indication of postoperative intravenous patient-controlled analgesia (IV PAC). Simulation study of oxycodone demonstrated that minimum effective analgesic concentration (MEAC) of oxycodone was most quickly reached with higher loading dose and IV PCA with background infusion, which may reduce the necessity of rescue analgesics during immediate postoperative period. Previous studies for postoperative pain management with intravenous oxycodone are limited in sample size, mostly less than 100 patients, which may not be large enough to assess safety of intravenous oxycodone. The effectiveness and tolerability of IV PCA with oxycodone should, therefore, be evaluated in large scale clinical trials in Korean populations.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.40-44
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• 2018

Background: Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain. Methods: Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period. Results: The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth. Conclusion: A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.279-284
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• 2018

Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.86-97
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• 2017

Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.97-101
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• 2011

Intravenous Patient Controlled Analgesia (IV PCA0 after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.411-417
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• 2019

Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

• Women's Health Nursing
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• v.10 no.2
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• pp.128-135
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• 2004

Purpose: Women who undergo gynecological surgery have moderate and severe sensation and distress of pain despite the advent of patient controlled analgesia (PCA). The purposes of this study were to describe perception of non-pharmacological therapy for postoperative pain control and examine changes of pain sensation and distress in women who had gynecological surgery. Method: The sample consisted of 52 women who were having gynecological surgery. Subjects who agreed to participate in the study were asked for their opinion about non-pharmacological approaches for postoperative pain control using a structured study questionnaire. Pain sensation and distress were assessed by VAS in the morning and afternoon for 2 days following the surgery. Result: About 50% of the subjects thought that non-pharmacological methods such as relaxation, music, massage, or meditation would be helpful for their postoperative pain control. If both pharmacological and non-pharmacological therapy were given for pain control, 96% of subjects reported it would be effective. Nurses can apply techniques of relaxation, deep breathing, meditation, and music therapy to surgical patients along with PCA. Expected sensation and distress of pain was high, but pain levels gradually decreased over time. However, subjects experienced moderate levels of pain postoperatively although they used PCA. Conclusion: The effect of a combined method of pharmacological and non-pharmacological approach needs to be tested if postoperative pain is to be decreased more.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.401-410
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• 1997

An acute pain is the common experience following surgery. Pain is a most miserable experience in person and most preoperative patients have fear o! postoperative pain. In nursing, it is very important to understand and relieve the pain of post oprative patients as much as possible. This study was designed to compare the descriptive patterns of pain between group of Patient Controlled Analgesia and group of traditional Muscular Injection in surgcal patients. This information can be utilited as data of understanding nursing care and treatment planning for pain in surgical patients. The subjects in this study were 45 post-hysterectomy patients in Gynecology ward in C. N. U. H., in Taejon. Data was collected from May 12 to June 27. 1996. The instrumants used for this study were subjective Visual Analog Scale, Objedive nonverbal pain scale composed of Facial Apperance. Vocal Sound Change, and Sweating score. and the Melzack's Mcgill pain Qusetionaire. nine Items of Developmental Pain Intensity Scale by Lee En Ok. Analysis of data was done by using S. P. S. S. percentage, t-test, x²-test. ANOVA, and Repeated measure ANOVA. Results were obtained as follows. 1. Hypothesis 1 : There was very highly statistically significant difference in subjective self-report pain score(Visual Analog Scale) between PCA Group and IM Group(P=0.0001). 2. Hypothesis 2 : There was very highly statistically significant difference in muscle strength score (Visual Analog Scale) between PCA Group and IM group(P0.0001). 3. Hypothesis 3 : There was very highly statistically significant difference in facial appearance score between PCA Group and IM group(P=0.0001). 4. Hypothesis 4 : There was very highly statistically significance difference in vocal sound change score between PCA Group and IM group(P=0.0001). 5. Hypothesis 5 : There was no statistically significant difference sweating scores between PCA group and IM group(F=2.50, P=0.1220). But, postoperation time of 12, 24 was statistically difference between two groups(P=0.0001). So, it was partially supported. 6. Hypothesis 6 : There was very highly statistically significant difference in vocabulary pain score between PCA Group and IM group. 7. Hypothesis 7 : There was very highly statistically significant difference in amounts of total analgesic between PCA Group and IM group. There was very highly statistically significant difference in Visual Analog Pain Score, Facial Appearance Score, Vocal Sound Change Score, Vocabulary Score, amounts of total analgesic between PCA group and IM group. So, It is verified to asses of postoperative pain with VAS, Checklist of facia appearance, vocal sound change, and sweating, and Vocabulary Scale.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.652-663
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• 2023

Objective : This study compared the quality of recovery (QoR) after minicraniotomy for clipping of unruptured intracranial aneurysms (UIAs) between patients with and without scalp nerve block (SNB). Methods : Patients were randomly assigned to the SNB (SNB using ropivacaine with epinephrine, n=27) and control (SNB using normal saline, n=25) groups. SNB was performed at the end of surgery. To assess postoperative QoR, the QoR-40, a patient-reported questionnaire, was used. The QoR-40 scores were measured preoperatively, 1-3 days postoperatively, at hospital discharge, and 1 month postoperatively. Pain and intravenous patient-controlled analgesia (IV-PCA) consumption were evaluated 3, 6, 9, and 12 hours and 1-3 days postoperatively. Results : All QoR-40 scores, including those measured 1 day postoperatively (primary outcome measure; 155.0 [141.0-176.0] vs. 161.0 [140.5-179.5], p=0.464), did not significantly differ between the SNB and control groups. The SNB group had significantly less severe pain 3 (numeric rating scale [NRS]; 3.0 [2.0-4.0] vs. 5.0 [3.5-5.5], p=0.029), 9 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.048), and 12 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.035) hours postoperatively. The total amount of IV-PCA consumed was significantly less 3 hours postoperatively in the SNB group (2.0 [1.0-4.0] vs. 4.0 [2.0-5.0] mL, p=0.044). Conclusion : After minicraniotomy for clipping of UIAs, SNB reduced pain and IV-PCA consumption in the early postoperative period but did not improve the QoR-40 scores.