• Journal of Korean Clinical Nursing Research
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• v.17 no.3
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• pp.455-466
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• 2011

Purpose: The purpose of this study was to investigate the effects of a structured preoperative PCA education on the knowledge and attitude regarding PCA usage, level of pain, and the consumption of analgesics after operation for colorectal surgery patients. Methods: This study was conducted from 18 Feb to 2 May, 2008. Participants were 80 colorectal cancer patients who would use the IV-PCA after colorectal surgery in a cancer hospital in Gyeonggi-do, Korea. Two groups, experimental and control were consisted of 40 patients each. The 20-minute structured education regarding PCA usage was applied to each patient individually in the experimental group but only the routine anesthetic consultation was given to each patient in the control group the day before the surgery. The SPSS/PC 10.0 program was introduced to analyze the collected data on frequency, percentage, mean, standard deviation, $x^2$-test, t-test and paired t-test. Results: The experimental group with the structured preoperative PCA education showed higher knowledge and more positive attitudes regarding the PCA usage than the control group. Also the experimental group showed better pain control and lower consumption of analgesics at 4, 8 and 24 hours after than the control group. Conclusion: The structured preoperative PCA education is an effective nursing intervention for improving the knowledge and attitude of the colorectal surgery patients on the PCA usage, and enabling the patient to take the analgesic more effectively with lower consumption, while reducing the patients' pain after operation.

• 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.

• 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.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.30-38
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• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

• Korean Journal of Anesthesiology
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• v.71 no.6
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• pp.440-446
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• 2018

Background: The aim of this study was to evaluate aprepitant in combination with palonosetron as compared to palonosetron alone for the prevention of postoperative nausea and vomiting (PONV) in female patients receiving fentanyl-based intravenous patient-controlled analgesia (IV-PCA). Methods: In this randomized single-blinded study, 100 female patients scheduled for elective surgery under general anesthesia were randomized to two groups: Group AP (80 mg aprepitant plus 0.075 mg palonosetron, n = 50) and Group P (0.075 mg palonosetron, n = 50). The patients in group AP received 80 mg aprepitant per oral 1-3 h before surgery, while all patients received 0.075 mg palonosetron after induction of standardized anesthesia. All patients had postoperative access to fentanyl-based IV-PCA. The incidence of nausea and vomiting, use of rescue medication, and severity of nausea were evaluated at 6 and 24 h after surgery. Results: The incidence of nausea (54%) and vomiting (2%) in group AP did not differ significantly from that in group P (48% and 14%, respectively) during the first 24 h after surgery (P > 0.05). Patient requirements for rescue medication in group AP (29%) were similar to those in group P (32%) at 24 h after surgery (P > 0.05). There was no difference between the groups in severity of nausea during the first 24 h after surgery (P > 0.05). Conclusions: Aprepitant combined with palonosetron did not reduce the incidence of PONV as compared to palonosetron alone within 24 h of surgery in women receiving fentanyl-based IV-PCA.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.210-216
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• 2021

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

• Journal of Photoscience
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• v.1 no.1
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• pp.31-37
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• 1994

Photoirradiation at > 300 nm onto a suspension of platinized TiO$_2$ (TiO$_2$-Pt) particles in an aqueous solution. of N$_{\varepsilon}$-carbamyI-L-lysine (Lys(CONH)$_2$) induced the selective N-cyclization of Lys(CONH$_2$) into almost optically pure L-pipecolinic acid (PCA) under argon atmosphere at ambient temperature. Among various TiO$_2$-Pt catalysts, a P-25 (Degussa) powder platinized via impregnation from chloroplatinic acid followed by hydrogen reduction at 753 K exhibited the highest photocatalytic activity for Lys(CONH$_2$) consumption and L-PCA production. GC-MS analyses of L-PCA obtained photocatalytically from $^{15}$N$\alpha$-Lys(CONH$_2$) revealed the selective formation $^{15}$N-substituted L-PCA. This implies that the mechanism for L-PCA production contains selective cleavage of C$_{\varepsilon}$-N bond and intramolecular alkylation at $\alpha$-amino group. Effect of pH on the rate of this photocatalytic reaction was investigated in detail and compared with the pH-dependent charge distribution in Lys(CONH$_2$) molecule. It is clarified that protonation-deprotonation of $\alpha$-amino group gives marked influence on the rate and selectivity of the photocatalytic reaction. On the basis of these results, it is concluded that the selective production of optically pure L-PCA, especially in an acidic suspension of TiO$_2$-Pt, was attributed to the enhanced protonation of $\alpha$-amino group to prevent undesirable oxidation by photogenerated positive holes and blocking of $\varepsilon$-amino group to yield racemic Schiff base intermediate.

• Journal of Sasang Constitutional Medicine
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• v.13 no.3
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• pp.75-88
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• 2001

The purpose of this research was to investigate the effects of Kwakhyangjeonggisan (KJS) on the anti-allergic action. In the present study, we examined the effect of KJS on type I and type IV allergic reaction. KJS inhibited the systemic anaphylaxis induced by compound 48/80 and platelet activating factor (PAF), and inhibited the passive cutaneous anaphylaxis (PCA) induced by anti-dinitrophenyl (DNP)-IgE and DNP-human serum albumin (HSA) in vivo. In addition, KJS dose-dependently inhibited the release of histamine from peritoneal mast cells in rat. Also, KJS inhibited the delayed type hypersensitivity (DTH) induced by SRBC and the contact dermatitis induced by dinitrofluorobenzene (DNFB). KJS inhibited the proliferation of splenocytes, the subpopulation of B220+ cells and CD4+CD8-(Th) cells in splenocytes and the production of γ-interferon in serum and splenocytes. These findings suggest that KJS prevented the type I allergy by the inhibition of histamine release from mast cells and the type IV allergy by the inhibition of γ-interferon production and B lymphocytes subpopulation. These results indicate that KJS may be useful for the prevention and treatment of type I and type IV allergy related disease.

• The Korea Journal of Herbology
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• v.27 no.5
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• pp.37-44
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• 2012

Objectives : The present study was undertaken to determine whether the ethanol extact of Citri Pericarpium (CP, Pericarp of Citrus unshiu Markovich, Rutaceae) is effective against atopic dermatitis according to it's storage period. Methods : To evaluate antiallergic effect of CP and OCP (Old Citri Pericarpium) evaluated in vivo their inhibitory effects against passive cutaenous anaphylaxis (PCA) reaction induced by IgE-antigen complex and scratching behaviors by compound 48/80. The Anti-atopic effects were measured by contact dermatitis, prurient animal model and PCA reaction. Contact dermatitis in mice as a model of the Type IV reaction caused by Oxazolone. Results : The results showed that anti-pruritus effects, analgesic effects of CP was depends on its hesperetin contents. And It also showed that keep longer in storage appeared to be higher in hesperetin contents. Both CP and OCP(Old CP) have a dose-dependent analgesic action in acetic acid induced writhing syndrome. OCP Potently inhibited PCA reaction in mice, although OCP weakly inhibited in long term contact dermatitis model in mice. Conclusions : These results suggest that the Proportional to the storage period, Citri Pericarpium possesses analgesic effects and anti-allergic effects.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.2
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• pp.288-299
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• 2002

The patients with abdominal surgery usually have acute pain. It is important for a patient's qualify of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics. t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1. For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002). monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p = 0.0001). 2. For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (P=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (P =0.0063). 3. For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012). and operation title (p =0.0033). 4. For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p =0.0128). monthly income (p=0.0008), diagnosis (p =0.0007), and operation title (p =0.0008). 5. The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r =0.51, p =0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50. p=0.0001) and the relationship between Depression and pain revealed a significant positive correlation (r =0.49. p =0.0001).