• 디지털융복합연구
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• 제19권1호
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• pp.211-216
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• 2021

본 연구는 다제내성균 환자가 사용한 병실 환경에 대한 환경관리 평가 방법 중 미생물 배양검사와 Adenosin Triphosphate Bioluminescence 방법을 이용하여 오염도를 파악 한 후 환경소독제를 이용하여 소독효과를 평가하고자 시도되었다. 환경표면은 다제내성균으로 격리된 환자병실을 대상으로 하였다. 검체채취는 인퓨전펌프, IV 폴대, 상두대, 침대난간, 키보드 혈압기 커프 5곳을 실시하였고 소독 전, 소독 직후, 소독 후 5분 후 ATP와 미생물배양검사를 실시하였다. 연구결과 Infusion pump의 환경표면이 소독·후 오염도가 통계적으로 유의하게 감소하였다. 또한 IV 폴대, 침상난간, 키보드는 소독 전후 균 검출이 감소하였다. 즉 정기적인 환경표면소독은 환자에게 감염으로부터 안전한 환경을 제공할 수 있다. 따라서 향후 다기관을 대상으로 소독제의 지속성 등을 평가하여 환경표면 소독방법, 소독주기 등의 지침을 마련하는 것이 필요하다.

• The Korean Journal of Pain
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• 제22권1호
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• pp.68-73
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• 2009

Opioids profoundly inhibit evoked discharges of spinal nociceptive neurons, thereby inhibiting the transmission of pain. Intrathecal administration of opioids using implantable continuous infusion systems is an effective method of pain relief when other treatments have failed, as well as for patients with adequate analgesia on high dose therapy that produces unacceptable side effects. We report two cases of intrathecal pump implantation performed in patients suffering from intractable chronic pain. A test dose of 3 mg morphine was injected into the epidural space. No side effects were noted and patients experienced considerable pain relief. Implantation was performed one day after the test. The initial intrathecal morphine delivery dose was half of the equivalent dose of daily oral intake opioids and the infusion rate was increased gradually under close observation for opioid side effects. Two days post-implantation, both patients were discharged without any complications.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.454-458
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• 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

• Journal of Ginseng Research
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• 제16권1호
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• pp.13-17
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• 1992

The present experiments were performed to investigate the effects of the ginseng total saponin on the development of physical dependence on morphine via intracerebroventricular (i.c.v) route. Morphine (10 $\mu\textrm{g}$/${mu}ell$/hr) was continuously infused via osmotic minipumps into lateral cerebral ventricle of male Sprague Dawley rats for 7 days. Concurrent ginseng total saponin (100, 200 $\mu\textrm{g}$/10${mu}ell$/hr) was infused intraperitoneally (i.p) via osmotic pumps for 7 days. Treatment with ginseng total saponin (200$\mu\textrm{g}$/10${mu}ell$/hr) significantly diminished jumping, teeth chattering, hypothermia and weight loss precipitated by naloxone, compared with those animals received only morphine infusion. These results suggest that ginseng total saponin has central effect on the inhibition of physical dependence on morphine, as systemic ginseng total saponin inhibits the development of physical dependence in rats infused with morphine intracerebroventricularly.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.55-59
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• 2016

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

• 대한의용생체공학회:의공학회지
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• 제40권1호
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• pp.20-31
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• 2019

Medical device performance management is an activity that allows a device to be safely used and maintained even after it is put on the market. The purpose of this study is to provide procedures and criteria for selection of medical device items that should manage the safety and performance among medical devices in hospital. Investigate the performance management status of medical devices in hospitals and identify the performance management status by domestic and advanced regulatory agencies. Provides selection procedures and test methods for medical devices subject to performance management in hospitals based on medical device risk management and reliability. In addition, a case study on drug infusion pumps was conducted.

• 임상간호연구
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• 제29권1호
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• pp.146-147
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• 2023

• 대한치과마취과학회지
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• 제1권1호
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• pp.16-20
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• 2001

연구배경: 일반적으로 자가통증조절기가 자가진정조절을 위해 적합한 것으로 알려져 있다. 그러나 이 장치들은 몇몇 진정제 투여 시 너무 긴 최소 폐쇄간격을 가지고 있다 WalkMed사(Medex inc, USA)의 자가통증조절기는 폐쇄간격을 0으로 설정할 수 있으며 30 ml/h로 추가용량을 투여할 수 있다. 이번 연구에서는 환자 개개인의 요구에 맞추어 환자의 진정을 조절하기 위하여 위장치를 이용한 propofol 자가진정조절기의 가능성를 조사하였다. 방법: Propofol과 전산 프로그램된 WalkMed 주입장치를 이용한 자가진정조절법이 치과치료를 받는 24명의 건강한 환자에게 시행되었다. Propofol 지속 주입량은 2 mg/kg/h로, 추가용량은 5 mg으로 조절되었으며 치소 폐쇄간격은 0으로 설정하였다. Ketoloac 30 mg이 통증 조절을 위하여 진정법 시행 전에 근주되었다. 결과: 진정법 시행 동안 주입된 propofol의 평균량은 3.4 mg/kg/h이었으며 평균 추가용량은 1.6 mg/kg/h이었다. 시간 당 추가용량에는 많은 변이가 있었다(0-32). 모든 환자는 진정법 시행 동안 완전한 각성상태였으며 이러한 진정 법에 만족하였다. 진정 법과 관련된 주요한 합병증은 관찰되지 않았다. 결론: WalkMed사의 자가통증조절기를 이용한 propofol 자가진정조절법이 치과 치료를 받는 환자들에게 유용하게 사용될 수 있다.

• The Korean Journal of Pain
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• 제27권2호
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• 중환자간호학회지
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• 제8권1호
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• pp.41-49
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• 2015

Purpose: The purpose of this study was to measure the noise levels in intensive care units (ICUs) and to analyze the causes of the noise and patient perceptions of the noise. Methods: Noise levels were recorded in adult ICUs for 24 h over a week from the patients' bedside with a sound level meter. Noise sources were categorized into three groups: medical equipment, health care providers, and the environment. Noises from the environment were recorded in an empty ICUs side room. Perceptions of the noise of 125 patients admitted to the ICUs were recorded using a questionnaire. Results: The mean level of noise in the ICUs was 58.5 dBA (range: 34.2-80.2 dBA). The causes of noise higher than 70 dBA were nebulizers and infusion/syringe pumps among medical equipment, and drawer slamming, phone ringing, and stripping packages of medical fluids among environmental noises. According to the questionnaire, 64.0% of the patients responded that the ICUs were noisy and that they suffered from sleep disturbance because of the noise. Conclusion: Noise is considerably high in ICUs and is an annoying factor for the patients. Most noise sources are adjustable, and we should try to reduce noise whenever possible to make the ICUs environment more pleasant.