• 제목/요약/키워드: Pain: cancer pain

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뼈의 통증이 있을 때 감별해야 할 악성종양 (Malignancies in children who present with bone pain)

  • 이준아
    • Clinical and Experimental Pediatrics
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    • 제51권8호
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    • pp.792-796
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    • 2008
  • 소아청소년기에 뼈의 통증은 일차진료에서 흔히 접할 수 있는 문제이다. 대부분은 성장통이나 스포츠 활동과 관련된 물리적인 원인에 의한 것이지만 급성 림프구성 백혈병, 신경모세포종, 원발성 골종양 등의 악성종양이 뼈의 통증으로 발현하는 경우도 있다. 뼈의 통증을 호소하는 소아청소년 중 악성종양으로 진단 받는 환자는 1% 미만으로 그 빈도가 매우 낮지만 진단과 적절한 치료가 지체되면 환아의 예후에 악영향을 미칠 수 있으므로 어떠한 경우에 악성종양을 의심해야 하는지 숙지해야 한다. 환아가 잠을 잘 수 없을 정도로 심한 뼈의 통증을 2주 이상 호소하며, 발열, 피로감, 야간발한 등의 전신증상이 동반되거나 림프절 비대, 간비장 비대, 사지 혹은 배가 부어 보이고 덩어리가 만져지면 CBC with differential count, 말초혈액 바른검사, CRP, ESR, 단순 방사선 촬영을 시행해야 한다. 위의 검사결과 이상소견이 발견되면 즉시 소아청소년 혈액종양 전문의에게 의뢰를 해야 할 것이다.

말기 담낭암 환자의 통증조절을 위해 MS Contin 투여중 발생한 호흡억제 -증례 보고- (Respiratory Depression during Oral MS-Contin Administration for Pain Management of Gall Bladder Cancer)

  • 이철우;이병호;이용희
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.239-243
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    • 1996
  • MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

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한의학적 치료로 호전된 전이성 대장암 환자의 복통에 대한 증례보고 (A Case Report of Abdominal Pain Relief in a Patient with Metastatic Colorectal Cancer Treated with Korean Medicine)

  • 윤미정;김나연;최홍식;김승모;김경순
    • 대한한방내과학회지
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    • 제42권4호
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    • pp.687-694
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    • 2021
  • Objectives: The aim of this case report is to present abdominal pain relief in a patient diagnosed with colorectal cancer with several organ metastases. Methods: The patient was treated with herbal medicine, acupuncture, and moxibustion. The effect of the treatment was measured by a numeric rating scale (NRS). Results: The NRS of the patient's abdominal pain was reduced after Korean medicine treatment. Conclusions: This case report suggests that Korean medicine may be effective for treating abdominal pain in cancer patients. However, additional study is needed to confirm interactions between Korean medicine and the control of abdominal pain.

유방암 환자의 통증 관련 약물 현황과 통증에 미치는 요인 (Pain-related Prescribing Patterns and Associated Factor in Breast Cancer Patients)

  • 이진;박이병;서화정
    • 한국임상약학회지
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    • 제31권2호
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    • pp.115-124
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    • 2021
  • Background: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564-2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p=0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.

국소적 전기근육자극을 결합한 기구 필라테스가 유방절제술 후 유방암 환자의 통증, 림프부종 및 팔 관절가동범위에 미치는 효과 : 무작위 교차실험 연구 (The Effects of Instrument Pilates Exercise with EMS on Pain, Lymphedema and Range of Motion of Upper Extremity in Subjects after Mastectomy : Randomized Cross-over Design)

  • 강채영;박현주;천승철
    • 대한통합의학회지
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    • 제10권4호
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    • pp.113-120
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    • 2022
  • Purpose : Lymphedema is a common complication in mastectomy patients and is usually characterized by pain, swelling, and limited range of motion (ROM) in the arm. Electromyostimulation (EMS) is widely used for the rehabilitation and recovery of subjects with various neuromusculoskeletal disorders after breast cancer. However, EMS has not yet been used in many Pilates exercises. This study was aimed at comparing the effects of instrument Pilates integrated with EMS on pain, lymphedema, and ROM of the upper extremity (UE) in breast cancer subjects after mastectomy. Methods : Nine female breast cancer subjects who had undergone mastectomy participated in the study. The subjects underwent instrument Pilates with EMS (experimental group) or instrument Pilates only (control group). Pain, lymphedema, and ROM of the UE were measured using the visual analog scale (VAS), the circumference length of the UE, and the ROM of the UE. The Wilcoxon signed-rank test was used to compare the pain, lymphedema, and ROM of the arm before and after the intervention, and the Mann-Whitney U test was used to compare the two groups. The statistical significance level was set to p < .05. Results : In the experimental group, there were significant differences in pain (p<.05) and UE circumference (p<.05) before and after intervention. However, there was no significant difference between the two groups in VAS (p>.05) or circumference length of the UE (p>.05). There was one significant difference between the groups in terms of internal rotation of the ROM of the UE (p<.05). Conclusion : These results show that instrument Pilates exercises combined with EMS may positively affect the internal rotation of the ROM of the UE in breast cancer patients after mastectomy, thus contributing to existing knowledge about instrument Pilates using EMS for the effective management of in breast cancer subjects after mastectomy.

제 12흉추부위에서 시행한 내장신경차단 (Splanchnic Nerve Block at T12 Level)

  • 박정현;윤덕미;오흥근
    • The Korean Journal of Pain
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    • 제5권1호
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    • pp.17-22
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    • 1992
  • Splanchnic nerve block(SNP) is performed to relieve intractable upper abdominal cancer pain. Boas, in a technique using fluoroscopy, was the first to note the difference between transcrural celiac plexus block and retrocrural splanchnic nerve block(SNB). We have experienced 10 cases of SNB at the T12 level under control of fluoroscopy. Our results support this approach as an effective method for upper abdominal cancer pain control.

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심리사회적 중재가 암환자의 통증완화에 미친 효과: 메타분석 (Meta-analysis of Psychosocial Interventions to Reduce Pain in Patients with Cancer)

  • 오복자;한숙정
    • 대한간호학회지
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    • 제43권5호
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    • pp.658-668
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    • 2013
  • Purpose: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. Methods: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. Conclusion: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

매개모델을 이용한 유방암 환자의 증상클러스터 검증 (A Symptom Cluster Analysis of Breast Cancer Patients Using a Mediation Model)

  • 김경덕;장현진
    • 종양간호연구
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    • 제12권4호
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    • pp.274-279
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    • 2012
  • Purpose: This study was conducted to test whether sleep disturbance mediates the effect of pain on fatigue, whether fatigue mediates the effect of pain on depression, and whether fatigue mediates the effect of sleep disturbance on depression. Methods: This study was conducted from September 12th to December 20th, 2011. One hundred eighty-eight breast cancer patients were recruited from D city and S city in Korea. The instruments used in this study were the pain, sleep disturbance, fatigue, and depression scales. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and mediation pathway with the SPSS 12.0 and AMOS 20.0 programs. Results: There was correlation among pain, fatigue, sleep disturbance, and depression. Mediation analyses indicated that pain influences fatigue. sleep disturbance, and depression directly as well as indirectly. Sleep disturbance influences fatigue and depression directly, also fatigue influences depression directly. But sleep disturbance had no direct effect on depression. Conclusion: Significant correlations among the four symptoms supported the existence of the symptom cluster. Effects of pain on fatigue was partially mediated by sleep disturbance, also effects of pain on depression was partially mediated by fatigue. However, the effects of sleep disturbance on depression was fully mediated by fatigue.

Effects of Distant Reiki On Pain, Anxiety and Fatigue in Oncology Patients in Turkey: A Pilot Study

  • Demir, Melike;Can, Gulbeyaz;Kelam, Ayhan;Aydiner, Aydin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4859-4862
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    • 2015
  • Background: Fatigue, stress and pain are common symptoms among cancer patients, affecting the quality of life. The purpose of the present study was to determine the effect of distant Reiki on pain, anxiety and fatigue in oncology patients. Materials and Methods: Participants in the control group received usual medical and nursing care during their stay. The intervention group received usual care plus five distant Reiki sessions, one each night for 30 min. A face to face interview was performed and patient personal and illness related characteristics were evaluated using the Patient Characteristics form. Pain, stress and fatigue were evaluated according to a numeric rating scale. Results: The experimental group was predominantly composed of women (71.4%), married individuals (40%), and primary school graduates (40%). The control group was predominantly male (72.7%), married (60%), and primary school graduates (60%). The control group demonstrated greater levels of pain (p=0.002), stress (p=0.001) and fatigue (p=0.001). The Reiki group pain score (p <0.0001), stress score (p <0.001) and fatigue score were also significantly lower. Conclusions: The results of this study indicate that Reiki may d ecreasepain, anxiety and fatigue in oncology patients.

대건중탕 및 쑥뜸치료로 호전된 간세포암 환자의 암성 통증 1례 (A Clinical case of a Hepatocellular carcinoma Patient with abdomen pain Improved by Daegunjoong-tang and Moxibustion.)

  • 이수정;하정빈;유재환
    • 대한암한의학회지
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    • 제25권2호
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    • pp.13-21
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    • 2020
  • Objective: Most cancer patients suffer from various forms of pain. This study presents the case of a patient with hapatocellular carcinoma with abdominal pain treated by Daegunjoong-tang. Method: For 7 days, the patient was treated with Daegunjoong-Tang and Moxibustion. We planned to maintain moxibustion CV12(中脘), CV4(關元) for 20 minutes everyday. To evaluate the therapeutic effect, we used Visual Analogue Scale (VAS) and Clinical Opiate Withdrawal Scale (COWS). Results: After the treatments, Visual Analogue Scale (VAS) and Clinical Opiate Withdrawal Scale (COWS) score about abdominal pain are decreased. Conclusions: These results suggested that Daegunjoong-tang and Moxibustion have a beneficial effect on relieving abdominal pain caused by cancer.