• 제목/요약/키워드: Pain Control

검색결과 2,928건 처리시간 0.033초

Programmed-release intraosseus anesthesia as an alternative to lower alveolar nerve block in lower third molar extraction: a randomized clinical trial

  • Pol, Renato;Ruggiero, Tiziana;Bezzi, Marta;Camisassa, Davide;Carossa, Stefano
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권3호
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    • pp.217-226
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    • 2022
  • Background: Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Methods: Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). Results: The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. Conclusion: The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

Balb/c 생쥐에 대한 어싱 매트리스에 의한 항염 효과 (Anti-inflammatory Effects of Earthing Mattress in Mouse)

  • 김지연
    • 동의생리병리학회지
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    • 제36권3호
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    • pp.89-93
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    • 2022
  • Earthing, caused by direct skin contact with the Earth's surface, is used to reduce the symptoms of inflammation (fever, fever, swelling and pain). However, there is little evidence to support the anti-inflammatory effects of earthing mattresses. Therefore, this study was conducted to investigate whether anti-inflammatory effect of earthing mattress using an in vivo animal model. The anti - inflammatory effect was evaluated by measuring ear thickness and foot volume in 12-O-tetradecanoylphorbol-13 acetate (TPA) - induced ear edema and carrageenan - induced paw edema model, respectively. Balb/c mouse in carrageenan paw edema model showed significant anti - inflammatory effect in the group treated with earthing mattress for 4 hours or 24 hours for 3 days. For females, the anti-inflammatory effect was greater when the earthing mattress was added to the mattress than the mattress alone treatment. From the above results, it was found that the female responds more to the effect of the earthing as well as the mattress effect. In addition, when the male and female Balb/c mice were exposed to mattresses and earthing mattresses for 24 h for 3 days, respectively, the mattress and earthing mattresses showed significant inhibition of IL (Interleukin)-1β levels compared to the control. In the TPA ear edema model, Balb/c mouse showed significant anti - inflammatory effect in the group treated with the earthing mattress for 4 hours or 24 hours for 3 days. Both males and females showed more anti-inflammatory effects when they were exposed to earthing mattresses with mattresses added to the mattresses. From the above results, it was found that both male and female respond to the effect of earthing as well as the mattress effect in the TPA ear edema model. In conclusion, in this study, we have verified that earthing mattress shows inhibitory effects on TPA and carrageenan-induced inflammation. From these results, it is suggested that the anti-inflammatory effect can be expected by applying the earthing mattress to patients suffering from inflammatory diseases. However, there is a need to pinpoint exactly how the earthing mattress relieves inflammation, and further research is needed to investigate the mechanism.

Effect of knife castration on leukocyte cytokine expression and indicators of stress, pain, and inflammation in Korean cattle bull calves

  • Seonpil Yoo;Seok-Hyun Beak;Hyeok Joong Kang;Da Jin Sol Jung;Dilla Mareistia Fassah;InHyuk Jeong;Seung Ju Park;Md Najmul Haque;Myunghoo Kim;Myunggi Baik
    • Animal Bioscience
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    • 제36권3호
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    • pp.521-528
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    • 2023
  • Objective: This study investigated the effects of surgical castration on behavior, physiological and inflammatory indicators, and leukocyte cytokine mRNA levels in Korean cattle bull calves. Methods: Nineteen Korean cattle bull calves (average body weight, 254.5 kg; average age, 8.2 months) were divided into two treatment groups: control (n = 9) and castration (n = 10). Surgical castration was performed using Newberry knives and a Henderson castrating tool. Blood was obtained just before castration (0 h) and at 0.5 h, 6 h, 1 d, 3 d, 7 d, and 14 d after castration. Plasma cortisol (PC), saliva cortisol (SC), plasma substance P, and plasma haptoglobin concentrations, and the leucocyte mRNA levels of the interleukin-1-alpha (IL1A), interleukin-1-beta (IL1B), interleukin-1 receptor antagonist (IL1RN), and interleukin-6 (IL6) genes were analyzed. Results: Castration decreased (p<0.01) the average daily gain and gain/feed ratio. Castration reduced the time spent eating (p<0.001) and the eating frequency (p<0.01) and increased (p<0.001) the lying frequency. Castration temporarily increased (p<0.05) circulating PC and SC concentrations at 0.5 h after castration. Castration temporarily increased (p<0.05) plasma substance P concentrations at 1 d after castration. Castration increased (p<0.05) plasma haptoglobin concentrations at 1 and 3 d after castration. Castration increased (p<0.05) leukocyte mRNA levels of the IL1A, IL1B, IL1RN, and IL6 genes at 6 h after castration. Conclusion: Castration temporarily induced stress and expression of leucocyte inflammatory cytokine genes in Korean cattle bull calves.

두통에 대한 이혈 방혈요법의 유효성 분석: 체계적 문헌고찰 및 메타분석 (Effectiveness of Auricular Blood-letting Therapy for Headaches: A Systematic Review and Meta-Analysis)

  • 이경은;박민령;이지원;황인준;이보람;서종철;권찬영
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.259-274
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    • 2023
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of auricular blood-letting therapy (ABT) for headaches. Methods: Studies were identified by a comprehensive search of five databases. Randomized controlled trials (RCTs) that investigated the effects of the ABT for headaches were included. Two authors independently extracted the data and assessed the methodological quality of the included studies using Cochrane's risk-of-bias tool. If two or more studies reported the same outcome, a meta-analysis was performed. Meta-analysis results for dichotomous variables are expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Results: A total of eight RCTs were included in this review. The total effective rate (TER) was the most commonly used outcome measurement. Among the eight RCTs, five were included in the metaanalysis. The TER was not statistically significantly different in the ABT group compared to the medication group (two studies, n=55, RR=1.24, 95% CI: 0.78 to 1.96, p=0.36, I2 =86%). However, the TER of the combined ABT and medication group was significantly different compared to the medication alone group (four studies, n=159, RR=1.23, 95% CI: 1.12 to 1.35, p<0.0001, I2 = 0%). Pain and mental health-related outcomes in the combined ABT and medication group were significantly different from the control groups. The methodological quality of the included RCTs was generally low. Conclusions: ABT combined with medication may be effective for treating headaches. However, the number of studies included was small, so the results were insufficient, and statistically significant effects were not confirmed for a single implementation of ABT. Thus, well-designed further studies based on the findings of this study are recommended.

한국 의료기관에서 임상병리사의 채혈 업무 현황과 안전 실태 조사 (Blood Collection Workload and Safety of Medical Technologists at Korean Hospitals)

  • 박성배;제갈석;황원주;이도왕;서충원;김성현
    • 대한임상검사과학회지
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    • 제55권3호
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    • pp.159-166
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    • 2023
  • 본 연구에서는 진단검사를 수행하기 위해 가장 중요하다고 할 수 있는 채혈 업무에 대한 임상병리사의 현 상황을 알아보고, 이를 통해 채혈 업무에 대한 행위료의 보험 수가 산정 및 상대 가치점수 부여를 통한 임상병리사의 권익을 향상시키고자 하였다. 부산·울산·경남 지역의 병원에서 근무하고 있는 임상병리사를 대상으로 설문조사를 실시하였고, 총 650명의 임상병리사를 대상으로 연구를 수행하였다. 연구결과 1명의 임상병리사가 약 100명의 피검자를 대상으로 채혈 업무를 수행하는 것을 확인할 수 있었다. 채혈 실패 건수는 하루에 1건 이상 실패하는 것을 확인할 수 있었고, 통증 호소 환자 및 이를 통한 민원 발생은 1년간 1건 이상 발생하여 검사자의 부담감이 높은 것을 확인할 수 있었다. 사용한 바늘에 채혈자가 찔리는 경우도 1년간 1건 이상 발생되고 있고, 자상으로 인한 감염관리 진료 및 치료를 받은 경우도 약 15% 발생되고 있음을 확인하였다. 채혈 업무로 인한 근골격계 질환 발생 및 정신적 스트레스를 받는 비율은 절반 이상의 인원이 받는 것을 확인할 수 있었다. 현재 같은 주사침을 이용한 정맥 및 근육 주사와는 달리 채혈 업무에 대한 행위료는 없는 상황이기 때문에, 이러한 연구 결과를 기반으로 채혈 업무에 대한 행위료 산정 및 상대 가치점수 부여를 통해 임상병리사의 안전 및 권익을 향상시킬 수 있을 것으로 사료된다.

항암제 유발 신경독성을 관리하는 한의학 및 보완대체요법들과 임상시험 현황 (The Present Clinical Studies of Oriental Medicine and CAM Therapies in Chemotherapy-induced Peripheral Neurotoxicity)

  • 박선주;고호연;한유진;고성규;김성훈
    • 대한본초학회지
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    • 제24권4호
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    • pp.205-213
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    • 2009
  • Objectives : Cancer incidence is increasing in all countries and chemotherapy-induced peripheral neuropathy (CIPN) in patients undergoing chemotherapeutic agents have been a clinically serious problems. So far therapeutic options for CIPN patients are limited and no confirmed methods have yet been established for dealing with peripheral neuropathy. Therefore this review is to provide an evidence-based summary of oriental medicine and CAM (complementary and alternative medicine) neuroprotective and treatment therapies which have gone through clinical trials. Methods : An overview of the domestic and international papers of adult clinical trials relating management of only CIPN symptoms through 1990 to present were searched by electronic databases. Search key words were chemotherapy-induced neurotoxicity, chemotherapy-induced peripheral neuropathy, chemotherapy toxicity & herb, chemotherapy toxicity & acupuncture, chemotherapy toxicity & CAM. Only English and Korean written papers were reviewed. Total 25 papers were reviewed in this study, 18 papers were retrieved by electronic search. Results : Clinical studies of managing CIPN were rare, two acupuncture clinical studies and four herb medicinal studies were found. Rest of 19 papers were about other CAM clinical studies. Total 25 papers were analyzed, and all interventions were focused on their pain control efficacy. Other 24 trials of potential therapies except one proved to be effective for CIPN, however some described to be inadequate positive or sufficient negative. Conclusions : As most of the studies were pilot studies, interventions for the prevention and treatment of CIPN have to go through prospective confirmatory studies, such as larger scale randomized, double-blinded, placebo controlled clinical trials must be done for the safe and effective use of proposed therapies. Also standard measurement scales have to be developed for the better clinical study of CIPN.

발목강화운동과 무지테이핑 걷기훈련이 하체운동기능에 미치는 영향 (The Effects of Ankle Strengthening Exercise and Toe Taping Walk Training to Lower Body Exercise Function)

  • 강지수;이종복;조일영;김현태;김종혁;김인동;김재중;박정범
    • 산업융합연구
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    • 제21권7호
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    • pp.51-63
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    • 2023
  • 본 연구는 발목강화운동과 무지테이핑 걷기훈련 운동을 통하여 얻어지는 효과를 알아보기 위하여 4주간 발목강화운동과 무지테이핑 걷기운동이 하체기초체력과 보행에 미치는 영향을 검증하고자 하였다. 이를 위해 A대학에 재학중인 20대 여성 30명을 무선 선정하여 발목강화운동군, 무지테이핑 걷기운동군, 통제군 각 10명으로 선정하였다. 본 실험으로는 주 3회 60분간 4주간 수건 및 마사지볼, CRT를 이용한 마사지와 발목강화운동을 실시하였으며, 또한, 화이트 테이프 처치 후 20분간 걷기 및 키네지오 테이프를 이용한 무지외반 테이핑을 실시하였다. 위의 내용을 종합해본다면 4주간의 발목강화운동과 무지테이핑 걷기운동은 20대 여성의 하체기초체력(근력, 순발력, 평형성)과 보행(활보장, 족저압, COP)에는 통계적으로 일부 유의미한 효과를 나타내었다. 따라서, 본 연구에서 실시한 발목강화운동과 무지테이핑 걷기운동이 하체 운동기능에 대한 효과를 확인하였으며, 후속연구에서는 통증위치별, 정형외과적 소견별로 나누어 보다 다양한 효과를 알아보는 연구가 필요할 것이라고 사료된다.

아쿠아로빅 운동이 노인 여성의 신체구성, 체력 및건강관련 삶의 질(SF-36)에 미치는 영향 (Effects of Aquarobics Exercise on Body Composition, Fitness andHealth Related Quality of Life(SF-36) in Elderly Women)

  • 소위영;홍지영;전은진;최대혁;김기홍
    • 한국노년학
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    • 제30권3호
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    • pp.683-694
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    • 2010
  • 본 연구는 아쿠아로빅 운동이 노년 여성에게 미치는 신체적, 심리적 효과를 동시에 관찰함으로써, 노인운동처방에 관한 다각도적인 기초자료를 제공하고자 하였다. 본 연구의 피험자는 I시 Y구 보건소 아쿠아로빅 운동프로그램에 참가를 희망하는 60-70대 노년 여성으로 운동군 25명, 통제군 30명으로 분류하였다. 아쿠아로빅 운동은 8주 동안 주 2회 최대여유심박수 40~70%의 운동강도로 실시하여, 운동 전후의 신체구성, 체력 및 건강관련 삶의 질(SF-36)의 변화를 측정하였다. 아쿠아로빅 운동 전후 신체구성의 체중(p=0.044), 체질량지수(p=0.038) 및 체지방률(p=0.005)의 모든 변인에서 시점에 따라 집단 간에 유의한 차이가 나타났다. 체력변인의 의자에서 일어섰다 앉기, 의자앉아 앞으로 굽히기는 시점에 따라 집단 간에 유의한 차이가 나타나지 않았으나, 2분 제자리걷기(p=0.002), 덤벨들기(p=0.005), 등 뒤에서 손잡기(p=0.023), 244cm 왕복걷기(p<0.001)는 시점에 따라 집단 간에 유의한 차이가 나타났다. 건강관련 삶의 질(SF-36)의 신체기능, 신체역할제한, 감정역할제한, 사회적 기능, 정신건강, 피로는 시점에 따라 집단 간에 유의한 차이가 나타나지 않았으나, 신체통증(p=0.039)과 일반적인 건강(p=0.024)은 시점에 따라 집단 간에 유의한 차이가 나타났다. 노년 여성에게 있어서 아쿠아로빅 운동은 신체구성의 개선과 체력의 향상을 위한 좋은 운동형태가 될 수 있음을 확인할 수 있었으나, 건강관련 삶의 질(SF-36)에 관하여서는 8가지 요인 중 2가지의 일부 요인에서만 긍정적인 영향이 나타났음을 확인할 수 있었다.

급성 심근경색으로 인한 심인성 쇼크 환자에 대한 경피적 순환 보조장치($EBS^{(R)}$) 적용의 초기경험 (Initial Experience of the Emergency Bypass System ($EBS^{(R)}$) for the Patients with Cardiogenic Shock due to an Acute Myocardial Infarction)

  • 류경민;김삼현;서필원;류재욱;김석곤;김영화;박성식
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.329-334
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    • 2008
  • 배경: 경피적 순환 보조장치는 다른 수단으로는 소생이 불가능한 심인성 쇼크 환자에 있어서 매우 효과적인 생명유지 장치이다. 특히 심근경색 및 고위험군의 관상동맥중재술, 심장수술 후 심인성 쇼크 등 다양한 임상상황에서 사용되며, 사용이 손쉬운 장점을 가지고 있다. 저자들은 급성 심근경색으로 입원한 환자 중 심인성 쇼크가 발생하여 경피적 순환 보조장치를 사용한 환자들의 초기경험을 분석하였다. 대상 및 방법: 2005년 1월부터 2006년 12월까지 급성 심근경색에 의한 심인성 쇼크 환자 8명에게 경피적 순환 보조장치(CAPIOX emergent bypass system, $EBS^{(R)}$, Terumo Inc., Tokyo, Japan)를 적용하였다. Seldinger방법을 사용하여 대퇴정맥에 20Fr의 유입관을 우심방까지 거치하고, 대퇴동맥에 16Fr의 유출관을 거치하면서 동시에 자가 충진을 완료하였다. 혈류량을 $2.5{\sim}3.0L/min/m^2$으로 유지하였고, 헤파린을 정주하면서 ACT를 200초 이상으로 유지하였다 결과: 환자의 평균나이는 $61.1{\pm}14.2$세($39{\sim}77$세)였다. 관상동맥중재술(PCI) 시행 이전에 거치한 경우가 3예, 중재술 도중 발생하여 거치한 경우가 3예, 중재술 후가 1예, 관상동맥우회술 후가 1예였다. 평균 $EBS^{(R)}$가동시간은 $47.5{\sim}27.9$시간$(8{\sim}76$시간)이었으며, 이 중 $EBS^{(R)}$ 이탈이 가능하였던 경우가 5명(62.5%)으로 이들은 모두 퇴원이 가능하였다. $EBS^{(R)}$적용으로 인한 합병증은 모두 3예로 급성 신부전이 2예, 위장관 출혈이 1예 있었다. 사망한 3명의 환자 중 2명은 $EBS^{(R)}$ 적용 전 심정지가 와 있었던 경우였으며, 1명은 난치성 심실세동이 있었던 경우였다. 퇴원한 환자는 모두 생존하여 평균 $16.8{\pm}3.1$개월($12{\sim}20$개월)째 외래 추적관찰 중이다. 결론: 다른 방법으로 소생이 힘든 급성 심근경색으로 인한 심인성 쇼크 환자에게 $EBS^{(R)}$를 적용함으로써 환자의 생명을 구할 수 있었고, 일단 회복된 환자들은 별다른 후유증 없이 생존하였다. 향후 $EBS^{(R)}$의 적절한 적용시기와 적용방법에 대해서는 보다 많은 경험 및 임상연구가 필요할 것으로 생각된다.

추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구 (An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • 대한간호학회지
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    • 제20권2호
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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