• Journal of Korean Physical Therapy Science
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• v.24 no.1
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• pp.59-68
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• 2017

Purpose : The aims of this study was to conduct a systematic literature review with meta-analysis to investigate the effect of virtual reality based rehabilitation program on balance of patient with stroke in Korean studies. Method : The studies for analysis were searched in electronic databases(Research Information Sharing Service; RISS, Korean Studies Information Service; KISS, DBpia, e-articles, National Assembly Library). The key words for search were 'virtual reality', 'stroke', and 'balance' and only randomized controlled trials and clinical controlled trials were included. Of 40 studies identified in the search, 20 studies met the criteria of this study and included in this meta-analysis. Result : The results were as follows: 1) The overall effect size of virtual reality based rehabilitation program was 0.557(95% critical interval; 0.340~0.774). 2) In the analysis of sub-categorical variables, effect size was as follows; the commercial game type(0.621) > virtual environment type(0.335); the dynamic balance measurement(0.750) > static balance measurement(0.226); randomized controlled trial(0.653) > clinical controlled trial(0.275); and thesis type(0.706) > article of journal type(0.339). 3) In the analysis of sub-continuous variables, as time of program(per session) increased, the balance increased(p<0.05). Conclusion : The results of this study showed that virtual reality based rehabilitation program moderately improves the balance of stroke patient. Further studies are recommended to investigate the effect of sub-variables related to virtual reality programs on motor functions of patient with stroke.

• Journal of the Korea Convergence Society
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• v.9 no.2
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• pp.371-380
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• 2018

The purpose of this study was to investigate the effects of patient controlled analgesia(PCA) convergence education on postoperative pain management in spinal surgery patients. Sixty spinal surgery patients were included. For the experimental group(n=30), PCA education using video, booklet, and a PCA model practice was provided before surgery. The data were collected using questionnaire and were analyzed using descriptive statistics, ${\chi}^2-test$, Fisher's exact test, t-test and repeated measures ANOVA. PCA knowledge-attitude, PCA satisfaction and pain control satisfaction were higher in the experimental group than the control group(p<.001; p=.001; p<.001). Postoperative pain and frequency of additional analgesia use of the experimental group were significantly lower than those of the control group(p<.001; p=.001). This findings showed that the convergence PCA education of audiovisual aids with PCA practice training could be effective pain management intervention in patients undergoing spinal surgery. These apply to development of convergence nursing interventions in clinical practice.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.181-186
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• 2005

Background: Hydromorphone has an intermediate lipid solubility range that falls between morphine and fentanyl. Lipophilic activity during opioid epidural administration is important in relation to both the side effects and analgesic efficacy. The purpose of this study was to compare epidural hydromorphone and fentanyl when concomitantly infused with bupivacaine in patients undergoing a thoracotomy. Methods: Seventy-seven thoracotomy patients, with patient-controlled epidural analgesia (PCEA), were blindly allocated into two groups [group F (n = 34); 0.1% bupivacaine and fentanyl $5{\mu}g/ml$, group H (n = 34); 0.1% bupivacaine and hydromorphone $16{\mu}g/ml$)]. The basal PCEA rate and demand dose were 4 ml/hr and 3 ml, respectively. The visual analogue scale (VAS) for pain, and pruritus, sedation and nausea were measured at 6, 12 and 24 hours after the operation. Results: There were no significant differences in the VAS pain scores and the incidences of pruritus, nausea and sedation between the two groups. The total infused volume after 24 hours was lower in H compared to that of F group (P < 0.05). Conclusions: We conclude that epidural hydromorphone or fentanyl administration has a similar analgesic efficacy and shows similar incidences of side effects, when concomitantly infused with bupivacaine, in the management of acute pain following a thoracotomy.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.60-64
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• 1998

Background: We compared butorphanol and fentanyl for opioids use in patient-controlled analgesia(PCA) with ketorolac to determine a suitable drug combination for postoperative pain control. Methods: Sixty patients were equally divided into 2 Groups. Group 1 (n=30) butorphanol 10 mg with ketorolac 180 mg; Group 2 (n=30) fentanyl 1 mg with ketorolac 180 mg, diluting 100 ml solutions intravenously via PCA pump after total abdominal hysterectomy under general anesthesia. Total infusion dosage of PCA drug, VAS pain scores, and side effects of both group were manitored. Results: Total infusion dosages were as follows: (Group 1) butorphanol 8.3 mg with ketorolac 149.7 mg; (Group 2) fentanyl $646.6\;{\mu}g$ with ketorolac 116.2 mg. The two groups showed similar pain scores auld side effects. Conclusions : Both butorphanol and fentanyl were effective for postoperative pain control using PCA pump, but butorphanol was more economical. The putative potency ratio of butorphanol to fantanyl was 12.8 : 1.

• The Journal of Korean Academic Society of Nursing Education
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• v.24 no.1
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• pp.5-15
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• 2018

Purpose: The purpose of this study was to investigate the knowledge and practice of patient-controlled analgesia use and management (PCA-UM) among nurses. Methods: Data were collected from 182 nurses employed by four general hospitals having more than 300 beds in Daejeon. The data were collected using self-report questionnaires from November 4 to November 20, 2015. Collected data were analyzed using descriptive statistics, t-test, and ANOVA. Results: The average nurses' knowledge about PCA-UM was 14.8 points out of 20. PCA-UM knowledge was significantly higher for nurses with experience in PCA education (t=3.55, p<.001). Most participants (91.2%) wanted to get PCA training, 86.8% of them provided PCA education to patients after surgery. Approximately 62% of participants regularly evaluated the level of consciousness of patients with PCA. Conclusion: Findings indicate that the knowledge and practice of PCA-UM among nurses were insufficient to provide safe and effective pain management to postoperative patients with PCA. Therefore, it is concluded that it is necessary to develop standardized PCA education programs for nurses to provide safe and effective pain management to postoperative patients with PCA.

• Journal of Korean Biological Nursing Science
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• v.17 no.3
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• pp.253-261
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• 2015

Purpose: The purpose of this study was to identify the effects of the patient controlled analgesics (PCA) education program (including practicum) on post-op pain suffered by patients who have undergone gynecologic laparoscopic surgery. Methods: The research was designed for a nonequivalent control group before and after the test design. The subjects of this study were 54 in all and were divided into an experimental group and a control group. The program consisted of a brochure for PCA use and a practicum with an actual PCA instrument. Data were collected with questionnaires and observations and were analyzed on the basis of frequency, percentage, mean, standard deviation, ${\chi}^2$ and t-test. Results: Complaints regarding pain by the experimental group were significantly less than those of the control group in both post-op 24-hour and post-op 48-hour reporting. The experimental group pressed the PCA button much less frequently than the control group in post-op 24 hours. However, there were no significant differences in side effects between the two groups. Conclusion: Based on the results of this study, this PCA education program can be useful in the clinical nursing field and helpful for patients who use PCA.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.131-140
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• 2014

Purpose: This study was done to evaluate the efficacy of Nei-Guan acupressure on nausea and vomiting in patients undergoing laparoscopic prostatectomy with intravenous patient controlled analgesia (IV-PCA). Methods: Data were collected between August 13, 2012 and January 31, 2013 at a hospital in Busan. The participants were 45 men, who underwent the surgery laparoscopic prostatectomy, with IV-PCA. Data were analyzed using descriptive statistics, $x^2$-test, repeated measures ANCOVA and Games-Howell test with PASW 18.0. Results: Nei-Guan acupressure had an interaction effect on nausea between group and time (F=5.01, p<.001), group (F=10.80, p<.001), time (F=26.51, p<.001) in laparoscopic prostatectomy with IV-PCA and also an interaction effect on vomiting between group and time (F=2.77, p=.032), group (F=8.89, p=.001), time (F=4.01, p=.022). Conclusion: Results indicate that nei-guan acupressure is a potentially effective therapy for the prevention of nausea and vomiting which occur with IV-PCA. Therefore, if patients complain of nausea and vomiting when receiving IV-PCA, nurses can provide patients with information about nei-guan acupressure and help them with nausea and vomiting.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.236-243
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• 2018

Purpose: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. Methods: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients' Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. Results: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR= 1.75; confidence interval, CI= 1.09-2.82), nausea (OR= 105.27; CI= 61.03-181.58), total intravenous anesthesia (TIVA) of the thyroidectomy (OR= 10.43; CI= 5.01-21.70). Conclusion: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom associated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing interventions.

• Journal of East-West Nursing Research
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• v.16 no.1
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• pp.44-52
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• 2010

Purpose: The study examined the effects of preoperative patient controlled analgesia (PCA) education on postoperative pain, knowledge of PCA, and attitude toward pain medication. Methods: The participants were patients who underwent surgery in H University Hospital,and were assigned to PCA group (experiment group, n=30) or the control group (n=30). Results: Knowledge of PCA and positive attitude toward pain medication were higher in the experiment group than in the control group. Postoperative pain scores in the experiment group were significantly lower than those in the control group at 48 and 72 hr after surgery, but there was no significant difference at 24 hr after surgery. The experiment group had more positive attitudes on the medication than the control group. Conclusions: Preoperative PCA education could be an effective nursing intervention for pain management of patients after surgery.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.177-181
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• 2012

Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.