Rupture of a bronchus is an unusual result of blunt trauma to the chest. We experienced a case of bronchial rupture caused by blunt chest trauma without external wound or rib fracture. This case was a 13 years old male who was elementary school student. He was compressed on anterior chest by basket ball goal post being failed down on the afternoon of admission day. After this accident, he was suffered from progressive dyspnea and chest pain. The bronchial rupture was confirmed by bronchogram, The operation was performed through standard posterolateral thoracotomy incision along the 5th rib course. The right upper lobe bronchus and intermediate bronchus was completely transected. The right upper lobectomy was done. The ruptured intermediate bronchus was connected direct simply. Post-operative course was uneventful. Thus we report this case of traumatic bronchial rupture with review of literature.
Background: Postoperative bleeding is a common complication in transurethral resection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two Methods for post-operative analgesia. Methods: We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group (I, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusion rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl $50\sim100{\mu}g$ followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP. Results: Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group. Conclusions: Postoperative continuous epidural pain block and IV-PCA are both effective Methods of postoperative pain control with lower incidence of side effects.
Journal of Korea Entertainment Industry Association
/
v.14
no.2
/
pp.187-194
/
2020
This study is a descriptive cross-sectional study to identify the perception of post-operative pain management by nursing college students. The study involved 171 nursing college students with clinical practice experience. The data collection was made using structured questionnaires from March to June 2019. The results showed 65.1 percent general knowledge, 58.0 percent knowledge of analgesics and 81.9 percent attitude toward pain management. Pain knowledge and attitude were higher for pain training and men. The general knowledge score for pain showed a positive correlation between knowledge of analgesics, attitudes to pain management. We hope that the results of this study will be used to develop a postoperative pain management program by showing the need for systematic training programs for nursing college students and continuous training for postoperative pain management.
Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.
Objectives: Osteonecrosis of the femoral head (ONFH) is caused by a circulatory disorder. If symptoms are not present, the patient's progress is observed, but if symptoms are present, non-surgical methods or total hip replacement are performed. Several case reports have described the effects of Korean Medicine treatment on ONFH, but the number of cases is still small, and few studies have used blood stasis-based herbal medicines like Hwaeo-jeon (HEJ). This study reports the effectiveness of Korean Medicine treatments, including HEJ, on a case of ONFH. Methods: A patient diagnosed with ONFH by CT and MRI was treated with Korean Medicine treatments consisting of herbal medicine including HEJ, bee venom pharmacopuncture, acupuncture, cupping, and physical therapy. The improvement of pain was assessed using a numerical rating scale. Inflammation levels were determined by blood tests conducted during hospitalization. Results: Korean Medicine treatment, including herbal medicine, resulted in good clinical improvement responses, including reduced pain, improved mobility, and reduced inflammatory levels in the blood tests. Conclusions: Korean Medicine treatments, including HEJ, may be effective for ONFH patients. Further studies are needed to determine the recovery of osteonecrosis and the improvement of post-operative aftereffects using Korean Medicine treatments, as well as the reduction of pre-operative pain.
Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.
The purpose of this study was to evaluate the effect of informational intervention on postoperative pain following tonsillectomy in children. This study was performed on 30 children, aged 5-15 years, undergoing tonsillectomy and their parents by providing informational intervention with colored figure; operation procedure and information. Pain assessment was done by Pain Questionnaire. The results from this study were as follows : 1. Children in experimental group with mean 16.07 had lower pain scores than control group with mean 14.87 at 4th hours after operation(p<0.05). It showed 'significant difference' and first hypothesis was adopted. 2. Children in experimental group with mean 20.60 had lower pain scores than control group with mean 17.27 at 8th hours after operation(p<0.05). It showed 'significant difference' and second hypothesis was adopted. 3. Children in experimental group with mean 28.80 had lower pain scores than control group with mean 25.70 at 24th hours after operation(p<0.05). It showed 'significant difference' and third hypothesis was adopted. 4. When we analyzed the time difference and difference between two groups simultaneously by repeated measure ANOVA, the significant difference was not found. And so 'the experiential group with operation-related information will show the lower pain sense than the control group just as the time flows after operation', fourth hypothesis was rejected. Generally, it was found that providing information about operation to children and their parents reduced effectively postoperative pain in children, but in clinical settings there are minimum preoperative information-providing because of insufficient time and inconvenience although nursing staffs and patients know its needs. Conclusionally providing preoperative information should help children and their parents cope with Pre, Peri and Post operative events effectively.
Fouad, Ahmed Zaghloul;Abdel-Aal, Iman Riad M.;Gadelrab, Mohamed Rabie Mohamed Ali;Mohammed, Hany Mohammed El-Hadi Shoukat
The Korean Journal of Pain
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v.34
no.2
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pp.201-209
/
2021
Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.
Postoperative pain is one of the most frequently occurred pain in hospitals, but it has been underestimated because it is only a part of postoperative physiological Process and may disappear in time. It is necessary that nurses me the relaxation technique, planning and implementing by themselves independently, to reduce this postoperative pain. This study is aimed at showing the effect of relaxation technique on reduction of postoperative pain, and exploring the factors influencing postoperative. pain Fifty-seven patients with abdominal surgery who admitted in attacked D Medical Center to K University in Daegu have been studied. Of them twenty-nine were experimental group and the remaining twenty-eight were control group. This study has been conducted for collecting data through interviews and observation from August 23 to October 24, 1984. The tools of this study were two kinds: Postoperative Pain Scale is obtained from a review of references by the researcher, and relaxation technique, designed to use postoperative setting adequately, is also obtained from a review of references by the researcher. After confiriming no significant differences between the two groups, the hypotheses were statistically verified by x²-test, t-test, and pearson Correlation Coefficient. The results of this study are summerized as follows; * The nam hypothesis that the experimental group who use relaxation technique will have less degree of postoperative pain than the control group who don't use relaxation technique is devided into three sub-hypotheses. 1. The first sub-hypothesis that the experimental group will have less score of postoperative pain than control group was accepted (t=7.810, p <.01). Even with controlling pain threshold, showing difference in some degree between the two groups, the experimental group has less score of postoperative pain than the control group. Therefore this confirms the acceptance of the first sub-hypothesis more strongly. 2. The second sub-hypothesis that the expermental group will have less frequency of analgesics than the control group is accepted (x²=9.85, p <.01). 3. The third sub-hypothesis that the experimental group will have less variation of pulse, respiration, and blood pressure between pre End post operative periods than the control group is rejected. So this hypothesis is reverified through comparing the variation of pulse, respiration, and blood pressure between pre and post changing Position to measure the pure effect of relaxation technique. pulse and respiration is significantly lowered in the experimental group (t=7.209, p<.01, t=3.473, p<.01), but systolic and diastolic blood pressure is not different significantly between the two groups (t= 1.309, p>.05, t=1. 727 p>.05). Therefore the third sub-hypothesis is partially accepted. Conclusively, the researcher thinks that it is necessary that nurses should provide patients with relaxation technique to reduce postoperative pain, and to increase independence of nursing.
Hyaluronic acid (HA) has long been studied in diverse applications. It is a naturally occurring linear polysaccharide in a family of unbranched glycosaminoglycans, which consists of repeating di-saccharide units of N-acetyl-D-glucosamine and D-glucuronic acid. It is almost ubiquitous in humans and other vertebrates, where it participates in many key processes, including cell signaling, tissue regeneration, wound healing, morphogenesis, matrix organization, and pathobiology. HA is biocompatible, biodegradable, muco-adhesive, hygroscopic, and viscoelastic. These unique physico-chemical properties have been exploited for several medicinal purposes, including recent uses in the adjuvant treatment for chronic inflammatory disease and to reduce pain and accelerate healing after third molar intervention. This review focuses on the post-operative effect of HA after third molar intervention along with its various physio-chemical, biochemical, and pharmaco-therapeutic uses.
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