• Title/Summary/Keyword: Postoperative Care

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The Effects of Oral Care with Difflam Spray 0.3% and Sodium Bicarbonate-Normal Saline Solution on Postoperative Oral Comfort, Sore Throat, and Halitosis (디프람 스프레이(Difflam spray 0.3%)와 중조 생리식염수 분무요법이 전신마취 하 수술 환자의 구강 안위감, 인후통 및 구취에 미치는 효과)

  • Choi, Eun Hee;Lee, Hyun Su;Ko, Mi Suk
    • Journal of muscle and joint health
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    • v.28 no.1
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    • pp.41-49
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    • 2021
  • Purpose: This study aimed to compare the effects of the Difflam spray 0.3% with the sodium bicarbonate-normal saline spray on oral care for postoperative patients. Methods: The participants were randomly allocated to either the Difflam (n=22) group or the saline solution (n=23) group. The data were collected at the 1-, 4-, 7-, and 10-hour marks after returning to the ward post operation using the Beck's subjective oral discomfort scale, Visual Analogue Scale for sore throat, and portable halitosis detector. Results: The sore throat (F=7.25, p=.001) score significantly decreased after oral care using the Difflam spray 0.3%. However, the difference in the scores of oral comfort (F=0.34, p=.797) and halitosis (F=0.91, p=.443) between the two groups was not statistically significant. Conclusion: These findings suggest that the Difflam spray 0.3% is effective in improving postoperative sore throat. A further study that explores the effect of various oral solutions for postoperative patients is needed to present systemic and effective evidence-based oral care guidelines.

Effect of Abdominal Breathing on Postoperative Pain, State Anxiety, Blood Pressure, and Heart Rate of Patients Undergoing Cardiac Surgery (복식호흡이 심장 수술후 36시간 이내 환자의 통증, 상태불안, 혈압 및 심박동수에 미치는 효과)

  • Lee, Min-Jee;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.37-50
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    • 2011
  • Purpose: This study is to evaluate the effect of abdominal breathing on postoperative pain, state anxiety, blood pressure, and heart rate of cardiac surgery patients treated in intensive care unit. Methods: A non-synchronized design of nonequivalent control group pre-post test was used. Participants were divided into an experimental group(n=22) and a control group(n=21). Just usual postoperative treatments were provided to the control group, while abdominal breathing interventions were provided to the experimental group, in addition to usual treatments. The intervention was consisted of 4 stages-introductions, breathing perception, breathing training, and closing-and it lasted twelve minutes in total. Pain, state anxiety, blood pressure and heart rate were the dependent variables of the abdominal breathing. Results: Those who carried out abdominal breathing showed a significant reduction in pain, as well as decrease of systolic blood pressure. However, it turned out to have no effect on state anxiety, diastolic blood pressure and heart rate. Conclusion: Abdominal breathing is simple and harmless and is effective for reducing postoperative pain.

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Delirium Screening, Delirium Knowledge, and Delirium Care among Hospital Nurses at a Tertiary Hospital based on Postoperative Delirium Cases (일 상급종합병원 병동간호사의 수술 후 섬망 사례를 이용한 섬망 선별과 섬망 지식 및 섬망 간호)

  • Choi, Jae In;Kim, Jeoung Hee;Park, Jeong Yun
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.157-166
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    • 2022
  • Purpose: The purpose of this study was to investigate hospital nurses' delirium screening for postoperative delirium, delirium knowledge, and delirium care using case scenarios at a tertiary hospital in Seoul. Methods: A total of 235 nurses working at surgical units participated in this questionnaire-based study. Five cases scenarios were developed based on diagnosed postoperative delirium cases. Data were collected from April 1 to May 1, 2021. Results: The delirium screening score was 4.20±1.17 out of 5. The delirium knowledge score was 34.35±4.57 out of 47. The delirium care score was 67.61±9.26 out of 92. The correlation between the delirium screening and delirium knowledge was statistically significant (r=.18, p=.005). The correlation between the delirium knowledge and delirium care was statistically significant (r=.25, p<.001). Conclusion: The findings showed that the continuing educations of delirium for hospital nurses and the development of a delirium education programs were important to improve delirium screening and care.

PECS II block is associated with lower incidence of chronic pain after breast surgery

  • De Cassai, Alessandro;Bonanno, Claudio;Sandei, Ludovica;Finozzi, Francesco;Carron, Michele;Marchet, Alberto
    • The Korean Journal of Pain
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    • v.32 no.4
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    • pp.286-291
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    • 2019
  • Background: Breast cancer is complicated by a high incidence of chronic postoperative pain (25%-60%). Regional anesthesia might play an important role in lowering the incidence of chronic pain; however it is not known if the pectoral nerve block (PECS block), which is commonly used for breast surgery, is able to prevent this complication. Our main objective was therefore to detect any association between the PECS block and chronic pain at 3, 6, 9, and 12 months in patients undergoing breast surgery. Methods: We conducted a prospective, monocentric, observational study. We enrolled 140 consecutive patients undergoing breast surgery and divided them in patients receiving a PECS block and general anesthesia (PECS group) and patients receiving only general anesthesia (GA group). Then we considered both intraoperative variables (intravenous opioids administration), postoperative data (pain suffered by the patients during the first 24 postoperative hours and the need for additional analgesic administration) and development and persistence of chronic pain (at 3, 6, 9, and 12 mo). Results: The PECS group had a lower incidence of chronic pain at 3 months (14.9% vs. 31.8%, P = 0.039), needed less intraoperative opioids (fentanyl $1.61{\mu}g/kg/hr$ vs. $3.3{\mu}g/kg/hr$, P < 0.001) and had less postoperative pain (3 vs. 4, P = 0.017). Conclusions: The PECS block might play an important role in lowering incidence of chronic pain, but further studies are needed.

A Study on Nursing Care and Self-Care of Lymphedema in Mastectomy Patients (유방절제술 환자의 림프부종 자가관리 및 간호활동)

  • Park, Hyoung Sook;Oh, Sang Ju;Park, Kyung Yeon
    • Korean Journal of Adult Nursing
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    • v.18 no.3
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    • pp.386-394
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    • 2006
  • Purpose: The purpose of this study was to provide nursing intervention with basic data extracted through investigating self-care and nursing of lymphedema in patient who have had a mastectomy. Method: The subjects for this study consisted of 214 mastectomy patients in 2 hospitals. The data were collected from December 1, 2004 to February 28, 2005. The instruments used for this study were both the Self-care Practice Scale by Cho, Myoung-Ok et al.(2003) which we modified and the Nursing Evaluation Scale developed by the researchers. Results: The mean score of self-care on lymphedema was $59.96{\pm}12.46$ The mean score of nursing was $25.64{\pm}9.25$ Factors influencing the self-care were the postoperative period (F=17.505, p<.001), the location of the tumor (F=3.826, p=.023), menstruation (t=7.333, p=.007), and complications (F=5.427, p<.001). Conclusion: Self-care and nursing care on the lymphedema management were shown to be lower than expected. Especially, the score of self-care was the lowest in the more than 3 year postoperative period. Therefore, the longer the postoperative period is, the more active management on lymphedema needs to be. Also, education should be given to both nurses and patients on the importance of self-care on lymphedema with mastectomies.

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Anorectal Malformation - Postoperative Care and Functional Results - (항문직장기형 - 수술 후 관리 및 기능적 결과 -)

  • Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.115-125
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    • 2006
  • Postoperative management of anorectal malformation consists of colostomy management and then management after definitive surgery. Colostomy management requires attention to certain details, i. e. complete decompression of the distal limb to avoid secondary megarectosigmoid and prevention and treatment of urinary tract infections in patients with rectourethral fistula. Management after definitive surgery requires the care of catheters placed in the rectourethral fistula or cloacal defect. Prevention and treatment of various complications after definitive operation, i. e. wound infection, anal stenosis or stricture, anal mucosal prolapse, and management of functional disorders, i.e. constipation, fecal incontinence and urinary incontinence are also necessary. In this review, recent trends for the prevention and treatment of the above mentioned problems after operation for anorectal malformation are presented.

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A Clinical Study on Case 4, Hospitalized after Total Hysterectomy (자궁적출술 후 입원 관리를 한 환자 치험 4례)

  • Kim, Mi-Rim;Lim, Eun-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.109-120
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    • 2014
  • Objectives: The purpose of this study is to report the effect of Korean medicine treatments on Postoperative symptoms. Methods: The patient was treated with herbal medicine, acupuncture and electronic moxibustion. The efficacy of treatment was evaluated with visual analogue scale (VAS), the degree of symptom relief and presence or absence of symptoms. Results: After hospital care with korean medicine treatments, symptoms such as fatigue, lower abdominal pain, thirst, hot flush, cold hypersensitivity of hands and feet and tinnitus were disappeared. Conclusions: To promote physical strength and reduction of fatigue, intensive hospital care with korean medicine treatment seems to be effective. After discharge, continued outpatient treatment for complications of surgery and menopausal disorder seems to contribute to quality of life and satisfaction for patient who undergoing hysterectomy.

Prediction of Postoperative Lung Function in Lung Cancer Patients Using Machine Learning Models

  • Oh Beom Kwon;Solji Han;Hwa Young Lee;Hye Seon Kang;Sung Kyoung Kim;Ju Sang Kim;Chan Kwon Park;Sang Haak Lee;Seung Joon Kim;Jin Woo Kim;Chang Dong Yeo
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.203-215
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    • 2023
  • Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R2 and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R2 value was 0.27 and in set II, LightGBM was the best model with the highest R2 value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R2 value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.

Role of dexmedetomidine as adjuvant in postoperative sciatic popliteal and adductor canal analgesia in trauma patients: a randomized controlled trial

  • Ahuja, Vanita;Thapa, Deepak;Chander, Anjuman;Gombar, Satinder;Gupta, Ravi;Gupta, Sandeep
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.166-175
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    • 2020
  • Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

Impact of Enhanced Recovery Program on Colorectal Cancer Surgery

  • Lohsiriwat, Varut
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3825-3828
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    • 2014
  • Surgical outcomes of colorectal cancer treatment depend not only on good surgery and tumor biology but also on an optimal perioperative care. The enhanced recovery program (ERP) - a multidisciplinary and multimodal approach, or so called 'fast-track surgery' - has been designed to minimize perioperative and intraoperative stress responses, and to support the recovery of organ function aiming to help patients getting better sooner after surgery. Compared with conventional postoperative care, the enhanced recovery program results in quicker patient recovery, shorter length of hospital stay, faster recovery of gastrointestinal function, and a lower incidence of postoperative complications. Although not firmly established as yet, the enhanced recovery program after surgery could be of oncological benefit in colorectal cancer patients because it can enhance recovery, maintain integrity of the postoperative immune system, increase feasibility of postoperative chemotherapy, and shorten the time interval from surgery to chemotherapy. This commentary summarizes short-term outcomes and potential long-term benefits of enhanced recovery programs in the treatment of colorectal cancer.