• 기본간호학회지
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• 제14권1호
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• pp.18-28
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• 2007

Purpose: This study was to identify knowledge, attitude, use and state of the Patient Controlled Analgesics (PCA) in postoperative patients. Method: The research design was a descriptive research. From December 7, 2005 to January 6, 2006, 102 postoperative patients in a university hospital at Daegu were participated in the study Results: Analgesics with PCA were mainly morphine complex 73.5% and Demerol complex 26.5%. Previous experience of using PCA was only 28.4%, and the main sources of information were other post-op patients and families(43.1%). The most common reason of choice was a recommendation from other post-op patients and families(46.1%). The most common side effects of PCA were nausea and vomiting(20.6%). About 57% of the patients were satisfied with PCA, and pain scores decreased with PCA. Mean score for knowledge about PCA was 2.55 out of a possible 6, and for attitude related to pain medication. 2.31 out of possible 5. Conclusion: To increase the score on knowledge of PCA, a structured preoperative PCA education program should be developed by nursing staff.

• 대한한의학회지
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• 제41권4호
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• pp.120-132
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• 2020

Objectives: Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting during pregnancy (NVP) with weight loss, ketonuria, and electrolyte imbalance. Many NVP or HG patients get hard to take herbal medicine since the smell and taste of it. Therefore, the distilled herbal medicines are often used in clinical practice. A 32-year-old, 14-week pregnant female was admitted for 3 weeks at a Korean medicine hospital. She was experiencing HG accompanied by 19.61% (10 kg) weight loss, ketonuria, and electrolyte imbalance. The patient received Bosaeng-tang gagambang in its distilled form, acupuncture, electro-acupuncture, sticker needles, cupping, moxibustion, and hydration during admission. The severity and frequency of NVP, weight loss, and ketonuria significantly improved without any side effects. Before the therapy, she admitted to two obstetrics and gynecology hospitals, 1 week each, with no improvement. This case presents the therapeutic potential of Korean medicine including herbal medicine in its diluted form for HG and NVP.

• Journal of Pharmaceutical Investigation
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• 제40권3호
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• pp.167-173
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• 2010

Repeated oral administration of hydrochlorothiazide, a loop diuretic, due to transient high blood levels, may cause adverse effects such as gastric disturbance, nausea, high blood sugar, and hyper lipidemia. Transdermal administration could avoid some of these systemic side effects and gastric disorders. We have developed a matrix using ethylene-vinyl acetate (EVA), a heat-processible and flexible material, for transdermal delivery of hydrochlorothiazide. Drug solubility was highest at 40% PEG-400 volume fraction. Drug release increased as concentration increased with a linear relationship between the release rate and the square root of loading dose. Increasing temperature increased drug release from the EVA matrix. The activation energy, measured from the slope of log P versus 1000/T, was 11.9 kcal/mol for a 2.5% loading dose from EVA matrix. Diethyl phthalate had the highest plasticizing effects on the release of hydrochlorothiazide. To increase the skin permeation of hydrochlorothiazide from the EVA matrix, enhancers such as the saturated fatty acids, the unsaturated fatty acids, and the non-ionic surfactants were added to the EVA matrix, and skin permeation was evaluated using a modified Keshary-Chien diffusion cell fitted with intact excised rat skin. Polyoxyethylene 23-lauryl ether showed the highest enhancing effects. In conclusion, transdermal delivery of hydrochlorothiazide could be improved from an EVA matrix containing plasticizer and permeation enhancer.

• Journal of Hospice and Palliative Care
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• 제4권1호
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• pp.41-46
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• 2001

목적 : 경구로 투여되는 진통제 중에서 $Myprodol^{(R)}$은 codeine, ibuprofen과 paracetamol이 복합 처방된 진통제로서 최근에 임상에 사용되기 시작한 약제이다. 본 연구는 실제로 임상에서 $Myprodol^{(R)}$이 사용되고 있는 질환의 종류, 부작용과 진통 효과 등을 알아보기 위하여 수행되었다. 방법 : 부산대학교병원에서 $Myprodol^{(R)}$을 사용한 적이 있는 183명의 환자의 병력기록지를 조사하여 통증의 원인이 된 질환의 종류와 통증의 유형, 병원에 내원하여 최초로 $Myprodol^{(R)}$이 투여되었을 때까지의 통증의 기간 $Myprodol^{(R)}$을 투여한 기간, $Myprodol^{(R)}$의 투여 이후에 나타난 부작용, 통증에 대한 $Myprodol^{(R)}$의 통증 조절 정도를 통증시각등급(VAS)의 변화 등을 분석하였다. 결과 : $Myprodol^{(R)}$을 사용한 환자의 질환은 각종 암성 통증으로 인한 경우가 64.3%이었고, 비암성 통증으로 인한 경우가 35.7%이었다. 투여 중에 나타난 부작용에는 암성 통증 환자에서 메스꺼움, 변비, 전신부종이 있었고, 비암성 통증 환자에서는 위복부통, 변비 등이 있었다. 비암성 통증 관리측면에서 $Myprodol^{(R)}$은 암성 통증 치료에서보다 더 효과가 있었다. 결론 : $Myprodol^{(R)}$은 약한 초기 암성 통증에 비교적 적은 부작용으로 진통효과를 나타내었다. 비암성 통증 환자에서는 흉통, 요통, 치과 수술 후에 주로 사용되었고 적은 부작용으로 진통효과를 나타내었다.

• Radiation Oncology Journal
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• 제19권2호
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• pp.127-135
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• 2001

목적 : 본 연구는 중등도 정도의 오심 및 구토의 발생 위험도를 가지는 복부 방사선치료를 받는 환자들을 대상으로 오심 및 구토에 대한 항구토제의 효과와 부작용 여부를 비교하는 전향적 무작위 임상연구로, 예방 목적으로 항구토제를 사용할 때 현재 통상적으로 많이 처방되는 항구토제인 메토클로프라미드(metoclopramide)에 비하여 온단세트론(Ondansetron; $Zofran^{\circledR}$)을 사용하는 것이 더 나은 효과를 가져오는지 알아보고자 하였다. 대상 및 방법 : 대상 환자의 포함 기준은 병리학적으로 암으로 확진되고 전이성 원인이 아닌 원발 부위에 치료를 받는 환자, 신체수행도가 ECOG 기준으로 2기 이하인 환자, 항암 화학요법이나 방사선치료를 받은 과거력이 없는 환자로 하였다. 1997년 3월부터 1998년 2월까지 총 60명의 환자가 덜 연구에 참여하였다. 내원한 순서에 따라 미리준비된 난수표에 의하여 각각 온단세트론 투약군(O군)과 메토클로프라미드 투약군(M 군)으로 할당하였다. O군의 온단세트론 용량은 8 mg, bid 로 하였고, M군의 메토클로프라미드 용량은 5 mg, tid 로 하였다. 평가 항목은 오심의 정도, 구토 회수, 식욕감소의 정도로 하였다. 환자에게 일일 기록카드를 교부하여 환자의 주관적인 증상인 오심의 정도, 구토의 횟수, 식욕감소의 정도를 기록하도록 하였다. 치료기간을 일주일 간격으로 나누어 각 주별 오심 및 식욕감소의 정도, 평균 구토횟수를 구하였다. 결과 : 본 연구에 참여한 60명의 대상 환자 중 55명의 환자에서 분석이 가능하였다. M군은 28명, O군은 27명이었다. 환자 특성 및 방사선치료에 관한 특성은 연령을 제외하면 차이가 없었다. 연령은 M 군이 $52.9{\pm}11.2$세, O군이 $46.5{\pm}9.6$세로 통계적으로 의미 있는 차이가 있었다. M군에 비해 O군에서 오심의 정도, 구토의 횟수, 식욕감소의 정도의 세 항목 모두 낮은 점수 분포를 보였다. M군의 경우 방사선치료를 시작한 후 5주째 각 항목별 점수가 가장 높은 경향을 보였다. 혼합모형을 이용한 반복측정 자료의 분석 결과 오심의 정도에는 원발암의 종류, 투약군이 의미 있게 영향을 미치는 요소였다. 구토의 횟수에는 성별, 연령, 총선량, 투약군이 의미 있게 영향을 미치는 요소였다. 식욕감소의 정도에는 연령, 투약군이 의미 있게 영향을 미치는 요소였다. 따라서, 투약군이 유일하게 세 가지 항목 모두에 통계적으로 의미 있는 영향을 미치는 요소임을 알 수 있었다. 전 치료기간 동안 양 투약군 모두 약제의 투여로 인한 부작용은 없었으며, 일반혈액검사 및 일반화학검사에서도 이상 소견을 보이지 않았다. 결론 : 연령이 적으면 오심 및 구토의 위험도가 증가하는 점을 고려하면, 양 투약군 간에 연령의 차이가 있었던 점이 통계적 변별력을 저하시켰을 가능성이 있다. 상기 결과를 토대로 본 연구자들은 중등도 정도의 오심 및 구토의 발생 위험도를 가지는 상복부 및 전복부조사를 전통적인 분할조사법을 이용하여 치료하는 경우 현재 흔히 사용되는 항구토제인 메토클로프라미드에 비해 온단세트론이 오심 및 구토, 식욕의 저하 등의 급성 부작용을 더 효과적으로 억제함을 알 수 있었다. 하지만, 온단세트론을 투여하는 경우에도 오심 및 구토가 호전되지 않는 경우도 많이 있으므로 이 부작용을 더욱 경감하기 위한 여러 가지 방안들이 강구되어야 한다고 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10445-10449
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• 2015

Objective: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. Methods: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. Results: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P>0.05). Baseline pain score of patients with moderate pain in treatment and control group was $4.9{\pm}0.8$ and $5.1{\pm}0.8$, respectively; and decreased to $1.8{\pm}1.1$ and $1.2{\pm}1.1$ after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P=0.028). Average daily consumption of oxycodone prolonged-release tablets was ($54.0{\pm}19.6$) mg and ($44.7{\pm}18.7$) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were $8.3{\pm}1.1$ and $8.3{\pm}1.1$, respectively; and pain intensity after treatment decreased to $2.9{\pm}1.0$ and $2.3{\pm}1.0$. Pain intensity was significantly reduced in the treatment group, with statistical significance (P=0.026). Average daily consumption of oxycodone prolonged-release tablets was ($132.0{\pm}42.2$) mg and ($110.7{\pm}33.9$) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). Conclusion: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

• The Korean Journal of Pain
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• 제11권2호
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• pp.268-272
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• 1998

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.

• 대한한방부인과학회지
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• 제32권4호
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• pp.144-158
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• 2019

Objectives: The purpose of this study is to report the effect of Korean medical treatment in case of germ cell tumor patient treated by chemotherapy. Methods: The patient was treated with Korean medical treatment (herbal medicine, acupuncture) for 11 months. By taking computed tomography and laboratory testing, we could compare before and after. Results: The patient treated with combination of Korean medical treatment and Chemotherapy recovered after taking Korean medicine for 11 months. Panax ginseng, C.A. Meyer, Astragalus membranaceus, Rhus Verniciflua Stokes were main ingredient of the korean medical treatment. Conclusions: This report shows the Korean medical treatment is effective on Germ cell tumor patient. Korean medical treatment alleviates the side-effect of Chemotherapy such as nausea, vomiting, hot flush and anorexia. Also Blood test results prove long-term use of Korean medicine is safe for lung and kidney function.

• 대한한방내과학회지
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• 제32권4호
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• pp.610-615
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• 2011

Objectives : To observe the mitigating effects of a Traditional Korean Medicine treatment program, called Wheel Balanced Cancer Therapy (WBCT), with Adriamycin and 5-FU chemotherapy on a breast cancer patient. Methods : A 26 year old female patient diagnosed with stage IIb breast cancer was admitted to the East-West Cancer Center (EWCC) in February of 2010. She received Adriamycin and 5-FU from February 22nd, to July 20th, 2010 followed by WBCT consisting of herbal medicine, acupuncture, moxibustion and physiotherapy for 5 months. Her symptoms were measured by Common Terminology Criteria for Adverse Events (CTCAE) and her quality of life was measured by Eastern Cooperative Oncology Group (ECOG). Results : WBCT significantly alleviated chemotherapy-induced nausea, oral dryness, and peripheral neuropathy. Quality of life also significantly improved. Conclusions : This case study potentiates WBCT's significant efficacy in aiding breast cancer patients suffering from Adriamycin plus 5-FU chemotherapy induced adverse effects.

• The Korean Journal of Pain
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• 제31권2호
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• pp.102-108
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• 2018

Background: Nefopam is a non-opioid, non-steroidal analgesic drug with fewer adverse effects than narcotic analgesics and nonsteroidal anti-inflammatory drugs, and is widely used for postoperative pain control. Because nefopam sometimes causes side effects such as nausea, vomiting, somnolence, hyperhidrosis and injection-related pain, manufacturers are advised to infuse it slowly, over a duration of 15 minutes. Nevertheless, pain at the injection site is very common. Therefore, we investigated the effect of warmed carrier fluid on nefopam injection-induced pain. Methods: A total of 48 patients were randomly selected and allocated to either a control or a warming group. Warming was performed by diluting 40 mg of nefopam in 100 ml of normal saline heated to $31-32^{\circ}C$ using two fluid warmers. The control group was administered 40 mg of nefopam dissolved in 100 ml of normal saline stored at room temperature ($21-22^{\circ}C$) through the fluid warmers, but the fluid warmers were not activated. Results: The pain intensity was lower in the warming group than in the control group (P < 0.001). The pain severity and tolerance measurements also showed statistically significant differences between groups (P < 0.001). In the analysis of vital signs before and after the injection, the mean blood pressure after the injection differed significantly between the groups (P = 0.005), but the heart rate did not. The incidence of hypertension also showed a significant difference between groups (P = 0.017). Conclusions: Use of warmed carrier fluid for nefopam injection decreased injection-induced pain compared to mildly cool carrier fluid.