• Title/Summary/Keyword: Surgical pain

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Nurse Attitude-Related Barriers to Effective Control of Cancer Pain among Iranian Nurses

  • Sadeghy, Adel;Mohamadian, Robab;Rahmani, Azad;Fizollah-zadeh, Hussein;Jabarzadeh, Franak;Azadi, Arman;Rostami, Hussein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2141-2144
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    • 2016
  • Background: Many cancer patients still experience pain worldwide. There are many barriers for effective control of cancer pain and many of these are related to health care providers. There is a need for further investigation of these barriers. The aim of this study was to investigate nurse-related barriers to control of cancer pain among Iranian nurses. Materials and Methods: In this descriptive study 49 nurses from two hospitals affiliated to Tabriz and Ardebil Universities of Medical Sciences participated using a census sampling method. A demographic and profession related checklist and Barriers Questionnaire II (BQ-II) were used for data collection. Results: The results showed negative attitudes of participants regarding control of cancer pain. Participants believed that cancer pain medications do not manage cancer pain at acceptable levels; patients may become addicted by using these drugs; cancer pain medications have many uncontrollable effects; and controlling cancer pain may distract the physicians from treating disease. Conclusions: Iranian nurses have negative attitudes toward pain control in cancer patients especially about effectiveness of pain medication and their side effects. Educational intervention to reduce these misconceptions is needed.

Practical strategies for the prevention and management of chronic postsurgical pain

  • Bo Rim Kim;Soo-Hyuk Yoon;Ho-Jin Lee
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.149-162
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    • 2023
  • Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

Comparative Study of Surgical Treatment for Concomitant Ankle Joint Injury in Tibia Shaft Fracture (경골 간부 골절에서 족관절 손상에 대한 수술적 치료의 비교 연구)

  • Jinho Park;Seungjin Lee;Hyobeom Lee;Gab-Lae Kim;Jiwoo Chang;Heebum Hahm
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.87-92
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    • 2023
  • Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

Construction and Application of Nursing Information System Using NANDA-NOC-NIC Linkage in Medical-Surgical Nursing Units (간호진단-간호결과-간호중재 연계를 이용한 내외과계 간호단위 간호정보시스템 구축 및 적용)

  • Ko, Eun;So, Hyang-Sook
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.365-376
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    • 2013
  • Purpose: The purpose of this study was to construct, develop, and apply a nursing information system (NIS) using NANDA-NOC-NIC linkage in medical-surgical nursing units. Methods: This study consisted of three phases which were the construction of the database, development of the NIS, and application of the NIS. To construct the database, a questionnaire and nursing record review by an expert group were used. Collected data were analyzed by the SPSS/WIN 13.0 program. Results: In first phase, the database was made up of 50 nursing diagnoses, 127 nursing outcomes and 300 nursing interventions. In the second phase, NIS was developed according to its flow diagram and then tested. In the third phase, the developed NIS was applied to 130 inpatients. Nursing diagnoses frequently used were acute pain, delayed surgical recovery, and deficient knowledge (specify). Nursing outcomes for a nursing diagnosis of 'acute pain' were identified as pain control, pain level and comfort level. Nursing interventions for the nursing outcome 'pain control' were pain management, patient controlled analgesia assistance and medication management. Conclusion: The results of this study will facilitate the use of the newly proposed NIS in nursing practice and provide a guideline for evidence-based nursing.

The Study for Treatment of Temporo-mandibular Joint Pain (악관절의 통증에 관한 연구)

  • Choe, Joong-Rieb;Song, Chan-Woo
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.86-92
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    • 1995
  • Temporomandibular disorders typically present findings of limited or asymmetric patterns of jaw opening and joint sounds usually described as clicking, popping, grating, or crepitus. Recently, patients with temporomandibular disorders have received an increasingly aggressive treatment with a greater emphasis on surgical and dental reconstruction. Scientific studies have not clearly identified the specific causes of the temporomandibular disorders and therefore some of the treatments are empiric, without a firm scientific foundation. We carried out a study on the patients of pain clinic OPD and concluded that the causes of the temporomandibular joint(TMJ) pain are the prolonged contraction of the muscles of mastication, especially the masseter muscle. Therefore, the spasmolytic treatment of masseter muscle would be a better treatment for TMJ syndrome rather than the surgical and dental reconstruction.

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Alcohol Neurolysis for the Treatment of Trigeminal Neuralgia (Alcohol Neurolysis를 이용한 삼차 신경통 치험예)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.45-48
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    • 1989
  • Trigeminal neuralgia is one of the diseases which cause most chronic and intractable pain on the facial area. Several drugs includding analgegics, anticonvulsants, tranquilizers, vitamins or hormonal preparations have been expected to be effective but no drug could effectively relieve the patients from the pain. The pain could be relieved by surgical neurectomy or neurolysis of the Gasserian ganglion or the involved branches with absolute alcohol alternatively. Surgical microvascular decompression may be performed if the pain resulted from compression of the nerve by adjucent arterial loops. 4 cases of trigeminal neuralgia are presented. They were treated with alcohol neurolysis of the involved peripheral nerves combined with or without carbamazepine and/or amitriptyline with favorable result of pain relief.

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Thermo-Visual Evaluations of Acute Abdomen Pain in Children

  • Aleck Ovechkin;Kyeong-Seop Kim;Jeong-Whan Lee;Sang-Min Lee
    • KIEE International Transaction on Systems and Control
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    • v.2D no.2
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    • pp.59-64
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    • 2002
  • About two thirds of patients admitted to hospitals world-wide suffer from acute abdomen pains of varying degrees of severity. Acute abdomen pain due to appendicitis or pancreatitis usually requires urgent surgical treatment, whereas pain due to heart ischemia or enteroviral infection requires only drug treatment. In general, making an immediate decision about whether or not acute abdomen pain requires urgent surgery is very difficult. This decision becomes even more difficult when the patient is a young child who can't properly describe the abdominal pain. In this case, thermo-visual inspection can alternatively be used to decide whether urgent surgical treatment is necessary to cure the abdominal pain.

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Effect of Preoperative Intravenous Morphine on Postoperative Pain, Plasma Cortisol and Serum Glucose Levels (술전 Morphine 정주가 술후통증과 혈장 Cortisol 및 혈당치에 미치는 영향)

  • Lee, Seung-Cheol;Park, Han-Suk;Chung, Chan-Jong;Hwang, Ho-Yong
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.235-240
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    • 1998
  • Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of CNS and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative intravenous morphine could affect postoperative pain and change plasma cortisol and serum glucose levels. Methods: Thirty eight patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. Control group (n=11) did not received intravenous morphine, preoperative group (n=13) received intravenous morphine (0.1 mg/kg as a bolus 10 min before operation and followed by 1.5 mg/hr for 10 hours), postoperative group (n=14) received the same doses and method of intravenous morphine of preoperative group postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative visual analogue scores (VAS), analgesic requirement (first request time, total amounts used), side effects, plasma cortisol and serum glucose levels were compared. Results: VAS were different between control group and the other two goups, but were not different between preoperative and postoperative group. Total amounts of used fentanyl were not different among groups, but first request time were significantly delayed in the preoperative group compared with the other two groups ($66.2{\pm}33.9$ vs $39.0{\pm}15.4$ and $45.0{\pm}14.9$ min respectively, p<0.05). Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Above dosage of preoperative and postoperative morphine has analgesic effect, but could not block surgical stress induced plasma cortisol and serum glucose increase.

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Importance of Sacrotuberous Ligament in Transgluteal Approach for Sciatic Nerve Entrapment in the Greater Sciatic Notch (Piriformis Syndrome)

  • Byung-chul Son
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.217-226
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    • 2024
  • Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.