• The Korean Journal of Pain
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• v.12 no.1
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• pp.108-113
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• 1999

Background: There is some concern that the administration of epidural analgesia for pain relief during labor increases the likelihood of cesarean delivery. But, several investigators showed a decrease in the rate of emergency cesarean delivery after epidural analgesia. The purpose of this study was to compare the emergency cesarean rate between the two groups with and without epidural analgesia. Methods: We reviewed retrospectively the medical records for 7846 parturients admitted our hospital between January 1, 1995 and December 31, 1996 and whose attending physician anticipated a normal labor and vaginal delivery. The number of parturients with epidural analgesia using 0.25% bupivacaine with fentanyl were 2839 and parturients without epidural analgesia were 5017. Results: An administration of epidural analgesia was not associated with the incidence of cesarean rate. 149 (5.25%) of 2839 parturients in epidural group and 371 (7.31%) of 5017 parturients in non-epidural group underwent emergency cesarean section. Conclusions: Our retrospective study has shown that an administration of epidural analgesia neither decrease nor increase in the rate of emergency cesarean delivery when compared with a non-epidural analgesia.

• Journal of Acupuncture Research
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• v.40 no.4
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• pp.377-381
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• 2023

This study included a 42-year-old female farmer with a 2-year history of Graves' disease who visited the hospital for a total thyroidectomy for her grade III goiter based on World Health Organization classification. Besides Hegu (LI4) and Neiguan (PC6), extensively used for acupuncture analgesia in thyroid surgery in previous studies, three additional acupuncture points for acupuncture analgesia in thyroidectomy were evaluated in this study: Shuitu (ST10), Quepen (ST12), and Yifeng (SJ17). In this case, we used an electroacupuncture stimulator to stimulate the acupuncture points and combined acupuncture analgesia with diazepam and atropine sulfate administration as adjunct medications to calm the patient. The operation was completed without any complications. The findings revealed that stimulating the five acupuncture points, i.e., Hegu (LI4), Neiguan (PC6), Shuitu (ST10), Quepen (ST12), and Yifeng (SJ17), for acupuncture analgesia combined with adjunct medications is safe for maintaining an adequate level of analgesia and hemodynamic stability during thyroidectomy.

• Women's Health Nursing
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• v.9 no.3
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• pp.235-244
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• 2003

Purpose: To examine the difference of physical discomfort and childbirth satisfaction between postpartum women with and without having taken Epidural Analgesia. Method: The subjects were divided into one group of 128 primipara taken Epidural Analgesia and the other of the same 70 women who were not taken it. Data were collected by questionnaires of their own physical discomfort and birth satisfaction at postpartum 1 to 2 days in OBGY hospitals, and data were analyzed using SPSS Program. Result: Women having taken epidural analgesia appealed higher physical discomfort than those without it in the lower limbs exercise discomfort, difficult urination, urinary retention, nausea & vomiting, whereas appeared vice versa in breast pain. Among indicators for childbirth satisfaction, women having taken epidural analgesia preferred the same delivery method later again more than those without it. Conclusion: It is confirmed that the method of epidural analgesia is not an absolute way to control labor pain, rather stir physical discomfort after childbirth and does not fully increase the women's childbirth satisfaction. Therefore, it is proposed that nurses should provide the pregnant women the right knowledge and information, thereby enabling them to select the useful method of childbirth to their own course of childbirth and health-recovering after the delivery.

• The Korean Journal of Physiology and Pharmacology
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• v.14 no.3
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• pp.191-198
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• 2010

The effects of different doses of tramadol on analgesia and electroencephalographic (EEG) spectralparameters were compared in rats. Saline or tramadol 5, 10, 20 or 40 mg/kg was administered. The degree of analgesia was evaluated by tail-flick latency, and the degree of seizure was measured using numerical seizure score (NSS). Additionally, band powers, median power frequency and spectral edge frequency 95 were measured to quantify the EEG response. All doses of tramadol produced spike-wave discharge. Tramadol significantly and dose-dependently increased the analgesia, but these effects did not correspond with the changes in the EEG spectral parameters. NSS significantly increased in the Tramadol 20 and 40 mg/kg treatment groups compared to the Control and TRA5 groups, and two rats given 40 mg/kg had convulsions. In conclusion, tramadol dose-dependently increased the analgesic effect, and the 10 mg/kg dose appears to be a reliable clinical dose for analgesia in rats, but dose-dependent increases in analgesia and seizure severity did not correlate with EEG spectral parameters.

• Women's Health Nursing
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• v.18 no.2
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• pp.126-134
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• 2012

Purpose: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. Methods: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. Results: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower post-analgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. Conclusion: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.55-59
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• 1993

Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

• Journal of Veterinary Clinics
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• v.8 no.2
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• pp.177-182
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• 1991

In order to develop an effective methods of electroacupuncture regional analgesia for Cattle, six adult Korean-native cattle, which were healthy and had ordinary perception response, were examined on the study. Using them, there were treated with six different prescription applying on six mendian points including Samyang Rack, Keud Mun, Bu Yang, Sameum Kyo, Backhyo and Hu Hae. The results are summerized as follows. 1 In the case of the acupuncture treatment on Samyang Rack and Keuk Mun located on both fore-legs. the good effect of regional analgesia was obtained toward the anterior part of cattle; on the other hand, when treated with Bu Yang and Sameum Kyo at both hindlegs. the same result were represented toward the posterior part. 2. The level of the electronic current of each electro-acupuncture treatment for bovine regional analgesia was proved to necessitated the same amount of which had given body general electro-acupuncture analgesia. 3. Any significant changes could not find out the hematological and biochemical values of all acupuncture-treated cattle during the experiment. 4. Each elector-acupuncture prescription appeared to be considerably effective for bovine regional analgesia, and also showed the possibility on applying the standing position of cattle for various surgical treatment regardless its operation areas.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.192-196
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• 2006

Background: Epidural opioids are commonly used for postoperative analgesia. However, the side effects of epidural opioids include respiratory depression, sedation, pruritus, nausea, vomiting and urinary retention. Meperidine, due to its intermediate lipid solubility and local anesthetic properties, permits postoperative analgesia. The aim of this study was to compare meperidine alone to meperidine coupled with bupivacaine, and to determine the effects of epidural meperidine without bupivacaine, when used for epidural analgesia following hepatectomy abdominal surgery. Methods: Patients received thoracic epidural analgesia with meperidine alone (3.5 mg/ml in saline) or with additional bupivacaine (0.15%) for 2 days after surgery. Postoperative pain was assessed using a visual analog scale (VAS) pain score 2 days after the operation, with the incidence and dose supplementation also evaluated. Postoperative side effects were assessed using a 3 grade system. Results: No significant difference was found between the two groups in terms of age and weight, or in the pain scores, side effects, incidence and dose supplementation. Conclusions: 3.5 mg/ml epidural meperidine at a dose of 2 ml/hr provides effective postoperative analgesia.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.171-176
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• 1998

Postoperative pain following tonsillectomy remains a significant obstacle to speedy recovery and smooth convalescence. Inadequate analgesia causes poor oral intake and influences the length of hospital stay and ability to return to normal activity. Patient Controlled Analgesia (PCA) is a method of analgesia adminstration that consists of a computer driven pump with a button that the patient may press to adminster a small dose of analgesic drug. The aim of this study was to examine whether Intravenous Patient Controlled Analgesia (IV-PCA) can reduce postoperative pain after tonsillectomy. The 100 patients undergoing tonsillectomy with general anesthesia were divided into two groups. The PCA group patients (n=80) received a mixture of nalbuphine and ketorolac by Walkmed PCA infusor during first 48 postoperative hours. In control group (n=20), the patients received oral acetoaminophen (Tyrenol) regularly and tiaprofenic acid (Surgam) intramuscularly on a p.r.n basis. Analgesic efficacy was evaluated with visual linear analogue scale (VAS) and the adverse effects were evaluated with 4 point scale. The patients of PCA group had less pain than those of control group. The adverse effects in the PCA group were nausea and vomiting. This study suggests that IV-PCA may be safe and effective method of pain control after adult tonsillectomy and is better accepted than oral or intramuscular pain medications.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.95-100
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• 2018

We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. This retrospective, observational study based on the review of the medical records from February 2014 to July 2017. Epidural analgesia was initiated with a 10 mL epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. Non-epidural analgesia was initiated with pethidine 12.5 mg bolus, followed by additional boluses as needed. The primary outcome was the duration of the labor. 149 healthy nulliparous women at term pregnancies with no evidence of fetal distress were enrolled in this study. 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. Using a Kaplan-Meier survival analysis, there was no significant difference in the overall duration of the labor(P=0.233). The duration of the first stage of labor was $187.6{\pm}167.3min$ in Group NE, $248.6{\pm}168.7min$ in Group E (Mean${\pm}$SD, P=0.032). The duration of the second stage of labor was $67.1{\pm}57.8min$ in Group NE, $64.1{\pm}47.5min$ in Group E (Mean${\pm}$SD, P=0.693). Epidural analgesia delayed the first stage of labor in this study. But there were no significant differences between the two groups in the duration of the second stage and the total duration of labor.