• 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.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1017-1022
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• 1996

Patients with fractured ribs necessarily suffer from severe chest ain, which prevents coughing, deep breathing and bronchial toilette, cause atelectasis and pulmonary shunting. Relief of chest pain is benecial to patients, providing consort and facilitating physiotherapy and effective expectoration. We compared the efficacy of pain relief be!ween continuous epidural analgesia and conventional intramlrscular analgesia in 20 patients with fractured ribs. Among 20 patients, epidural analgesia was done or 10 patients(experimental group) and the remainder ten received intramuscular analgesia(control group). The pain and ROM(range of motion) scores, vital sign, PaO2, forced vital capacity(FVC) and forced expiratory volume for 1 second(FEVI) were checked on immediate admission and 12, 24 hours, third, fifth, and seventh day after starting of continuous epidural block. The pain and ROM scores were decreased and the PaO2, FRC and FEVI were significantly increased in experimental group. The side effects of epidural analgesia were mild and reversible. With th se result, we can suggest that epidural analgesia is more effective for pain relief and restoration of pulmonary mechanics in patients with fractured ribs.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.68-75
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• 2001

Background: Thoracotomy is the operation that produces the most postoperative pain, necessitating the highest requirements for postoperative analgesics. The common methods of treating postthoracotomy pain are the use of thoracic epidural analgesia, intemittent or continuous intercostal nerve blocks, intravenous narcotics and cryoanalgesia. We designed to assess the analgesic effect of epidural analgesia, cryoanalgesia and the combined analgesia in thoracic surgery. Methods: A prospective study was carried out in 59 patients undergoing elective thoracotomy for parenchymal disease. Patients were randomized into three groups: C (cryoanalgesia), CE (cryoanalgesia and thoracic epidural analgesia), E (epidural analgesia). All patients had standard anesthesia with endotracheal intubation using a double lumen endotracheal tube, and one-lung ventilation. Subjective pain relief was assessed on a visual analog scale. Analgesic requirements, complications and the degree of satisfaction were evaluated during the 7 days following surgery. Results: Subjective pain relief was significantly better in Group CE and Group E in comparison with Group C (P < 0.05). Cryoanalgesia provided a better pain score on the 6th and 7th POD than the early postoperative periods. Analgesic requirements were higher in Group C than in the Group CE and Group E during the first POD. The incidence of side effects was similar in Group CE and Group E. Conclusions: If we can reduce the concentration of fentanyl and local anesthetics in combined analgesia of epidural and cryoanalgesia, the disadvantages of each method would be overcome and would be a better method of postthoracotomy pain control.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.192-196
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• 2016

Background: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. Methods: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. Results: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). Conclusions: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.

• The Korean Journal of Pain
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• v.31 no.3
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• pp.191-198
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• 2018

Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. Methods: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. Results: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. Conclusions: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.

• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.244-253
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• 1997

This study was performed to evaluate the possibility of inducing analgesia by electroacupuncture stimulation at single acupoint or combined acupoints and to examine the analgesic effects following the combination of premedication and electroacupunrture analgesia(EA). Analgesia was induced by EA with the current of 1-4 volts and the frequency of 10-45 Hz to the acupoints Uown to be related to analgesia on the head/necIL axial part thoracic and pelvic limb. In Yi Feng acupoint of head/neck part pain responses were not disappeared after electroacupunrture stimulation to the head/necIL thoracic limbo thoraxl abdomen, loin, rear and pelvic limb. Pain responses were remained after EA of Tian Men-Tian Ping and Shen Yu arupoints of axial park whereas hypoalgesia was observed after EA of Tian Ping-Bai Hui acupoint in all parts of body. There was no analgesic effects after EA stimulation of the brachial plexus and Wai Kuan acupoint, whereas after EA stimulation of San Yang Lo, pain responses were disappeared in headfnecll, thoracic limb and pelvic limbo and in the other parts of body hypoalgesia was shown. In EA stimulation of Tsu San Li acupoint pain responses were disappeared in pelvic limb and in San Yin Chiao acupoint pain responses were disappeared in head/necIL thoracic and pelvic limb, and hypoalgesia was shown in abdomen. On the combination of San Yang Lo Pli Men) and San Yin Chiao (Pu Yan6 acupoints, pain response in heauneck was decreased in 5 minutes, whereas analgesia in thoracic and pelvic limb was induced after 20-30 minutes and in abdomen was noted after 50 minutes. The more frequrncy was increased, the more rapid analgesic e11%t was induced. The analgesic effects wert not good in laparotomy under EA at the combination of San Yang Lo (Xi Men) and San Yin Chiao (Pu Yang) arufoints. Enteroanastomosis could not be continued under acrpromazine, xylazine and diazepam with EA. However, under EA followed by tiletaminetzolazepam, the operation could be completed without additional anesthesia and the analgesic effects were good. There were no changes in clinical signs, hematological and serological values after combination of the premeditation of tiletamine+zolaEepam and EA. It is considered that EA alone is not suitable for the main surgery, but the combination method of EA and sedatives can be utilized in practice.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.105-112
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• 2019

Background: Severe pain always develops after thoracotomy; intrapleural regional analgesia is used as a simple, safe technique to control it. This study was performed to evaluate whether a small dose of naloxone with local anesthetics prolongs sensory blockade. Methods: A prospective, randomized double-blinded controlled study was conducted on 60 patients of American Society of Anesthesiologists statuses I and II, aged 18 to 60 years, scheduled for unilateral thoracotomy surgery. After surgery, patients were randomly divided into two groups: through the intrapleural catheter, group B received 30 ml of 0.5% bupivacaine, while group N received 30 ml of 0.5% bupivacaine with 100 ng of naloxone. Postoperative pain was assessed using the visual analog pain scale (VAS). Time for the first request for rescue analgesia, total amount consumed, and incidence of postoperative complications were also recorded. Results: The VAS score significantly decreased in group N, at 6 h and 8 h after operation (P < 0.001 for both). At 12 h after injection, the VAS score increased significantly in group N (P < 0.001). The time for the first request of rescue analgesia was significantly longer in group N compared to group B (P < 0.001). The total amount of morphine consumed was significantly lower in group N than in the bupivacaine group (P < 0.001). Conclusions: Addition of a small dose of naloxone to bupivacaine in intrapleural regional analgesia significantly prolonged pain relief after thoracotomy and delayed the first request for rescue analgesia, without significant adverse effects.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.2 no.1
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• pp.1-16
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• 1989

The studies were attempted experimental effects of Jingyochangchooltang (Sample A), Jingyochangchooltang plus Sophorae Semen (Sample B) and Deungyangjingyochangchooltang (Sample C) on analgesia, antipyretic, antiinflammatory action and Tramsport of Intestinal contents in mice. The result of studies were as follows: 1. Analgesia action by Acetic acid method was showed significant effect at all sample groups. 2. Analgesia action by Acetylcholine-HCil method was showed significant effect in sample A group. 3. Analgesia action by Reandall-selitto method was showed significant effect at all sample groups especially sample B group was showed more significant effect from 2 hours to 3 shours. 4. Antipyretic action by yeast method was showed significant effect at all sample groups, especially sample A group and sample C group were showed more significant effect after 6 hours than sample B group. 5. Antiinflammatory action by carrageenine method was showed significant effect at all simple groups. 6. In the intestinal transport, in contrast to control group, sample A group revealed the increasing rate $38.7\%$ and sample B group revealed the increasing rate $47.7\%$. According to the above result, it can be concluded that Jingyochangchooltang, Jingyochangchooltang plus sophorae Semen and Deungyangjingyochangchooltang had a remarkable effect on the treatment of hemorrhoids caused by Pung Yul and inflammation of anus.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.41-45
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• 2001

Background: Clonidine, a selective ${\alpha}_2$ adrenergic agonist, increases the duration of anesthesia and analgesia when it is used with local anesthetics. This study was undertaken to evaluate whether clonidine, which was mixed with lidocaine for the brachial plexus block (BPB), has a local (peripheral) or a systemic (central) anesthetic effect. Methods: Seventy patients scheduled for upper extremity surgery were randomly allocated to two groups. In group IV (n = 35) an axillary perivascular BPB was performed with 40 ml of 1% lidocaine and 1：200,000 epinephrine, and just after BPB clonidine $2{\mu}g/kg$ was administered intravenously. In group BPB (n = 35) the same BPB was performed with 40 ml of 1% lidocaine, 1：200,000 epinephrine and clonidine $2{\mu}g/kg$. The following variables were recorded: onset time, duration of anesthesia and analgesia, and adverse effects. Results: Onset time was comparable in both groups. The duration of anesthesia and analgesia significantly increased to 306 min and 354 min in group BPB, when compared to 119 min and 151 min in group IV, respectively. No side effects such as hypotension, bradycardia, and sedation were reported. Conclusions: The duration of anesthesia and analgesia is prolonged by adding clonidine to lidocaine during brachial plexus block, which suggests that its effect is local rather than systemic.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.69-73
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• 1998

Background: The postoperative pain in children and adolescents is most commonly managed by intramuscular injections of NSAIDs or opioids. This approach may result in fluctuating plasma drug levels and cycles of pain, comfort, and sedation. Patient-controlled analgesia(PCA) is a method of analgesia administration that consists of a computer-driven pump with a button that the patient may press to administer a small dose of analgesic drug. Materials & Methods: Forty ASA physical status 1 or 2 children and adolescents were divided into two groups. In the PRN group, patients received intramuscularly diclofenac(Valentac$^{(R)}$) on a p.r.n. basis. The PCA group patients received a mixture of nalbuphine and ketorolac by WalkMed$^{(R)}$PCA infusor. Analgesic efficacy was evaluated with NRS(numerical rating scale) and Faces Pain Rating Scale. The side effects were evaluated. Results: The patients of PCA group had less pain than those of PRN group. Complications were similar in both group. Conclusions: PCA with nalbuphine and ketorolac is a safe and effective methods of pain relief in children and adolescents after surgery, and is better accepted than intramuscular injections.