• Title/Summary/Keyword: analgesics

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Clinical effect of preoperative intravenous non-steroidal anti-inflammatory drugs on relief of postoperative pain in patients after laparoscopic cholecystectomy: Intravenous ibuprofen vs. intravenous ketorolac

  • Gyeong Geon Lee;Joon Seong Park;Hyung Sun Kim;Dong Sup Yoon;Jin Hong Lim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.251-256
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    • 2022
  • Backgrounds/Aims: Postoperative pain management is a key to enhanced recovery after surgery. The aim of this study was to evaluate clinical effect of preoperative intravenous (IV) non-steroidal anti-inflammatory drugs (NSAIDs) on relief of postoperative pain in patients after laparoscopic cholecystectomy. Methods: This single center, retrospective study was conducted between September 2019 and May 2020. A total of 163 patients were divided into two groups: Ibuprofen group (preoperative IV ibuprofen, n = 77) and Ketorolac group (preoperative IV ketorolac, n = 86). The primary outcome was postoperative pain score measured immediately in the recovery room. Results: There was no difference in demographic characteristics between the two groups of patients. Postoperative pain score measured immediately in the recovery room was significantly higher in the Ibuprofen group than in the Ketorolac group (mean value: 5.09 vs. 4.61; p = 0.027). The number of patients who needed analgesics immediately in the recovery room was also higher in the Ibuprofen group than in the Ketorolac group (28 [36.4%] vs. 18 [20.9%]; p = 0.036). Conclusions: In this study, preoperative IV injection with ketorolac reduced postoperative pain and analgesic requirement in the recovery room more effectively than that with ibuprofen. However, both showed similar effects on peak pain and pain at discharge. Numbers of patients requiring additional analgesics were also similar between the two groups.

One Case of Effect of Dilantin in Terminal Cancer Patient Complained of Hyperthemia on Upper Right Extremity (상지의 열감을 호소한 말기 암 환자에서 dilantin의 효과를 본 1예)

  • Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.65-68
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    • 1998
  • The neuropathic pains are not well controlled by common analgesics and opioid drugs in terminal cancer patients. The types of these pains are divided within the two cages, one is due to continuous central sensitization and the other is due to paroxymal peripheral sensitization. The mechanism of continuous central sensitization is the activity of dorsal horn neurones that are activated by C-fiber input. The tricyclic antidepressants, non-tricyclic antidepressants, and oral local anaesthesia probably produce analgesic effects in neuropathic pains through suppression of this activity. The mechanism of paroxymal peripheral sensitization is the hyper-excitability of peripheral neurones. The neuropathic pains due to peripheral sensitization respond relatively the anticonvulsants and baclofen that stabilize membranes and suppress paroxymal electrical discharge. The patients was a 38-year-old female who complained of hyperthemia on upper right extremity. The symptom of this patient was improved with anticonvulsant(dilantin 600mg).

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Nursing students관 Knowledge on Pain Management (간호학생의 통증관리에 관한 지식)

  • 신영희;박영숙
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.164-172
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    • 1995
  • Pain management of postoperative patients or patients suffering from terminal cancer became one of the most important task of nurses in recent years. This study analyzed basic knowledge of 175 student nurses in Taegu on the pain assessment and management. The questionnaires included five areas : Assessment, pharmacological actions, medication, classification of opioids, and psychological dependence of analgesics. The results indicated that nursing students, in general, lacked knowledge on pain management : Correct responses on pain assessment varied between 9.7 and 100% , classification of opioids was in ranges of 61.7 to 95.4% ; Pharmacological actions was 16.6 to 80% : and medication was 14.9 to 85.7%. Less than 12.6% of students correctly identified the frequency of psychological dependence. These results suggested that the need of reinforcement on the pain management in formal nursing education.

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A study on dysmenorrhea of women labor workers (일부 생산직 여성근로자의 월경곤란증에 관한 연구)

  • Lee Inn-Sook
    • Journal of Korean Public Health Nursing
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    • v.13 no.2
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    • pp.115-130
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    • 1999
  • This study was conducted to investigate the prevalence of dysmenorrhea in women labor workers The subjects were 327 women labor workers in the area of Kyunggi. Kyungsang and Chunla Provinclils. The data were collected from 20. January to 20. February. 1999 by using self-administered structured questionnaires. The contents of, questionnaire were composed of demographic(3 items). work related(2 items). life style (6 items), obstetric-menstrual(8 items) characteristics. and experiences of dysmenorrhea(6 items). The results were as follows 1. Prevalence rate of dysmenorrhea was $76.8\%$. Among women who had dysmenorrhea. $52.0\%$ of them had family history on dysmenorrhea. $46.0\%$ of them experienced limitation of daily activities. $18.3\%$ of them have started the dysmenorrhea since their employment present company. and $8.8\%$ of them visited hospital due to dysmenorrhea of the subjects who took analgesics for relieving menstrnal pain. $7.2\%$ had no effect. 2. The frequency of dysmenorrhea was significantly different by educational level. working period. and the amount of mentrual flow.

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Management of Displaced Intra-articular Calcaneal Fracture (전위된 관절 내 종골 골절의 치료)

  • Lee, Jun Young;Na, Woong Chae
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.137-141
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    • 2015
  • Recently, open reduction and internal fixation has been the treatment of choice for displaced intra-articular calcaneal fractures for many orthopaedic surgeons. However controversy still surrounds the optimal treatment with regard to whether displaced intra-articular calcaneal fractures should be treated operatively or conservatively. Conservative treatments include use of splint, rest, leg elevation, icing, use of analgesics and early mobilization. Operative treatment is open reduction and internal fixation, performed through an extensile lateral approach with interfragmentary screws and application of a neutralization plate. We reviewed the question of whether operative treatment by open reduction and internal fixation provides a benefit compared with conservative treatment for displaced intra-articular calcaneal fractures.

Comparison of Patient Controlled Epidural Analgesia Alone and Patient Controlled Epidural Analgesia with Continuous Infusion (단독 경막외 통증자가조절법과 지속주입을 병용한 경막외 통증자가조절법의 비교)

  • Kim, Dong-Hee;Lee, Tae-Soo
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.368-373
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    • 1996
  • Background: The purpose of this study was to determine whether there is any advantage for a continuous background infusion during patient controlled epidural analgesia(PCEA) for postoperative pain control. Methods: 60 patients scheduled for elective cesarean section under epidural anesthesia were assigned randomly in a double-blind fashion to receive fentanyl and bupivacaine by PCEA with or without background infusion for 48 hours postoperatively. Results: Total amount of fentanyl and bupivacaine consumption and degree of sedation were not significantly different between the two groups. Visual analogue scale(VAS) pain scores at 24, 36, and 48h and sleep disturbance were significantly lower in background infusion group. Conclusion: Administration of fentanyl with bupivacaine by continuous background infusion is appropriate for PCEA for postcesarean section pain control.

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Fulminant Headache after Epiduroscopy -A case report- (경막외강 내시경술후 발생한 전격성 두통 -증례 보고-)

  • Oh, Wan-Soo;Lee, Seung-Jun;Hong, Ki-Hyuk
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.130-133
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    • 2000
  • Epiduroscopy is a new imaging and invasive technique that has become increasingly popular in the diagnosis and therapy of spinal pain syndrome. However, the risk of epiduroscopy is a major concern due to its invasiveness. The complications include hematoma, infection, neural damage, cardiac failure and raising of intracranial pressure. We have experienced a case of severe diffuse headache and dizziness following 1 day after epiduroscopy. Emergent brain MRI finding has no remarkable sign. The patient was admitted for 5 days to be treated with bed rest, adequate hydration and pain control with analgesics. After the treatments, she was recovered without residual sequelae and discharged. We need to take greater care of the undesirable effects detected intra- and post epiduroscopy, especially sign of increased intracranial pressure. Therefore, close monitoring of intracranial pressure is necessary during epiduroscopy.

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The Effect of Epidural Ketamine in Complex Regional Pain Syndrome Occuring after Lumbar Epidural Block -A case report- (요부경막외차단술 후 발생한 복합부위 통증증후군에서의 경막외 Ketamine의 효과 -증례 보고-)

  • Ock, Kyung-Jong;Han, Kyung-Rim;Kim, Jin-Soo;Kim, Chan;Kim, Eun-Young
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.251-254
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    • 2000
  • A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

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Pain medication and long QT syndrome

  • Klivinyi, Christoph;Bornemann-Cimenti, Helmar
    • The Korean Journal of Pain
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    • v.31 no.1
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    • pp.3-9
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    • 2018
  • Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation. Other substances, not used in the treatment of pain, such as proton pump inhibitors, antiemetics, and diuretics are also associated with long QT syndrome. When the possible benefits of therapy outweigh the associated risks, slow dose titration and electrocardiography monitoring are recommended.

A Effectiveness of Butorphanol and Nalbuphine as Utilized with Ketorolac in Patient Controlled Analgesia after Total Abdominal Hysterectomy (복식 전자궁 절제술 후 통증자가조절을 통하여 Ketorolac과 함께 투여한 Butorphanol과 Nalbuphine의 효과)

  • Kim, Dong-Hee;Park, Choong-Hak
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.263-267
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    • 1998
  • Background: This study was designed to know the dose requirement, analgesic efficacy and side effects of butorphanol and nalbuphine when administered with ketorolac by patient controlled analgesia (PCA) after total abdominal hysterectomy. Methods: Forty women who underwent total abdominal hysterectomy received ketorolac (bolus dose 2.4 mg, lockout interval 10 min) with either butorphanol (bolus dose 0.1 mg) or nalbuphine (bolus dose 1 mg) using PCA pump postoperatively. Results: Total amounts of 48 hr consumption were 8.7 mg (butorphanol)and 61.5 mg (nalbuphine). There were no significant differences between two groups in total ketorolac infusion doses, VAS score and side effects. Conclusions: Both butorphanol and nalbuphine were useful for PCA for postoperative pain control. We may suggest that ketorolac 180 mg with butorphanol 9 mg or nalbuphine 70 mg would be useful for 48 hr postoperative pain control.

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