• Title/Summary/Keyword: analgesics

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A Study on Efficacy of Preemptive Analgesia - A Comparison on Efficacy of Preoperative and Postoperative Analgesic Administration - (선행적 진통 요법의 효과성에 대한 연구 -발치 전과 후 진통 요법의 효과 비교-)

  • Jung, Young-Soo;Kim, Moon-Key;Park, Hyung-Sik;Lee, Eui-Wung;Kang, Jeong-Wan
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.10-18
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    • 2003
  • Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, preemptive analgesia is being used as a method to control the postoperative pain. Many studies on its efficacy have been processed in different ways about various drugs, administration methods and times for various operations. And the value of preemptive analgesia are still controversial regarding the results of other clinical studies. The authors performed a clinical study on efficacy of preemptive analgesia using an non-steroidal anti-inflammatory drug (NSAID) for the surgical extraction of impacted third molar teeth and present the more effective pain treatment after oral surgery with literature review. Methods: Using a randomized double blind test design, this study compared the analgesic efficacies of an NSAID, Talniflumate 370 mg. This drug administrated first either 1 hour preoperatively (experimental group) or when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) to respective 30 patients undergoing the removal of impacted third molars. Pain intensity and the time from the end of surgery were assessed postoperatively whenever the patients demanded additional drug over 5 scale for forty eight hours using same verbal rating scales. Results: The sex distribution, the age of the patients. and the time required for surgery in two groups were similar. The average first time for demanding additional drug after surgery was 163.9 minutes in experimental group and 191.5 minutes in control group. At this time, the average pain intensity was 5.8 in experimental group and 6.1 in control group. And the average second time for demanding additional drug was 365.5 minutes in experimental group and 351.8 minutes in control group. At this time. the average pain intensities were 6.6 in experimental group and 6.2 in control group. No statistically significant difference was found between the average first times and second times, and the average pain intensities at first and second times in two groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administrated preoperatively in present practices have weak efficacy of preemptive analgesia for postoperative pain, thus the authors recommend that only postoperative analgesics are adequate without preoperative use of analgesics.

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The Effectiveness of Ultrasound-Guided Thoracic Paravertebral Block for Percutaneous Radiofrequency Ablation of Hepatic Tumors: A Pilot Study (간종양의 경피적 고주파 열치료에서 초음파 유도하 흉부 방척추블록의 효용성: 예비 연구)

  • Kim, Hyungtae;Kim, Youngjun;Kim, Beum Jin;Shin, Sung In;Yim, So Mang;Lee, Ju-Hyung
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.323-331
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.

Adverse events following immunisation with the first dose of sputnik V among Iranian health care providers

  • Reza Jafarzadeh Esfehani;Masood Zahmatkesh;Reza Goldozian;Javad Farkhonde;Ehsan Jaripour;Asghar Hatami;Hamid Reza Bidkhori;Seyyed Khosro Shamsian;Seyyed AliAkbar Shamsian;Faezeh Mojahedi
    • Clinical and Experimental Vaccine Research
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    • v.12 no.1
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    • pp.25-31
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    • 2023
  • Purpose: Since late 2019, the novel coronavirus disease has been a global concern, and alongside preventive strategies, including social distancing and personal hygiene, vaccination is now the primary hope for controlling the pandemic. Sputnik V is an adenovirus vector vaccine used against coronavirus disease 2019 (COVID-19) among Iranian health care providers, and there is a lack of information regarding the Adverse Events Following Immunisation (AEFI) by Sputnik V among the Iranian population. The present study aimed to evaluate AEFI by Sputnik V vaccine among Iranian population. Materials and Methods: Every member of the Islamic Republic of Iran Medical Council received their first dose of the Sputnik V vaccine in Mashhad (Iran) and was referred to receive their second dose enrolled in the present study and asked to fill an English language checklist asking about development of any AEFI following immunization with the first dose of Sputnik V vaccine. Results: A total number of 1,347 with a mean±standard deviation age of 56.2±9.6 years filled the checklist. Most of the participants were male (838 [62.2%]). The present study demonstrated that immunization with the first dose of Sputnik V results in at least one AEFI in 32.8% of the Iranian medical council members. Most of the AEFI was related to musculoskeletal symptoms, including myalgia. By considering the age of 55 years as a cut-off point, individuals younger than 55 had a higher rate of AEFI (41.3% vs. 22.5%, p=0.0001). Male gender, use of analgesics, beta-blockers, and previous COVID-19 infection have a lower chance of developing AEFI (p<0.05). Conclusion: The present study demonstrated that most of the AEFI was related to musculoskeletal symptoms, including myalgia, and older individuals, male gender and those receiving analgesics and beta-blockers were less likely to develop AEFI following immunization with the first dose of Sputnik V.

A Case of Atopic Dermatitis with Sepsis (패혈증이 동반된 아토피피부염 치험 1례)

  • Yun, Young-Hee;Son, Byeong-Kook;Yu, Seung-Min;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.22 no.3
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    • pp.237-245
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    • 2009
  • Objective : It is well known that patients with atopic dermatitis are prone to cutaneous infections. Especially Staphylococcus aureus has been regarded as having an influence on atopic dermatitis. We observed and treated a case of an adult atopic dermatitis patient with sepsis by cooperation of east-west medicine. We present this case because there were no former reports of atopic dermatitis with sepsis treated by cooperation of east-west medicine. Method : We used herbal medication, acupuncture, herbal wet dressing combined with antibiotics and analgesics for 19 days. Atopic dermatitis grade was determined using SCORAD index. Result : The SCORAD index was lowered 32.3 at discharge than before of which the SCORAD index was 62.5 at admission. Other systemic inflammatory response such as fever, pus was also resolved. Conclusion : From this result, we suggest that herbal therapy associated with antibiotic therapy were shown to treat atopic dermatitis with secondary infection effectively.

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The Effect of Transcutaneous Electrical Nerve Stimulation on Pain and Pulmonary Function with Post-lobectomy Patient with Lung Cancer (경피적 전기신경자극이 폐암 환자의 폐엽절제술 후 통증과 폐기능에 미치는 효과)

  • Jeon, Hyun-Rye;Park, Jeong-Sook
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.519-528
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    • 2009
  • Purpose: This study was designed to evaluate the effect of TENS on pain and pulmonary function of post-lobectomy patients with lung cancer. Methods: The study data collection was done from February 4, 2008 to February 7, 2009. The subjects were assigned at random to the experimental group and control group with 20 subjects in each group. The experimental group was measured for pain and pulmonary function after surgery and then again after applying TENS 100 Hz frequency and 40 mA output for 20 minutes. The control group was measured the same as the experimental group except applying sham TENS. Results: The pain score of the experimental group which had TENS applied revealed that there were more significant reductions than the control group which had sham TENS applied. There was no significant difference with the number of times of receiving analgesics between the experimental and control group. The effect of TENS on pulmonary function was significantly different between the experimental group and the control group on VC 2 hours after surgery. There was no significant difference between FVC and FEV1. Conclusion: The findings of the study indicate that the TENS is effective in easing the pain of patients after a lobectomy.

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Safe Sedation and Hypnosis using Dexmedetomidine for Minimally Invasive Spine Surgery in a Prone Position

  • Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.313-320
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    • 2014
  • Dexmedetomidine, an imidazoline compound, is a highly selective ${\alpha}_2$-adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties. In order to minimize the patients' pain and anxiety during minimally invasive spine surgery (MISS) when compared to conventional surgery under general anesthesia, an adequate conscious sedation (CS) or monitored anesthetic care (MAC) should be provided. Commonly used intravenous sedatives and hypnotics, such as midazolam and propofol, are not suitable for operations in a prone position due to undesired respiratory depression. Dexmedetomidine converges on an endogenous non-rapid eye movement (NREM) sleep-promoting pathway to exert its sedative effects. The great merit of dexmedetomidine for CS or MAC is the ability of the operator to recognize nerve damage during percutaneous endoscopic lumbar discectomy, a representative MISS. However, there are 2 shortcomings for dexmedetomidine in MISS: hypotension/bradycardia and delayed emergence. Its hypotension/bradycardiac effects can be prevented by ketamine intraoperatively. Using atipamezole (an ${\alpha}_2$-adrenoceptor antagonist) might allow doctors to control the rate of recovery from procedural sedation in the future. MAC, with other analgesics such as ketorolac and opioids, creates ideal conditions for MISS. In conclusion, dexmedetomidine provides a favorable surgical condition in patients receiving MISS in a prone position due to its unique properties of conscious sedation followed by unconscious hypnosis with analgesia. However, no respiratory depression occurs based on the dexmedetomidine-related endogenous sleep pathways involves the inhibition of the locus coeruleus in the pons, which facilitates VLPO firing in the anterior hypothalamus.

Sedative and analgesic effects of essential oil of Acorus gramineus Soland in mouse (석청포 정유의 진정 및 진통효과)

  • Jung, Hye-sun;Park, Joon-hyoung
    • Korean Journal of Veterinary Research
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    • v.38 no.4
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    • pp.737-744
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    • 1998
  • The rhizomes of the Acorus gramineus Soland have been used as sedatives, analgesics, stomachics and anthelmintics in chinese medicine. It is known that the rhizomes of the Acorus gramineus Soland contains the essential oil about 0.5~0.8% and this essential oil contains asarone about 86%. The asarone possess many pharmacological properties similar to those of reserpine and chlorpromazine. Sedative and analgesic effects of essential oil of Acorus gramineus Solaad in mouse was observed. The essential oil of Acorus gramineus Soland decreased the frequency of ambulation on mouse in proportion of concentration. ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride) were markedly decreased in frequency of ambulation. The essential oil of Acorus gramineus Soland decreased writhing syndrome in mouse and ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride), opioids receptor antagonist(naloxone hydrochloride) were not increased above effects. In conclusion, these experimental results show that the essential oil of Acorus gramineus Soland have sedative and analgesic effects, but it did not antagonized ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride).

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Analysis on emergency care to the patients with acute myocardial infarction in pre-hospital and in-hospital phase (급성심근경색증 환자에 대한 병원 전 단계와 병원 단계에서의 응급처치 분석)

  • Lee, Han-Na;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.1
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    • pp.21-39
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    • 2013
  • Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

Four Clinical Cases of Tension-Type Headache Patients Treated with Different Types of Korean Medicine, including Gunoe-tang (구뇌탕(救腦湯)을 비롯한 한의치료로 호전된 긴장형 두통 환자 증례 보고 4례)

  • Shin, Ji-hye;Cho, Yoon-young;Baik, Tai-hyeun;Park, Hae-mo;Sun, Seung-ho
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.195-200
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    • 2017
  • Objectives: The purpose of this case report is to describe the effect of Korean medicine therapy on patients with tension-type headaches. Methods: This study consisted of four patients with tension-type headaches. The patients were treated with Korean medicine therapies, such as herbal medicine (Gunoe-tang), acupuncture, and cupping, in addition to physical therapy. None of the patients took any analgesics during the admission period. To evaluate the effects of the treatment, the Numeric Rating Scale (NRS) for headaches was used. Results: After the treatment, the patients' complaints decreased, as shown by the results of the NRS. Conclusion: Treatment with Korean medicine may ameliorate tension-type headaches.

The Effect of Pre-Operative Patient Controlled Analgesia Education on Elderly Patients with Total Knee Arthroplasty (슬관절 전치술 노인 환자의 수술 전 자가통증조절기 사용 교육이 수술 후 환자에게 미치는 효과)

  • Shim, Joohee;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.318-325
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    • 2014
  • Purpose: The purpose of this study was to investigate the effects of preoperative patient controlled analgesia (PCA) education on total knee replacement arthroplasty (TKRA) patients' PCA usage, level of pain, the frequency of pro re nata (prn) administrations, number of ambulations/day and continuous passive motion (CPM) angle after TKRA. Methods: This research used the non-equivalent control group pre-test and post-test design. Forty-five TKRA patients at a hospital in Seoul, Korea were included for in the study. For the experimental group, a 20-minute education session was provided a day before surgery. Data were analyzed using Windows SPSS Statistics 21.0 program. Results: Knowledge was higher in the experimental group than in the control group (p<.001). Incidence of nausea was lower in the experimental group (p=.01). No significant differences were found in post-operative pain scores, the frequency of prn analgesics administrations, dizziness, number of ambulations/day and CPM angle. Conclusion: This study showed that pre-operative PCA education could be an effective nursing intervention for increasing patient knowledge on PCA and nausea reduction after TKRA.