• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.296-302
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• 2016

Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.183-191
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• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.448-450
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• 2014

Nefopam, a centrally acting analgesic, has been used to control postoperative pain. Reported adverse effects are anticholinergic, cardiovascular or neuropsychiatric. Neurologic adverse reactions to nefopam are confusion, hallucinations, delirium and convulsions. There are several reports about fatal convulsive seizures, presumably related to nefopam. A 71-year-old man was admitted for surgery for a lumbar spinal stenosis. He was administered intravenous analgesics : ketorolac, tramadol, orphenadrine citrate and nefopam HCl. His back pain was so severe that he hardly slept for several days; he even needed morphine and pethidine. At 4 days of administration of intravenous analgesics, the patient suddenly started generalized tonic-clonic seizures for 15 seconds, and subsequently, status epilepticus; these were not responsive to phenytoin and midazolam. After 3 days of barbiturate coma therapy the seizures were controlled. Convulsive seizures related to nefopam appear as focal, generalized, myoclonic types, or status epilepticus, and are not dose-related manifestations. In our case, the possibility of convulsions caused by other drugs or the misuse of drugs was considered. However, we first identified the introduced drugs and excluded the possibility of an accidental misuse of other drugs. Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam.

• Journal of Korean Critical Care Nursing
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• v.5 no.2
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• pp.28-36
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• 2012

Purpose: The purpose of this study was to examine the effects of the systematic breathing exercise program on recovery of patients with pneumothorax. Methods: An nonequivalent interrupted time-series control group posttest design was used. Participants were 40 inpatients (Experimental Group; 20, Control Group; 20) at the one University Hospital in U city. The systematic breathing exercise program including education on deep breathing exercise using incentive spirometry, Range of motion (ROM) exercise in shoulder joint, walking exercise and feedback were provided to the experimental group, while the control group carried out deep breathing exercise using incentive spirometry. The duration of chest tube insertion, duration of hospitalization, and frequency of analgesics use were measured. The data were analysed by a SPSS/WIN program. Results: The duration of chest tube insertion and duration of hospitalization in the experimental group were significantly shorter than the control group. However, there is no difference of the frequency of analgesics use between the experimental group and control group. Conclusion: The result showed that the systematic breathing exercise program was effective to improve recovery of patients with pneumothorax. This program can be applied in hospitals for patients with pneumothorax as one of the nursing intervention modalities.

• Asian Oncology Nursing
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• v.12 no.2
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• pp.147-155
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• 2012

Purpose: The purpose of this study was to compare and check the levels of cancer pain management knowledge and awareness between doctors and nurses in a tertiary hospital and to develop an intervention program. Methods: Participants were 725 nurses and 95 doctors working in a hospital from May 2 to 29, 2009. Data were analyzed using t-tests, ${\chi}^2$-tests, and ANOVA with SPSS WIN 18.0. Results: In a comparison of the pain management score, nurses showed significant results for age (p<.001), carrier (p<.001), education (p<.001), workplace (p<.001), and doctors showed significant results only for age (p=.032). Doctors' marks were significantly higher than nurses' in pain management scores (p<.001). Knowledge about analgesic medication (t=-5.38, p<.001) and analgesic drug effect (t=-8.59, p<.001) were significantly different in the pain management subcategory score between nurses and doctors. There were four items with different awareness levels related to analgesics between nurses and doctors. Conclusion: The findings of this study demonstrate that it is possible to develop pain education content for nurses and doctors. The findings of this study are useful when seeking to change the awareness level of a medical team regarding opioid analgesics.

• Women's Health Nursing
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• v.8 no.1
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• pp.85-95
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• 2002

This study was undertaken to obtain the incidence of dysmenorrhea and differance of dysmenorrhea according to the general characteristics, lifestyle, and menstrual pattern in women community college students. For the data collection, self-administered questionnaire survey was made from April 7, 1999 to April 14, 1999 among the 204 women community college students. The resultant data were processed by SAS program for frequency, proportion, and Chi-square test. The results of this study are as follows ; 1) Prevalence rate of dysmenorrhea was 81.9%. Among women who had dysmenorrhea, 42.6% of them had family history on dysmenorrhea, 47% of them experienced the dysmenorrhea 'monthly', 89.2% of them had experienced dysmenorrhea on the first-second day, 38.5% of them responded that the most painful region was 'low abdomen', 61.5% of them responded that they used 'analgesics' to soothe dysmenorrhea, 92.3% of them responded that they had analgesics without doctor's prescription, and 42.6% of them responded that they experienced digestive system related symptoms during menstrual period. 2) The incidence of dysmenorrhea was significantly different by ordering of sisters, blood type, and body shape. 3) The incidence of dysmenorrhea was no significantly different by life style. 4) The incidence of dysmenorrhea was no significantly different by menstrual pattern.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.247-252
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• 1998

Background: Tonsillectomy is one of the most common operation in children. Postoperative pain and its sequelae are universal complaints of the patients. The purpose of this study was to evaluate the effects of nalbuphine on the posttonsillectomy pain in children. Methods: Fifty-four pediatric patients undergoing tonsillectomy under general anesthesia were randomly allocated to one of the 3 groups 1) control group who received no analgesics, 2) received IV nalbuphine before induction of anesthesia and 3) received IV nalbuphine after both tonsillectomy. In postanesthetic recovery room, comfort level in all patients was assessed using the objective pain scale (OPS). Systolic blood pressure, diastolic blood pressure and heart rate were measured at just before and immediately after extubation and postanesthetic recovery room. Results: The pain scale score in group 2 was significantly lower than group 1, but no significantly different with group 3. There were no significant differences in blood pressure among three groups. The heart rate in group 2 and 3 was significantly lower than group 1 only at immediately after arriving recovery room. Conclusions: Administration of nalbuphine before induction is more effective on postoperative pain control after tonsillectomy in children.

• The Korean Journal of Pain
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• v.23 no.3
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• pp.207-210
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• 2010

Fabry disease is an X-linked lysosomal disease caused by deficiency of ${\alpha}$-galactosidase, in which early diagnosis may be missed due to the wide variety of clinical symptoms presenting during disease progression. A 13 year-old boy visited our pain clinic complaining of pricking and burning pain in the toe tips of both feet. Continuous epidural infusion for pain management was performed because of oral analgesics ineffectiveness. The patient underwent ${\alpha}$-galactosidase A (GLA) enzyme analysis based on the clinical impression of Fabry disease from pain with a peripheral neuropathic component and history of anhidrosis. He was diagnosed with Fabry disease after confirming mutation of the GLA gene through a screening test of GLA activity. Enzyme replacement therapy was initiated and pain was tolerated with oral analgesics.

• Journal of Korean Academy of Nursing
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• v.14 no.1
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• pp.60-68
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• 1984

The main purpose of this study is to observe patterns of pain of surgical patients following surgery The postoperative pain was checked with the interval of every 2 hours from 6 hours to 80 hours after surgery. Graphic rating scale from unidimensional concept of pain and sensory intensity scale and unpleasantness scale from two dimensional concept of pain were used for pain measurement. Thirty two patients were participated in this study in which 22 were undergone upper abdominal surgery, 7 thyroid or neck surgery and 3 other surgeries. The findings obtained from this study were as follows: 1) In all cases of using 3 different pain measurement tools, postoperative pain was markedly decreased since 36 hours after surgery. In case of patient's less cooperation, either sensory intensity scale or graphic rating scale may be chosen for the measurement of pain. 2) Pain amounts measured by sensory intensity scale were highly correlated with those measured by unpleasantness scale in all situations except several situations having few cases included. Unpleasantness scale may be separately used for themeasurement of affective response due to pain. 3) Almost 90% of total amount of analgesics used for relief of pain were used within 36 hours after surgery. 4) Mean frequency of analgesics used by every patient during 80 hours following surgery was 0.84.