• 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.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.54-58
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• 1999

Background: We studied 150 patients who received intravenous patient controlled analgesia (PCA) after total abdominal hysterectomy to evaluate pain relief, analgesic consumption, patient's satisfaction and side effects. Methods: We made total 40 ml of analgesic mixture with morphine 40 mg, ketorolac 120 mg, droperidol 3 mg and normal saline. Loading/bolus/basal infusion dose and lockout interval was 2 ml, 1.5 ml, 0.5 ml/hr and 10 min, respectively. Numerical rating scale (NRS) pain score, cumulative analgesic consumption, degree of satisfaction, and incidence of side effects were evaluated. Also, correlation of age and edu ion with analgesic consumption were evaluated. Results: The average pain scores using NRS were $3.1{\pm}1.7$ (6 h), $2.1{\pm}1.5$ (24 h), $1.7{\pm}1.5$ (48 h). The average cumulative analgesic consumption were $11.7{\pm}5.0$ ml (6 h), $23.0{\pm}6.7$ ml (24 h), $32.1{\pm}3.7$ ml (48 h). The degree of satisfaction in postoperative pain control was good in 94% of patients. There was no correlation between degree of satisfaction and analgesic consumption. Also age and level of edu ion did not correlated with analgesic consumption. Conclusions: Intravenous PCA with morphine, ketorolac, and droperidol is an effective method of postoperative pain control because it provides adequate pain relief and a few side effects with high patient's satisfaction. However, age and level of education did not correlated with analgesic consumption.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.11-21
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• 2015

Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

• Korean Journal of Acupuncture
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• v.23 no.1
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• pp.111-118
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• 2006

Objectives : To test the therapeutic efficacy of acupuncture applied to PC6 and ST36 for the relief of fullness of epigastrium or epigastric pain. Subjects and Methods : We enrolled fifty patients in a case series study The patients were mainly female (94 %) with an average age of 55 years $({\pm}15.0)$; the average age of the male patients was 51 years $({\pm}20.0)$. Twenty four percent of patients were in acute phase which epigastric pain had lasted below 1 month. Twenty eight percent of patients were in chronic phase which the pain had lasted over 6 month. The rest were in subacute phase. Acupuncture needles were inserted into PC6 and ST36 bilaterally. The acupuncture treatments were performed 2 times a week for 4 weeks. One treat session was lasted for 30 min. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 4 scaled questionnaire. Results : After acupuncture treatment, a progressive improvement of pain intensity was reported in 46 of the 50 patients, including 23 of excellent and 23 of good. The progress of symptom was more superior in subacute phase to acute or chronic phase. The symptom of 22 of 24 patients in subacute phase was improved. No patient experienced minor side-effects during acupuncture treatment. Conclusion : These preliminary data suggest the acupuncture treatment provides good pain relief for most patients presenting with epigastric pain. Randomized trials with appropriate control groups are needed to validate the effectiveness of this therapy in the treatment of epigastric pain.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.155-164
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• 2007

This study is aimed at determining the effects of rehabilitation training on lumbar extension strength and relief of back pain in middle-aged women of low back pain. Twenty-nine subjects(total 29 people; CLBP 16, HLD 13) were trained twice per week for eight weeks and completed a maximum isometric test at various flexion angle(the degree of $0^{\circ}$, $12^{\circ}$, $24^{\circ}$, $36^{\icrc}$, $48^{\circ}$, $60^{\circ}$, $72^{\circ}$) by lumbar extension machine. The result showed that. 1. Patient group of CLBP were increased the maximum lumbar extension strength at a range of 7 flexion angles after rehabilitation rather than no rehabilitation(on the average 60.75%). The operated patient group in HLD also showed an increase of 56.55%. In view of these cases, all of two groups showed a significant increase of muscle strength(p<.05). But there is no difference between pre-exercise and post-exercise groups. 2. Patient group of CLBP were increased higher rate than 41% for maximum lumbar extension strength(91.79% at $0^{\circ}$, 79.41% at $12^{\circ}$, 65.89% at $24^{\circ}$) at all angles after 8 weeks training. Both groups indicated a significant increase(p<.05) of lumbar extension strength at all degrees. There is no difference between pre-exercise and post-exercise groups. 3. Relief of back pain in Patient group of CLBP showed a decrease of average 105.2% and patient group of HLD indicated a decrease of average 64.57% two groups showed a significant reduction (p<.05, p<.05). But in case of a decrease of pain, CLBP group got 3.44 points and HLD group got 4.77 points. In view of these results, two groups showed remarkable reduction of back pain, however HLD group had residual pain relatively.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.183-190
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• 2022

Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

• 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.

• The Korean Journal of Pain
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• v.25 no.1
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• pp.52-54
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• 2012

Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

• Women's Health Nursing
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• v.6 no.1
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• pp.46-53
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• 2000

The purpose of this study was to explore the structure of nursing needs during labor pain as perceived by women who have given birth. The phenomenological perspective of qualitative research theory guided the approach to the study. The sample consisted of 20 women who had undergone normal labor and had delivered a healthy baby at term. Collection of data was by means of in-depth interviews conducted 1-2 days after delivery in the admission room from March to may 1998. On average, the interviews lasted for about 30 minutes. Interviews were taken with the consent of the subjects. Data were analyzed by means of Giorgi's method and categorized according to the similarities of their contents. The investigator read the data repeatedly to identify themes and categories. Four categories were : 1) a sense of security 2) self esteem 3) willingness to learn 4) a sense of comfort. Under these categories there were twelve themes. I. A sense of security : (a) presence (b) conversation (c) touching II. Self esteem : (a) praise (b) encouragement (c) treating the women with respect (d) caregiver with good character III. Willingness to learn : (a) teaching (b) information IV. A sense of comfort : (a) self controlled pain relief (b) artificially controlled pain relief (c) skillfulness of caregiver The findings should sensitize nurses to the various needs of women in labor who are under their care. Further research should focus on developing instruments to assess the nursing needs of parturients. Researchers also need to identify ways to assess women's satisfaction with nursing needs.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.426-429
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• 1996

Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.