• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.1
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• pp.6-13
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• 2003

Purpose: A survey was done on knowledge of pain and pain interventions by clinical nurses in Deagu city and Kyoungbuk province. Method: The participants in this study were 209 nurses who worked in Daegu city, and 190 nurses who worked in Kyoungbuk province. The data were collected from August 5, to September 15, 2002. The data were analyzed with SPSS WIN 10.0 program using numbers, percentages, averages and standard deviation with t-test and ANOVA. Result: Out of a total of 30 points on general knowledge of pain, the clinical nurses had a high score of 28, and a low of 10. The average was 18.6 (SD=3.14). Of the participants, 57.9% reported not having had any pain education and 67.9% agreed that education is a necessity. Of pharmacological interventions, Tylenol had the highest score at 3.44 out of a possible 4 points. The most frequent route for giving medication was intramuscular injection (42.6%) and for 62.7%, there was a decision by the physician for routine medication or prn. On reactions after medication, moderate relief had the highest frequency (41.9%), and for side effects after the medication, feeling of nausea was most frequent (70.4%). Of the nonpharmacological approaches to pain relief, ice bag had the highest score with 2.95 out of a possible 4. Judgement to give medication was made by the nurse for 50.1% of the participants and 647% reported a little relief from pain. Conclusion: Based upon the results, continuing education and developing a better education programs (including pain mechanism, pain assessment, pharmacological interventions and nonpharmacological interventions) are needed for systematic pain management. Nurses need a high level of knowledge of pain, to be active in pharmacological interventions and nonpharmacological interventions.

• The Korean Journal of Pain
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• v.2 no.2
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• pp.189-193
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• 1989

The analgesic effects of epidural morphine were evaluated on various types of cancer-related pain in forty-eight adult patients. Epidural morphine injections were given via an epidural catheter introduced to an epidural level corresponding to the pain area. Pain relief was classified as excellent, fair, or poor by subjective scoring and by the subsequent need for systemic analgesics. Thirty-two patients of all the patients became pain-free. In sixteen patients, pain relief was complete only for one or two of various types of pain with a certain dose of epidural morphine, The best result was obtained when the pain was continuous and originated from deep somatic structures. Based on the results, the ranking order of different types of cancer pain with regard to their susceptibility to epidural morphine was as follows: 1) Continuous somatic pain 2) Continuous visceral pain 3) Intermittent somatic pain 4) Intermittent visceral pain The differential effects of epidural morphine on cancer-related pain may suggest that various types of noxious stimuli involve different kinds of opioid receptors which differ in affinity to morphine, and that there are some pain-mediating systems which function independently of opioid mechanisms.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.229-231
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• 1996

Spinal cord stimulation(SCS) was first attempted to relieve intractable pain in 1966. SCS has evolved into percutaneously implanted electrode with aim of activating spinal pain-inhibiting mechanism via dorsal columns. SCS is valuable for the treatment of many painful and difficult to treat conditions such as postamputation pain, painful peripheral neuropathies, chronic sciatic pain and so on. We treated a case of causalgia of the right lower extremity with successful outcome of 90% sustained relief of pain. And patient has satisfied using SCS(Model MNR-94, Neuromed) for 6 months follow-up.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.136-139
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• 1999

Bertolloti syndrome is the association between low back pain (LBP) and the presence of a lumbosacral transitional vertebrae. A transitional vertebrae is composed of one or both transverse process connecting with the sacrum or ilium and the presence of a vestigial intervertebral disc space caudal to the transitional vertebrae. We experienced a case of low back pain with intermittent radiating pain in patient with complete lumbosacral sacralization. Long term relief of low back pain was maintained with intra and/or periarticular infiltration of local anesthetics and steroid. The relief of LBP suggests a correlation between LBP and lumbosacral sacralization.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.153-157
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• 2016

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.214-217
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• 2001

Background: Intra-articular injection is a commonly performed procedure in patients with degenerative osteoarthritis of the knee. Several drugs are used for relief of pain in such cases. Local anesthetics, clonidine and steroids have been confirmed to be effective when used in an intra-articular injection. Ketorolac has recently become one of the most commonly used and potent NSAIDs. There have been many studies about the effect of ketorolac. Methods: Sixty-four patients were divided into 2 groups. In Group I (n = 31), 0.5% bupivacaine 3 ml and sodium hyaluronate 20 mg were used and in Group II (n = 33), 0.5% bupivacaine 3 ml, sodium hyaluronate 20 mg and ketorolac 5 mg were used. We observed the pain relief scale (PRS) at 15 minutes, 1 week and 1-3 months after injection. Results: After 15 minutes, PRS scores were $6.6{\pm}2.7$ (Group I) and $5.1{\pm}3.1$ (Group II), so there was a statistical difference between the two groups. After 1 week, the PRS scores were $5.9{\pm}2.0$ (Group I) and $5.8{\pm}2.4$ (Group II). At 1-3 months later, PRS scores were $5.6{\pm}3.0$ (Group I) and $5.1{\pm}2.7$ (Group II). Thus, there were no significant statistical differences between the two groups at 1 week or 1-3 months later, although some patients were more satisfied with pain relief in Group II at 1-3 months. Conclusions: Ketorolac provides more rapid pain relief of degenerative arthritis when used in intra-articular injection. And there was no statistical difference of effect after 1 week or 1-3 months later. Further studies are required on the effect of the intra-articular use of ketorolac.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.105-110
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• 2000

Central neuropathic pain may occur in 10~20% of the patients after spinal cord injury. The central pain syndrome include spontaneous continuing and intermittent pain as well as evoked pain. The pain is evoked by non-noxious stimulation of the region (allodynia) and repeated stimulation (wind-up phenomenon). Four patients were referred suffering from severe pain, allodynia and hyperaesthesia after spinal cord injury. They had received conventional treatment with non-steroidal anti-inflammatory drugs, steroid, anticonvulsant, antidepressant and rehabilitation which failed to provide pain relief. We administered combination of low doses of morphine and ketamine (10 mg) through the epidural catheter with other conventional therapy. Satisfactory pain relief was achieved in each patient. The reduction of pain was not associated with severe side effects. The most bothersome side effect of ketamine was dizziness in one patient, only caused by bolus injection (ketamine 10 mg with normal saline 10 ml). This suggests synergy from this combination that provides an alternative treatment for central pain.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.2
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• pp.171-177
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• 2008

Purpose: The aim of study was to identify the effects of exercise on the relief of low back pain in patients on absolute bed rest after TAE. Method: A nonequivalent control group pretest-posttest design research design was used. The participants were 43 patients who had received TAE in a university hospital; patients in the experimental group (21) received both exercise therapy and general post-op nursing care and in the control group (22) only the latter. The exercise program used in this study was modified from exercise for post CABG to exercise for post TAE, which deflect the movement of thigh in which the catheter was inserted, the lumbar region of the back and pelvis. Results: First, Low back pain scores in the experimental group were lower than the control group. Second, The first dose of analgesics in the experimental group was delayed compared to the control group. Third, There was no significant difference in bleeding complications between the experimental group control groups. Conclusion: The results suggest that the exercise program used in this study is effective for relief of low back pain in patients on absolute bed rest after TAE.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.781-786
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• 1993

Effrctive analgesia after elective thoracotomy can be provided by continuous extrapleural intercostal nerve block.This study was designed to prove the effectiveness of continuous extrapleural intercostal nerve block. Twenty patients undergoing elective thoracotomy were randomized into two groups. Group I received lumbar epidural block[N=10] and group II received continuous extrapleural intercostal nerve block[N=10]. Postoperative pain relief was assessed on Numeric Rating Scale[NRS] and recovery of pulmonary function was assessed by coparison of preoperatrive and postoperative FVC[Forced Vital Capacity], FEV1[Forced expiratory Volume in 1 second], VC[Vital Capacity]. Arterial blood gas analysis[ABGA], vital signs and amount of additive analgesics were compared also. No significant difference was observed between the groups concerning these parameters mentioned above. Systemic complications, such as urinary retention[2/10] and weakness of lower extremity[2/10], occurred in group I but no complication occurred in group II. We conclude that continuous extrapleural intercostal nerve block is as effective as epidural block in pain relief and restoration of pulmonary mechanics with fewer comlications. Also because of it`s ease and safetiness, this must be considered as a substitute of epidural block in routine use for thoracotomy pain relief.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.22-31
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• 2015

Background: The celiac plexus and splanchnic nerves are targets for neurolytic blocks for pain relief from pain caused by upper gastrointestinal tumors. Therefore, we investigated the analgesic effect of a celiac plexus block versus a splanchnic nerve block and the effects of these blocks on the quality of life six months post-intervention for patients with upper GIT tumors. Methods: Seventy-nine patients with inoperable upper GIT tumors and with severe uncontrolled visceral pain were randomized into two groups. These were Group I, for whom a celiac plexus block was used with a bilateral needle retrocrural technique, and Group II, for whom a splanchnic nerve block with a bilateral needle technique was used. The visual analogue scale for pain (0 to 100), the quality of life via the QLQ-C30 questionnaire, and survival rates were assessed. Results: Pain scores were comparable in both groups in the first week after the block. Significantly more patients retained good analgesia with tramadol in the splanchnic group from 16 weeks onwards (P = 0.005, 0.001, 0.005, 0.001, 0.01). Social and cognitive scales improved significantly from the second week onwards in the splanchnic group. Survival of both groups was comparable. Conclusions: The results of this study demonstrate that the efficacy of the splanchnic nerve block technique appears to be clinically comparable to a celiac block. All statistically significant differences are of little clinical value.