• Journal of the Korean Data and Information Science Society
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• 제27권1호
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• pp.203-215
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• 2016

신생아는 통증을 충분히 지각할 수 있는 해부학적 신경구조를 갖추고 있으며, 출생초기 통증경험은 이후 통증자극 경험 시 통증에 대한 민감도를 증가시켜 장기적인 신경해부학적, 행동적 후유증을 동반한다. 따라서 신생아기 통증관리는 신생아 간호의 주요 쟁점이 되고 있다. 본 연구는 진정효과가 있는 것으로 알려진 모유를 이용하여 통증이 동반되는 발뒤꿈치 천자 시 모유경구투여가 신생아의 통증완화에 미치는 효과를 검증함으로써 안전하고 효과적인 신생아 통증관리 중재에 대한 근거를 제시하고자 실시하였다. 연구결과 모유경구투여는 통증을 수반하는 간단한 처치 시 신생아의 통증을 완화시켜 주는데 효과가 있음을 확인할 수 있었다. 본 연구 결과는 모유의 통증완화 효과에 대한 경험적 근거를 제시함으로써 간호 실무에서 통증완화 중재로 널리 활용할 수 있는 계기를 마련한 점에서 의의가 있다. 추후 반복연구를 통한 경험적 근거의 축적과 더불어, 모유경구투여 중재가 독자적 간호중재로서 간호 실무에 적극 활용될 것을 기대하는 바이다.

• 동의신경정신과학회지
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• 제19권1호
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• pp.1-18
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• 2008

The purpose of this research is to examine the effect of Simjeongkyeok Sa-am acupuncture treatment for major symptoms of Hwa-byung. Method : In this randomized, single blind, placebo-controlled study, we compared Simjeongkyeok acupuncture with Sham acupuncture in the treatment for major symptoms of Hwa-byung. Likert scale for major symptom of Hwa-byung was measured as the 1st evaluative instrument, and STAXI-K, STAI-K, BDI-K and HRV were also measured as the 2nd evaluative instrument at the before treatment and after treatment. Results : In comparison of Likert scale for major symptoms, total score of after treatment decreased significantly at each point on both groups, but there was no significant difference between both groups. In comparison of STAXI-K, STAI-K, BDI-K, there was no significant difference in variation of score between both groups. But Simjeongkyeok group showed higher ratio variation of STAXI expression than that of Sham group, Also on subjects whose main complaint symptom were burning sensation and whose pattern identification were Qizhi, Simjeongkyeok group showed higher variation of Likert scale score and BDI-K than that of Sham group. The significance was border line around. Conclusion : We considered that Shimjeongkeok treatment will he likely to he recommended for treating Hwa-byung, especially on subjects in each group whose main complaint symptom were burning sensation or whose pattern identification were Qizhi. Also it may also be effective on the management of anger expression.

• 동의신경정신과학회지
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• 제19권1호
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• pp.107-124
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• 2008

We investigated the effects of distilled Astragali Radix Herbal Acupuncture on autonomic nervous system with the Heart Rate Variability(HRV) in adult man. as well as we tried to observe how distilled Astragali Radix Herbal Acupuncture on the balance of the autonomic nervous system. Methods : We investigated on 61 healthy volunteers consisted of 31 subjects in experiment(distilled Astragali Radix Herbal Acupuncture) group and 30 subjects in control(Normal Saline) group. Study form was a randomized, placebo-controlled, double-blind clinical trial. 31 subjects in experiment group were injected distilled Astragali Radix Herbal Acupuncture at GB21(Kyonjong) and 30 subjects in control group were injected Normal Saline at GB21(Kyonjong). except of 2 subjects(in control group) who can't be measured and 10 subjects(6 in experiment group and 4 in control group) who move or make unforceable error during measuring. Finally 25 subject in experiment group and 24 subject in control group are studied. We measured HRV by PolyG-I on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 10.0 for windows was used to analyze the data and the paired t test(in group) and Student t test(between two groups) were used to verify the result. Results : I. After distilled Astragali Radix Herbal Acupuncture injection, SDNN is significantly high from 5 minute to 10 minute and from 15 minute to 30 minute, Complexity is significantly low from 20 minute to 30minute. HRV index is significantly mgb for first 20 minute and from 25 minute to 30 minute, RMSSD is significantly high only from 15 minute to 20 minute. 2. HRV index of distilled Astragali Radix Herbal Acupuncture Group significantly increased from 25 minute to 30 minute, pNN50 of distilled Astragali Radix Herbal Acupuncture Group significantly decreased from 25 minute to 30 minute and RMSSD of distilled Astragali Radix Herbal Acupuncture Group significantly increased from 25 minute to 30 minute compared with those of Normal Saline group. 3. After distilled Astragali Radix Herbal Acupuncture injection, Ln(TP) is significantly high from 5 minute to 10 minute and from 15 minute to 30 minute. Ln(VLF) is significantly high after 5 minute, Ln(LF) is significantly high after 15 minute and Ln(HF) is significantly high from 5 minute to 10 minute and 25 minute to 30 minute, but significantly low for first 5 minute and from 10 minute to 20 minute. Normalized LF is significantly high after 20 minute and Normalized LF is significantly low after 20 minute. Conclusions : The results suggest that distilled Astragali Radix Herbal Acupuncture in healthy adult man tend to activate the autonomic nervous system within normal range. This result is derived from that parasympathetic nervous system was continuously activated and sympathetic nervous system was activated a little later.

• 치위생과학회지
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• 제12권6호
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• pp.660-665
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• 2012

본 연구는 회전법과 변형 스틸맨법간의 치면세균막 감소효과를 비교하기 위하여 천안 소재 대학교 31명의 대학생을 대상으로 무작위 배정한 순수실험을 설계하여 치면세균막 관리프로그램을 시행한 결과 다음과 같은 결과를 얻었다. 1. 중재 전후에 따른 각 잇솔질의 치면세균막 관리를 비교한 결과 중재 전에 측정한 SPS Score와 ${\Delta}R30$에서 두 잇솔질 방법간의 차이는 나타났으나(p<0.05), 나머지 측정값들과 중재 후의 측정값에서 유의한 관련성을 보이지 않았다(p>0.05). 2. 각 잇솔질 방법에 따른 중재 전 후의 치면세균막 관리를 비교한 결과 PCR, QLF-PCR, ${\Delta}R30$, ${\Delta}R60$에서 회전법과 변형 스틸맨법 집단은 통계적으로 유의한 차이가 있었다(p<0.05). 또한, 회전법보다 변형 스틸맨법 집단에서 치면세균막 지수는 더 큰 감소를 보였고, 잇솔질 교육 중재를 실행한 후 치면세균막 지수가 감소하는 것으로 나타났다. 3. PCR과 QLFD 촬영 측정값의 관계에서 PCR과 육안검사 QLF-PCR의 관계, SPS Score와 그 하위 척도 ${\Delta}R$값들의 상관관계는 보였으나, PCR와 QLF값의 상관관계는 보이지 않았다. 이상의 결과를 종합해보면, 회전법과 변형스틸맨법의 치면세균막 관리 효과는 통계적으로 유의하지 않았으나, 회전법보다 변형 스틸맨법 집단에서 치면세균막 감소차이는 더 큰 것으로 확인되었고, 잇솔질 교육을 실행함으로써 치면세균막 지수가 감소하는 것으로 나타났다.

• 대한한방부인과학회지
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• 제20권3호
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• pp.200-212
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• 2007

Purpose: To find objective validity of minimal acupuncture using a modified guide tube as a method to verify the effect of acupuncture. Methods: Subjects of this study were participants of a randomized clinical trial which was practiced to verify the effect of acupuncture on postmenopausal hot flash. There were 2 arms of treatment, one's for active acupuncture group(AG) with manipulation and De qi, the other's for minimal acupuncture group(MG) using a modified guide tube which was designed to give minimal stimulation to the patient. After 8 weeks' treatment followed by 4 weeks' observation, participants were asked to fill in self-report forms on their education, previous experiences of acupuncture, original idea on the efficacy of acupuncture and recognition of blinding. Results: 19 participants of 26 in AG and 19 of 26 in MG completed the self-report form. There was no difference between AG and MG in their education(p=0.5976, Fisher exact test) and previous experiences of acupuncture(p=0.9999, Fisher exact test). In their original ideas on the efficacy of acupuncture, most of AG and MG respondents have been thought that acupuncture is very effective or quite effective, and there was no difference between 2 groups(p=0.5065). 16 of 19 in AG and 14 of 19 in MG believed that they underwent more effective way, there was no statistical difference between 2 groups(p=0.6928, Fisher exact test). Participants believed in undergoing more effective way not because they recognized treatment method, but they were satisfied with the effectiveness of treatment retrospectively. Conclusion: As the result of this study, these authors suggest that minimal acupuncture using a modified guide tube is acceptable as a method to verify the effect of acupuncture in acupuncture-familiar Korean culture. Also further studies on the stimulation-specific effect of minimal acupuncture are demanded.

• The Korean Journal of Pain
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• 제34권1호
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• pp.106-113
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• 2021

Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

• 대한한의학방제학회지
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• 제30권1호
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• pp.27-36
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• 2022

장미색 비강진 환자에게 방풍통성산(防風通聖散)을 투여하여 증상의 호전과 치료의 안전성을 확인할 수 있었다. 소양감이 심하여 일상에 영향을 받는 등 치료가 필요한 상황이었고, 앞선 스테로이드 치료에는 반응하지 않았지만 한약 복용 후 소양감 및 피부 증상의 뚜렷한 개선을 보였다. 기존의 연구 보고를 근거로 방풍통성산(防風通聖散)이 소염 및 해열작용을 통해 피부 질환에서 유효한 효과를 갖는 것으로 보이고, 이로써 장미색 비강진에서 치료 효과를 발휘한 것으로 사료된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.339-348
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• 2022

Background: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) (1.7 ml) versus intraligamentary (IL) injection containing 0.4 ml of 4% articaine with 1:100.000 epinephrine after an inferior alveolar nerve block (IANB) with 1.7 ml 2% lidocaine in the first and second mandibular molars diagnosed with irreversible pulpitis (IP). Methods: One hundred subjects diagnosed with IP of either the mandibular first (n = 50) or second molars (n = 50) and failed profound anesthesia following an IANB were selected. They randomly received either the IL or BI techniques of anesthesia. Pain scores on a 170 mm Heft-Parker visual analog scale were recorded initially, before, and during supplemental injections. Furthermore, pulse rate was measured before and after each supplemental injection. During the access cavity preparation and initial filing, no or mild pain was assumed to indicate anesthetic success. The chi-square test, Mann-Whitney U test, and independent samples t-test were used for the analyses. Results: The overall success rates were 80% in the IL group and 74% in the BI group, with no significant difference (P = 0.63). In the first molars, there was no significant difference between the two techniques (P = 0.088). In the second molars, IL injection resulted in a significantly higher success rate (P = 0.017) than BI. IL injection was statistically more successful (P = 0.034) in the second molars (92%) than in the first molars (68%). However, BI was significantly more successful (P = 0.047) in the first molars (88%) than in the second molars (64%). The mean pulse rate increase was significantly higher in the IL group than in the BI group (P < 0.001). Conclusions: Both the IL and BI techniques were advantageous when used as supplemental injections. However, more favorable outcomes were observed when the second molars received IL injection and the first molars received BI.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.217-226
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• 2022

Background: Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Methods: Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). Results: The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. Conclusion: The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.