• Title/Summary/Keyword: 분만통증

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Survey of Recognition in Parturients for Vaginal Delivery Controlled by Epidural Block (경막외차단을 시행 받은 질식분만 산모들의 인식 조사)

  • Jang, Young-Ho;Park, Eun-Ji;Kim, Ae-Ra;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.96-100
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    • 1998
  • Bakground: At our institution, We have controlled pain during vaginal delivery with epidural block since 1986. We designed a questionaire for parturients to analyze the degree of satisfaction of epidural block. Method: The self-questionaire were sent to parturients(N=200), who had epidural block to control labor pain during vaginal delivery. The questionaire covered topics dealing with motivation, fear, satisfaction and complications, of epidural block. Results: Motivation by an experienced person was 72.5%(145 parturients), fear of epidural block was 66%(132 parturients), and satisfactory response was 84%(168 parturients). Parturients who knew the role of anesthesiologist numbered 105(52.5%). Scarcely, 46 parturients displayed confidence for safety of fetus; 111 parturients experienced more than one complications. But special therapy for complications were not necessary. Conclusions: Publicity through mass-media and direct contact will improve the recognition and merit of epidural block by parturients as well as the role of the department of anesthesiology.

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A Study on Back Pain, Pain Disability, and Labour Pain of Postpartum Women (산후여성의 임신중 요통, 요통장애와 분만중 통증에 관한 연구)

  • Shim, Mi-Jung
    • Women's Health Nursing
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    • v.10 no.1
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    • pp.8-14
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    • 2004
  • Purpose: The purpose of this study was to look into back pain, pain disability, labour pain, and related areas of pain experienced by postpartum women. Method: A survey about pain including a Visual Analogue Scale (VAS), Oswestry pain disability, and pain drawing was used in a descriptive research method on 98 women 2-3 days after delivery. Result: 57.1% of those surveyed reported experiencing back pain before pregnancy. 75.5% reported experiencing back pain during pregnancy. The average starting time of back pain for pregnant women was 2.9 months into pregnancy. 48.8% reported the most severe back pain in the last trimester of pregnancy, while most women complained of left and right pubic pain and lumbar area pain during pregnancy. Statistical relations were calculated and menstrual symptoms (F=5.938, p=0.004), back pain prior to pregnancy (F=4.714, p=0.000), back pain during pregnancy (F=-3.429, p=0.001), and back pain disability prior to pregnancy (F=-1.994). Conclusion: There is a relation in postpartum women's back pain between back pain prior to pregnancy and back pain during pregnancy. Pelvic examinations early in pregnancy can determine if back pain will change for the worse or relapse. Therefore, the application of a pain relieving nursing intervention is needed.

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Effects On Labor Pain and Duration of Delivery Time for Primipara Women treated by Hob-Gog(Li-4) Pressure (합곡(合谷 LI-4)지압이 초산부의 분만 통증정도와 소요 시간에 미치는 효과)

  • Kim, Young-Ran;Lee, Sun-Hye;Kang, Jin-Sun;Jung, Geum-Ok;Ju, Young-Ah
    • Women's Health Nursing
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    • v.7 no.3
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    • pp.331-347
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    • 2001
  • The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.

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Effect of Magnetic Field Therapy Applied to Acupuncture Point on Dysmenorrhea Experienced by High School Girls (경혈점에 적용한 자장요법이 여고생의 월경통에 미치는 효과)

  • Jang, Hyun-Jung;Park, Jeong-Eon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7367-7376
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    • 2015
  • This study was investigate the effects of the magnetic field therapy applied to the acupuncture point on dysmenorrhea experienced by high school girls and to verify the possibility to use this therapy as an effective in-home nursing intervention. Data were collected from Feburary to April, 2006. The research procedure was that female students who visited in public health center had to fill in questionnaires with dysmenorrhea Grapic Rating Scale(GRS) and Adjective Labor Pain Rating Scale(ALPRS), the gauge of pain, before participating the experiment. And then each group was tested for 3 hours. Participants before and after applying magnetic treatment filled each questionnaires with dysmenorrhea GRS and ALPRS. The GRS points and ALPRS points in the experimental group, applied by Magnetic Field therapy on acupuncture point is lower than that in the comparison group. The above result has proved that the magnetic field therapy on acupuncture has an effect on the pain alleviation of dysmenorrhea of female students in high school. Therefore, propose this therapy to dysmenorrhea of female students. In this research, ALPRS indicated validity on dysmenorrhea, so for verifying validity, further research is necessary.

The Analgesic Efficacy and Side Effects of Subarachnoid Sufentanil-Bupivacaine on Parturients in Advanced Labor (지주막하강 수펜타닐과 뷰피바케인의 혼합 투여가 분만 제 1 기 산모의 진통 효과에 미치는 영향)

  • Han, Tae-Hyung;Cho, Yong-Sang
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.21-27
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    • 1997
  • Background : Previous studies have proven beneficial in labor analgesia to use subarachnoid sufentanil(alone or with adjuvant) on parturients in early first stage of labor. We designed this prospective study to evaluate analgesic efficacy and side effects of subarachnoid sufentanil plus bupivacaine in women with cervical dilatation of 7 cm greater. Methods : This was an open-label, nonrandomized trial of 32 parturients in late first stage labor who requested labor analgesia. After signing the consent form each patient received subarachnoid sufentanil (10 ${\mu}g$) and bupivacaine (2.5 mg). Patients were asked to rate their verbal pain score (0-10 scale) before regional anesthesia and 5 minutes after subarachnoid injection, and every 20 minutes thereafter until delivery or request for additional analgesia. Blood pressure, pruritus, Bromage motor block score, mode of delivery and need for supplemental analgesics were recorded. Results : Thirty women were included in the study. Mean pain scores (mean${\pm}$SD) were $8.7{\pm}1.0$ pre-spinal, $0.7{\pm}1.5$ 5 minutes post-injection, and remained less than 5 for 130 minutes after spinal injection. Of 30 patients, 24 had unassisted vaginal delivery, 4 instrumental vaginal delivery (vacuum), and 2 cesarean delivery. Of 28 patients who delivered vaginally, 19 did not require supplemental analgesics and had a delivery pain score of 5 or lower. Blood pressure decreased in three patients after spinal analgesia (p<0.05), which necessitated treatment. The Bromage motor block score was 0 in 26 patients and 1 in 4 patients. Pruritus was noted in 22 patients. Conclusion : Subarachnoid sufentanil-bupivacaine provides rapid analgesia for an effective duration of approximately 130 minutes in parturients in late first stage of labor.

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Comparison of Analgesic Efficacy and Shortening of Labor Duration between $L_{1-2}$ and $L_{3-4}$ Epidural Blocks in Nulliparous Normal Vaginal Delivery (초산모에서 경막외 $L_{1-2}$$L_{3-4}$ 차단 시 제통효과와 분만기간의 비교)

  • Kang, Kyu-Sik;Lee, Sang-Yoon;Kim, Jung-Soon;Nam, Kae-Hyun;Park, Wook
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.61-67
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    • 2001
  • Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

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A Case of Rectus Sheath Hematoma and Intraperitoneal Hematoma Induced by Cough (기침으로 유발된 복직근초 혈종 및 복강내 혈종 1예)

  • Jeong, Hae Bin;Kang, Hyeon Hui;Im, Eun Joo;Kim, Hyun Gyung;Lee, Su Yeon;Maeng, Il Ho;Lee, Ji Myoung;Jang, Eun Hee;Lee, Sang Haak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.212-215
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    • 2008
  • Rectus sheath hematoma (RSH) is a rare condition that's caused by a sudden disruption of the deep epigastric vessels or direct damage to the rectus abdominis muscle. This condition is associated with old age, childbirth, abdominal surgery, severe cough, severe sneezing, anticoagulation therapy and/or coagulation disorders. RSH is characterized by abdominal pain and an abdominal mass, so that this is often misdiagnosed as a surgical condition such as appendicitis, intraabdominal abscess, torsion of the ovary and ruptured abdominal aortic aneurysm; this can lead to unnecessary surgery. Thus, we have to be cautious not to miss RSH when a patient with predisposing factors is suffered from abdominal pain and an abdominal mass. We report here on a case of rectus sheath hematoma that was induced by severe cough in a patient who was taking warfarin.