• Title/Summary/Keyword: 통증조절

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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A Study on the Hull-dimension of 89 ton class Stow-net Vessel with Stern-fishing (89톤급 선미식 안강망어선의 선형치수에 관한 연구)

  • Park, Je-Ung;Lee, Hyeon-Sang
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.3
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    • pp.159-165
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    • 1997
  • This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

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A Study for Assessing Pain Intensity and Investigating Factors of Satisfaction with Postoperative Pain Management (복부 수술 환자의 통증 정도 및 통증관리 만족도 영향 요인 - 통증 자가조절기 사용 환자를 중심으로 -)

  • Lee, Jong Kyung
    • Korean Journal of Adult Nursing
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    • v.18 no.1
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    • pp.125-135
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    • 2006
  • Purpose: The purpose of this study was to identify pain intensity according to activities over postoperative days and to identify factors of patient satisfaction with pain management after abdominal surgery. Methods: The subjects were 123 patients who were admitted at a general surgical ward and had abdominal surgery from Mar. 2005 to June 2005. The collected data were analyzed using the SPSS 12.0 program. Results: The average postoperative pain scores were 6.13 at POD 1, 5.46 at POD 2, and 4.22 at POD 3. In stepwise multiple regression analysis a total of 40% of variance in satisfaction with pain management was accounted for by pain intensity on POD 3 at rest (29.4%) and attitude toward using pain medicine (6.6%), and side effects of pain medicine (4.0%). Conclusion: According to the findings of this study, patients had inadequate pain management after abdominal surgery. Therefore, nurses need to provide educational programs focused on changing attitudes toward using pain medicine, to reduce side effects of pain medicine, and to develop nursing intervention for relieving pain.

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Risk Factors and Level of Acute Post-Operative Pain in Surgical Patients During the First 48 Hours after Surgery (수술 후 첫 48시간 동안의 수술후 통증에 영향을 미치는 요인)

  • Lee, Yoonshin;Son, Jaesoon;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.16 no.3
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    • pp.226-234
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    • 2014
  • Purpose: This prospective study was designed to investigate the incidence of acute postoperative pain (APP) ${\geq}4$ and the risk factors of APP${\geq}$ for the first 48 hours after surgery. Methods: Data from 531 surgical patients were collected from November, 2009 to May, 2010. APP was assessed from the time of arrival at the Post Anesthetic Care Unit (PACU) to the end of the post-operative 48 hours. Risk factors of APP${\geq}$ were analyzed by logistic regression analysis. Results: The incidence of APP ${\geq}4$ was 58.8% for the first postoperative 4 hours; 33.5%, 24 hours; 11.1%, 48 hours. The score of pain was 5.55, the highest on arriving at PACU; 5.03 at postoperative 30 minutes; 4.03 at 1 hour; 3.96 at 4 hours; 2.76 at 24 hours; 1.44 at 48 hours Risk factors for APP ${\geq}4$ were females (Odds ratio [OR], 1.94; p=.013), general anesthesia (OR, 4.29; p<.001) and patient controlled analgesia (PCA) (OR, 2.83; p<.001) at 4 hours after operation; body mass index (BMI) ${\geq}25$ (OR, 1.80; p=.009), duration of surgery ${\geq}1$ hour (OR, 2.87; p=.037), general anesthesia (OR, 3.99; p<.001) and PCA (OR, 6.23; p<.001) at 24 hours; general anesthesia (OR, 3.53; p=.003) and PCA (OR, 3.01; p=.013) at 48 hours. Conclusion: Surgical patients with BMI ${\geq}25$, PCA and general anesthesia seem to have a higher incidence of pain ${\geq}4$ through the first postoperative 48 hours.

Effects of lumbar stabilization exercise on multifidus muscle cross-sectional area, static posture control and pain in patient's with chronic low back pain (요부 안정화운동이 만성요통환자의 다열근 단면적, 정적자세조절, 통증에 미치는 영향)

  • Kim, Deahun
    • Journal of Convergence for Information Technology
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    • v.11 no.10
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    • pp.223-229
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    • 2021
  • This study analyzed the effects of an exercise program that combined lumbar stabilization exercise and muscle strengthening exercise and an exercise program that applied only lumbar muscle strengthening exercise on multifidus muscle cross-sectional area, static posture control ability, and low back pain in patients with CLBP. For the study method, 28 patients with CLBP were divided into two exercise propram groups and exercised three times a week for 8-weeks. The data analysis of this study used the t-test to compare before and after group exercise program application, and between each group (p<.05). As a result of the study, significant results were found before and after application of the exercise program within each group, such as multifidus muscle cross-sectional area, static posture control ability, and low back pain (p<.05). Between each group, the exercise program that combined lumbar stabilization exercise and muscle strengthening exercise was found to be more effective (p<.05). In conclusion, it was found that the exercise program with additional lumbar stabilization exercise improved the structure and function of various lumbar vertebrae and reduced lumbar pain.

Early Results of the Nuss Procedure (Nuss 술식의 조기 결과)

  • 박경택;김기봉;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.472-476
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    • 2001
  • Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.

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Relationship of Orofacial Pain and Sleep Quality (수면의 질과 구강 안면 통증의 관계)

  • Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.91-99
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    • 2006
  • This study was performed to investigate about sleep quality and orofacial pain pattern between experimental and control group. 101 subjects with temporomandibular disorders without any psychologic and neurologic problem were selected from the patients presented to Wonkwang University dental hospital. Routine clinical examination for TMD was carried out, especially for the frequency of headache and the craniocervical muscles were also done by the author in the first visit. All the subjects filled out the questionnaires, that was, for the evaluation of sleep quality using Pittsburgh sleep quality index(PSQI), and for the analysis of behavioral pain scale questionnaires. Data obtained were statistically processed by the SPSS Windows program and the results of this study were as follows: 1. Subjective sleep index, sleep latency, sleep disturbance, global score in control group were significantly lower than 2. Subjective sleep index, sleep disturbance, global score in subject with headache were significantly lower than subject without headache(P<0.05). 3. Medicine taker have sleeping drug. Caffeine drinkers was significantly higher in daytime dysfunction, global score than no drinker. 4. It have more frequent head and neck pain, pain spreading, daily life difficult in poor sleeper than good sleeper.

Analgesic Effect of Hippophae rhamnoides Extract in Orofacial Pain in Rats (구강안면통증모델에서 산자나무 추출물의 진통효과)

  • Kim, Yun-Kyung;Choi, Ja-Hyeong;Kim, Hee-Jin;Yoon, Hyun-Seo;Hyun, Kyung-Yae;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.495-500
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    • 2017
  • Hippophae rhamnoides L. (sea buckthorn) is a shrub wood that belongs to the bamboo tree family, and is rich in vitamin C, D, and E; it is referred to as a vitamin tree. It is mainly grown in the high mountains of Europe and Central Asia, and has been widely used in China and Russia as natural medicine. Recent studies have shown that it is effective in the treatment of cancer, liver diseases, cardiovascular diseases, and gastrointestinal diseases. However, results of studies on its effect on the regulation of pain are insufficient. In this study, we investigated the effect of sea buckthorn on the development and control of pain in two facial areas. The experimental animals included 7- to 8-week-old Sprague-Dawley rats (240~260 g). Formalin (5%), which is known as an inflammation inducer, was injected into the vibrissa pad or temporomandibular joints to induce orofacial acute pain. Rubbing or scraping of the region injected with formalin was regarded as a pain index, and the behavioral response was observed for 45 minutes after the injection. Sea buckthorn extract diluted to 150, 300 mg/kg (in 1 ml of distilled water) was orally administered 30 minutes prior to the acute pain. The facial pain behavior was effectively reduced in the 300 mg/kg group when compared to the control group (vehicle). Likewise, in an experiment in which formalin was injected into the temporomandibular joints, effective pain alleviation was confirmed at the same drug concentration. These results suggest that sea buckthorn extract may be useful in the development of therapeutic agents for acute inflammatory pain in the orofacial area and for controlling temporomandibular joint pain.

특집 - 혈당조절이 잘 되지 않는 환자는 이유가 있다!

  • An, Ji-Hyeon
    • The Monthly Diabetes
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    • s.217
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    • pp.24-26
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    • 2007
  • 당뇨병으로 인해 핏 속의 포도당인 혈당이 오랜 기간 높게 지속되면 우리 몸의 콩팥, 눈, 신경, 혈관은 손상을 입는다. 그 결과로 투석을 하게 되거나 시력을 잃을 수도 있다. 또한 신경 합병증으로 손과 발이 저리고 따끔거려 잠을 잘 이루지 못하거나 별안간 가슴에 심한 통증을 느끼기도 하고, 뇌졸중으로 쓰러질 수도 있다. 그런데, 더 무서운 것은 당뇨병이 심한 합병증을 일으킬 때까지 별다른 증상이 없기 때문에 대부분 대수롭지 않게 여기는 데에 있다. 당뇨병환자의 건강한 삶을 위해서 무엇보다 중요한 혈당조절, 왜 어려운지를 살펴보자.

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