• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.97-100
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• 2002

Background: Patient-controlled sedation (PCS) has been blown for a safe and effective sedative method on the same pharmacological concepts of patient-controlled analgesia. Many different kinds of infusion devices have been used but they often have too long nominal infusion rate and lockout time. $Perfuser^{\circledR}$ fm (B. Braun, Germany) is a new PCA device with 999.9 ml/hr nominal infusion rate and minimum 1 min lockout time. In this study, the feasibility of propofol PCS using $Perfuser^{\circledR}$ fm was examined in order to provide a safe satisfactory sedation for dental patients. Methods: Eleven healthy patients presenting for oral surgery were studied. Propofol PCS was performed using $Perfuser^{\circledR}$ fm, which was set to deliver a bolus dose of 5 mg with 999.9 ml/hr nominal infusion rate and 1 min lockout time. Propofol loading dose was randomly assigned to a bolus dose ${\times}$ 0, 2, and 3 (initial bolus). Patients were told to press the bolus button as often as they needed to relieve discomfort. Results: Total infused dose of propofol was mean 1.8 mg/kg/hr and D (Delivery)/A (Attempt) ratio was mean 72.8%. All patients was awake and there were no clinically significant intraoperative side effects during the sedation. Almost all patients were very satisfied with this type of PCS. Conclusion: Propofol PCS using $Perfuser^{\circledR}$ fm infusion pump provided good conscious sedation for dental procedures.

• Journal of Digital Convergence
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• v.14 no.12
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• pp.283-292
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• 2016

The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and thoughts regarding insulin therapy. Patients' perspectives and experiences relating to taking insulin formed three categories of themes: preoccupations about insulin, barriers to taking insulin, and benefits to taking insulin. The theme for preoccupations about insulin was "vague fear," while the theme of barriers to taking insulin were "worrisome insulin-related issues", "ambivalent feelings (trust/mistrust) about healthcare providers," "dependent life," "feeling about supporters(family, friends, and religion)," "inconvenience," "regret about the past," and "embarrassment." The theme of benefits to taking insulin were "recognition" and "physical recovery and confidence in regulating blood glucose". Based on this study, patients' feelings about their insulin should be respected by healthcare providers.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.118-126
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• 2008

Dental fear is one of the main barriers to the use of dental services, leading patients to avoid periodical dental check-ups or treatments, thus making oral health worse, and sometimes becoming the reason that dental professionals fail control the behavior of patients. Therefore, a dental fear must be controlled carefully in order to promote oral health and effective dental treatment. This study was taken from 313 people 13 to 18 year olds to measure their levels of dental fear. After analyzing the characteristics of dental fear and its related factors, as well as other factors which influence dental fear, we acquired the following results. 1. The level of dental fear was high, compared with advanced countries with relatively good oral health. 2. The strongest physiological response experienced during a dental treatment was the tension of muscles. These dental fears were mainly related to anesthetic needles and drills. 3. Levels of dental fear became higher, the number of times for the dental services utilization had reduced, avoid regular dental examination and perceived oral disease symptoms increased. 4. One of the biggest influences on dental fears turns out to be direct painful experiences and beliefs about dentists.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1279-1282
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• 2009

Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.169-173
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• 2007

Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.17-23
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• 2018

Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.260-265
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• 2005

Patient-controlled analgesia (PCA) has been widely used for postoperative pain control in medical surgery parts. Conventional intramuscular analgesia (IMA) is also effective in postoperative pain control, but it has some disadvantages that depend on patients' perception of pain and the anxiety that they endure caused by the delay of the injection time. This study was conducted to assess the efficacy and postoperative outcomes of intravenous PCA compared to IMA injections in 36 patients (BSSRO). Three factors were compared: amount of pain in PCA and IMA group ; amount of pain according to the sex in PCA and IMA group and the amount of pain according to the analgesia use. Results of this study did not demonstrate a statistically significant difference in any of these, using a p value of 0.05. The results of this study were as follows. : 1. There was no statistically significant difference in VAS pain score between IMA group and PCA group. 2. There was no statistically significant difference according to the sex. 3. There was no statistically significant difference according to the amount of PCA. The history of PCA is about 30 years and many literatures have reported about its effects, complications, methods, advantages and disadvantages. So, this study has some limitations of small sample size to conclude the effects of PCA. But when the decision about the method for postoperative pain control has to be made, it should be made based on patient or physician preference and cost factors rather than on the trend.

• Women's Health Nursing
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• v.19 no.4
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• pp.211-218
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• 2013

Purpose: The purpose of study was to examine effects of aromatherapy on stress, sleep, nausea and vomiting of women after laparoscopic hysterectomy. Methods: The participants were 60 women who had laparoscopic hysterectomy: experiment group for aromatherapy (n=30) and control group for routine care (n=30). The experimental group received inhalation aromatherapy for 5 minutes, twice; the first was done right after the operation, the second was at 9 pm before sleep on the same day-while the control group had no inhalation. Data were collected from July to September, 2012 at G hospital. Results: The degree of psychological stress was not significantly different between two groups (t=-1.96, p=.054). Yet, there were significant differences between two groups for degree of physiological stress (t=-3.20, p=.002), the level of cortisol (t=-2.01, p=.049), the score of sleep status (t=2.47, p=.016), the score of sleep satisfaction (t=2.43, p=.018), and the score for nausea and vomiting (t=-2.58, p=.012). Conclusion: Inhalation aromatherapy using the mixed oil of lavender, mandarin, and marjoram was effective in decreasing the level of physiological stress, cortisol, and the score for nausea and vomiting, and also allowed the participants to have a better sleep. Therefore, inhalation aromatherapy could be effective in improving the quality of life of these women during recovery.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.2
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• pp.98-103
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• 2009

Background: Despite increasing popularity of dental implants, there is limited information on the pain experience associated with the surgical implant placement under general anesthesia. The aim of this study was to assess the characteristics of patient-reported pain and efficacy of patient controlled analgesia after implant surgery under general anesthesia. Methods: Total 39 patients who underwent implant surgery under general aensthesia were enrolled. In PCA group (n=30), patients received patient controlled analgesia (fentanyl 700 mg and ketorolac 150 mg) set to basal rate 1 ml/h, bolus 1 ml, and lockout interval 10 min. In control group (n=9), patients received ketorolac 30 mg intravenously when they feel painful. We evaluated pain intensity using VAS score at the end and after 12 hr of the operation and recorded the number of bolus injection as a surrogate of rescue therapy. We compared the VAS data, the frequency of complication between two groups. Results: The self reported pain was highest at 1 hous after surgery in both groups. However, the intensity was not severe (PCA group = 5.7, control group = 5.6), and decreased gradually thereafter. Total demand bolus number was less than 6 in nearly 65% patients. And there was no significant difference in the frequency of complications such as nausea, vomiting and dizziness between both groups. Conclusions: The Pain following the surgical placement of dental implants was generally mild and gradually decreased with time. There was no difference in complications between control group and PCA group.

• Journal of Korean Ophthalmic Optics Society
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• v.10 no.2
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• pp.103-110
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• 2005

Binocular vision had a short history in Korea. As there were many near works in these days, the needs about comparative study have been increased. There was related to both refractive error and binocular anomalies, but it is difficult to applying for binocular vision expected findings in itself due to the fact that Korean differ from foreigner. Objects were 100 adults in 18-36 years old ages, The test was Von Gaefe method and used aparatus was phoropter(Shinnippon VT10)and visual chart(Shinnippon CT30). According to interview results was that symptom in near works were headaches 28.0%, blinking 27.3%, red eye 25.1%, eyepain 15.6%, watering 15.3%, itch 12.2%, photophobia 8.5% and eye strain 7.4%. A people who have above ${\pm}0.50$ D refractive error in total objectives (100-male 45/female 55) were classified into ametropia. There was a results such as emmetropia (12.0%), ametropia(88.0%), exophoria(32.0%), esophoria(12.0%). Far negative relative convergence were that in case of high 43.0%, in case of low 7.0%. Far positive relative convergence were that in case of high 15.0%, in case of low 38.0%. Near phoria was exophoria(32.0%), esophoria(12.0%). Near negative relative convergence were that in case of high 23.0%, in case of low 38.0%. Far positive relative convergence were that in case of high 29.0%, in case of low 23.0%. Near negative relative accommodation were that in case of high 10.0%, in case of low 14,0%, Far positive relative convergence were that in case of high 69.0%, in case of low 12.0%. Results were different from expected findings, and especially positive relative accommodation was very high, However, We suggest that the expected findings in Korea for several subjects must study in binocular function.