• Title/Summary/Keyword: 환자통증조절장치

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Propofol Patient-Controlled Sedation Using WalkMed (Medex Inc, USA) Infusion Pump in Dental Patients (치과 환자에서의 WalkMed사(Medex Inc, USA)의 자가통증조절기를 이용한 Prorofol 자가진정조절법)

  • Kim, Hyun-Jeong;Park, Chang-Joo;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.16-20
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    • 2001
  • 연구배경: 일반적으로 자가통증조절기가 자가진정조절을 위해 적합한 것으로 알려져 있다. 그러나 이 장치들은 몇몇 진정제 투여 시 너무 긴 최소 폐쇄간격을 가지고 있다 WalkMed사(Medex inc, USA)의 자가통증조절기는 폐쇄간격을 0으로 설정할 수 있으며 30 ml/h로 추가용량을 투여할 수 있다. 이번 연구에서는 환자 개개인의 요구에 맞추어 환자의 진정을 조절하기 위하여 위장치를 이용한 propofol 자가진정조절기의 가능성를 조사하였다. 방법: Propofol과 전산 프로그램된 WalkMed 주입장치를 이용한 자가진정조절법이 치과치료를 받는 24명의 건강한 환자에게 시행되었다. Propofol 지속 주입량은 2 mg/kg/h로, 추가용량은 5 mg으로 조절되었으며 치소 폐쇄간격은 0으로 설정하였다. Ketoloac 30 mg이 통증 조절을 위하여 진정법 시행 전에 근주되었다. 결과: 진정법 시행 동안 주입된 propofol의 평균량은 3.4 mg/kg/h이었으며 평균 추가용량은 1.6 mg/kg/h이었다. 시간 당 추가용량에는 많은 변이가 있었다(0-32). 모든 환자는 진정법 시행 동안 완전한 각성상태였으며 이러한 진정 법에 만족하였다. 진정 법과 관련된 주요한 합병증은 관찰되지 않았다. 결론: WalkMed사의 자가통증조절기를 이용한 propofol 자가진정조절법이 치과 치료를 받는 환자들에게 유용하게 사용될 수 있다.

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Comparison of the Effects of an Adductor Canal Block and Periarticular Multimodal Drug Local Injection on Pain after a Medial Opening High Tibial Osteotomy (내측 개방 근위 경골 절골술 후 통증 조절에서 관절 주위 다중 약물 국소 주사와 내전근관 차단술의 효과 비교)

  • Kim, Ok-Gul;Kim, Do-Hun;Seo, Seung-Suk;Lee, In-Seung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.120-126
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    • 2019
  • Purpose: The efficacy of periarticular multimodal drug injection and adductor canal block after a medial opening-wedge high tibial osteotomy was compared in terms of the postoperative pain level. Materials and Methods: From November 2016 to March 2017, 60 patients underwent a medial opening-wedge high tibial osteotomy under spinal anesthesia. Preemptive analgesic medication, intravenous patient controlled anesthesia were used for pain control in all patients. Thirty patients received a periarticular multimodal drug injection (group I), and 30 patients received an adductor canal block (group II). These two groups were compared regarding the postoperative pain level, frequency of additional tramadol injections, total amount of patient-controlled analgesia, and number of times that the patients pushed the patient-controlled analgesia button at each time interval. Results: The visual analogue scale scores over the two-week postoperative period showed no statistical significance. The frequency of additional tramadol hydrochloride injections was similar in the two groups over time. The mean number of times that patients pushed the patient-controlled analgesia button was similar in two groups over time. The total amount of patient-controlled analgesia was similar in the two groups over time. Conclusion: This study shows that intraoperative periarticular multimodal drug injections and adductor canal block may have a similar effect on postoperative pain control in patients who have undergone a medial opening-wedge high tibial osteotomy for unicompartmental osteoarthritis of the knee.

Development of the Flow Control Regulator for Patient Controlled Analgesia (환자통증조절장치(PCA)의 유량제어조절기 개발)

  • Kim, S.Y.;Song, S.J.;Seo, H.B.
    • Transactions of The Korea Fluid Power Systems Society
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    • v.7 no.4
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    • pp.39-43
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    • 2010
  • The flow regulators we widely use have some disadvantages. They have a constant flow within each regulator and an inaccuracy with extruding capillary. In this study, we have developed a new type of regulator which was made up of two different capillary tubes overlapped each other. The developed regulator can vary and control the amount of flow. The design parameters of the developed regulator are obtained by using the analytical software. We have proved that the developed regulator can control flow properly through making a trial product and experiment.

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Surgical Invasiveness is Important for Determining Severity of Postoperative Pain after Oral & Maxillofacial Surgery (구강악안면 수술의 침습도 및 술 후 통증의 정도와의 상관성)

  • Shin, Teo-Jeon;Park, Yun-Ki;Seo, Kwang-Suk;Han, Hyo-Jo;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.9-15
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    • 2011
  • 배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

The Effects of Preoperative PCA Education with Multimedia and Brochure on Pain Management in Surgical Patients (수술환자를 위한 동영상과 소책자를 활용한 자가통증조절장치 교육의 효과)

  • Kang, Hee-Young;Lee, Sang-Yoon;Yang, Kyung-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.4
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    • pp.498-507
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    • 2010
  • Purpose: The purpose of this study was to evaluate the effects of preoperative PCA (Patient-Controlled Analgesia) education on pain, patient attitude, and patient satisfaction in surgical patients. Methods: The study was a quasi-experimental research design. The participants were 54 patients who were admitted for surgery at I hospital in G city, Korea. Of the 54 patients, 26 were assigned to the experimental group and the rest to the control group. The PCA education was provided in the nurses' station, individually to patients in the experimental group the day before their operation. Multimedia and brochure, and a real PCA model were used. The control group received only verbal education about PCA. Results: The postoperative pain scores were significantly different for lapse of time in the experimental group compare to the control group. Patient attitude toward using pain medicine was significantly more positive in the experimental group than in the control group. The postoperative patient satisfaction with pain management was significantly higher in the experimental group than in the control group. Conclusion: The study findings indicate that preoperative PCA education could be an effective nursing intervention for pain management of surgical patients.

Cost Analysis of Post Operative Pain Management for Surgical Patients using PCA (자가 통증조절장치를 이용하는 수술환자의 통증관리 실태 및 통증관리 비용분석)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.2
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    • pp.137-146
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    • 2013
  • Purpose: The purposes of this study were to identify and compare various types of post operative pain management and the costs for pain management following 4 different types of surgery. Methods: Data were collected from 325 medical charts which were extracted from the billing databases of a tertiary hospital and analyzed using numbers, percentages, one way ANOVA, and Scheff$\acute{e}$ test. Results: For pain management, 10.5% of patients used PCA only, but the other patients combined other methods with PCA. The average length of PCA use was significantly different by operation. Almost one third (32.9%) of patients experienced at least one of side effects due to analgesics used for pain management, with highest incidence being for nausea and vomiting. For patients who underwent a total abdominal hysterectomy, 34.7% used PCA less than 2 days due to side effects of the analgesics and the ratio of analgesia cost to total hospital cost and total pharmacy cost were highest compared to other operations. Conclusion: The results of this study indicate a need to develop new strategies to more effectively manage postoperative pain to decrease incidences of side effects without increasing medical costs.

Antisnoring Effects of Adjustable Anterior Positioner: Case Study (조절성 전방이동형 코골이 방지장치의 효과)

  • Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.213-219
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    • 2012
  • Oral appliances are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are considered as an alternative for patients with severe OSA who have failed continuous positive airway pressure (CPAP) or upper airway surgery. But it is true that OAs have varying degrees of effectiveness depending on different oral appliances and the efficacy of OAs are established in some but not all patients. New oral appliance, which is one of Adjustable Anterior Positioners, was developed by Dept of Oral Medicine, Dental School, Dankook University. This is a report for treating severe OSA patient with a failure of previous uvulopalatopharyngoplasty using a new Adjustable Anterior Positioner, followed by significant success of controlling OSA.

Effect of conservative therapy and Mandibular condylar bone change on Adolescents with osteoarthritis of TMJ (청소년 측두하악관절 골관절염의 보존적 치료효과 및 관절면의 변화 비교)

  • Jeon, Hye-Mi;Kim, Kyung-Hee;Ok, Soo-Min;Heo, Jun-Young;Jeong, Sung-Hee;Ko, Myung-Yun;Ahn, Young-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.357-366
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    • 2013
  • This study is designed to evaluate the treatment outcome of occlusal stabilizing splint and to assess follow-up study of condylar bony changes using cone beam computed tomography(CBCT) in adolescents patients (12-19 years) with TMJ osteoarthritis(OA). 167 eroded condyles in 149 subjects were chosen among the patients who presented to the Department of Oral Medicine of Pasan National University Hospital, diagnosed as TMJ osteoarthritis by clinical exam, x-ray and CBCT from 2009 to 2012. They were treated conservatively with physical therapy, medication, behavioral therapy and occlusal stabilizing splint therapy. After average 9 months, CBCT was retaken and subjective symptoms and clinical findings were investigated. Condyle bony changes were classified by unchanged, less severe and more severe. The obtained results were as follow: 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurement of TMJ OA patients were markedly improved after conservative treatment. 2. In the occlusal stabilizing splint therapy group, Pain and LOM were statistically significant improved than non-occlusal stabilizing splint therapy group. 3. In the acute occlusal stabilizing splint therapy group, Pain and LOM were remarkably improved. 4. In comparison of CBCT1 and CBCT2 images, the transition of bone changes to lesser severe was most commonly in joint with erosive change. 5. In the non-occlusal stabilizing splint therapy group, the transition of condylar bone changes from erosion to more severe was many than occlusal stabilizing splint therapy group.

Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Trigeminal Neuralgia Cases Managed by Yinyang Balancing Appliance of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System (FCST의 음양균형장치를 활용 삼차신경통 증례보고)

  • Lee, Young Jun;Lee, Sang-bae;Park, Min-Cheol;Lee, Hwa Jeong;Yin, Chang Shik
    • Journal of TMJ Balancing Medicine
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    • v.5 no.sup
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    • pp.11-18
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    • 2015
  • Therapeutic effect of Yinyang Balancing Appliance (YBA) of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in a trigeminal neuralgia case. One Trigeminal neuralgia case was managed with YBA on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was performed by subjective rating and clinical observations. The patient's subjective rating and clinical symptoms showed improvement immediately after the initial treatment and this improvement maintained over the follow-up period. Although it is not clear whether the effect is temporary in its nature, a positive effect was observed and further clinical and biological research on FCST is expected.

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