• Title/Summary/Keyword: 48 hr-PCA

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The Effect of Combination of Ondansetron and Droperidol on Prevention of Postoperative Nausea and Vomiting (Ondansetron과 Droperidol의 혼합 투여가 술 후 오심과 구토 예방에 미치는 효과)

  • Kim, Dong-Hee;Cho, Duk-Hyun
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.46-50
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    • 2001
  • Background: Ondansetron is both a central and peripheral serotonin (5HT) receptor antagonist and droperidol is a dopaminergic blocking drug which acts centrally at the chemoreceptor trigger zone. We assessed the efficacy and adverse effects of ondansetron, droperidol or both, in the prevention of postoperative emesis during postoperative intravenous patient-controlled analgesia (PCA) using butorphanol and ketorolac medication. Methods: We studied 60 women, aged 25-60 yrs, who underwent total abdominal hysterectomy (TAH), under general anesthesia using $N_2O-O_2$-enflurane. A bolus dose of 1 mg of butorphanol and 4 mg of ondansetron were given to patients and thereafter, PCA was started using 10 mg of butorphanol and 240 mg of ketorolac mixed into the 5% D/W solution (total volume; 100 ml, 1 ml of bolus dose, and 10 min of lockout interval). We also added ondansetron 4 mg (Group O, n = 20), ondansetron 4 mg and droperidol 2.5 mg (Group OD, n = 20), or droperidol 2.5 mg (Group D, n = 20) to the PCA drug. The severity of pain, nausea, vomiting, sedation and other side effects were assessed at 0, 1, 2, 6, 12, 24, 36 and 48 hr after awakening. Results: There was no difference in the incidence of nausea and vomiting between the three group [Group O: 4 (20%) and 3 (15%), respectively; Group OD: 1 (5%) and 1 (5%), respectively; Group D: 3 (15%) and 3 (15%), respectively]. Group O showed a lower sedation score than the other groups (P < 0.05). The pain score and other side effects did not show any difference between the groups. Conclusions: The combination of ondansetron and droperidol showed no clinical benefit compared with ondansetron or droperidol alone for prevention of postoperative nausea and vomiting during postoperative PCA using butorphanol and ketorolac.

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Comparison of Quality of Pain Using Patient-Controlled Analgesia (PCA) after Total Abdominal Hysterectomy (TAH) (전자궁적출술후 통증자가조절장치 사용에 따른 통증점수 비교)

  • Lee, Jung-Koo;Park, Seok;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.253-257
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    • 1998
  • Background: The purpose of this study was to examine the extent and evaluation of pain after total abdominal hysterectomy (TAH) and to establish correlation between three types of pain; pain at rest, pain with movement and pain with coughing (maximum pain). Methods: The present study compared quality of pain during pain management in 48 patients undergoing TAH. Patients received i.v. meperidine as loading dose in the recovery room and PCA with nalbuphine 90 mg, ketorolac 180 mg, buprenorphine 0.9 mg, droperidol 5 mg, plasma solution A 28 ml for 3 days. The PCA device used was the Baxter infusor$^{(R)}$ (PCA module PC-19-55, 0.5 ml/hr basal rate, 15 minute lockout interval). Patients were then interviewed on Operative Day (OPD), Postoperative Day 1, 2, and 3 (POD 1, 2 and 3) to assess their pain on a visual analogue scale (VAS) of 0 (none) to 10 (worst imaginable). Results: The mean pain score at rest was 2.0 on OPD and decreased to 0.7 on POD 3. The mean pain score with movement was 3.2 on OPD and decreased to 1.6 on POD 3. The mean pain score with coughing was 4.2 on OPD and decreased to 2.2 on POD 3. Conclusions: Patients' experience of three types of postoperative pain emphasizes the need for more effective pain management.

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Patient-Controlled Analgesia(PCA) for Pain Management after Gynecological Surgery (Baxter $Infusor^{(R)}$를 이용한 부인과 수술후의 통증 자가 조절)

  • Lee, Jung-Koo;Kim, Jin-Mo;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.49-54
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    • 1993
  • The use of intravenous patient-controlled analgesia is an effective and increasingly used means of providing postoperative pain relief. Recently a non-electric, disposable and portable infusor, the Baxter $Infusor^{(R)}$, has developed. This delivers not only a continuous drug infusion but can also deliver extradoses of medication on demand. The present study examined the benefits of two kinds of analgesics for pain management in 28 patients undergoing gynecological surgery. One group, 14 patients, received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA with meperidine 3 mg/kg/day for 3 days only(M group). In the other group, 14 patients, also received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA meperidine 3 mg/kg/day for 3 days and droperidol 5 mg(MD group). The PCA device used was the Baxter $Infusor^{(R)}$. This unit was fitted with patient control module which had a flow rate 0.5 ml/hr and the lockout time was 15 min. Resulting from the study, the MD patients in the first and second days post-operatively, reported less pain compared with the M group. VAPS(Visual Analogue Pain Scales) values were $3.52{\pm}l.61$ vs. $2.22{\pm}0.69$, $2.38{\pm}1.12$ vs. $1.45{\pm}0.48$ and $1.93{\pm}1.65$ vs. $0.98{\pm}0.36$, respectively pertaining to M and MD groups. In conclusion, the MD group with meperidine and droperidol(mixed regimen) provided more effective postoperative analgesia than M group(meperidine only).

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Effect of Intraoperative Continuous I.V. Fentanyl on Tourniquet Induced Cardiovascular Changes and Postoperative Preemptive Analgesia in Total Knee Replacements (슬관절 전치환술 중 지속 정주한 Fentanyl이 압박띠로 인한 심혈관계 변화 및 수술 후 선행 진통에 미치는 효과)

  • Lee, Jong Won;Jun, Jong Hun;Kim, Young Sun;Cheong, Mi Ae;Shim, Jae Chol;Kim, Kyo Sang
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.165-170
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    • 2005
  • Background: It is difficult to treat tourniquet-induced hypertension despite adequate anesthesia, and the mechanism of that is not known. And it may be possible that intraoperative continuous infusion of opioid induces preemptive analgesia postoperatively. We investigated the effect of intraoperative continuous i.v. fentanyl on tourniquet induced cardiovascular changes and postoperative preemptive analgesia in total knee replacements. Methods: Sixty patients were randomly assigned to two groups; In study group ($1.5{\mu}g/kg$ loading and $0.5{\mu}g/kg/hr$ continuous infusion of fentanyl before skin incision and tourniquet inflation) and control group (no treatment). Anesthesia was maintained with enflurane (1-2 MAC) and 50% nitrous oxide in oxygen. Arterial pressure and heart rate were compared between two groups. They received postoperative pain treatment with patient-controlled analgesia (PCA) with fentanyl during the postoperative 48 hours after total knee replacement. Visual analog scale (VAS) scores at either rest or movement were used to assess pain. Total fentanyl dose delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. Results: There were no significant differences between the two groups on cardiovascular changes by tourniquet induced pain effect. VAS, PCA delivered dose and PCA demands at movement in the 24-48 hour decreased in study group compared with control group (P < 0.05). But there were no significant differences between the two groups on the other time periods except 24-48 hour's patient satisfaction and adverse events. Conclusions: We suggest that intraoperative continuous i.v. fentanyl infusion dose not affect cardiovascular change by tourniquet induced pain. But it may induce preemptive analgesia postoperatively.

Clinical Experience on Intravenous Patient Controlled Analgesia after Total Abdominal Hysterectomy (전자궁적출술후 시행한 정맥내 통증자가조절법의 임상 경험)

  • Kim, Yun-Hee;Choe, Huhn
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.54-58
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    • 1999
  • Background: We studied 150 patients who received intravenous patient controlled analgesia (PCA) after total abdominal hysterectomy to evaluate pain relief, analgesic consumption, patient's satisfaction and side effects. Methods: We made total 40 ml of analgesic mixture with morphine 40 mg, ketorolac 120 mg, droperidol 3 mg and normal saline. Loading/bolus/basal infusion dose and lockout interval was 2 ml, 1.5 ml, 0.5 ml/hr and 10 min, respectively. Numerical rating scale (NRS) pain score, cumulative analgesic consumption, degree of satisfaction, and incidence of side effects were evaluated. Also, correlation of age and edu ion with analgesic consumption were evaluated. Results: The average pain scores using NRS were $3.1{\pm}1.7$ (6 h), $2.1{\pm}1.5$ (24 h), $1.7{\pm}1.5$ (48 h). The average cumulative analgesic consumption were $11.7{\pm}5.0$ ml (6 h), $23.0{\pm}6.7$ ml (24 h), $32.1{\pm}3.7$ ml (48 h). The degree of satisfaction in postoperative pain control was good in 94% of patients. There was no correlation between degree of satisfaction and analgesic consumption. Also age and level of edu ion did not correlated with analgesic consumption. Conclusions: Intravenous PCA with morphine, ketorolac, and droperidol is an effective method of postoperative pain control because it provides adequate pain relief and a few side effects with high patient's satisfaction. However, age and level of education did not correlated with analgesic consumption.

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면역계 질환 치료제로서의 인삼의 생리활성 성분의 개발 연구

  • 이시용;김경만;임동구;오기완;최수형
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.232-232
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    • 1994
  • 인삼이 면역계 질환의 일종인 과민성 반응에 대한 치료약으로서의 가능성을 연구하기 위해서 in viva와 in vitra실험을 수행하였다. in vitra실험으로서는 hyaluronidase의 활성을 지표로 삼았으며, in viva실험에서는 mouse이각, rat등피부, 복강 비만세포, 그리고 guinea pig의 ileum에서 면역반응에 대한 아답타겐의 작용을 관찰하였다. in uitra 실험에서는 hyaluronidase와 histamine 분비를 항알레르기 작용의 지표로 사용하였다. hyaluronidase의 경우 그 활성은 Cacl2로 활성화 시키기 전이나 후에 모두 아답타겐(100, 50, 및 10 mg/ml)에 의해서 현저하게 억제되었다. 한편 rat 복강 비만 세포에서의 histamine유리 시험에서는 아답타겐(0.5, 1, 5mg/ml)이 histamine유리가 증가되었다. Guinea pig의 ileum 평활근에서는 아답타겐이 평활근 자극 작용없이 항히스타민 효과률 나타내었다. in uiua 실험의 첫 단계로 우리는 혈관 투과성에 미치는 아답타겐의 효과를 mouse 이각과 rat 등피부에서 관찰하였다. Mouse이각에서의 실험에서는 hoistamine, serotonin, 그리고 LTC4로 challenge하여 관찰한 결과 histamine과 serotonin의 경우, 혈관투과성 항진은 아답타겐(50-400mg/m1)에 의해서 유의성있게 억제되었으나, rat 등 피부에서는 mouse에서와는 달리 48-hr PCA가 증가 되었고, histamine에 의한 혈관투과성 항진은 아답타겐에 의해 영향을 받지 않았다. 반면에 compound 48/80과 serotonin에 의한 혈관투과성 항진은 mouse 의 경우에서처럼 아답타겐에 의해 억제되었다.

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Protein and Amino-acid Contents in Backtae, Seoritae, Huktae, and Seomoktae Soybeans with Different Cooking Methods (콩의 종류 및 조리방법에 따른 단백질·아미노산 함량 변화)

  • Im, Jeong Yeon;Kim, Sang-Cheon;Kim, Sena;Choi, Youngmin;Yang, Mi Ran;Cho, In Hee;Kim, Haeng Ran
    • Korean journal of food and cookery science
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    • v.32 no.5
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    • pp.567-574
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    • 2016
  • Purpose: The objective of this study was to provide nutritional information (protein and amino-acid contents) of soybeans (Baktae, Seoritae, Huktae, and Seomoktae) with different cooking methods. Methods: Raw, boiled (in $100{\pm}15^{\circ}C$ of water for 4 hr), and fried (in a pan at $110{\pm}15^{\circ}C$ for $20{\pm}5min$) soybean samples were prepared. Contents of protein and amino acids were determined. Results: Protein content in raw Baktae, Seoritae, Huktae, and Seomoktae soybeans ranged from 361.0 to 386.8 mg/g. Protein contents differed according to cooking methods. They were higher in pan-fried beans (107.9-113.5%) than in raw or boiled soybeans (48.2-49.5%). A total of 18 amino acids were analyzed. Amino acid data sets were subjected to principle component analysis (PCA) to understand their differences according to soybean types and cooking methods. Bean samples could be distinguished better according to cooking method in comparison with bean types by principle component (PC1) and PC2. In particular, fried soybeans contained much higher levels of cystein. Other amino acids were the dominant in raw and boiled ones. On the other hand, the amounts of threonine, histidine, proline, arginine, tyrosine, lysine, tryptophan, and methionine were higher in raw bean samples than in cooked ones. Conclusion: The contents of amino-acids and proteins are more effected by different cooking methods in comparison with soybean types.