• Title/Summary/Keyword: Analgesia pain

Search Result 523, Processing Time 0.022 seconds

Treatment of 43 Patients with Buerger's Disease (Buerger환자 43명의 치료 경험)

  • Cheun, Jae-Kyu;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
    • /
    • v.9 no.1
    • /
    • pp.114-119
    • /
    • 1996
  • Buerger's disease is a nonatherosclerogic occlusive inflammatory disease of medium and small arteries, and veins, of unknown cause. It occurs predominantly in young males who are habitual tabacco users. These patients often complain of painful ulcerations of their digits. The care of this disease is very difficult when the treatment is delayed. Consequently, early treatments are most important to patients with Buerger's disease. This disease can be treated with sympathetic block such as stellate ganglion block for upper extremities and lumbar epidural block, and lumbar sympathetic block for lower extremities. Intravascular regional sympathetic block can be another method of treatment. However, discontinuation of smoking is the most basic and essential treatment for Buerger's disease. We treated 43 Buerger's disease patients with stellate ganglion block and laser therapy. The treatment was not effective for three patients who definitely required amputation.

  • PDF

A Case of CRPS Treated with Implantable Port System -A case report- (Implantable Port System을 이용한 복합부위통증증후군 치험 1예 -증례 보고-)

  • Shin, Sung-Shick;Kim, Tae-Sam;Yang, In-Sook
    • The Korean Journal of Pain
    • /
    • v.10 no.2
    • /
    • pp.274-277
    • /
    • 1997
  • The complex regional pain syndrome(CRPS) exhibit symptoms such as: abnormal skin color, temperature change, abnormal pseudomotor activity, edema. If CRPS is not treated appropriately at acute stage, then the affected extremity may become a useless, painful appendage. Treatment of CRPS by sympathetic blockade may be achieved by repeated intravenous regional guanethidine blocks, repeated anesthetic sympathetic blocks, surgical sympathectomy or oral sympatholytic therapy. We treated 29-year-old male patient with CRPS of left upper extremity by continuous cervical epidural blockade. Due to wound infection and dislocation of the epidural catheter, we inserted an implantable port system to inject the mixture of local anesthetics and small amount of morphine. After 10 months of treatment, patient was cured of symptoms and signs of CRPS and was able to resume a normal life.

  • PDF

Ultrasonography-Guided Multifidus Cervicis Plane Block as a New Approach for the Treatment of Chronic Axial Neck Pain (만성 축성 경부통에 경추 다열근 평면 차단술의 유용성)

  • Hong, Jun Taek;Cho, Han Eol;Park, Jung Hyun
    • Clinical Pain
    • /
    • v.20 no.1
    • /
    • pp.30-34
    • /
    • 2021
  • Multifidus cervicis plane block has been effectively used to provide analgesia during and after cervical spine surgery, but not for any other purpose. Here, we report three cases of chronic axial neck pain unresponsive to medical treatment. We performed multifidus cervicis plane block bilaterally, which lowered numerical rating scale (NRS) score within 2 weeks. Thus, multifidus cervicis plane block is one of the novel options that may be used for chronic axial neck pain.

Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

  • Tae-Yeong Kim;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
    • /
    • v.25 no.4
    • /
    • pp.339-346
    • /
    • 2022
  • Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

Pain Passport as a tool to improve analgesic use in children with suspected fractures in emergency departments

  • Hwang, Soyun;Choi, Yoo Jin;Jung, Jae Yun;Choi, Yeongho;Ham, Eun Mi;Park, Joong Wan;Kwon, Hyuksool;Kim, Do Kyun;Kwak, Young Ho
    • The Korean Journal of Pain
    • /
    • v.33 no.4
    • /
    • pp.386-394
    • /
    • 2020
  • Background: In the emergency department (ED), adequate pain control is essential for managing patients; however, children with pain are known to receive less analgesia than adults with pain. We introduce the Pain Passport to improve pain management in paediatric patients with suspected fractures in the ED. Methods: This was a before-and-after study. We reviewed the medical records of paediatric patients who were primarily diagnosed with fractures from May to August 2015. After the introduction of the Pain Passport, eligible children were enrolled from May to August 2016. Demographics, analgesic administration rates, time intervals between ED arrival and analgesic administration, and satisfaction scores were obtained. We compared the analgesic prescription rate between the two periods using multiple logistic regression. Results: A total of 58 patients were analysed. The baseline characteristics of subjects during the two periods were not significantly different. Before the introduction of the Pain Passport, 9 children (31.0%) were given analgesics, while after the introduction of the Pain Passport, a significantly higher percentage of patients (24/29, 82.8%) were treated with analgesics (P < 0.001). The median administration times were 112 (interquartile range [IQR], 64-150) minutes in the pre-intervention period and 24 (IQR, 20-74) minutes in the post-intervention period. The median satisfaction score for the post-intervention period was 4 (IQR, 3-5). The adjusted odds ratio for providing analgesics in the post-intervention period was 25.91 (95% confidence interval, 4.36-154.02). Conclusions: Patient-centred pain scoring with the Pain Passport improved pain management in patients with suspected fractures in the paediatric ED.

The Effect of Nefopam on Postoperative Fentanyl Consumption: A Randomized, Double-blind Study

  • Moon, Jee Youn;Choi, Sang Sik;Lee, Shin Young;Lee, Mi Kyung;Kim, Jung Eun;Lee, Ji Eun;Lee, So Hyun
    • The Korean Journal of Pain
    • /
    • v.29 no.2
    • /
    • pp.110-118
    • /
    • 2016
  • Background: Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient controlled analgesia (PCA). Methods: Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl $1,000{\mu}g$; Group B, fentanyl $500{\mu}g$ + nefopam 200 mg; and Group C, fentanyl $500{\mu}g$ + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. Results: Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. Conclusions: The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.

Practical strategies for the prevention and management of chronic postsurgical pain

  • Bo Rim Kim;Soo-Hyuk Yoon;Ho-Jin Lee
    • The Korean Journal of Pain
    • /
    • v.36 no.2
    • /
    • pp.149-162
    • /
    • 2023
  • Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

Acupuncture analgesia for operation in Korean native goats

  • Lee, Soo-jin;Park, Chang-sik;Jun, Moo-hyung;Kim, Nam-joong;Lee, Jae-il;Kim, Young-suk;Kim, Myung-jin;Lee, Jae-yon;Jeong, Seong-mok;Kim, Duck-hwan;Kim, Myung-cheol
    • Korean Journal of Veterinary Research
    • /
    • v.45 no.4
    • /
    • pp.581-585
    • /
    • 2005
  • The purpose of this study is to establish the analgesic effects of electroacupuncture for Korean native goat. Electroacupuncture was applied to the 6 Korean native goats. In 3 of them, rumenotomy was performed, and in the other 3, laparotomy was done. The analgesic induction time was 15 to 30 minutes. The acupoints used were Tian-ping (Celestial Peace, GV-5), Bai-hui (Hundred Meetings, GV-20), left 13th thoracic nerve and left 3rd lumbar nerve. Electroacupuncture was performed in lateral recumbency. Needles were inserted 1-2 cm deep, and connected to the electroacupuncture apparatus. The electrical stimulation condition was 30 Hz and 2-6 volts. Initially, the voltage of analgesia mode was maximized in each channel. And, the output was slowly reduced to the critical point that goats could tolerate without obvious discomfort or pain. Surgical operation was done successfully under electroacupuncture analgesia in 6 Korean native goats. In addition, the changes of temperature, heart rate and respiratory rate were studied during acupuncture analgesia. For 3 months after surgery, no experimental animals showed clinical problem in 6 Korean native goats.

Assessment for the Role of Serotonin Receptor Subtype 3 for the Analgesic Action of Morphine at the Spinal Level (척수 수준에서 Morphine 의 진통 작용에 대한 Serotonin 3형 수용체 역할에 작용에 대한 평가)

  • Yoon, Myung Ha;Bae, Hong Buem;Choi, Jeong Il;Kim, Seok Jae;Kim, Chang Mo;Jeong, Sung Tae;Kim, Kwang Su;Jin, Won Jong;Kim, Jong Pil;Kim, Jong Sik;Kim, Se Yeol;Jeong, Chang Young
    • The Korean Journal of Pain
    • /
    • v.18 no.2
    • /
    • pp.113-117
    • /
    • 2005
  • Background: Serotonin 3 receptor is involved in the modulation of nociceptive transmission in the spinal cord. The serotonin 3 receptor antagonist has been used for the management of opioid-induced nausea and vomiting. The aim of this study was to examine whether the analgesic effect of morphine is antagonized by serotonin 3 receptor antagonists at the spinal level. Methods: Rats were implanted with lumbar intrathecal catheters. For nociception, a formalin solution (5%, $50{\mu}l$) was injected into the hind paw of male Sprague-Dawley rats. To determine whether the effect of intrathecal morphine was mediated via serotonin 3 receptors, serotonin 3 receptor antagonists were intrathecally administered 10 min prior to the morphine delivery. Following the formalin injection, formalin-induced nociceptive behavior (flinching response) was observed for 60 min. Results: Intrathecal morphine produced a dose-dependent suppression of the flinches in both phases during the formalin test. The analgesic action of morphine was not reversed by serotonin 3 receptor antagonists (LY-278,584, ondansetron), which had little per se effect on the formalin-induced nociception. Conclusions: Spinal serotonin 3 receptors may not be involved in the analgesia of morphine on a nociceptive state evoked by a formalin stimulus.