• The Korean Journal of Pain
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• v.13 no.1
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• pp.38-43
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• 2000

Background: Preemptive analgesia may decrease postoperative pain by preventing nociceptive inputs generated during surgery. The preemptive effect of intravenous nalbuphine was examined in gynecological surgery. Methods: Forty female patients scheduled for gynecological surgery were randomly allocated into two groups. Each patient received 10 mg of intravenous nalbuphine as a bolus dose at the closure of peritoneum in group I (n=20) and before the skin incision in group II (n=20). After the bolus dose, the intravenous patient controlled analgesia (IV-PCA) which contained 50 mg of nalbuphine, 120 mg of ketorolac, 0.25 mg of droperidol and 90 ml of 5% dextrose water was given continuously at the rate of 2 ml/min. The postoperative visual analogue scale pain score (VAS), the total amount of the analgesics used, the degree of satisfaction of the patients and the developement of side effects were examined for 2 days. Results: VAS were significantly lower in group II than in group I after 9 and 12 hours. The cumulative consumption of analgesics in group II was significantly less than in group I. Most patients were satisfied with this regimen. There were no remarkable side effects. Conclusions: Preemptive analgesia with intravenous nalbuphine decreased postoperative pain and analgesic requirement. The analgesic effect of IV-PCA with nalbuphine-ketorolac was effective in control of postoperative pain in gynecologic surgery.

• Journal of the Korea Convergence Society
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• v.9 no.2
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• pp.371-380
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• 2018

The purpose of this study was to investigate the effects of patient controlled analgesia(PCA) convergence education on postoperative pain management in spinal surgery patients. Sixty spinal surgery patients were included. For the experimental group(n=30), PCA education using video, booklet, and a PCA model practice was provided before surgery. The data were collected using questionnaire and were analyzed using descriptive statistics, ${\chi}^2-test$, Fisher's exact test, t-test and repeated measures ANOVA. PCA knowledge-attitude, PCA satisfaction and pain control satisfaction were higher in the experimental group than the control group(p<.001; p=.001; p<.001). Postoperative pain and frequency of additional analgesia use of the experimental group were significantly lower than those of the control group(p<.001; p=.001). This findings showed that the convergence PCA education of audiovisual aids with PCA practice training could be effective pain management intervention in patients undergoing spinal surgery. These apply to development of convergence nursing interventions in clinical practice.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.211-216
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• 2008

Background: Postoperative pain after bilateral total knee replacement (TKR) is expected to be more severe than unilateral TKR. Intravenous patient-controlled analgesia (IV PCA) is less effective than other methods of pain management especially immediately after an operation even though it is an easily controlled method for managing pain. This study was designed to evaluate the effect of femoral nerve blocks combined with IV PCA after bilateral TKR for postoperative pain control. Methods: The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) were given bilateral femoral nerve blocks with 12 ml of 0.25% bupivacaine and epinephrine 1 : 400,000 before extubation followed by an IV PCA. Main outcome measures included numerical rating pain score, cumulative opioid consumption, hourly dose during each time interval, and side effects. Results: The pain score in group II was significantly lower than that in group I immediately after recovery of awareness and at 3, 6, 12 hours postoperatively. Cumulative opioid consumption was significantly decreased in group II during the first 48 hours postoperatively. The hourly dose in group II was also significantly lower than that in group I until 12 hours postoperatively. There was no difference in side effects between the groups. Conclusions: We concluded that bilateral femoral nerve blocks improve analgesia and decrease morphine use during IV PCA after bilateral TKR.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.201-209
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• 2021

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.100-104
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• 1993

Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.263-267
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• 1998

Background: This study was designed to know the dose requirement, analgesic efficacy and side effects of butorphanol and nalbuphine when administered with ketorolac by patient controlled analgesia (PCA) after total abdominal hysterectomy. Methods: Forty women who underwent total abdominal hysterectomy received ketorolac (bolus dose 2.4 mg, lockout interval 10 min) with either butorphanol (bolus dose 0.1 mg) or nalbuphine (bolus dose 1 mg) using PCA pump postoperatively. Results: Total amounts of 48 hr consumption were 8.7 mg (butorphanol)and 61.5 mg (nalbuphine). There were no significant differences between two groups in total ketorolac infusion doses, VAS score and side effects. Conclusions: Both butorphanol and nalbuphine were useful for PCA for postoperative pain control. We may suggest that ketorolac 180 mg with butorphanol 9 mg or nalbuphine 70 mg would be useful for 48 hr postoperative pain control.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.146-149
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• 1998

Herpes zoster is a viral disease characterized by skin rash and persistent pain. Early treatment with epidural analgesia provides very effective pain relief and reduces the incidence of postherpetic neuralgia. However, epidural analgesia in elderly, deliberated or hypovolemic patients may complicate circulatory depression such as hypotension and bradycardia. Even if temporary, a major decrease in blood pressure may decrease coronary blood flow of patients with arteriosclerosis and ischemic accident may occur. We experienced a case of unstable angina pectoris after lumbar epidural blockade in a herpes zoster patient with chronic stable angina pectoris.

• The Korean Journal of Pain
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• v.2 no.2
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• pp.167-173
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• 1989

Inadequate pain relief after upper abdominal surgery increases the incidence of pulmonary complications due to the difficulty in coughing and deep breathing. Kvalheim and Reiestad (1984) introduced intrapleural administration of local anesthetic solutions to produce analgesia following cholecystectomy performed through a subcostal incision, unilateral breast surgery and renal surgery. We studied continuous intrapleural administration of bupivacaine and epinephrine, and its effect in controlling pain after cholecystectomy. In 9 patients, an intermittent dosage technique was used. An intrapleural catheter was inserted and 20 ml of 0.5% bupivacaine and 1:100,000 epinephrine was administered. Results were as following: 1) Mean analgesic duration from the initial intrapleural injection to secondary administration of supplementary bupivacaine was 13.5 hours. 2) No specific changes were noted on vital signs and arterial blood gases. 3) Effective analgesia, produced by intrapleural bupivacaine resulted in significant improvement in tidal volume as measured by spirometry. 4) No signs of systemic toxicity and complications were encountered. 5) Intrapleural administration of a local anesthetics after cholecystectomy provides a satisfactory duration of analgesia.

• Women's Health Nursing
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• v.9 no.3
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• pp.235-244
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• 2003

Purpose: To examine the difference of physical discomfort and childbirth satisfaction between postpartum women with and without having taken Epidural Analgesia. Method: The subjects were divided into one group of 128 primipara taken Epidural Analgesia and the other of the same 70 women who were not taken it. Data were collected by questionnaires of their own physical discomfort and birth satisfaction at postpartum 1 to 2 days in OBGY hospitals, and data were analyzed using SPSS Program. Result: Women having taken epidural analgesia appealed higher physical discomfort than those without it in the lower limbs exercise discomfort, difficult urination, urinary retention, nausea & vomiting, whereas appeared vice versa in breast pain. Among indicators for childbirth satisfaction, women having taken epidural analgesia preferred the same delivery method later again more than those without it. Conclusion: It is confirmed that the method of epidural analgesia is not an absolute way to control labor pain, rather stir physical discomfort after childbirth and does not fully increase the women's childbirth satisfaction. Therefore, it is proposed that nurses should provide the pregnant women the right knowledge and information, thereby enabling them to select the useful method of childbirth to their own course of childbirth and health-recovering after the delivery.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.363-367
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• 1996

Background: Recently postoperative pain control with continuous epidural analgesia has been increased. This study aimes to evaluate backpain following continuous epidural analgesia by pressure threshold meter (algometer). Methods: After informed consent, 50 ASA physical status I or II patients undergoing elective gynecologic surgery were selected. After placing epidural catheter, patients received morphine 0.05mg/kg with 0.25% bupivacaine 5 ml followed by continuous infusion of 0.125% bupivacaine 100 ml with morphine 4 mg for 48 hours. backpain was measured by pressure algometer over lumbar paraspinalis at the L4 level, 5 and 7 cm from the midline on preoperative, operation day, 1st, 2nd, 3rd, and 4th postoperative days. Results: Postoperative mean pressure thresholds of were higher than preoperative value (p<0.05). Conclusion: The continuous epidural analgesia dose not provide or aggravate postoperative backpain, but it must be evaluated for long term follow-up.