• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.654-665
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• 2000

The purpose of this study was to elucidate the effects of music therapy on the preoperative anxiety of surgerial patients. The research design was a nonequivalent control, group non-synch-ronized design. The data were collected during the period from January 4 to March 17, 1999 at C-University hospital in Seoul. The subjects were sixty patients who had surgery under general anesthesia and had undergone laparotomy. They were assigned to two groups, thirty to the experimental group and thirty to the control group. They also did not have any complication, were alert enough to be interviewed and agreed willingly to participate in this study. The tool of Trait Anxiety Inventory was used to measure trait-anxiety on all patients and the Visual Analogue Scale(VAS) was used to measure state-anxiety on all patients. And systolic and diastolic blood pressure, pulse rate, and blood sugar levels were collected a the day before surgery and the preoperative period. The experimental group received music therapy with self-selected music tapes after choosing from a Music Preference Questionnaire, while the control group didn't receive music therapy. Data were analyzed by ${\chi}^2$-test, t-test, paired t-test. The results of this study are summarized as follows: 1. The preoperative state anxiety of the experimental group was re-markably lower than that of the control group. 2. Decreasing rate in the vital signs of the experimental group was remarkably lower than that of the control group. 3. The preoperative blood sugar of the experimental group was remarkably lower than that of the control group. According to these results, Music Therapy can be regarded as an effective nursing intervention that relieves preoperative anxiety of surgical patients and helper stabilize vital signs. From this study, the following recommendations can be made: 1. In order to decrease surgical patient's preoperative anxiety, I suggest the nursing intervention should go side by side with music therapy.

• Korean Journal of Adult Nursing
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• v.21 no.4
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• pp.379-390
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• 2009

Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.182-190
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• 2008

Fracture of mandible is the most frequent fracture among many types of maxillofacial fracture, and reduction of mandible fracture is performed using various methods of treatment to maintain bonding strength of fractured bone. Among these treatment of bone fracture, a semirigid fixation method which can reduce the period of intermaxillary fixation using metal mini plate under general or local anesthesia is spotlighted these days. The metal mini plate used during this semirigid fixation procedure is Titanium which is bio-inactive one and was used widely, but because the side effect of fracture reduction using titanium have been demonstrated recently, fracture reduction using biodegradable plate become to attract people's attention. The purpose of this study was to report the clinical case and review of the literature with the reduction of mandible fracture using biodegradable plate.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.157-173
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• 1992

The purposes of study were to investigate the prenatal psychological adaptation and the perception of birth experience, and to identify the relationship between them. The subjects consisted of 162 women who visited the obstetrical outpatient clinic for prenatal examinations and who delivered the in babies at SNUH during the period from June 20 to August 10, 1990. The tools used for measurement were Lederman's Prenatal Self Evaluation Questionnaire and Marut & Mercer's scale of the Perception of Birth. The results are summarized as follows : 1. The orders and item means of psychosocial adaptation in pregnancy were the Acceptance of pregnancy(1.58). Identification of motherhood role(1.63). Relationship with husband(1.65) and Relationship with mother(1.67). The preparation for labor, concern for wellbeing of self and baby, and fear of pain, helplessness and loss of control were found to be less adaptive. 2. The level of the perception of the birth experience was mid-range(item mean : 3.22). The score of the perception of birth experience for primiparas was higher than for multiparas. However there was not a significant difference the groups. There were significant differences in the perception of the birth experience between certain general characteristics, namely, sex of the baby(p＜0.05), type of delivery(p＜0.005), and type of anesthesia(p＜0.005). 3. There were significant differences in the perception of the birth experience between the groups below the mean and above the mean of concerti for wellbeing of self and baby, Fear of pain, Helplessness and loss of control, Relationship with husband and Identification of motherhood role (p＜0.05). The perception of the birth experience was predicted by Fear of pain, Helplessness and loss of control (11%), Type of Delivery(6%), Concern for wellbeing of self and baby(3%), Preparation for labor(1%), sex of baby(1%), Relationship with mother(1%), Parity(1%) and Identification of motherhood role(1%). The Childbirth education should be revised to improve the psychosocial adaptation in pregnancy.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.159-165
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• 1996

Background: Epidural analgesia has been widely used for postoperative pain relief. However, it is not known which regimen provides the best result due to many variety. The aim of this study is to evaluate the analgesia and side effects of epidural mixute of fentanyl, bupivacaine and clonidine, as one kind of regimen. Methods: One hundred adult patients scheduled for upper abdominal surgery under general anesthesia were evaluated. Epidural catheterization was done after operation. A bolus, 0.1% bupivacaine 10 ml containing fentanlyl 100 ${\mu}g$, was administered and followed up with continuous infusion of mixture of fntanyl 600 ${\mu}g$, 0.5% bupivacaine 20ml and clonidine 150 ${\mu}g$ at a rate of 2ml/hr for 50 hours. Analgesia was assessed using VAS, PHS and PRS. Side effects and number of patients who took additional analgesics were evalutated. Plasma samples were obtained to determine fentanyl concentration. Results: After the administrations of drugs, patients pain scores decreased notably, and pain relief scores increased significantly. Minimum side effects were noted. Twenty-one patients required additional analgesics. Plasma concentration of fentanyl was 0.07~0.14 ng/ml. Conclusion: Epidural infusion of mixture of fentanyl, bupivacaine and clonidine is an effective regimen for postoperative pain relief after upper abdominal surgery.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.166-171
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• 1996

The purpose of this study is to compare the postoperative analgesic effect of morphine and meperidine, employing intravenous patient controlled analgesia after cesarean section. Among fifty nine parturients undergoing cesarean section with general anesthesia, 32 were administered morphine designated as 'morphine group', and 27 parturient administered meperidine as 'meperidine' group, during 48 hours after commencement of PCA. Doses administered, based on potency for this setting, were equivalent to 1 mg morphine or 10 mg meperidine. Loading dose was administered when parturient first complained of pain after cesarean section. This was followed with bolus dose, 1 mg for morphine group and 10 mg for meperidine group, with a lockout interval of 8 minutes between doses wherever parturient requested additional analgesia. Visual analog scale(VAS) pain scores during rest were significantly lower at only 1 and 2 hour for the meperidine group, than morphine group. Loading dose and cumulative dose at 1, 2 and 3 hours were significantly lower for meperidine group than the morphine group. There were no significant difference in total dose and hourly dose for 48 hours and cumulative dose at 6, 12, 24, and 48 hours between both groups. More than 90% of the parturients from both groups were satisfied with the analgesic effects of pain relief. Morphine group experienced side effects such as: pruritus, sedation and dizziness. Meperidine group had sedation, dizziness, nausea and local irritation. Neither group required any specific treatment for any of the above side effects. We conclude that meperidine had greater analgesic effect at early stage of post-operative period.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.223-227
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• 2006

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.358-364
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• 2007

Purpose: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. Methods: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. Results: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. Conclusion: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.220-225
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• 2013

Background A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients. Methods Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment. Results The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1). Conclusions The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.80-83
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• 2011

Purpose: Traumatic posterior dislocation of the shoulder in a child is extremely rare, and posterior dislocation of the shoulder concomitant with ipsilateral humeral surgical neck fracture has not been reported in a child previously in Korea. Materials and Methods: The authors treated a 10-year-old with posterior dislocation of left shoulder and an ipsilateral humeral surgical neck fracture, that occurred during Taekwondo practice, by open reduction of the shoulder and pin fixation under general anesthesia. Results: A normal range of motion with complete union and good remodeling was achieved without redislocation or avascular necrosis of humeral head at 1 year after surgery. Conclusion: The authors report a successfully treated case of traumatic posterior dislocation of the shoulder with an ipsilateral humeral surgical neck fracture in child.