• The Korean Journal of Pain
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• v.27 no.2
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.713-716
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• 2013

Social and behavioral scientists have proposed that a person's belief system crucially influences his or her behaviour, and therefore may affect outcomes of pain management. The purpose of this study was to explore the relationship between analgesic beliefs, analgesic adherence and pain experience amongst Taiwanese cancer outpatients. The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese). Beliefs about pain and opioids demonstrated a significant relationship with patients' opioid adherence (r = -0.30, p < 0.01). The more negative beliefs regarding opioids and pain the patient had, the worse their adherence to around the clock (ATC) analgesic regimen. However, there was no significant correlation between opioid belief and pain experience. As well, there were no significant relationships between adherence to opioid regimen and any of the measures of pain experience. The study highlights the potential importance of a patient's pain and opioid beliefs in adherence to pain medication.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.32-38
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• 2013

Background: Intrathecal opioid administration has been used widely in patients suffering from severe cancer pain that is not managed with conventional modalities. However, the potential serious neurological complications from the procedure and the side effects of intrathecal opioids have made many clinicians reluctant to employ continuous intrathecal analgesia as a first-line therapeutic option despite its dramatic effect on intractable pain. We retrospectively investigated the efficacy, side effects, and complications of intrathecal morphine administration through intrathecal catheters connected to a subcutaneous injection port (ICSP) in 22 Korean terminal cancer patients with successful intrathecal morphine trials. Methods: Patient demographic data, the duration of intrathecal opioid administration, preoperative numerical pain rating scales (NRS) and doses of systemic opioids, side effects and complications related to intrathecal opioids and the procedure, and the numerical pain rating scales and doses of intrathecal and systemic opioids on the $1^{st}$, $3^{rd}$, $7^{th}$ and $30^{th}$ postoperative days were determined from medical records. Results: Intrathecal morphine administration for $46.0{\pm}61.3$ days significantly reduced NRS from baseline on all the postoperative days. A significant increase in intrathecal opioids with a nonsignificant decrease in systemic opioids was observed on the $7^{th}$ and $30^{th}$ postoperative days compared to the $1^{st}$ postoperative day. The most common side effects of intrathecal opioids were nausea/vomiting (31.8%) and urinary retention (38.9%), which were managed with conservative therapies. Conclusions: Intrathecal morphine administration using ICSP provided immediate and beneficial effects on pain scores with tolerable side effects in terminal cancer patients.

• Asian Oncology Nursing
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• v.11 no.1
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• pp.83-92
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• 2011

Purpose: This study was to analyze the characteristics and effect size of intervention studies in reference to cancer pain. Methods: In order to conduct a meta-analysis, a total of 208 studies were retrieved from search engine. And 29 studies published from 2000 to 2010 were selected upon their satisfaction with the inclusion criteria. The data was analyzed by the RevMan 5.0 program of Cochrane library. Results: 1) Intervention studies included 7 studies on reflexology (24.1%), 5 for pain management education (17.2%), 3 studies for each music therapy, spiritual care and hand massage (10.3%, respectively), and 2 studies for each hospice and horticultural therapy (6.7%, respectively). 2) The effect size of the intervention studies were high in hand massage (d=-0.98), reflexology (d=-0.74), spiritual care (d=-0.72), pain management education (d=-0.66), music therapy (d=-0.41), and horticultural therapy (d=-0.32). Conclusion: This study suggest that non-drug therapy can reduce the levels of cancer pain intensity, even though the numbers of intervention studies and randomized controlled trials are very rare.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.286-289
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• 2010

A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from $500{\mu}g/hr$ to $3,650{\mu}g/hr$, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl $4,050{\mu}g/hr$ for more than 16 months.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.458-467
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• 2014

Pain is one of the most common and painful symptoms that cancer patients suffer from. Pain seriously affects 30-50% of the patients at the early cancer diagnosis stage or who receive active anticancer treatments, 60-70% of the patients with progressive cancer, and 80-90% of the patients at the late stage of cancer. However, there is no systematic and easy pain control program for the cancer patients. In this study, an algorithm is proposed to provide quick pain relief service upon the occurrence of sudden pain, for the purpose of controlling the sudden pain that cancer operation survivors experience. In developing the algorithm, questionnaires, evaluation forms and National Comprehensive Cancer Network (NCCN) guideline were considered, and a trial service was provided to a group of 20 cancer patients for a month to evaluate the designed algorithm. The results of the trial service were examined by expert medical workers to evaluate the proposed algorithm, and a 90% compatibility decision was derived, which verified the effectiveness of the proposed algorithm. In the case of incompatibility decision, the management of the pain diary did not have compatible results. Therefore, the further study will additionally address the customized pain diary algorithm.

• Women's Health Nursing
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• v.27 no.1
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• pp.49-57
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• 2021

Purpose: Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). Methods: A cross-sectional survey was conducted on 123 BCS (stages I-III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. Results: Beliefs about endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with beliefs about endocrine therapy (r=-.18, p<.05). Conclusion: AI continuation intention can be modified by reinforcing patients' beliefs about endocrine therapy. Musculoskeletal pain may have a negative effect on beliefs about endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce beliefs about endocrine therapy.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.99-102
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• 1995

Psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and postoperative pain control. Nowadays this block is advocated for the management of pain in the thighs, legs and lumbar area for various reasons. To relieve pain in the thigh and leg, 21 times of block were performed and observed clinically in the 17 patients at our hospital. The results were excellent for the relief of pain in metastatic cancer patients. And this block is satisfactory in the thigh pain but not in the leg pain. So we recommend psoas compartment block as a useful and simple method for the relief of pain in metastatic cancer pain in the thigh.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.60-73
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• 2000

Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.179-185
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• 1991

We investigated the effect of oral analgesics for patients with cancer pain, retrospectively. One hundred forty six cases were randomly selected during the period between 1986 to 1990. These patients were treated with Tramadol (n=31), Tylenol III(Acetaminophen plus codein phosphate, n=44) or MS-Contin (n=71). partial to complete pain relief as achieved accord to each durg group at 67.8, 68.2 and 76.1% respectively. Minimal side effects were noted in a few patients. Our results show encouraging possibilities for pain control in cancer patients. However, futher studies should be done to find more effective cancer pain management by oral analgesics.