• The Korean Journal of Pain
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• v.5 no.1
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• pp.69-75
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• 1992

The author experienced of four patients with intractable pain who were treated by continuous intraventricular infusion of morphine through an implanted port system. One suffered from tongue cancer and the others from bone metastasis or distant metatasis of abdominal cancer which were ineffectively to managed through an epidural route. Our experience is that this is a safe and effective method of pain management in patients with head and neck cancer. It is useful as well in patients who have intractable pain that cannot be managed through an intrathecal or epidural route.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.71-74
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• 2014

Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to $80^{\circ}C$ for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.

• Journal of Pharmacopuncture
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• v.6 no.1
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• pp.16-17
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• 2003

Objectives : This study was designed to evaluate effects of 'Soyeum' on cancer patients accompanied by pain. Materials and Methods : We retrospectively analyzed the medical records of 9 patients accompanied by pain who had been injected with 'Soyeum' for over 14 days continuously in East-West Cancer Center of Oriental Hospital of Daejeon University from June 2002 through august 2002. Results : The statistical significance between the pre-treatment and post-treatment results (Changes of Cytokine Level, QOL, BPQ and Pain relief after pain management) were analyzed. Analysis of cytokines (IL-12, IFN- ) level showed that the percentage of increase of lL-12 is $60\%$, IFN- is $60\%$. Analysis of QOL showed that the percentage of maintenance and improvement is $77.8\%$. $55.5\%$ of the patients reported a 'worst pain' intensity score of 3 or greater, $44.5\%$ reported a 'least pain' intensity score of 2 or greater, and $66.7\%$ reported 'average pain' intensity score of 2 or greater. $33.3\%$ of the patients were in pain at the time of interview and $22.2\%$ had a current intensity score of 2 or greater. Analysis of pain relief after pain management showed that the percentage of pain relief score of 2 and 3 is $55.6\%$. The data was expressed as Mean SE by using descriptive statistics. Statistical significance examined by using paired t-test. Conclusions : It is suggested that 'Soyeum' has effects on pain of cancer patients, also expected that 'Soyeum' is useful to improve immunoactivity and for cancer patients

• The Korean Journal of Pain
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• v.13 no.2
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• pp.259-262
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• 2000

There are many difficulties in the management of terminal cancer pain. We often encounter difficulties when nerve blocks or epidural injection of drugs do not produce good results. Local anesthetics, opioids and adjunctives, were administered to two patients intrathecally. The results were very satisfactory. It has complications such as hypotension or infection due to intrathecal route. In the first case, the pancreatic cancer patient complicated with severe epigastic pain but unfortunately no management was effective in pain control. Intrathecal injection of bupivacaine and morphine mixture was successful even if syncope which was relieved by bed rest. In the second case, the patient complicated with lower abdominal pain due to ovarian cancer who very well controlled by epidural injection of morphine and clonidine mixture but morphine demand was greatly increased. Intrathecal injection of morphine and ketamine were tried. The patient had comportable analgesic effect. CSF leakage to subcutaneous occurred but resolved by change of the catheter position or retunnelling. There were no significant complications reported in two cases.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.240-245
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• 2007

It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.2
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• pp.196-204
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• 2006

Purpose: This study was purposed to identify the effect of pain monitoring program for improving the knowledge, attitude and assessment ability of cancer pain in oncology nurses. Methods: In this study pain monitoring program was developed based on the literature, and constructed it with various teaching method including several group lectures, workshop, focus group and implementation at the clinical practices. In order to test the effect of this program, contrast group, pretest-post test quasi-experimental design was designed. 46 oncology nurses randomly assigned to either control or experimental group. The tool used are 32 item scale for the evaluation of the nurses' knowledge, attitude toward pain modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The pain monitoring program for the oncology nurses was statistically significant for improving the level of the knowledge about and attitude toward pain management, and pain assessment behavior. Conclusion: More sensitive multiple measurement tool for the attitude toward pain management needs to be developed. Nurses need more knowledge and effective attitude toward cancer pain management. Pain monitoring program in this study is effective to improve the quality of pain management.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4983-4988
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• 2014

Background: In Muslim majority countries (MMC) opioid use for pain management is extremely low. The underlying factors contributing to this are not well defined. Aim: The aim of this study was to survey the attitudes of cancer patients towards morphine use for pain management in a MMC and identify the factors that influence patient decisions to accept or refuse morphine as treatment for cancer pain. Settings/participants: Patients were questioned whether they had pain or not, the severity and the medications for pain management. Questions included what type of medication they thought morphine was, whether or not they would be willing to take morphine if recommended for pain management and the basis for their decision if they were against morphine use. Results: Four hundred and eighty-eight patients participated in the study. Some 50% of the patients who refused morphine use and 36.8% of the patients who would prefer another drug, if possible, identified fear of addiction as the basis for their decision. Reservation of morphine for later in their disease was the case for 22.4% of the patients who refused morphine use. Only 13.7 % of the patients refusing morphine and 9.7% of the patients who preferred another drug, if possible, cited religious reasons as the basis for this decision. Conclusions: Identifying the underlying factors contributing to low opioid use for pain management in MMC is important. Once the underlying factors were identified, all efforts should be taken to overcome them as they are barriers to improving patient pain management.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.115-124
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• 2016

The purpose of this converged study is to find nurses' knowledge and performance of cancer pain management targeting 295 nurses in M City. Cancer pain management knowledge and performance scales by Jo(2009) were the research tool used. Using SPSS 18.0, t-test, ANOVA, Multiple Linear Regression were carried out. The average scores of knowledge and performance were $19.2{\pm}6.16$ out of 30, and $3.12{\pm}0.40$ out of 4 each. There was a significant difference between nurses' knowledge and performance according to Cancer Pain Management Guideline(CPMG). There was a positive correlation between nurses' knowledge and performance(r=.488, p=.001). Explanation rate of the knowledge on the performance was 38.6%. For the purpose of increasing nurses' performance level of cancer pain management, systematic education and elevating awareness of CPMG are needed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.548-553
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• 2007

In general, cancer pain is neither fully recognized nor adequately treated. The inadequate pain control is due to failure of accurate assessment of cancer pain. This study was aimed to understand various characters of cancer pain and investigate available assessment scales which have been designed for, or frequently used with people with cancer pain. A total of 23 articles were selected from two different databases. The selected articles were analyzed according to three aspects of initial assessment, patient self-report and assessment of the outcomes of pain management. The characters of cancer pain is complex and includes physical, psychosocial, and spiritual dimension. Also, subjective pain can be classified into at least four specific factors, such as pain intensity, pain affect, pain relief, and pain quality. Based on various classification, the pain assessment scales can be divided into unidimensional or multidimensional. Among the more commonly used clinical tools are numeric rating scales, verbal rating scales, visual analog scales, and picture scales. Above all, in order to assess cancer pain objectively, the clinician must select appropriate assessment instruments which reflect pain definition and clinical purpose.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.22-29
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• 2024

Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.