• 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.

• 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.

• Journal of East-West Nursing Research
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• v.11 no.2
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• pp.146-154
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• 2005

Purpose: This study was designed to identify the relationship between quality of life, perceived health status, perceived susceptibility severity to recurrence of cancer and character of object in cancer patients to provide the basic data of effective nursing interventions. Method: The subject of this study was randomly chosen from the patients diagnosed of cancer and being hospitalised or receiving chemotherapy as outpatients, at a Division of Hemato-Oncology, Department of Internal Medicine of a university hospital located in Seoul. The tool used in this study was a measurement tool for quality of life (${\alpha}=.829$), perceived health status (${\alpha}=.903$), and perceived susceptibility and severity for cancer recurrence (${\alpha}=.860$). The collected data were analysed using SPSS PC 12.0 Programme for real number, percentage, average, standard deviation, Pearson's Correlation, t-test and ANOVA, according to the purpose of this study. Result: 1) The score of quality of life in cancer patients was 3.64 point, perceived health status was 2.62 and perceived susceptibility severity to recurrence of cancer was 2.41. 2) There was a significant difference in the quality of life according to general characteristics, such as level of education, occupation, level of activity, pain, medication period, diagnosis, disease stage, purpose of medication, and recurrence. There was a significant difference in perceived health status according to age, level of activity, pain, diagnosis, purpose of medication, and recurrence. There was a significant difference in perceived susceptibility severity to recurrence of cancer according to age, level of education, and pain. 3) The cancer patients' quality of life showed significant correlation with perceived health status, perceived susceptibility severity to recurrence of cancer, pain, job, treatment purpose, relapse. The perceived health status showed significant correlation with perceived susceptibility severity to recurrence of cancer, pain, treatment purpose, relapse. The perceived susceptibility severity to recurrence of cancer showed significant correlation with pain. The relapse showed significant correlation with treatment purpose. The cancer patients' quality of life, perceived health status, and perceived susceptibility and severity for cancer recurrence, as confirmed above, showed differences according to the related factors of each subject, and it was also confirmed that those factors were significantly related with general characteristics. Upon these results, I suggest further studies on the factors that affect the cancer patients' quality of life.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.75-86
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• 2020

This study examined the effects of auricular acupressure on the pain and quality of life of lung cancer patients. Forty-four participants, and were divided into an experimental group (n=22) and a placebo control group (n=22). The patients in the experimental group received vaccaria seed to the four auricular acupressure points. In contrast, the patients in the placebo control groups received auricular acupressure on cancer-related points unrelated to pain. The intervention was implemented for six weeks, with five consecutive days a week. The pain intensity, pain pressure threshold, and quality of life score were used to validate the effects of the treatment. The pain intensity of the experimental group showed a significant decrease compared to the placebo control group after the intervention (Z=-2.78, p=.006). The pain pressure threshold of the experimental group showed a significant increase compared to the placebo control group after the intervention (Z=-2.69, p=.007). The quality of life among lung cancer patients showed a significant increase after the intervention compared to the placebo control group (t=3.20, p=.003). Therefore, auricular acupressure can be used as a proven nursing intervention method for lung cancer patients from cancer-related pain and the quality of life.

• Journal of the Korea Convergence Society
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• v.10 no.11
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• pp.445-451
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• 2019

This study was done to identify the perception of cancer pain among nurse and 4th grade medical school and to apply it to the development of systematic educational program. The subjects were 258 nurses and 211 4th grade medical school students. The results of the analysis using the SPSS WIN 18.0 statistical program showed statistically significant differences in the next question between the two groups ; "Cancer patients don't get addicted to painkillers the more often they use them.", "Cancer pain can occur regardless of age.", "Injections or neurotheraphy are not temporary, but effective over a long period of time when cancer patients have pain.", "Cancer patients are not easily addicted to painkillers compared to other patients." Therefore, it is necessary to establish the educational direction and related education programs for the theory and practice of systematic cancer pain in both groups.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.158-162
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• 2018

Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.45-49
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• 2024

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.456-462
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• 2001

Objective : Although cingulotomy has been applied to patients with affective disorders more frequently, there are numerous reports of its use for the control of severe pain. The goal of this study was to investigate the role of stereotactic bilateral anterior cingulotomy for intractable cancer pain. Method : Between January and June, 2000, we underwent stereotactic bilateral anterior cingulotomy in 6 patients for intractable cancer pain with poor response to opioids. The patients were suffering from widespread musculoskeletal or visceral pain. We made four lesions along the two tracks on either side of the cingulate cortex. Result : In all patients, pain reliefs after cingulotomy were dramatic and immediate. Five out of six patients did not require any opioids and one patient could reduce dose of opioids. There were no deaths or serious complications related to the procedure. Conclusion : These results suggested that a bilateral anterior cingulotomy might be useful method to control intractable cancer pain associated with the widespread metastatic disease. To provide rationale of bilateral anterior cingulotomy in intractable cancer pain, the theoretical mechanisms and role of bilateral anterior cingulotomy are discussed, along with our surgical techniques and the course of our patients.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.236-243
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• 2015

Background: Chemotherapy-induced peripheral neuropathy is a major side effect of anti-cancer drugs, and our knowledge of its mechanisms is lacking. Several models for chemotherapy-induced neuropathy have been introduced. However, the outcomes of these models differ significantly among laboratories. Our object was to create a model of chemotherapy-induced neuropathy in rats with cancer. Methods: Female Sprague-Dawley rats were used. Mammary rat metastasis tumor (MRMT-1) cells were implanted subcutaneously in rats. Chemotherapy-induced peripheral neuropathy was induced by injection of cisplatin once a day for four days. The responses to mechanical and thermal stimuli were examined using von Frey filaments, acetone, and radiant heat. Results: Cisplatin (2 mg/kg/day) produced mechanical allodynia, while it did not induce cold allodynia or thermal hyperalgesia. This dose of cisplatin could work successfully against cancer. Body weight loss was not observed in cisplatin-treated rats, nor were other abnormal behaviors noted in the same rats. Conclusions: Repeated injection of intraperitoneal cisplatin induced peripheral neuropathic pain in rats. Thus, this type of rat model has broad applicability in studies related to searching for the mechanism of cisplatin-induced mechanical allodynia and agents for the treatment of neuropathic pain.

• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.541-555
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• 2002

Objectives: This study is aimed to analyze the trend of research on nutrition, pain and fatigue of cancer patients in Korea, suggest direction for future research of nutrition, pain and fatigue of cancer patients. Methods: 74 studies published from 1991 to 2001 were examined according to the year of publication, types of journal, research design, types of disease, care methods, major concepts, tool and research findings. Results: 1) The number of studies related nutrition, pain and fatigue of cancer patients had increased rapidly since the 1996's(78.4%). 2) 42 nutrition, pain and fatigue of cancer patients studies(56.1%) were done for a thesis for a degree and 32 were nondegree research studies(43.9%). 3) 70 studies(94.7%) were quantitative study, which included in 40 descriptive studies(54.1%), 22 experimental studies (29.75), 5 correlative studies(6.8%), 2 comparative studies(2.7%) and 1 case study(1.4%), and 4 studies(5.3%) were qualitative study, which included in 3 content analysis studies(3.9%) and 1 phenomenological study(1.4%). 4) Researches about cancer more than 2 were the most by 48 studies (66.1%), following leukemia researches were 8 studies(10.8%), breast cancer researches were 7 studies(9.5%), gastric cancer researches were 4 studies(5.4%), pediatric cancer researches were 3 studies(4.1%), uterine cancer researches were 2 studies(2.7%). 5) Researches about chemotherapy were the most by 39 studies(52.6%), following analgesic researches were 14 studies(18.9%), researches that do not present treatment method were 9 studies(12.2%), radiation researches were 7 studies(9.5%). 6) In 22 experimental studies, the effects of 13 types of nursing interventions were tested. Research findings were effective almost but muscle relaxation therapy to decrease nausea and vomiting was no effect. Conclusion: We need more researches about research of nutrition, pain and fatigue of cancer patients, especially need to prove the effect of intervention or program for nutrition, pain and fatigue of cancer patients by experimental research designs and need more qualitative researches to identify indepth the meaning of nutrition, pain and fatigue of cancer patients.