Post-tonsillectomy pain in children is a difficult problem to manage. We examined the effect of 10% aerosol lidocaine for the post-tonsillectomy analgesia. ASA physical status I or II, between five and thirteen years of age were assigned, in a randomized fashion, into two groups. The Group I, 30 patients, received a total dose of 4 mg/kg of ten percent aerosol lidocaine on the tonsillar beds. Lidocaine was administered at the end of the surgical procedure. The Group II, 30 patients, were not sprayed with lidocaine aerosol. The postoperative pain scores were assessed by a "red and white" visual analoge pain scales (VAPS). VAPS values were obtained at one and eight hours after the operation. Values of one hour after the operation in the group I and II were $20.83{\pm}10.01$ and $34.50{\pm}10.53$, values of eight hours after the operation were $17.33{\pm}9.07$ and $23.5{\pm}11.08$. The post-tonsilectomy pains were significantly lower in the group I compared with the group II at one and eight hours after the operation. In conclusion, 4 mg/kg of ten percent aerosol lidocaine applied directly on the tonsillar beds was showen a superior, immediate post-tonsillectomy analgesic technique.
Purpose: This study was done to identify nursing interventions clinically applicable to relieve displeasure and anxiety of patients having an operation in which loud noise was unavoidable. Methods: Participants were 34 patients scheduled to have a total knee replacement. They were assigned to either the control (17 patients) or experimental (17 patients) group. Data were collected from September to November 2010. The instruments used for the survey included noise-control earplugs, a noise level meter (TES-1358) and a structured scale measuring degree of noise perception, displeasure and anxiety. Data were analyzed using frequency, percentage, standard deviation, $x^2$-test, and t-test with the SPSS WIN 18.0 program. Results: Hypothesis 1: 'The displeasure levels of the experimental group of patients wearing earplugs will be lower than the control group patients without earplugs' was accepted (t=-20.769, p<.001). Hypothesis 2: 'The anxiety levels of the experimental group of patients wearing earplugs will be lower than the control group patients without earplugs' was accepted (t=-6.298, p<.001). Conclusion: Based on these findings, the wearing of earplugs for patients having a surgical operation with loud noises is recommended as an effective nursing intervention to relieve patient displeasure and anxiety during their surgical operations.
Objective : The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. Methods : Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. Results : When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. Conclusion : The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.
Journal of the Korean Society of Fisheries and Ocean Technology
/
v.30
no.1
/
pp.1-12
/
1994
Stow-net is originally spreaded with a lifting beam and a depressing beam. The net is improved by using canvas-made spreading devices by Mr. Han and his colleagues in the beginning of 1980's. The net is improved again by changing the partial shape of netting and arrangement of net pendants so as to be fitting with the actual performance of the net by Dr. Lee and his colleagues since 1988. The author studied to compare the fishing efficiency of those two kinds of nets(The former which was improve by Mr. Han is expressed as a traditional net and the latter improved again by Dr. Lee is expressed as an improved net in the present study). Twenty-one stow-netters concerned with the present study were selected among those based on the Port of Inchon, and were classified into two groups-eleven of them are a traditional net used group and ten are an improved net used group. The data on the fishing operation from August 1992 to March 1993, including the catch, the price of sell, the fishing operated times in every cruise and the fished position noticed by every stow-netter were offered by concerned stow-netters. From the data the times of operation, catch and value in every cruise were extracted and analyzed. The results obtained can be summarized as follows: 1. The times of operation in cruise were 13.7 by the traditional net used group and 12.7 by the improved net used group. 2. The mean catch per cruise showed 10.1M/T in the traditional net used group and 12.2M/T in the improved net used group, so the latter showed 21% better. 3. The mean catch per operation showed 0.7M/T in the traditional net used group and 0.9M/T in the improved net used group, so the latter showed 28% better. 4. The rate of three important species(starks, hair tail and croakers) in the total catch showed 83%, and the catch showed greater by the improved net used group at the rate of starks 141%, hair tail 110%, croakers 107%. 5. The rate of three important species in the total price showed 82%, but the price of starks which occupied the biggest in catch showed merely 5%, then the economical efficiency appeared low. 6. The mean price per stow-netter and per operation showed about 20%, greater respectively by the improved net used group and the mean price per operation by two important species(hair tail and croakers) showed greater about 30% by the improved net used group.
Purpose: The purpose of this study was to identify the effect of the exchange of saline used in surgical procedures on surgical site infections. Method: Patients with stomach cancer were assigned to the experimental group or to the control group by random sampling, respectively. The experimental group received an exchange of saline during the operation right after the excision of the stomach in a gastrectomy but the control group did not. Data were collected from the medical charts of 34 patients from Dec. 1, 2002 through May 31, 2003. Result: The surgical site infection rate of the experimental group was 5.9% while surgical site infection rate of the control group was 17.6%. In total, the surgical site infection rate was 11.8%. The experimental group maintained a normal level of WBC on post operative day 3; however, the control group, showed an increase of WBC on post operative day 3. Conclusion: The exchange of saline used in an operation immediately after the excision of the stomach in a gastrectomy decreases the contamination level of saline used in the operation, and can prevent surgical patients from a surgical site infection.
Jang, Jae Youn;Ko, Young Hwii;Song, Phil Hyun;Choi, Jae Young
Journal of Yeungnam Medical Science
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v.36
no.1
/
pp.16-19
/
2019
Background: This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast. Methods: Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into three groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively compared between three groups. Results: No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time-group 1, $71.3{\pm}46.6min$; group 2, $33.0{\pm}13.7min$; and group 3, $24.6{\pm}8.0min$. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient. Conclusion: Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.
Kim, Eun-Young;Jung, Kyu-Whan;Park, Tae-Jin;Park, Kwi-Won;Jung, Sung-Eun;Kim, Hyun-Young
Advances in pediatric surgery
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v.16
no.2
/
pp.117-125
/
2010
Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.
Background: Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). Methods: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. Results: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. Conclusion: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.
Objective: To observe the influence of propofol, isoflurane and enflurance on interleukin-8 (IL-8) and IL-10 levels in cancer patients. Methods: Ninety cancer patients with selective operation from March 2011 to May 2014 were randomly divided into group A (34 cases), group B (28 cases) and group C (28 cases). Intramuscular injections of scopine hydrochloride and phenobarbital sodium were routinely conducted to 3 groups. After general anesthesia was induced, tracheal intubations were given. During the maintenance of anesthesia, 0.5~1.0 mg/kg propofol was intravenously injected to group A discontinuously, while continuous suctions of isoflurane and enflurance were subsequently performed to group B and C correspondingly. Clinical outcomes, postoperative complications as well as serum IL-8 and IL-10 levels before operation (T0), at the time of skin incision (T1), 3 h after the beginning of the operation (T2) and 24 h (T3) and 72 h (T4) after the operation were observed among 3 groups. Results: Operations in all groups were successfully completed. The rates of surgery associated complications were 8.82% (3/34), 7.14% (2/28) and 7.14% (2/28) in group A, B and C, respectively, and there were no significant differences (P>0.05). Serum IL-8 and IL-10 levels increased gradually from the beginning of the operation and reached the peak at T3, and were evidently higher at each time point than at T0 (P<0.01). At T1, serum IL-8 and IL-10 levels had no significant differences among 3 groups (P>0.05), but the differences were significant at T2, T3 and T4 (P<0.05). Moreover, correlation analysis suggested that serum IL-8 level was in positive relation with IL-10 level (r=0.952, P<0.01). Conclusions: Propofol, which is better in inhibiting serum IL-8 secretion and improving IL-10 secretion than isoflurane and enflurance, can be regarded as a preferable anesthetic agent in inhibiting traumatic inflammatory responses.
The present study applied the IPA(Importance-Performance Analysis) to derive several practical alternatives for the improvement of Chuncheon Silver Orchestra program using IPA(importance-performance analysis). Most importantly, this work performed a comparative study using sample data collected from two groups of silver member(N=53) and program operator(N=32). A careful literature review leaded to the development of six types of evaluation sectors, including 'connection with the local community', 'budget operation', 'program operation', 'manpower operation', 'public relations strategy' as well as 'environment for program operation'. This work further devised twenty-two evaluation items. The results indicated that silver member group rated 'manpower operation' the highest in their both perceived importance and performance. Program operator group rated 'budget operation' and 'manpower operation' rated the highest in their perceived importance and performance, respectively. The results form IPA matrix analysis provides an important implication that much efforts and interests should be sustainably given from the perspective of the silver member group and the program operator group coupled with four types of IPA quadrant, accordingly.
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