• The Korean Journal of Pain
• /
• 제6권2호
• /
• pp.213-219
• /
• 1993

수술후 통증관리에 있어서 경막외 buprenorphine의 유용성을 알아보기 위하여 상복부 수술을 받은 환자에 있어서 morphine 2 mg 및 4 mg, buprenorphine 0.15 mg, 및 0.3 mg을 경막외로 각각 투여하여 혈압과 맥박의 변화, 작용발현기간, 작용 지속 시간, 부작용의 발생을 관찰하여 다음과 같은 결과를 얻었다. 1) 모든 군에서 혈압 및 맥박의 유의한 변동은 초래하지 않았다. 2) 작용 발현은 morphine 2 mg군에서는 약물 주입후 30분에, 나머지 군에서는 15분에 유의하게 나타났다. 3) 진통 지속 시간은 morphine 2 mg 군에서는 $10.79{\pm}3.64$시간이었고, morphine 4 mg군에서는 $21.13{\pm}4.36$시간, buprenorphine 0.15 mg군에서는 $15.19{\pm}3.12$시간, buprenorphine 0.3 mg군에서는 $33.94{\pm}3.97$시간이었다. 4) 부작용의 발생은 buprenorphine군에서 오심, 구토가 많았으며, 졸림증이 현저하게 많았고, 소양감과 배뇨 곤란은 morphine군에서 많았다. 이상의 결과로 수술후의 통증관리에 있어서 경막외로의 buprenorphine주입은 유용한 방법이며, 경막 외 morphine에 비해 장점과 단점을 아울러 포함하고 있다고 사료된다.

• The Korean Journal of Pain
• /
• 제27권3호
• /
• pp.278-284
• /
• 2014

Background: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. Methods: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. Results: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P<0.05). The methylprednisolone + etoricoxib combination caused a significant reduction in postoperative pain and fentanyl consumption as compared to methylprednisolone or etoricoxib alone (P<0.05); however, there was no significant difference between the methylprednisolone and etoricoxib groups (P>0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P<0.05). Conclusions: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo.

• 한국수산과학회지
• /
• 제34권6호
• /
• pp.672-677
• /
• 2001

2000년 5월 부산에서 수입 냉동어 S. stellatus에 의하여 발생한 설사성 식중독의 원인성분을 규명하기 위하여 조사한 결과는 다음과 같다. 식중독 환자들의 증상은 $0.5\~2$시간 (평균 1시간)에 증상이 시작되었으며 주된 증상은 소화기계의 설사 ($92\%$), 메스꺼움 ($77\%$), 복통 ($54\%$), 구토 ($46\%$), 두통 ($31\%$), 어지러움 ($23\%$), 발열 ($16\%$) 등의 순으로 나타났다. 어육 추출물로부터는 식중독과 관련된 어떠한 자연독 성분도 검출되지 않았으며, diacyl glycol빌 ethers (DAGEs)를 다량 함유한 특이 지질이 다량 ($23\%$) 함유되어 있었다. 설사의 원인으로 추정되는 DAGE의 alkyl chain에는 16:0, 18:1이 주성분이었으며 8개의 다른 장쇄 alkyl chain이 소량 함유되어 있었고, DAGEs의 sn-1,2에 결합된 주요 지방산은 oleic acid (18:1)이었다. DAGEs를 구성하는 분자종은 O-16:0-18:1-18:1($16.2\%$),O-16:0-18:1-22:1 ($14.7\%$), O-18:0-18:1-22:1 ($11.0\%$)이 주된 구성성분이었다.

• 대한장애인치과학회지
• /
• 제5권1호
• /
• pp.12-17
• /
• 2009

Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients' disabilities altogether.

• 한국임상약학회지
• /
• 제28권2호
• /
• pp.101-106
• /
• 2018

Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.

• 지역사회간호학회지
• /
• 제13권3호
• /
• pp.541-555
• /
• 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.

• 대한임상독성학회지
• /
• 제2권1호
• /
• pp.41-44
• /
• 2004

With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

• The Korean Journal of Pain
• /
• 제7권1호
• /
• pp.78-83
• /
• 1994

수술후 통증치료에 morphine과 buprenorphine의 효과를 알아보기 위하여 morphine과 buprenorphinec을 단독 투여하거나(1, 2군) buprenorphine과 ketorolac을 반량씩 혼합하여 지속적으로 정주(3군)하여 다음과 같은 결과를 얻었다. 1) 각군에서 모두 혈압과 맥박의 의의있는 변화는 초래하지 않았다. 2) Visual analogue scale으로 평가한 진통 발현은 각군에서 모두 비슷하였다. 3) Visual analogue scale과 Prince Henry Scale로 평가한 진통효과는 morphine군에서 가장 우수하였고, buprenorphine군과 buprenorphine+ketorolac의 반량 투여군에서는 비슷하였다. 4) 부작용의 발생은 1군과 2군에서 비슷하였으나 3군에서 가장 낮았다. 이상의 결과로 보아 지속적 정주에 의한 술후 통증의 억제에 있어서 buprenorphine은 morphine을 대치할 수는 있으나 morphine보다 우수하지는 못한 것으로 사료되며, buprenorphine 사용시는 ketorolac을 병용하여 사용량을 줄염으로써 부작용을 줄일 수 있을 것으로 사료된다.

• The Korean Journal of Pain
• /
• 제33권3호
• /
• pp.234-244
• /
• 2020

Background: Chronic pain affects approximately 22% of the world's population. Opioids can be useful in chronic pain management. However, some patients have negative perception of opioids. The purpose of this research was to evaluate patients' perception about opioids and investigate problems associated with prescribing and taking opioids in South Korea. Methods: Patients who visited a pain clinic in 14 university hospitals of South Korea from September through October 2018 were asked to complete anonymous questionnaires about taking opioids. Results: Of the 368 patients that were surveyed (female 53.3%, male 46.7%), 56.8% were prescribed opioids. In the opioid group, 92.8% patients had heard of opioids from their doctor and 72.6% of them had a positive perception about opioids. The side effects associated with opioid use were constipation (35.4%), dizziness (24.6%), nausea and vomiting (17.4%), dysuria (6.2%), and addiction (2.0%). In the no opioid group, the primary sources of information about opioids were doctors (49.2%), mass media (30.8%), and the internet (16.2%). The main reasons why 39.0% patients did not take opioids were fear of addiction (57.7%) and side effects (38.5%). There were 71.5% and 60.9% patients in the opioid and no opioid group, respectively, who wished to take opioids when their numeric rating scale pain score was ≥ 7. Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons.

• 한방안이비인후피부과학회지
• /
• 제12권1호
• /
• pp.396-407
• /
• 1999

Although tinnitus is a common disease, it's reason, pathogenesis and treatment are not examined clearly. As tinnitus is a subjective complaint, it is not easy to evaluate objectively and to compare with another. In this study, we intend to estimate the effect of a variety of oriental medical treatments to tinnitus. We inquired about 30cases of tinnitus patients visited the Kwang-ju Oriental Medical Hospital of Wonkwang University from Apr. 1998 to Sep. 1998. We examined the 30cases in the view of sex, age, occupation, duration, etiologic factors, past history, associating symptoms, quality of tinnitus, and recovery rate after treatments. The results were as follows: 1. In distribution of sex, the ratio of male was $63.3\%$(19cases)and\;female\;was\;36.6\%$(11cases). 2. In distribution of age, the ratio of the 2th decade was $6.6\%(2cases),\;the\;3th\;decade\;was\;20.0\%(6cases),\;the\;4th\;decade\;was\;16.6\%(5cases),\;the\;5th\;decade\;was\;23.3\%(7cases),\;the\;6th\;decade\;was\;30.0\%\;(9cases),and\;the\;7th\;decade\;was\;3.3\%(1case)$. 3. In distribution of occupation, the ratio of employee was $23.3\%$(7cases), house-keeper was $63.3\%(11cases),\;farmer\;was\;16.6\%(5cases),\;teacher\;was\;13.3\%$ (4cases), and student, merchant, soldier was each $3.3\%$(1case). 4. In distribution of duration, the ratio of under 1month was $6.6\%$ (2cases), 1 month -6 months was $20.0\%$(6cases), 6 months- 12months was $30.0\%$(9cases), 12months-36months was $23.3\%$(7cases), and over 36months was $20.0\%$(6cases). 5. In etiologic factor of tinnitus, the ratio of unknown reason was $40.0\%$ (12cases), overwork was $16.6\%$(5cases), emotional stress was $10.0\%$(3cases), noise was $6.6\%$(2cases), cases of laying overwork upon stress was $13.3\%$(4cases), head trauma was $3.3\%$(1case), gun report was $3.3\%$ (1case), and after sickness was $6.6\%$(2cases). 6. 9 cases had experienced such a disease as meniere's disease, tympanitis, labyrinthitis, trauma of tympanum, hypertension, etc. 7. Commonly associated symptoms were dizziness, deafness, uneasiness, headache, ear fullness, fatigue, insomnia, nausea, vomiting, and forgetfulness. 8. Most frequent quality of tinnitus were buzzing, whistling, humming etc. 9. In $76.6\%$(23cases) of tinnitus patients, it was improved, but in $23.3%$(7cases) of them, not improved. Total recovery rate was $42.2\%$.