• The Korean Journal of Pain
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• v.2 no.1
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• pp.97-99
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• 1989

Epidural block is used extensively in each of the fields of surgical anesthesia, obstetric anesthesia, and diagnosis and management of acute and chronic pain. New developments in the understanding of pain conduction have extended the use of continuous epidural blockade to the administration of drugs that selectively block pain conduction while leaving sensation and motor power essentially unchanged. The safety and the reliability of spinal epidural catheter techniques have permitted relief of acute and chronic pain. However, one of the important aspects of the management of the epidural catheter is the possibility of epidural infection. We have experienced a case of epidural infection during control of post-herpetic neuralgia and discuss management of the epidural catheter in this article.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.59-62
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• 1990

Epidural block is used for surgical analgesia, postoperative pain management, obstetric relief and management of chronic pain. Long-term pain control for chronic pain is achieved by development of epidural catheter placement technic. But long term placement of epidural catheteter has several problems, epidural hematoma, epidural absess and neural damage. We had successfully managed long-term placement of epidural catheter in patient with diabetic neuropathy who was susceptable to infection. The duration of epidural catheter placement was 416 days and specific complication was not occurred.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.192-204
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• 2010

Purpose: Sanhupung's pathological conditions is different from non-postpartum's disease. So it is important to analyze Sanhupung's construction, onset factors and Oriental theraphy. Methods: We studied 104 Sanhupung women visiting $\bigcirc\bigcirc$ hospital form January 2008 to December 2009. We analyzed the general characteristics, kinds of symptoms and Oriental theraphy's present condition. Also We compared patients' age, the number of live births and delivery month to the National Statistical Office's results. Results: 1. Patients over the age of 30, who have one child and who gave birth in September(14.42%) and in Summer(43.26%) occupied the highest percentage. But delivery method was not correlated with Sanhupung. 2. Musculo-skeletal symptoms(42.13%) were the most common symptoms. Wrist, waist, knees(59.59%) were the most common pain areas and the other pain symptoms (40.21%) appeared a significant portion of cases respectively. 3. In the 21~30days after delivery, the most patients visited. The number of patients admitted within 30 days after delivery or within 90 days was small comparing with Sanhupung onset. Patients treated within 10 days(47.12%) and treated only herb medicine(54.90%) were the most common. And the patients responded satisfacion or over were 88.46%. Conclusion: Patients' age, the number of born babies, delivery time were correlated with Sanhupung symptoms, but the method of delivery was not associated. And musculo-skeletal symptoms were the most common symptoms. Sanhupung patient's treatment period and methods were limited.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.285-290
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• 1997

Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

• Women's Health Nursing
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• v.7 no.3
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• pp.393-406
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• 2001

The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.354-362
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• 1996

Background: We started postoperative pain management service using an intravenous patient-controlled analgesia (IV-PCA, PCA), which is known as convenient and effective analgesic method. In this report, we describe the efficacy and safety of PCA and the experience of developing an acute pain service to treat postoperative pain using a PCA. Methods: Practices of an acute pain service were started at a ward for general surgery after preparation of the standardized protocols for PCA. In each patient, PCA was connected following administration of initial loading doses of analgesics at recovery room after operation. All patients were checked by acute pain service team once or twice daily. The scope of acute pain service was gradually spread to other departments such as orthopedic, thoracic, obstetric and gynecologic departments by requests of patients or surgeons. We managed 1,590 patients during first 22 months. among them, nine hundred seventy two cases were prospectively evaluated for their analgesis efficacy and side effects of PCA. Results: The number of patients was increased day by day. the most common type of operation was gastrectomy (21.6%). Commonly used analgesics were nalbuphine (59%) and morphine (37%). The mean duration of PCA attachment was 3.3 days. The degree of analgesia on operation day was good in 44.8% and tolerable in 52.6% of patients. Only 3.9% of patients complained severe pain during their postoperative periods. One elderly patient experienced respiratory depression (0.06%) owing to accidental misuse of PCA by his relatives. Overall patient's satisfaction was over 93%. Conclusion: According to our experiences, we conclude that PCA is an effective, relatively safe and highly satisfactory method for postoperative pain management. Because of these advantages of PCA, the creation of our acute pain service using a PCA was successful and expanded rapidly.

• Women's Health Nursing
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• v.12 no.2
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• pp.97-105
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• 2006

Purpose: The purpose of this study is to verify the effects of the Qigong training program on the anxiety and labor pains of primipara. Method: The research subjects were a total of 60 primipara who consulted a doctor regularly concerning their antenatal care. Among them, 30 people were the experimental group, and the other 30 people were the control group, and were selected as homogeneous with the experimental group. The degree of anxiety and labor pains were measured by State-Trait Anxiety Inventory(STAI) and Graphic Rating Scale(GRS). SPSS WIN 11.0 was used for data analysis. Obstetric and general characteristics between experimental and control groups, and a homogeneity test of state and trait anxiety were done by both $X^2$ test and t-test. The hypothesis testing was analyzed by ANCOVA with a covariate of pretest value. Result: The first hypothesis, 'Primipara who join the Qigong training program have lower anxiety than those who do not join' was supported (F=28.8, p<.000). The second hypothesis, 'Primipara who join the Qigong training program have lower labor pain than those who do not join' was unsupported. Conclusion: It was verified that the Qigong training program was effective in alleviating anxiety; however it did not have any effect on relieving labor pain, so more in-depth research is needed later on.

• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.2
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• pp.79-96
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• 2011

Objectives: This study was to investigate clinical usage of Guibi-tang based on actual application in obstetrics and gynecology. Methods: This study investigated the number of patients who were prescribed Guibi-tang-gami-bang and what herbal medicines were adjusted according to their chief complaint from January 1st, 2007 to August 31th, 2008. Results: The number of patients who were prescribed Guibi-tang for obstetrics and gynecological diseases at the Department of Obstetrics and Gynecology was 721. Guibi-tang has been used to treat menstrual irregularity, postpartum general weakness, postpartum pantalgia, perimenopausal symptoms and postmenopausal syndrome most frequently. And Guibi-tang has been widely used in obstetric and gynecologic diseases such as general weakness after abortion or gynecological surgery, pelvic pain, dysmenorrhea, uterine myoma, endometriosis, infertility, premenstrual syndrome, urinary incontinence and breast disease. Conclusions: Guibi-tang can be used in obstetric and gynecologic diseases as described in classical oriental medicine literatures, and it is necessary to research clinical usage of Guibi-tang through randomized controlled trial.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.2
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• pp.322-325
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• 2011

Motor paralysis by herpes zoster is rare. The incidence of herpetic motor involvement was reported to be between 0.5-31%. This case was reported to evaluate the effects of oriental medicine therapy on vocal cord paralysis and upper limb motor paralysis caused by herpes zoster. The subject was a 48-year-old man who suffering from hoarseness, right upper limb paralysis, right upper limb weakness, right post ear pain, headache. After our treatment, clinical symptoms were improved and VAS score significantly decreased. This study suggests that herbal medicine and acupuncture complex therapy is probably effective in the treatment of vocal cord paralysis and upper limb motor paralysis.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.86-96
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• 2022

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.