• The Korean Journal of Pain
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• 제34권3호
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• pp.304-314
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• 2021

Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

• The Korean Journal of Pain
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• 제13권1호
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• pp.93-96
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• 2000

Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.

• The Korean Journal of Pain
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• 제25권4호
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• pp.254-257
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• 2012

Background: Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Methods: Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. Results: We observed significantly better comprehension in the video education compared with paper instruction (P < 0.001). Patient satisfaction was also higher in the video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P < 0.001). Proportion of referral-line call for further explanation were similar (P = 0.302). Conclusions: Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

• 대한임상검사과학회지
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• 제39권1호
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• pp.42-48
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• 2007

This study was carried out to review and evaluate anti-CCP ELISA assay for diagnostic in RA patients from an early arthritis clinic (EAC). The subjects were obtained from patients visiting the outpatient clinic of the Dept. of Rhumatology med.of P hospital in Daegu, during 6 months from July 1, 2006 to December 31, 2006. The subjects were 140 cases : 80 cases from RA patients (60 women and 20 men; mean age 58 years; range, 32-68 years) confirmed by clinical diagnostic. 39 cases of these RA patients were classified as having early RA (EAC). 50 cases (non-RA) did not fulfill the criteria for RA, and 10 cases were from healthy individuals. We performed the analysis with solid phase-ELISA method (ETI-max3000, Diasorin; Italy) for anti-CCP and Nephelometry assay (Roche/Hitachi 902 analyzer; USA) for RF. The results obtained were summarized as follows ; anti-CCP ELISA is more specific than RF Nephelometry assay (specificity 94% vs 90%) to diagnose RA patients with suspected EAC (early arthritis clinic). The combination test "anti-CCP and RF" had a very high specificity (specificity 98.3%, PPV; RA group 96%, EAC 95%), the difference was statistically significant (p<0.05). Anti-CCP ELISA had more sensitivity in EAC (Early arthritis clinic) patients than chronic RA patients (sensitivity 64% vs 24%, respectively), anti-CCP of RA group and EAC group was more specific than RF (anti-CCP PPV; 92%, 89% vs 89%, 81% respectively), the difference was statistically significant (p<0.05). The difference of antibody concetration between anti-CCP and RF for RA and the control group is statistically significant (p<0.05). In conclusion, anti-CCP ELISA testing may be useful if performed concomitantly with RF Nephelometry assay to diagnose RA patients with suspected EAC (early arthritis clinic).

• Journal of Genetic Medicine
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• 제18권1호
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• pp.38-43
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• 2021

Purpose: Demand for genetic counseling on cancer predisposition syndrome is increasing. We evaluated the psychological effect on counselees after genetic counseling at a clinic in a single center. Materials and Methods: We surveyed a total of 72 enrolled participants who visited a genetic counseling clinic at the Samsung Medical Center (SMC). The initial survey was conducted before the first genetic counseling session, and the second survey was conducted after the second genetic counseling session. A total of 43 participants completed both the initial and second surveys. Results: The initial survey of 72 participants indicated higher feelings of guilt in the group with religion, higher depression and anxiety in the group with a diagnosis of self, and higher anxiety in the group on self-referral to the genetic counseling clinic. In the completed survey of 43 participants, overall decreased depression was observed after the second genetic counseling session (P=0.013). Risk perception and anxiety decreased in the group diagnosed with benign variant/variant of uncertain significance (BV/VUS, 25/3) and increased in the group diagnosed with pathogenic variant (PV, 15). Risk perception and anxiety differed between the BV/VUS and PV groups (P<0.001 and P=0.03, respectively). Conclusion: The genetic counseling clinic at the SMC was effective in ameliorating the depression score. Assessment of survey results revealed different depression scores, feelings of guilt and anxiety, and different effects of the genetic counseling clinic, depending on the subgroups. Understanding the needs and psychological characteristics of different groups is necessary for improving genetic counseling services.

• 임상간호연구
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• 제22권3호
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• pp.305-313
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• 2016

Purpose: The purpose of this research was to identify the effects of providing an information service program by media on preoperative anxiety and postoperative educational satisfaction in patients with cataract surgery. Methods: For this study 52 patients who visited the ophthalmology clinic at P Hospital in B metropolitan city and who were scheduled to undergo one-day cataract surgery under local anesthesia were recruited. The 52 patients were assigned to the experimental group (25) or the control group (27). This study was conducted from August 27, 2015 to May 29, 2016. Results: Following the provision of cataract surgery related information service by media, the experimental group had a lower mean score for anxiety and higher mean score for educational satisfaction compared to the control group of patients. Conclusion: Results indicate that information service program by media "Goodbye Cataract" is useful educational materials for cataract patients in outpatient department and outpatient operating rooms.

• 한국산학기술학회논문지
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• 제16권12호
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• pp.8820-8829
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• 2015

최근 질병 치료과정에서 의료서비스에 대한 인식이 부각되면서 의료기관의 서비스 공간과 대기시간에 대한 연구가 활발히 진행되고 있다. 특히 종합병원 이용 시 방문자의 장시간 대기가 불가피하고, 이것은 환자에게 심리적 불안 및 부정적 감정으로 다가 올 것이다. 이는 의료소비자들의 불만을 가중시키고, 병원의 재방문 가능성을 낮추는 요인으로 작용하기 때문에 병원의 마케팅 및 이미지 제고를 위해서 대기시간의 연구가 절실한 실정이다. 따라서 본 연구는 의료서비스과정에서 발생하는 대기시간의 변수인 대기 환경과 대기 환자의 태도가 체감 대기 시간에 어떠한 영향을 주는가를 알아보고 병원 계획의 대안을 제시한 것을 연구목적으로 한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• 대한치과마취과학회지
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• 제5권1호
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• pp.6-14
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• 2005

Chronic periodontitis is one of the most common diseases in clinical dentistry, which requires various surgical interventions to treat the moderately to severely destructed supporting periodontium. Most patients have anxiety and fear to these surgical procedures and dentists often have problems dealing with these patients. By applying the conscious sedation technique in outpatient units, periodontists have become able to manage their patients successfully with less anxiety or fear. Also, we have experienced the increased level of patients' satisfaction. Generally, periodontal treatments are time consuming procedures and patients are usually reluctant to the periodontal instruments. This study is focused on the sedation procedure with intravenous midazolam infusion performed in Department of Periodontology of Ewha Womans University Hospital. Using questionnaires, we evaluated 80 randomly selected patients for the anxiolytic effect of intravenous midazolam. Anxiety control using IV sedation was very helpful in performing various periodontal reconstructive and advanced surgical procedures in implant dentistry.

• 대한치과마취과학회지
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• 제4권1호
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• pp.17-20
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• 2004

Chronic periodontitis is one of the most common disease in clinical dentistry, which needs various surgical interventions to treat the moderate to severe destruction of supporting periodontium. Most patients have fear and anxiety to these surgical procedures and some dentists also have problems to deal with these patients. Applying the conscious sedation technique in outpatient units, periodontists have become to manage their patients successfully without any fear and anxiety and increased the level of patients' satisfaction. Particularly, periodontal treatments require relative long chair-time and patients are usually reluctant to the periodontal instruments used in the oral cavity. This study is focused on the sedation procedure with intravenous midazolam infusioon performed in Department of Periodontology, Ewha Womans University Hospital. The whole procedure of intravenous midazolam sedation is briefly reviewed from patient selection to patient discharge.