• Asian Pacific Journal of Cancer Prevention
• /
• 제15권12호
• /
• pp.4983-4988
• /
• 2014

Background: In Muslim majority countries (MMC) opioid use for pain management is extremely low. The underlying factors contributing to this are not well defined. Aim: The aim of this study was to survey the attitudes of cancer patients towards morphine use for pain management in a MMC and identify the factors that influence patient decisions to accept or refuse morphine as treatment for cancer pain. Settings/participants: Patients were questioned whether they had pain or not, the severity and the medications for pain management. Questions included what type of medication they thought morphine was, whether or not they would be willing to take morphine if recommended for pain management and the basis for their decision if they were against morphine use. Results: Four hundred and eighty-eight patients participated in the study. Some 50% of the patients who refused morphine use and 36.8% of the patients who would prefer another drug, if possible, identified fear of addiction as the basis for their decision. Reservation of morphine for later in their disease was the case for 22.4% of the patients who refused morphine use. Only 13.7 % of the patients refusing morphine and 9.7% of the patients who preferred another drug, if possible, cited religious reasons as the basis for this decision. Conclusions: Identifying the underlying factors contributing to low opioid use for pain management in MMC is important. Once the underlying factors were identified, all efforts should be taken to overcome them as they are barriers to improving patient pain management.

• 대한통합의학회지
• /
• 제9권1호
• /
• pp.49-57
• /
• 2021

Purpose: The purpose of this study was to investigate the effect of manual lymphatic drainage (MLD) methods on muscle tone, pain, and depression in patients with breast cancer. Methods: The study had a two-group pretest-posttest design. A total of 24 patients with breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD (n=12) and control (n=12) groups. Measurements of muscle tone, pain, and depression were taken prior to starting the intervention and after completing the 4 week program. The muscle tone, pain, and depression were measured using noninvasive muscle tone measuring equipment, the short-form McGill pain questionnaire, and the Beck depression inventory, respectively. The intervention was performed for 20 minutes a day, three times a week, for four weeks. A paired t-test was used to compare pretest and posttest values within each group, and an independent t-test was used to compare to pretest and posttest changes between the groups. Results: Comparison of the effects within the groups revealed significant reductions in muscle tone, pain, and depression in the MLD group after 4 weeks (p<.05), whereas the control group showed no differences. Comparison of the effects between the groups revealed significantly better reductions in muscle tone, pain, and depression in the MLD group than in the control group after 4 weeks (p<.05). Conclusion: These results suggest that MLD is an effective method for reducing muscle tone, pain, and depression in patients with breast cancer.

• 한국산학기술학회논문지
• /
• 제21권8호
• /
• pp.75-86
• /
• 2020

본 연구에서는 이압요법을 적용하여 폐암 환자의 통증과 폐암 관련 삶의 질에 미치는 효과를 검증하고자 한다. 본 연구는 비동등성 대조군 전후 설계 유사 실험연구로 폐암 환자를 실험군, 대조군에 각각 22명씩 배정하였다. 실험군은 폐암 환자의 통증과 관련된 반응구역(점)에 이압요법을 실시하였고, 대조군은 폐암과 관련 없는 반응구역(점)에 이압요법을 실시하였다. 첩압 후 첩압 스티커는 5일 동안 유지하고 2일 휴식하는 과정을 6주 동안 진행하였다. 통증을 평가하기 위해 NRS(Numeric Rating Scale), 압통기를 이용하였다. 폐암 관련 삶의 질은 FACT-L(Functional Assessment of Cancer Therapy-Lung)의 한국어판을 사용하여 실험 전·후에 자가 설문 방법으로 평가하였다. 본 연구의 결과 통증 강도가 시간이 지남에 따라 통계적으로 유의한 차이가 있었으며(Z=-2.78, p=.006), 압통 역치도 그룹 간 통계적으로 유의한 차이가 있었다(Z=-2.69, p=.007). 폐암 관련 삶의 질 변화도 두 그룹 간 차이가 통계적으로 유의하게 나타났다(t=3.20, p=.003). 본 연구에서 시행한 6주간의 이압요법은 폐암 환자의 통증을 감소시키고 폐암 관련 삶의 질을 향상시키는데 효과가 있는 것으로 나타났다. 특히 대상자의 주관적인 통증뿐만 아니라 객관적인 통증 평가에도 효과가 있음을 확인하여 이압요법이 암 환자의 통증 조절에 효과적인 중재 방법으로 사용될 수 있을 것이다.

• The Korean Journal of Pain
• /
• 제1권1호
• /
• pp.47-52
• /
• 1988

Since 1979 forty-three cancer patients have been given intrathecal block at the pain clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most of them were in the 4th and 5th decades of age. In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in 7 cases, bladder cancer in 4 cases and colon cancer in 3 cases. Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine block and rest of them had only test block. Fourteen patients whose pain sites were lumbar or lumbar and upper sacral dermatomes were put into the lateral recumbent position on the fluoroscopic table. The spinal puncture was performed as close to the spinal roots to be impregnated as possible. In 22 patients the pain sites were covered by the sacral dermatomes and so the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the affected site. Fifty one blocks were performed and their results are classified into three categories: good, fair antral poor. We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in 2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94.2% of patients. After intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7, defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present in 3 patients. The mean duration of pain relief was 2.5 months and longer than the mean survival time of 2.25 months. When patients are selected carefully and tile block is performed with great caution and good technique, the risk is minimal and a long lasting relief of intractable cancer pain achieves a painless life until death.

• The Korean Journal of Pain
• /
• 제5권1호
• /
• pp.113-116
• /
• 1992

The psoas compartment block has been advocated as the technique of choice for the surgical correction of the fractured neck of the femur. It is, moreover, widely used as a technique for postoperative analgesia. This block has not been discribed in the treatment of pain in cancer patients unitl 1988. A 54-year-old woman with advanced stomach cancer complained of pain in the right leg. Psoas compartment block using bupivacaine and methylprednisolone; was effective for pain control. Psoas compartment block is a useful procedure and can be of particular use in patients who have not responded to opiates or find the side effects intolerable.

• The Korean Journal of Pain
• /
• 제23권1호
• /
• pp.88-91
• /
• 2010

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.

• The Korean Journal of Pain
• /
• 제4권1호
• /
• pp.42-46
• /
• 1991

Splanchnic nerve block with neurolytics has been used to control the upper abdominal cancer pain. This gastric cancer case with severe chronic obstructive pulmonary disease complained of upper abdominal pain, severe dyspnea and orthopnea. He maintained a sitting position most of the time with nasal oxygen inhalation because he could not remain in a supine or prone position. We performed the unilateral splanchnic nerve alcohol block under right lateral position at the T12 and L1 vertebral level. For a short time after the block, he required oxygen inhalation therapy. Three months after unilateral alcohol block, he is still alive without severe abdominal pain and severe dyspnea.

• The Korean Journal of Pain
• /
• 제35권2호
• /
• pp.202-208
• /
• 2022

Background: Neurolytic celiac plexus block (NCPB) is a typical treatment for severe epigastric cancer pain, but the therapeutic effect is often affected by the variation of local anatomical structures induced by the tumor. Greater and lesser splanchnic nerve neurolysis (SNN) had similar effects to the NCPB, and was recently performed with a paravertebral approach under the image guidance, or with the transdiscal approach under the guidance of computed tomography. This study observed the feasibility and safety of SNN via a transdiscal approach under fluoroscopic guidance. Methods: The follow-up records of 34 patients with epigastric cancer pain who underwent the splanchnic nerve block via the T11-12 transdiscal approach under fluoroscopic guidance were investigated retrospectively. The numerical rating scale (NRS), the patient satisfaction scale (PSS) and quality of life (QOL) of the patient, the dose of morphine consumed, and the occurrence and severity of adverse events were recorded preoperatively and 1 day, 1 week, 1 month, and 2 months after surgery. Results: Compared with the preoperative scores, the NRS scores and daily morphine consumption decreased and the QOL and PSS scores increased at each postoperative time point (P < 0.001). No patients experienced serious complications. Conclusions: SNN via the transdiscal approach under flouroscopic guidance was an effective, safe, and easy operation for epigastric cancer pain, with fewer complications.

• 한국임상약학회지
• /
• 제31권2호
• /
• pp.115-124
• /
• 2021

Background: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564-2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p=0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.

• 대한통합의학회지
• /
• 제10권4호
• /
• pp.113-120
• /
• 2022

Purpose : Lymphedema is a common complication in mastectomy patients and is usually characterized by pain, swelling, and limited range of motion (ROM) in the arm. Electromyostimulation (EMS) is widely used for the rehabilitation and recovery of subjects with various neuromusculoskeletal disorders after breast cancer. However, EMS has not yet been used in many Pilates exercises. This study was aimed at comparing the effects of instrument Pilates integrated with EMS on pain, lymphedema, and ROM of the upper extremity (UE) in breast cancer subjects after mastectomy. Methods : Nine female breast cancer subjects who had undergone mastectomy participated in the study. The subjects underwent instrument Pilates with EMS (experimental group) or instrument Pilates only (control group). Pain, lymphedema, and ROM of the UE were measured using the visual analog scale (VAS), the circumference length of the UE, and the ROM of the UE. The Wilcoxon signed-rank test was used to compare the pain, lymphedema, and ROM of the arm before and after the intervention, and the Mann-Whitney U test was used to compare the two groups. The statistical significance level was set to p < .05. Results : In the experimental group, there were significant differences in pain (p<.05) and UE circumference (p<.05) before and after intervention. However, there was no significant difference between the two groups in VAS (p>.05) or circumference length of the UE (p>.05). There was one significant difference between the groups in terms of internal rotation of the ROM of the UE (p<.05). Conclusion : These results show that instrument Pilates exercises combined with EMS may positively affect the internal rotation of the ROM of the UE in breast cancer patients after mastectomy, thus contributing to existing knowledge about instrument Pilates using EMS for the effective management of in breast cancer subjects after mastectomy.