• 제목/요약/키워드: Pain Care

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An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses

  • Jain, Niharika;Gupta, Abhishek;Meena, N.
    • The Korean Journal of Pain
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    • 제26권4호
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    • pp.347-355
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    • 2013
  • Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.

심리적 요인과 관련된 통증장애 - 증례 및 고찰 - (Pain Disorder Associated with Psychological Factors - Case Report and Review -)

  • 이경규
    • 정신신체의학
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    • 제10권2호
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    • pp.166-175
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    • 2002
  • 통증 생리의 생물학적 측면에 대한 새로운 지식이 폭발적으로 늘어나게 되면서, 통증에 대한 개념도 매우 많이 바뀌고 있다. 통증의 원인에 심리적, 정서적 요인들이 많이 작용하며 개인과 가족역동의 중요성, 빈번한 정신과 질환의 공존, 만성통증의 치료에 있어서 많은 정신과 약물의 사용, 그리고 다양한 치료적 접근의 중요성의 부각 동을 고려할 때 정신과 의사들은 만성통증 환자의 치료에 참여할 수 있는 능력이 있으므로 적극적으로 참여해야 한다. 그리고 현재 효과적인 통증치료에 다양한 환자의 치료가 필요한 것이 인정되고 있으며, 통증치료에서 좋은 치료 결과를 보이는 외국의 대부분의 통증센터나 통증크리닉에서는 정신과 의사의 역할이 중요하게 인식되고 있으나 아직까지 국내에서는 이러한 인식의 부족으로 정신과 의사의 참여가 거의 없어서 다양한 치료적 접근을 하지 못하고 있다. 이에 저자는 통증장애에 대하여 정신과 의사들의 관심을 환기하고 적극적인 참여를 유도하기 위하여 통증장애 환자 3 증례를 보고하고, 이에 관하여 고찰하였다. 통증장애를 다루기 위해서는 통증에 대한 생물-정신-사회적인 관점 모두에서의 전반적인 고찰을 다루어야 하지만, 본 논문에서는 심리적 요인과 관련된 통증장애 환자에 대한 종례만을 보고하므로 이를 중심으로 다루었다.

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분만통증의 경험에 관한 현상학적 연구 (Women's Experience of Labor Pain : Phenomenological Method)

  • 정은순;여정희
    • 여성건강간호학회지
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    • 제4권2호
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    • pp.203-216
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    • 1998
  • Pain is commonly characterized as a multi-dimensional experience, varing in quality as well as in intensity. So, We need to understand the lived experience of primiparous women in order to provide basic information of nursing care. Therefore, The purpose of the study is to explore the construction of labor pain experience. The data are collected through in-depth interviews of 20 primiparous women in Pusan city from March 1998 to May 1998. Their labor pain experiences conducted 1-2 days after delivery at admission room. Each interview lasted about 25 minutes average. I have interviews one time with each subject. The record was taken with the consent of the subject. Data were analyzed by means of Giorgi's phenomenological analysis methods and categorized according to the similarities of its contents. The investigator read the data repeatedly to identify and categorized themes and main meaning. Eleven themes of labor pain as experienced by these subjects were : 1) fear 2) suffering 3) evasion of pain 4) will power about overcome 5) support need 6) apprehension of parent 7) producing confidence 8) obtain his roles 9) attributing the cause of labor pain to others 10) not feeling of touching 11) ambivalence. Five main meaning identified were : 1) fear 2) evading and confrontation 3) the maturity of personality 4) unreality 5) ambivalence. The significes of this study for nursing are : 1) It enables nurses and other health care providers understand more clearly the lived experience of labor pain. 2) It provides that the way of more effective pain management.

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Small dose of naloxone as an adjuvant to bupivacaine in intrapleural infiltration after thoracotomy surgery: a prospective, controlled study

  • Amer, Asmaa Fawzy;Omara, Amany Faheem
    • The Korean Journal of Pain
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    • 제32권2호
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    • pp.105-112
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    • 2019
  • Background: Severe pain always develops after thoracotomy; intrapleural regional analgesia is used as a simple, safe technique to control it. This study was performed to evaluate whether a small dose of naloxone with local anesthetics prolongs sensory blockade. Methods: A prospective, randomized double-blinded controlled study was conducted on 60 patients of American Society of Anesthesiologists statuses I and II, aged 18 to 60 years, scheduled for unilateral thoracotomy surgery. After surgery, patients were randomly divided into two groups: through the intrapleural catheter, group B received 30 ml of 0.5% bupivacaine, while group N received 30 ml of 0.5% bupivacaine with 100 ng of naloxone. Postoperative pain was assessed using the visual analog pain scale (VAS). Time for the first request for rescue analgesia, total amount consumed, and incidence of postoperative complications were also recorded. Results: The VAS score significantly decreased in group N, at 6 h and 8 h after operation (P < 0.001 for both). At 12 h after injection, the VAS score increased significantly in group N (P < 0.001). The time for the first request of rescue analgesia was significantly longer in group N compared to group B (P < 0.001). The total amount of morphine consumed was significantly lower in group N than in the bupivacaine group (P < 0.001). Conclusions: Addition of a small dose of naloxone to bupivacaine in intrapleural regional analgesia significantly prolonged pain relief after thoracotomy and delayed the first request for rescue analgesia, without significant adverse effects.

Prevalence of incidental distal biceps signal changes on magnetic resonance imaging

  • Eugene Kim;Joost T.P. Kortlever;Amanda I. Gonzalez;David Ring;Lee M. Reichel
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.260-266
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    • 2023
  • Background: Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging. Methods: MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication. Results: Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training. Conclusions: The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care. Level of evidence: IV.

제2형 당뇨병 환자의 성별 자가관리와 자각증상 차이 (Self-care and Physical Symptom by Gender in Korean Type2 Diabetic Patients)

  • 김희승;박재순
    • 여성건강간호학회지
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    • 제9권3호
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    • pp.270-276
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    • 2003
  • Purpose: The purpose of this study was to investigate the self-care and the physical symptom and to analyse the correlation between self-care and physical symptom in type2 diabetic patients. Method: 201 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by self report self-care and physical symptom questionnaire. Results: The alcohol drinking frequency was lower in female than in male patients. The frequency of nausea or vomiting, morning headaches, lightheadedness, weakness, pain in the heart, pain in the back, stiffness in any join or muscle, and getting very tired in a short time were higher in female than in male diabetic patients. The exercise frequency was negatively correlated with physical symptom in female patients. Conclusion: The alcohol drinking frequency was lower in female than in male patients. The female patients had more physical symptoms than the male patients. The exercise frequency was negatively correlated with physical symptom in female patients.

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산욕기 과보온으로 야기된 산욕기 발한 과다에 대한 증례 보고 (The cases report of postpartum hyperhidrosis caused by keeping overwarm)

  • 조형래
    • 대한한방부인과학회지
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    • 제18권4호
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    • pp.203-210
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    • 2005
  • Purpose : The keeping warm and avoidance of cold are one of important Korean traditional postpartum care, but sometimes overwarm for example over-bundling, an overheated room or a steam bath cause heavy sweats. I observed and treated three patients complained of heavy sweats, chills, fatigue, malaise, cold sensation and pain caused by keeping overwarm for postpartum care. Although the symptoms have aggravated, they have maintained keeping overwarm because of a belief of Korean traditional postpartum care. The purpose of these cases studies are to report postpartum hyperhidrosis caused by keeping overwarm and to make a point of keeping the appropriate room temperature and humidity during puerperium. Methods : I observed and treated three patients complained of heavy sweats, chills, fatigue, malaise, cold sensation and pain caused by keeping overwarm for postpartum care. I found that a cause of the symptoms was hyperhidrosis by keeping overwarm, and administered herbal medicine and was to keep the appropriate room temperature. Results : After medication of Herbal medicine(補中益氣湯加味方) and keeping the appropriate room temperature, they were improved. Conclusion : Postpartum care is not to keep overwarm but to keep the appropriate room temperature and humidity.

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선호 음악 감상의 음악치료가 말기암환자의 통증 정도에 따른 정서 및 스트레스에 미치는 효과 (The Effects of Music Therapy by Self-Selected Music Listening on Terminal Cancer Patients' Affect and Stress by Pain Level)

  • 이은해;최성은
    • Journal of Hospice and Palliative Care
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    • 제15권2호
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    • pp.77-87
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    • 2012
  • 목적: 이 연구는 선호 음악 감상이 말기암환자의 통증 정도에 따른 정서 및 스트레스에 미치는 효과를 파악하고자 함이다. 방법: 이 연구에 참여한 대상자는 경상북도 선린병원의 호스피스 완화의료 병동에 입원한 18세 이상의 말기암환자 20명이었으며, 대상자들에게 자신이 선호하는 음악을 선택하도록 하여 각 회기 당 30분씩 총 6회 제공하였으며, 실험 전후, 사전사후 조사를 하였다. 연구 도구로는 통증 자각 척도 중 숫자 통증 등급(Numerical rating scale, NRS), 정서상태 측정 설문지, 스트레스 설문지를 사용하였다. 통증인식 수준에 따른 집단 간 차이를 비교하기 위해 실험 전 자가 통증 척도에 따라 두 집단(통증 점수가 5점 이하인 집단과 통증 점수가 6점 이상인 집단)으로 나눈 후, 주 2회로 매 1회 당 30분씩 총 6회 실험하였다. 매 회기 사전사후 정서 변화를 측정하였고, 1회기 전과 6회 후 스트레스를 측정하였다. 정서 변화와 스트레스는 대응 2-표본 비모수 통계 처리하였고, 추가 분석으로 정서 변화 검사에서 1회기 전과 매회기 후를 반복 측정 분산 분석으로 처리하였다. 결과: 정서상태 변화를 위한 사전사후 검증에서 유의한 차이가 나타났고(P<0.001), 스트레스도 감소된 것으로 나타났다(P=0.001). 두 집단은 통증 인식 수준이 달랐지만 음악치료중재를 통해 모든 대상자들은 정서상태 변화와 스트레스 감소 효과를 나타냈다. 결론: 본 연구 결과들은 선호 음악 감상이 호스피스 완화의료 병동에 입원한 말기암환자들의 통증인식 정도 차이에도 불구하고 두 집단 모두에게 정서와 스트레스를 긍정적으로 전환하기 위한 효과적이고 적절한 중재임을 보여준다.

Role of dexmedetomidine as adjuvant in postoperative sciatic popliteal and adductor canal analgesia in trauma patients: a randomized controlled trial

  • Ahuja, Vanita;Thapa, Deepak;Chander, Anjuman;Gombar, Satinder;Gupta, Ravi;Gupta, Sandeep
    • The Korean Journal of Pain
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    • 제33권2호
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    • pp.166-175
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    • 2020
  • Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

일부 고등학생의 치과치료 공포감에 대한 관련요인분석 (A relevant factor analysis on dental treatment fear in some high school students)

  • 홍선화;오정숙
    • 한국치위생학회지
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    • 제12권4호
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    • pp.741-749
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    • 2012
  • Objectives : High school students to measure fear of dental treatment, dental health care workers according to the level of reliability of this study is to determine the extent of terror was carried out. Methods : Located in Gwangju, 165 high school students were surveyed. SPSS windows ver. 11.0 by demographic characteristics and oral health characteristics of the frequency and percentage, and dental health care workers about the reliability of the Chi-square test, the general characteristics and oral health characteristics by dental fear of the t-test and one way ANOVA and were factors associated with dental fear of the stepwise multiple regression analysis was performed. General characteristics, except Cronbach-${\alpha}$ coefficient was 0.911. Results : According the general fear of Dental Treatment Fear Factor item 4, you'll feel the highest fear when you feel the muscle tension and the needle pricks your skin. The reliability of dental health care workers if the dentist lower the higher the grade, subjective oral health status is considered more reliable health was higher, the stronger the reliability of pain was significantly lower (p<0.05). Other care coordination include the reliability of sources of interest in subjective oral health history, no past experience in treating pain and increase the number of reliability was low (p<0.05), past experience and increase the number of pain during treatment the stronger the fear of more pain showed an increase (p<0.05). Conclusion : According the related factors about the fear of dental treatment, stimulus-response and fear of dental office have increased, the fear of dental treatment increase.