• Korean Journal of Adult Nursing
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• v.24 no.1
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• pp.20-30
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• 2012

Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.117-120
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• 1997

Cancer is a devastating disease, and the treatment of related pain is an extremely challenging task. Providing adequate analgesia while avoiding unnecessary drug effects often requires a polypharmacologic approach in cancer pain management. A 36-year old woman with breast cancer metastatic to the axial skeleton and bilateral hip joints was admitted to hemato-oncology service with complaints of intractable abdominal and hip pain. Despite rapidly increasing doses of intravenous morphine up to 350 mg per day; transdermal fentanyl; midazolam; ketorolac; lorazepam; dexamethasone, the patient continued to describe her pain as 10 of 10, refusing all surgical/diagnostic interventions not directly related to pain control. She did, however, consent to lumbar epidural catheter placement. The patient was sedated with titrating doses of propofol to assist with positioning. Even though the procedure was not successful due to significant thoracolumbar scoliosis, the patient admitted feeling better than she has in months during attempted placement. After continuous infusion of propofol was initiated at subhypnotic dose, the patient's analgesic demand was drastically reduced and described her pain as "1 to 3" of "10". Approximately 96 hours after the propofol infusion was started, the patient expired comfortably. There had been no change in her medical regimen during fecal 48 hours. In the case described, propofol was extremely advantageous as an adjuvant in the management of cancer related pain.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.2
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• pp.196-204
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• 2006

Purpose: This study was purposed to identify the effect of pain monitoring program for improving the knowledge, attitude and assessment ability of cancer pain in oncology nurses. Methods: In this study pain monitoring program was developed based on the literature, and constructed it with various teaching method including several group lectures, workshop, focus group and implementation at the clinical practices. In order to test the effect of this program, contrast group, pretest-post test quasi-experimental design was designed. 46 oncology nurses randomly assigned to either control or experimental group. The tool used are 32 item scale for the evaluation of the nurses' knowledge, attitude toward pain modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The pain monitoring program for the oncology nurses was statistically significant for improving the level of the knowledge about and attitude toward pain management, and pain assessment behavior. Conclusion: More sensitive multiple measurement tool for the attitude toward pain management needs to be developed. Nurses need more knowledge and effective attitude toward cancer pain management. Pain monitoring program in this study is effective to improve the quality of pain management.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.123-128
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• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.155-160
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• 2012

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit $II^{(R)}$ needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of $5{\times}50$ ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment. Results: The mean NRS was significantly improved from $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups. Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.

• Journal of Korea Entertainment Industry Association
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• v.14 no.2
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• pp.187-194
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• 2020

This study is a descriptive cross-sectional study to identify the perception of post-operative pain management by nursing college students. The study involved 171 nursing college students with clinical practice experience. The data collection was made using structured questionnaires from March to June 2019. The results showed 65.1 percent general knowledge, 58.0 percent knowledge of analgesics and 81.9 percent attitude toward pain management. Pain knowledge and attitude were higher for pain training and men. The general knowledge score for pain showed a positive correlation between knowledge of analgesics, attitudes to pain management. We hope that the results of this study will be used to develop a postoperative pain management program by showing the need for systematic training programs for nursing college students and continuous training for postoperative pain management.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.115-123
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• 2006

Purpose: This study is purposed to provide basic data needed in constructing the educational contents about cancer pain management for the health care professionals. Methods: This study surveyed the degree of knowledge in cancer pain management of clinical nurses and doctors. Subjects were clinical 143 nurses and 88 doctors in 3 cities. The tool used are 32-item scale for evaluation of health care professionals' knowledge modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The level of the health care professionals' knowledge about and attitude toward pain management were insufficient. The level of the doctors' knowledge and attitude showed higher score than those of the nurses'. The knowledge of health professional who were not hesitated to administrate analgesia was showed more higher than who were hesitated to do. Conclusion: Nurses need more knowledge and effective attitude toward cancer pain management. Various and sufficient educational program about cancer pain management can be contribute to improve the nursing quality of cancer pain.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.123-127
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• 1999

Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.9-15
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• 1988

Postherpetic neuralgia, the most feared complication of acute herpes zoster, may agonize the pain clinician because the appropriate management of intractable pain can fail inspite of various and prolonged therapeutic techniques. Of all patients with herpes zoster, approximately 5~10% will develop postherpetic neuralgia. Postherpetic neuralgia is very rare in young patient but very common in patients over 60. In other words, the older, the higher incidence. In our pain clinics, 13 postherpetic neuralgic patients were treated with sympathetic blocks, local infiltration with local anesthetics and steroids, TENS, Laser and various drugs including antiderpressant. The results of management of pain in 13 patents were as follows. 1. Excellent pain control :4(30.8%) 2. Good pain control :3(23.0%) 3. Fair pain control :2(15.4%) 4. No effect :4(30.8%).