• Title/Summary/Keyword: Pain experience

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Patient-controlled Epidural Analgesia with Ropivacaine and Fentanyl: Experience with 2,276 Surgical Patients

  • Kim, Shin Hyung;Yoon, Kyung Bong;Yoon, Duck Mi;Kim, Chan Mi;Shin, Yang Sik
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.39-45
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    • 2013
  • Background: Good postoperative pain control is an important part of adequate postoperative care. Patient-controlled epidural analgesia (PCEA) provided better postoperative analgesia compared to other conventional analgesic methods, but several risks have been observed as well. We therefore surveyed the efficacy and safety of PCEA in this retrospective observational study. Methods: We analyzed collected data on 2,276 elective surgical patients who received PCEA with ropivacaine and fentanyl. Patients were assessed by a PCA service team in the post-anesthesia care unit (PACU), at 1-6 h, 6-24 h, and 24-48 h postoperatively for adequate pain control. The presence of PCEA-related adverse events was also assessed. Results: Numerical pain score (median [interquartile range]) were 3 [1-4], 5 [4-7], 4 [3-5], and 3 [3-5] in the PACU, at 1-6 h, 6-24 h, and 24-48 h postoperatively. Median pain scores in patients underwent major abdominal or thoracic surgery were higher than other surgical procedure in the PACU, at 1-6 h after surgery. Nausea and vomiting (20%) and numbness and motor weakness (15%) were revealed as major PCEA-related adverse events during the postoperative 48 h period. There were 329 patients (14%) for whom PCEA was ceased within 48 h following surgery. Conclusions: Our data suggest that the use of PCEA provides proper analgesia in the postoperative 48 h period after a wide variety of surgical procedures and that is associated with few serious complications. However, more careful pain management and sustainable PCEA monitoring considering the type of surgical procedure undergone is needed in patients with PCEA.

Stroke after the Procedure of Lumbar Facet Joint block and Lumbar Epidural Block -Case reports- (요부 추간관절차단 및 요부 경막외차단 후 발생한 뇌졸증 -증례 보고-)

  • Lee, Hyo-Keun;Kim, Sung-Mo;Han, Kyung-Ream;Lee, Jong-Moo;Ko, Seok-Shin;Kim, Chan
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.131-133
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    • 1997
  • Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

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Failure of Urination and Defecation after Intrathecal Phenol-glycerin Block for Management of Chronic Perineal Pain -A case report- (만성회음부 통증 치료를 위한 지주막하 페놀글리세린 차단 후 발생한 배변 및 배뇨장애 -증례 보고-)

  • Ahn, Hyun-Jung;Kim, Jong-Il;Lee, Sang-Gon;Ban, Jong-Seouk;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.268-271
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    • 1999
  • Intrathecal phenol-glycerin block is a potent tool in stepwise approach to intractable perineal pain. At outpatient clinic, intrathecal phenol-glycerin block have been frequently used to control the cancer pain, as this procedure does not require special equipment. However, undesirable effects may occur with any given intrathecal injection. Although most side effects do not last long, they deserve well to prevent. Recently, we have been controlled the perineal and perianal cancer pain with intrathecal phenol-glycerin block without any specific complications. However, one patient we managed experienced that one patient, with this procedure for chronic non-malignant perineal pain control experience gait disturbance and one-week of voiding and defication difficulties. This research reports these practices, including the review of literature.

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Experience of Epidural Steroids in Transverse Myelitis -A case report- (횡단척수염 환자에서 경막외 스테로이드 투여에 의한 치료 경험 -증례보고-)

  • Nam, Voki;Mun, Ho Sik;Kim, Jung Hak;Kim, Dae Sung;Sung, Choon Ho
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.92-95
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    • 2009
  • Transverse myelitis is a focal inflammatory disorder of the spinal cord characterized by motor, sensory, and autonomic dysfunction. A 41-year-old man with transverse myelitis and no pre-existing neurologic disease presented with hypesthesia, numbness, weakness in the both lower extremities, back pain, decreased libido, constipation, and dysuria. A MRI test showed intramedullary high signal intensity between T4 and T8 on a T2-weighted image. After high-dose intravenous methylprednisolone and oral prednisolone therapy, he showed facial swelling and acneiform eruption. Therefore, we injected 40 mg methylprednisolone via an epidural route. A 7-dose serial treatment improved most symptoms. A follow up MRI showed radiological improvement. We report a case of transverse myelitis treated by epidural steroids.

The Influence of General Characteristic in Patients with Low Back Pain on the Psychologic Status (요통 환자의 일반적인 특성이 요통의 심리적 측면에 미치는 영향)

  • Han Dong-Wook;Park Ji-Whan;Kim Yong-Gun
    • The Journal of Korean Physical Therapy
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    • v.14 no.3
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    • pp.407-417
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    • 2002
  • The purpose of this study was to examine the influence of general characteristic of the patient with low back pain on the psychologic Status. The Questionnaires was done for 312 persons with low back pain who live in Daejeon. The study was conducted between 1st, June and 26th, July in 2000. The results were as follows: 1. The effects of general characteristic of the patient with low back pain on the psychologic Status were related age(p<0.01), education level(p<0.01), job(p<0.01), husband and wife existence(p<0.01), disease(p<0.01). 2. The influence of an item on Handler score was related the reason of pain(r=0.377, p<0.01), the site and pattern of pain(r=0.314, p<0.01), the influence of climate(r=0.370, p<0.01), the frequency of pain(r=0.396, p<0.01), the position of producible pain(r=0.411, p<0.01), one's desire(r=0.394, p<0.01), experience of pessimism(r=0.421, p<0.01).

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Low Back Pain and Job Stress in Hospital Nurses (종합병원 간호사의 요통과 직무스트레스)

  • Kim, Yeon-Hee;Kim, Young-Sin;Ahn, Yang-Heui
    • Journal of muscle and joint health
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    • v.14 no.1
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    • pp.5-12
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    • 2007
  • Purpose: The purpose of the study was to identify the relationship between low back pain and job stress in hospital nurses. Method: A descriptive correlation research design was employed. The participants were 355 nurses who worked in a general hospital in W city Kangwon-do and consented to participate in this study. The Visual Analog Scale and job stress scale were used in this study. Analysis included descriptive statistics, t-test, ANOVA, and partial correlation coefficients. Results: Experience of low back pain for nurse in the past was 86.5% and in the present was 67.5% for low back pain which measured an average of 4.4 points for the level of low back pain. The mean score for job stress was relatively low(M=47.2). Job demand, organization system, job instability and conflict in relationships contributed to high stress scores, instead inappropriate compensation, job culture, and job autonomy contributed to low stress. There was a significant relationship between low back pain and job stress. Conclusion: These results suggest that further research is needed to develop programs to prevention and management of low back pain for nurses.

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A Clinical Experience of Facial Nerve Palsy Treated by Magnetic Resonance Analyser and Drug Therapy -A case of facial palsy- (자기공명분석기와 약물요법을 이용한 안면신경마비의 치험 -1예 보고-)

  • Chun, Sung-Hong;Shin, Jae-Hwan;Jeon, Yong-Sub;Yoon, Suk-Jun;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.347-349
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    • 1995
  • A 43 year old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and drug therapy. Treatment of facial palsy is generally composed of stellate ganglion block(SGB), drug therapy and operative intervention. Short periods of exposure to appropriate magnetic resonance can beneficially modulate the balance of autonomic nervous system that are responsible for sympathetic overflow. It was concluded that recovery of facial palsy by application of both MRA and drug therapy was effective in patient who refused SGB.

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The Study of Factors Affecting Functional Disability of the Low Back Pain Patients Using Oswestry Disability Index(ODI) Assessment Tool (Oswestry Disability Index(ODI) 평가 도구를 이용한 요통환자의 기능장애에 영향을 미치는 요인 연구)

  • Lee, Sang-Ho;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.1
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    • pp.18-25
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    • 2007
  • Objective: The Purpose of this study is the factive and descriptive research to identify the factors affecting the functional disability of the chronic low back pain patients. We investigated the effect of ODI by the Questionnaire and questioned an 70 patients who were back pain unit at G university hospital in D city from March to May, 2007. The functional disorder in this study were based on the Oswestry Disability Index(ODI) lower back pain disability questionnaire by fairbank(1980), and these data were proceeded by using SPSS/WIN version 10.0. Result: 1. The functional disorder in accordance with age, gender, academic background, occupation, diagnosis, pain cause, pain experience, treatment duration had no significantly similar difference statistically(p>0.05). 2. The functional disorder in accordance with duration of painful generation had statistically significance(P<0.05). Conclusion: we could verify that duration of painful generation affect on the factors affecting the functional disability of the low back pain patients.

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Analysis of 1,590 Patients of IV-PCA for Postoperative Pain Management (정맥내 통증 자가조절법에 의한 술후통증관리 1,590예에 대한 분석)

  • Song, Sun-Ok;Jee, Dae-Lim;Koo, Bon-Up
    • 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.

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Post-COVID-19 pain syndrome: a descriptive study in Turkish population

  • Topal, Ilknur;Ozcelik, Necdet;Atayoglu, Ali Timucin
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.468-474
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    • 2022
  • Background: The new type of corona virus has a wide range of symptoms. Some people who have COVID-19 can experience long-term effects from their infection, known as post-COVID conditions. The authors aimed to investigate prolonged musculoskeletal pain as a symptom of the post-COVID-19 condition. Methods: This is a descriptive study on the patients who were diagnosed with COVID-19 in a university hospital, between March 2020 and March 2021. Patient records and an extensive questionnaire were used to obtain relevant demographic and clinical characteristics, including hospitalization history, comorbidities, smoking history, duration of the pain, the area of pain, and the presence of accompanying neuropathic symptoms. Results: Of the diagnosed patients, 501 agreed to participate in the study. Among the participants, 318 had musculoskeletal pain during COVID-19 infection, and 69 of them reported prolonged pain symptoms as part of their a post-COVID condition which could not be attributed to any other cause. The mean duration of pain was 4.38 ± 1.73 months, and the mean pain level was 7.2 ± 4.3. Neuropathic pain symptoms such as burning sensation (n = 16, 23.2%), numbness (n = 15, 21.7%), tingling (n = 10, 14.5%), stinging (n = 4, 5.8%), freezing (n = 1, 1.4%) were accompanied in patients with prolonged musculoskeletal pain. Conclusions: Patients with COVID-19 may develop prolonged musculoskeletal pain. In some patients, neuropathic pain accompanies it. Awareness of prolonged post-COVID-19 pain is crucial for its early detection and management.