• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.6
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• pp.1085-1088
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• 2011

This study aims to investigate the effect of acupuncture on PC6 for preventing opioid-induced nausea and vomiting under circumstance whether the participants are conscious or non-conscious. 143 patients receiving intravenous patient controlled analgesia(PCA) with fentanyl were assigned to three groups. Two groups were given acupuncture on PC6 before anesthesia(PreAN) or after anesthesia(PoAN) respectively. One group was control group without acupuncture treatment(NC). Assessment of nausea and vomiting was obtained from all patients for 48hours after surgery. The incidence of nausea and vomiting was significantly lower in the PreAN group and PoAN group than in the NC group. The severity of nausea was the lowest in PreAN group, second to in PoAN group, and the highest in NC group. This results show that acupuncture on PC6 even without patients' consciousness has effect on preventing PONV.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1637-1640
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• 2007

There is growing interest in the use of nonpharmacologic approaches to prevent postoperative nausea and vomiting. This study was designed to investigate the effect of acupuncture on P6 for preventing Opioid-induced nausea and vomiting. A total of 83 patients receiving intravenous patient controlled analgesia(PCA) with fentanyl were randomly assigned to two groups. In acupuncture group, they've got treatment after surgery at recovery room for 20minutes. Assessment of nausea and vomiting was obtained from all patients for 48hours. The incidence of nausea, that of vomiting and the nausea grade-the severity of nausea within 48 hours after surgery- were the main outcome measures which showed no statistically significant difference between groups. There is no sufficient evidence to suggest effect of acupuncture on P6 for preventing PONV.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.234-240
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• 2009

Background: The purpose of this study was to compare the analgesic effect of 0.25% and 0.5% levobupivacaine for real time ultrasound guided single-injection femoral nerve block for the patients who are undergoing bilateral total knee arthroplasty (TKA). Methods: Femoral nerve block was done to all patients with 20 ml of 0.9% normal saline on one leg and 20 ml of 0.25% levobupivacaine on the other leg for group I (n = 16) and 0.5% levobupivacaine for group II (n = 15) with 1:200,000 epinephrine and using real-time ultrasound and a nerve stimulator. The data concerning the verbal numerical rating scale (VNRS) for each leg, the consumption of the intravenous patient-controlled analgesia (IV PCA) and the demands for the additional analgesics was collected at 0, 1, 6, 12, 24 and 48 hours after the operation. Results: The legs on which femoral nerve block was done with levobupivacaine showed a lower VNRS score than the legs with normal saline in either group I or group II. The VNRS scores between the two legs, the consumption of the IV PCA and the demand for additional analgesics showed no significant differences between the groups. Conclusions: Our results demonstrate that single-injection femoral nerve block using real-time ultrasound with either 0.25% levobupivacaine or 0.5% levobupivacaine 20 ml provides a good effect for the postoperative pain control after TKA.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.291-299
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• 2024

Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods. Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME). Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01). Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.2
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• pp.288-299
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• 2002

The patients with abdominal surgery usually have acute pain. It is important for a patient's qualify of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics. t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1. For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002). monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p = 0.0001). 2. For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (P=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (P =0.0063). 3. For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012). and operation title (p =0.0033). 4. For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p =0.0128). monthly income (p=0.0008), diagnosis (p =0.0007), and operation title (p =0.0008). 5. The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r =0.51, p =0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50. p=0.0001) and the relationship between Depression and pain revealed a significant positive correlation (r =0.49. p =0.0001).

• The Korean Journal of Pain
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• v.33 no.4
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• pp.378-385
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• 2020

Background: The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block. Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. Methods: Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture). The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. Results: Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P = 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.241-246
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• 1998

Background: Opioids and local anesthetics have been administered epidurally for the purpose of the postoperative analgesia. However opioids have a serious risk of respiratory depression and local anesthetics have the risks of hypotension, sensory block, or motor one. In recent years, reports of spinal administration of midazolam for acute postoperative pain control have appeared in the literature. This study was performed to observe the effect of epidural midazolam in patient-controlled analgesia (PCA) device. Methods: Forty-five patients scheduled for the elective total hysterectomy were randomly selected; epidurally take morphine only (group I, n=15), morphine plus 0.1% bupivacaine (group II, n=15), or morphine plus midazolam (group III, n=15). The visual analogue scale (VAS) at rest and with movement, the sedation score, the degree of the satisfaction, the total amounts of a morphine usage, and the incidence of the side effects were observed. Rusults: The VAS at rest of group II and III were decreased significantly than that of group I. The VAS with movement of group III was significantly decreased than that of group I and II. The sadation score and the cumulative dose of a morphine were statistically insignificant within groups. Conclusion: Epidural morphine plus midazolam was proven to be clinically effective in the post-operative pain control especially for the pain with movement, compared with epidural morphine only and morphine plus 0.1% bupivacaine.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.138-141
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• 2005

Background: There have been many attempts to alleviate pain after surgery, but there is no common approach to the control of postoperative pain. The use of epidural opioids, with local anesthetics, has been a widely employed formula to date. Ketamine, an N-methyl-d-aspartate receptor antagonist, has an excellent analgesic effect. Although there have been many reports on the dose and route of administrating analgesics, there have been few concerning the continuous epidural infusion of ketamine with fentanyl. We designed this study to find the effects of ketamine compared to those of epidurally injected bupivacaine and fentanyl, and used this trial to study any potential side effects. Methods: In a double blind trial, 55 patients received either fentanyl, $0.3{\mu}g/kg/h$ (Group F), or fentanyl, $0.3{\mu}g/kg/h$, and ketamine, 0.1 mg/kg/h (Group FK), added to 0.125% bupivacaine, at rates as high as 2 ml/h, for patient controlled epidural analgesia (PCEA) following a transabdominal hysterectomy. Ten minutes before the operation, patients received 10 ml of 0.125% bupivacaine, with either 0.5 mg/kg ketamine or the same amount of normal saline with $50{\mu}g$ fentanyl added. The pain scores and the side effects were recorded at 1, 3, 6 and 24 hour post operation. Results: There were no differences in the pain scores or side effects between the two groups. Conclusions: We failed to find any effect of the addition of epidural ketamine compared to the that of the bupivacaine and fentanyl formula. However, it is suggested that further investigations will be required on the dose and route of administration.

• Women's Health Nursing
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• v.19 no.4
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• pp.211-218
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• 2013

Purpose: The purpose of study was to examine effects of aromatherapy on stress, sleep, nausea and vomiting of women after laparoscopic hysterectomy. Methods: The participants were 60 women who had laparoscopic hysterectomy: experiment group for aromatherapy (n=30) and control group for routine care (n=30). The experimental group received inhalation aromatherapy for 5 minutes, twice; the first was done right after the operation, the second was at 9 pm before sleep on the same day-while the control group had no inhalation. Data were collected from July to September, 2012 at G hospital. Results: The degree of psychological stress was not significantly different between two groups (t=-1.96, p=.054). Yet, there were significant differences between two groups for degree of physiological stress (t=-3.20, p=.002), the level of cortisol (t=-2.01, p=.049), the score of sleep status (t=2.47, p=.016), the score of sleep satisfaction (t=2.43, p=.018), and the score for nausea and vomiting (t=-2.58, p=.012). Conclusion: Inhalation aromatherapy using the mixed oil of lavender, mandarin, and marjoram was effective in decreasing the level of physiological stress, cortisol, and the score for nausea and vomiting, and also allowed the participants to have a better sleep. Therefore, inhalation aromatherapy could be effective in improving the quality of life of these women during recovery.