• 한국엔터테인먼트산업학회논문지
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• 제14권2호
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• pp.187-194
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• 2020

본 연구는 간호대학생의 수술 후 통증 관리에 대한 인식을 파악하기 위한 서술적 조사연구이다. 연구 대상자는 임상실습 경험이 있는 간호대학생 171명이었다. 자료수집은 2019년 3월부터 6월까지 구조화된 설문지를 사용하여 이루어졌다. 연구결과 정답률은 일반적 지식 65.1%, 진통제 사용에 대한 지식 58.0%, 통증 관리에 대한 태도 81.9%로 나타났다. 통증 교육을 받은 경우와 남자인 경우 통증 지식과 태도가 더 높았다. 통증에 대한 일반적 지식 점수는 진통제 사용에 대한 지식, 통증 관리에 대한 태도와 양의 상관 관계가 나타났다. 본 연구 결과는 수술 후 통증 관리를 위해서 간호대학생을 위한 체계적인 교육프로그램의 개발과 지속적인 교육이 필요함을 보여줌으로써 수술 후 통증 관리를 위한 중재프로그램 개발하는데 활용되길 기대한다.

• Advances in pediatric surgery
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• 제8권1호
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• pp.64-67
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• 2002

Since Swenson and Bill established the treatment principles of Hirshsprung's disease in 1948, there have been significant advances in the management of this disease. During the last decade, one-stage correction of Hirshsprung's disease without colostomy and primary laparoscopic pull-through procedure became popular with recent advances in the technology and refinement of the equipments. But the outcomes for Hirshsprung's disease are not always successful, and long-term follow-up isessential. Most children after corrective surgery show significant improvement in respect to fecal continence and constipation, that may not be apparent until late adolescence. The purpose of this study was to review the postoperative problems of Hirschsprung's disease and it's management.

• The Korean Journal of Pain
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• 제9권2호
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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.

• Journal of Chest Surgery
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• 제57권3호
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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.

• Radiation Oncology Journal
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• 제12권2호
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• pp.159-164
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• 1994

Purpose : To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. Methods and Materials : A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type(4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56 Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. Results : Overall actuarial progression free survival(PFS) at 5 years was $80\%$. Survival was most likely affected by histologic subtypes. Five year PFS rate was $52\%$ for benign angioblastic histology as compared with $100\%$ for classic benign histology. For malignant meningiomas, 5 year PFS rate was $44\%$. The recurrence rates of classic, angioblastic, and malignant type were $5\%(1/21),\;80\%(4/5)$, and $50\%(4/8)$, respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. Conclusion . Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate.

• 대한치과마취과학회지
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• 제13권4호
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• pp.167-178
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• 2013

Oxycodone is a semi-synthetic opioid synthesized from poppy-derived thebaine. It is a narcotic analgesic generally indicated for relief of moderate to severe pain. Although developed in an attempt to improve on the existing opioids, the adverse effects of oxycodone are those that are typically found in opioids. In recent years, the use of the opioid oxycodone has increased markedly and replacing morphine as the first line choice of opioid in several countries. There are formulations for oral immediate, oral extended release and intravenous use. In 2013, intravenous oxycodone was approved for marketing by Ministry of Food and Drug Safety (MFDS), with the indication of postoperative intravenous patient-controlled analgesia (IV PAC). Simulation study of oxycodone demonstrated that minimum effective analgesic concentration (MEAC) of oxycodone was most quickly reached with higher loading dose and IV PCA with background infusion, which may reduce the necessity of rescue analgesics during immediate postoperative period. Previous studies for postoperative pain management with intravenous oxycodone are limited in sample size, mostly less than 100 patients, which may not be large enough to assess safety of intravenous oxycodone. The effectiveness and tolerability of IV PCA with oxycodone should, therefore, be evaluated in large scale clinical trials in Korean populations.

• 한국임상수의학회지
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• 제38권4호
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• pp.184-188
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• 2021

A 10-year-old spayed female Maltese with a history of vomiting and lethargy was referred to the hospital. Physical examination revealed dehydration and severe pain following abdominal palpation. A large mass was observed in the cranial abdomen through radiography and ultrasonography. Laparotomy was performed to find the origin of the mass. The mass was about 8 cm originating from the cecum and subsequently removed. Histopathologic evaluation revealed that the cecal mass was suspected to be a mesenchymal-derived tumor. Through immunohistochemistry, the mass was diagnosed as a gastrointestinal stromal tumor (GIST) based on the c-kit expression. Given its recurrence, postoperative preventive therapy was initiated with masitinib mesylate, which is a tyrosine kinase inhibitor. The animal did not show any side effects during the medication period. After 6 months of therapy, it was well controlled without any recurrence. In this case, we introduced a novel postoperative management of GIST using masitinib mesylate.

• The Korean Journal of Pain
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• 제34권2호
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• pp.201-209
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• 2021

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.

• 임상간호연구
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• 제14권3호
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• pp.47-59
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• 2008

Purpose: The purpose of the study was to compare the active pain management (APM) with structured physiotherapy (SPT) with the conservative care on postoperative pulmonary complications, pain, and comfort in children under three year. Method: A non-equivalent control group, non-synchronized design study was used. A total of 64 children participated in the study. The children in the experimental group (n=32) received APM with SPT after surgical operation. After transferred to the general unit, the parents were instructed to hold the child for 30 minutes to relieve anxiety and have him/her sleep comfortably for 2 hours. Scheduled 20 minutes chest percussion was performed by the parents for 2 days: twice every 4 hours, one in 6 hours, then one every 8 hours for the rest of two days. Analgesic was administered as needed. Pain and comfort were observed and recorded by nurses using the FLACC and COMFORT Behavior Scale. Results: One child in the control group was diagnosed with postoperative pneumonia. The children in the experimental group who were received the APM with SPT reported higher scores in comfort and lower scores in pain than those in the control group. Conclusion: The findings suggest that APM with SPT can help prevent postoperative pulmonary complications and pain.

• 성인간호학회지
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• 제18권1호
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• pp.125-135
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• 2006

Purpose: The purpose of this study was to identify pain intensity according to activities over postoperative days and to identify factors of patient satisfaction with pain management after abdominal surgery. Methods: The subjects were 123 patients who were admitted at a general surgical ward and had abdominal surgery from Mar. 2005 to June 2005. The collected data were analyzed using the SPSS 12.0 program. Results: The average postoperative pain scores were 6.13 at POD 1, 5.46 at POD 2, and 4.22 at POD 3. In stepwise multiple regression analysis a total of 40% of variance in satisfaction with pain management was accounted for by pain intensity on POD 3 at rest (29.4%) and attitude toward using pain medicine (6.6%), and side effects of pain medicine (4.0%). Conclusion: According to the findings of this study, patients had inadequate pain management after abdominal surgery. Therefore, nurses need to provide educational programs focused on changing attitudes toward using pain medicine, to reduce side effects of pain medicine, and to develop nursing intervention for relieving pain.