• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.5-17
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• 2008

Purpose: The purpose of this study was to examine the effects of education regarding postoperative pain management provided for nurses as well as patients on related factors of pain management, including nurses' knowledge and attitude of postoperative pain, and the level of pain that patients felt after surgery. Method: A quasi-experimental research design was used in this research. Twenty-one nurses currently working in general surgery units and 32 patients who were taking on abdominal surgery in A university hospital were participated in this study. The three week-educational program of postoperative pain management including lecture, quiz, poster and discussion was provided for nurse participants. The postoperative pain management education for each patient was provided one day before his/her own operation for 20 minutes with the pamphlet developed by researchers. For assessing the effects, nurses' knowledge and attitude about pain management, patients' postoperative pain, pain control barriers, and satisfaction of pain management were measured. Results: The nurses' knowledge about pain management and the patients' satisfaction of pain management in the experimental group were higher than in the control group. The patients' postoperative pain in the experimental group was lower than in the control group. Conclusion: With the above results, the postoperative pain management education could be an effective nursing intervention for pain management of patients who were taking surgery.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.968-975
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• 2006

Purpose: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Method: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. Results: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. Conclusion: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.135-139
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• 2016

Purpose: Modified Mau and Akin osteotomy for hallux valgus is followed by moderate to severe postoperative pain. Ultrasound-guided sciatic nerve block can be an effective option for pain control. We attempted to evaluate the efficacy of the ultrasound-guided sciatic nerve block in controlling postoperative pain. Materials and Methods: The charts of 59 consecutive patients were retrospectively reviewed between December 2014 and August 2015. Twenty-eight patients (the patient group) has received the ultrasound-guided sciatic nerve block after surgery, and 31 patients (the control group) has not received such procedure. The primary outcome was the satisfaction scale for postoperative pain control and postoperative visual analogue scale (VAS) score. Results: The VAS score at postoperative day one was significantly lower in the patient group than in the control group. The satisfaction scale for pain control for postoperative 1 day was significantly different between the two groups. In patient group, most patients have rated positively ('strongly agree' 42.9%, 'agree' 42.9%); however, in the control group, the rating scales were distributed relatively negatively ('strongly agree' 9.7%, 'agree' 22.6%, 'neutral' 29.0%, 'disagree' 25.8%, 'strongly disagree' 12.9%). The number of postoperative rescue analgesics injection was significantly lower in the patient group than in the control group. Conclusion: Postoperative ultrasound-guided sciatic nerve block was effective for pain relief after hallux valgus surgery.

• Journal of Chest Surgery
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• v.27 no.11
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• pp.942-947
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• 1994

Post-thoracotomy pain is so severe that lead to postoperative pulmonary complications due to the patient`s inability to cough, deep breathing and chest wall motion. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1990, we reported the result that the cryoanalgesia reduce the immediate postoperative pain significantly. We try to compare the effect of cyroanalgesia with the effect of Bupivacain intercostal nerve block for the post-thoracotomy pain control. Ninety patients, who undergoing thoracotomy in Korea University Medical Center Guro Hospital between the January 1993 and September 1993, were evaluated. The patients were divided into three groups : Group A, control, the patients without pain control procedure [N=30], Group B, the patients with Bupivacain intercostal nerve block [N=30], Group C, the patients with cryoanalgesia [N=30]. Postoperative analgesic effects were evaluated by the scoring system which made arbiturary by author. The results were that the Bupivacain intercostal nerve block markedly reduced the immediate postoperative pain compare with two other groups, the cryoanalgesia reduced the immediate postoperative pain significantly compare with control group, the pain reduction effect of the two groups- cryoanalgesia and Bupivacain intercostal nerve block- were not different at postoperative seventh day, probably due to the action time of Bupivacain and the result that there were no significant complications of the procedures.

• Asian Oncology Nursing
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• v.11 no.2
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• pp.108-115
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• 2011

Purpose: The purpose of this study was to examine the effects of preoperative pain management education on postoperative pain control in patients with uterine tumor using patient controlled analgesia. Methods: This study used non-equivalent control group non-synchronized design. Data were collected from September, 2008 to March, 2009 at one university hospital in Daegu, Korea. There were 60 participants, 30 in both the experimental and control group. The experimental group was given preoperative pain education using videos, leaflets, and a PCA model. Postoperative pain intensity, frequency of the PCA button being pressed, and doses of additional analgesics were observed through 24 hours postoperative and knowledge of pain and attitude about the use of the pain medicine were measured at 3 days postoperative. Collected data were analyzed using t-test, ${\chi}^2$ test, repeat measured ANOVA, and Bonferroni methods. Results: There were no significant differences in the postoperative pain level between the experimental and control group. Postoperative frequency of the PCA button pressed, doses of additional analgesics, pain knowledge and attitude about the use of the pain medicine of the experimental group were significantly higher than those of the control group. Conclusion: Pain management education is an effective nursing intervention for pain control after surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.289-294
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• 2016

Background: Control of postoperative pain is an important aspect of postoperative patient management. Among the methods of postoperative pain control, patient-controlled analgesia (PCA) has been the most commonly used. This study tested the convenience and safety of a PCA method in which the dose adjusted according to time. Methods: This study included 100 patients who had previously undergone orthognathic surgery, discectomy, or total hip arthroplasty, and wished to control their postoperative pain through PCA. In the test group (n = 50), the rate of infusion was changed over time, while in the control group (n = 50), drugs were administered at a fixed rate. Patients' pain scores on the visual analogue scale, number of rescue analgesic infusions, side effects, and patients' satisfaction with analgesia were compared between the two groups. Results: The patients and controls were matched for age, gender, height, weight, and body mass index. No significant difference in the mount of drug administered was found between the test and control groups at 0-24 h after the operation; however, a significant difference was observed at 24-48 h after the operation between the two groups. No difference was found in the postoperative pain score, number of side effects, and patient satisfaction between the two groups. Conclusions: Patient-controlled anesthesia administered at changing rates of infusion has similar numbers of side effects as infusion performed at a fixed rate; however, the former allows for efficient and safe management of postoperative pain even in small doses.

• Journal of Korean Academy of Nursing
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• v.15 no.1
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• pp.76-96
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• 1985

Postoperative pain is one of the most frequently occurred pain in hospitals, but it has been underestimated because it is only a part of postoperative physiological Process and may disappear in time. It is necessary that nurses me the relaxation technique, planning and implementing by themselves independently, to reduce this postoperative pain. This study is aimed at showing the effect of relaxation technique on reduction of postoperative pain, and exploring the factors influencing postoperative. pain Fifty-seven patients with abdominal surgery who admitted in attacked D Medical Center to K University in Daegu have been studied. Of them twenty-nine were experimental group and the remaining twenty-eight were control group. This study has been conducted for collecting data through interviews and observation from August 23 to October 24, 1984. The tools of this study were two kinds: Postoperative Pain Scale is obtained from a review of references by the researcher, and relaxation technique, designed to use postoperative setting adequately, is also obtained from a review of references by the researcher. After confiriming no significant differences between the two groups, the hypotheses were statistically verified by x²-test, t-test, and pearson Correlation Coefficient. The results of this study are summerized as follows; ＊ The nam hypothesis that the experimental group who use relaxation technique will have less degree of postoperative pain than the control group who don't use relaxation technique is devided into three sub-hypotheses. 1. The first sub-hypothesis that the experimental group will have less score of postoperative pain than control group was accepted (t=7.810, p <.01). Even with controlling pain threshold, showing difference in some degree between the two groups, the experimental group has less score of postoperative pain than the control group. Therefore this confirms the acceptance of the first sub-hypothesis more strongly. 2. The second sub-hypothesis that the expermental group will have less frequency of analgesics than the control group is accepted (x²=9.85, p <.01). 3. The third sub-hypothesis that the experimental group will have less variation of pulse, respiration, and blood pressure between pre End post operative periods than the control group is rejected. So this hypothesis is reverified through comparing the variation of pulse, respiration, and blood pressure between pre and post changing Position to measure the pure effect of relaxation technique. pulse and respiration is significantly lowered in the experimental group (t=7.209, p<.01, t=3.473, p<.01), but systolic and diastolic blood pressure is not different significantly between the two groups (t= 1.309, p＞.05, t=1. 727 p>.05). Therefore the third sub-hypothesis is partially accepted. Conclusively, the researcher thinks that it is necessary that nurses should provide patients with relaxation technique to reduce postoperative pain, and to increase independence of nursing.

• The Korean Journal of Pain
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• v.30 no.2
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• pp.134-141
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• 2017

Background: Postoperative pain is a common, distressing symptom following arthroscopic knee surgery. The aim of this study was to compare the potential analgesic effect of dexmedetomidine after intrathecal versus intra-articular administration following arthroscopic knee surgery. Methods: Ninety patients undergoing unilateral elective arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The intrathecal dexmedetomidine group (IT) received an intrathecal block with intrathecal dexmedetomidine, the intra-articular group (IA) received an intrathecal block and intra-articular dexmedetomidine, and the control group received an intrathecal block and intra-articular saline. The primary outcome of our study was postoperative pain as assessed by the visual analogue scale of pain (VAS). Secondary outcomes included the effect of dexmedetomidine on total postoperative analgesic use and time to the first analgesic request, hemodynamics, sedation, postoperative nausea and vomiting, patient satisfaction, and postoperative C-reactive protein (CRP) levels. Results: Dexmedetomidine administration decreased pain scores for 4 h in both the intrathecal and intra-articular groups, compared to only 2 h in the control patient group. Furthermore, there was a significant reduction in pain scores for 6 h in the intra-articular group. The time to the first postoperative analgesia request was longer in the intra-articular group compared to the intrathecal and control groups. The total meperidine requirement was significantly lower in the intra-articular and intrathecal groups than in the control group. Conclusions: Both intrathecal and intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery. Less total meperidine was required with intra-articular administration to extend postoperative analgesia to 6 h with hemodynamic stability.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.21-26
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• 1999

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of central nervous system (CNS) and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative low dose epidural bupivacaine and morphine could affect postoperative pain, changes plasma cortisol, and serum glucose. Methods: Thirty patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. General anesthesia was induced in all patients and after that, epidural blocks were done except the control group (n=10) patients. Preoperative block group (n=10) received 0.5% bupivacaine 50 mg and morphine 2 mg epidurally as a bolus before operation and followed by 0.1% bupivacaine $5\;mghr^{-1}$ and morphine $0.2\;mghr^{-1}$ for 10 hours. Postoperative block group (n=10) received the same doses of bupivacaine and morphine under the same method postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative pain by visual analogue scores (VAS), analgesic requirement (first requirement time, total amounts used), side effects, plasma cortisol level and serum glucose level were compared. Results: Until postoperative 6 hrs, VAS of control group was higher than those of the epidural groups. No difference was observed in VAS between the two epidural groups. First analgesics requirement time and total amounts of used analgesics were not different between the two epidural groups, but first analgesic requirement time of preoperative block group was significantly prolonged compared with control group. Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Low dose preoperative epidural bupivacaine and morphine could not reduce postoperative pain, plasma cortisol level and serum glucose level compared with postoperative block group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.382-387
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• 1999

The concept of PCA(Patient Controlled Analgesia) was first described in 1968, by Sechzer. The earliest descriptions of actual self-administered PCA machines were by Forrest et al. In gastric bypass surgery, cesarian section, orthopedic surgery etc, PCA is widely used in the control of postoperative pain. Previous Studies have shown that PCA provides effective pain-control for the postoperative patient. The postoperative pain-control is a problem that should be solved in surgery. Especially in orthognathic surgery, it is not same as in the case of maxillofacial trauma surgery or of tumor surgery: most orthognathic surgery patients are under operation not accustomed to pains, and difficulties in pain-complaint due to IMF(Intermaxillary fixation), postoperative nausea, and vomiting are additional problem. In this study, we have compared PCA and IM analgesics with respect not only to time request but also to the quality of postoperative pain control.