• The Korean Journal of Pain
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• v.11 no.2
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• pp.268-272
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• 1998

Background: Postoperative bleeding is a common complication in transurethral resection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two Methods for post-operative analgesia. Methods: We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group (I, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusion rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl $50\sim100{\mu}g$ followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP. Results: Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group. Conclusions: Postoperative continuous epidural pain block and IV-PCA are both effective Methods of postoperative pain control with lower incidence of side effects.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.193-200
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• 2021

Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

• Women's Health Nursing
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• v.10 no.2
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• pp.128-135
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• 2004

Purpose: Women who undergo gynecological surgery have moderate and severe sensation and distress of pain despite the advent of patient controlled analgesia (PCA). The purposes of this study were to describe perception of non-pharmacological therapy for postoperative pain control and examine changes of pain sensation and distress in women who had gynecological surgery. Method: The sample consisted of 52 women who were having gynecological surgery. Subjects who agreed to participate in the study were asked for their opinion about non-pharmacological approaches for postoperative pain control using a structured study questionnaire. Pain sensation and distress were assessed by VAS in the morning and afternoon for 2 days following the surgery. Result: About 50% of the subjects thought that non-pharmacological methods such as relaxation, music, massage, or meditation would be helpful for their postoperative pain control. If both pharmacological and non-pharmacological therapy were given for pain control, 96% of subjects reported it would be effective. Nurses can apply techniques of relaxation, deep breathing, meditation, and music therapy to surgical patients along with PCA. Expected sensation and distress of pain was high, but pain levels gradually decreased over time. However, subjects experienced moderate levels of pain postoperatively although they used PCA. Conclusion: The effect of a combined method of pharmacological and non-pharmacological approach needs to be tested if postoperative pain is to be decreased more.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.31-37
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• 2000

Background: Recent studies suggested that a preoperative block of N-methyl-D-aspartate (NMDA) receptors with NMDA antagonists may reduce postoperative pain. In this double-blind study, magnesium sulfate, a natural NMDA receptor antagonist, was administered preoperatively to investigate the effects of magnesium sulfate on postoperative pain and pulmonary function. Methods: Seventy patients who were to undergo gastrectomy under general anesthesia were randomly assigned to one of three groups. Groups 2 and 3 received intravenous magnesium, preoperatively (Group 2: 50 mg/kg bolus, 7.5 mg/kg/hr for 20 hr, Group 3: 50 mg/kg bolus, 15 mg/kg/hr for 20 hr). Group 1 received normal saline as the control group. Visual analog scale (VAS) for postoperative pain and mood, cumulative analgesic consumption, recovery of pulmonary function and side effects were evaluated at 6, 24, 48 and 72 hours after the operation. Results: In Groups 2 and 3, plasma concentration of magnesium were significantly higher than in Group 1 at 6 and 20 hours after infusion (P<0.05). There were no significant differences in the analgesic consumption, and recovery of pulmonary function and the incidence of side effects at 6, 24, 48 and 72 hours after the operation among the three groups. In Group 3, pain scores at rest measured 24 and 48 hours after operation were lower than the control group, and pain scores when deep breathing were significantly lower than the control group at postoperative 6, 24, 48, and 72 hours. Conclusions: We conclude that intravenous infusion of greater amount of magnesium has little effectiveness in reducing postoperative pain. However, further studies are needed to characterize the clinical significance of these effects on postoperative pain.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.80-86
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• 1988

Caudal buprenorphine was investigated as a postoperative analgesic in a randominzed double blind study of 45 patients after abdominal surgery. At the end of surgery, patients were given 0.2 mg of caudal buprenorphine in 20 ml saline(n=30, experimental group) or no injection(n=15, control group). Pain relief was evaluated by the subsequent need for systemic analgesics(pethidine). Arterial blood gas and micturition disturbance were evaluated. In the buprenophine group, use of systemic analgesics was significantly reduced for the first 24 hours postoperatively. Arterial blond gas study values 2 hollers after buprenorphine administration were within normal range. 8 patients of the buprenorphine group developed urinary retention requiring temporary Nelaton catheterization of the bladder. Caudal buprenorphine for postoperative pain control was a good alternate method of postoperative pain management.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.11-15
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• 2021

In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.339-346
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• 2022

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.46-50
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• 2013

Background: Postoperative pain is one of the most prevalent and bothersome issues found in the surgical department. Nowadays, there are various methods of acupuncture used for relieving pain without the complications found in some routine postoperative analgesics. These methods could be especially useful for high risk patients prone to complications from analgesics, such as transplantation recipients. The aim of this study was to evaluate the efficacy of electro-acupuncture on postoperative pain control after inguinal surgeries. Methods: Ninety male patients, who were referred to our department with indications of inguinal surgery, were included in the study and randomly divided into two groups, such as acupuncture and control. We used electro-acupuncture for the acupuncture group and no actual acupuncture (but placed needle electrodes similar to the acupuncture group) for the control group. Postoperative pain was quantified by a blind observer in both groups using a visual analogue scale (VAS) standard score before being compared. Results: Pain intensity and analgesic use were significantly higher in the control group (P < 0.05). In the acupuncture group, the VAS pain scores were significantly lower than the control group at 0.5, 1 and 2 hours post operation. When the opioid related side effects were compared for each group, the results showed that the number of subjects who experienced dizziness in the acupuncture group was significantly lower than the control group (P < 0.05). Conclusions: Acupuncture in patients, after inguinal surgery, can reduce the need of analgesics, which also directly reduces the complications that may occur when analgesics are used in relieving pain postoperatively.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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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.

• 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.