• Title/Summary/Keyword: Postoperative pain control

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A Study on Postoperative Pain Perception by Effects of the Video Program as Preoperative Nursing Intervention (수술전 비디오간호중재에 따른 수술후 환아의 동통지각정도)

  • 주미경
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.210-221
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    • 1995
  • The purpose of this study was to identify relationships between a preoperative video program as nursing intervention and the perception of postoperative pain. The subjects consisted of an experimental group of 17 children and a control group of 13 children, for a total of 30 patients who were admitted the ENT Department for tonsilectomies. Data were collected from August 1, 1993 to September 31. The video program was made by the pediatric operating theater nursing staff. Postoperative painwas measured using the Face Pain Rating Scales devised by Beyer in 1984. The data were analyzed by a SPSS using frequencies, means, percentages, t-test and ANOVA to analyze the variables and demographic characteristics. The results of this study are as follows : The hypothesis, “Score of the experimental group which was shown the preoperative video program as a nursing intervention will be lower than the control group which did not see the video in postoperative pain perception.” was rejected by t=-.42, p>.05. No significant difference was found between the experimental group and the control group according demographic characteristics. From the above findings, this study suggests the following : 1. Further studies as randomized control-group pretest-posttest design are needed to control the extraneous variables. 2. A review will be suggested to be done by the preoperative video program as nursing intervention and an exploration to improve preoperative nursing care for pediatric patients with the inclusion such activities as preoperative visiting, operation theater tour etc.

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Intravenous Patient-controlled Analgesia Has a Positive Effect on the Prognosis of Delirium in Patients Undergoing Orthopedic Surgery

  • Heo, Dae Young;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.271-277
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    • 2014
  • Background: Postoperative delirium is relatively common. However, the relationship between intravenous patient-controlled analgesia (IV-PCA) and delirium has not been thoroughly investigated. The aim of this study was to evaluate the effects of IV-PCA on the prognosis of postoperative delirium in patients undergoing orthopedic surgery. Methods: Medical records of 129 patients with postoperative delirium were reviewed. Patients were divided into two groups according to whether they used IV-PCA with fentanyl and ketorolac. The IV-PCA group consisted of 73 patients who were managed with IV-PCA; the NO-PCA group consisted of 56 patients who were managed without PCA. Results: Incidences of multiple psychiatric consultations and prolonged delirium were significantly lower in patients using IV-PCA with fentanyl and ketorolac than in those without PCA. Conclusions: We recommend the use of IV-PCA for pain control and management of delirium in patients with postoperative delirium.

Effect of preoperative pregabalin on postoperative pain after gastrectomy

  • Park, Chan Yoon;Park, Sol Hee;Lim, Dong Gun;Choi, Eun Kyung
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.40-44
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    • 2018
  • Background: Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain. Methods: Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period. Results: The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth. Conclusion: A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

The Effects of Active Warming on Pain, Temperature, and Thermal Discomfort in Postoperative Patients after General Anesthesia for Abdominal Surgery (전신마취 복부 수술 후 적극적인 가온요법이 통증, 체온 및 체온불편감에 미치는 효과)

  • Kim, Unjin;Lee, Yun Mi
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.53-64
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    • 2017
  • Purpose : This study investigated the effects of active warming using a Warm Touch warming system or a cotton blanket in postoperative patients after general anesthesia for abdominal surgery. Methods : This quasi-experimental study utilized two experimental groups and one control group: a cotton-blanket group (n = 25) were warmed with a cotton blanket and a sheet; a forced-air warming group (n = 24) were warmed with a Warm Touch warming system, a cotton blanket, and a sheet; and a control group (n = 25) were warmed with a sheet. Measurement variables were postoperative pain, body temperature, and thermal discomfort. Data were analyzed using a one-way ANOVA, ${\chi}^2-tests$, Fisher's exact test, and a repeated measures ANOVA. Results : The effects of active warming using a Warm Touch warming system and a cotton blanket on postoperative patients was significant in reducing pain (F = 13.91, p < .001) and increasing body temperature (F = 12.49, p < .001). Conclusion : Active warming made a significant difference in pain and body temperature changes. Active warming methods may help patients' postoperative recovery and prevent complications. Further research is needed to explore the effects and side effects of active warming on recovering normothermia.

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Comparison of Administration Methods for Epidural Morphine in Postoperative Pain Control (수술후 통증 조절을 위한 경막외 모르핀 투여방법이 비교)

  • Yang, Seong-Sik;Choi, Jeong-Hwan;Gang, Yu-Gin;Song, Ho-Geong;Lee, Sung-Kyun
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.220-223
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    • 1993
  • Administration of local anesthetics or morphine through epidural space has the effect of curbing postoperative increases in endocrine hormone. Other benefits include improving metabolic reaction and eliminating postoperative pain. However, repeated administration of local anesthetics through epidural space causes tachyphylaxis, and the unstable blockade of sensory nerve resulting in insufficient analgesia. Morphine has excellent postoperative analgesic effect, but complications including: itching, nausea, vomiting, urinary retention and respiratory depression may be associated with its administration. Sixty patients that fall into the category of ASA class I and II were randomly selected for the purpose of the experiment. Thirty patients were give 4 mg of morphine and the rest, 4 mg of morphine plus 80 ml of 0.25% bupivacaine administered through epidural space with the Baxter infuser. Analgesic effect was satisfactory in both groups. On the day of operation, the effect was stronger in group I (P<0.05) and on postoperative second day, group II showed better analgesic effect (P < 0.05). Group II had more patients who complained of itching (P < 0.05). Other complications were statistically insignificant. The findings indicate that administration of morphine through epidural space for postoperative pain management is an effective procedure. Baxter infuser was found to be very instrumental in pain control while reducing the chance of complications.

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The Comparative Study of Butorphanol Versus Ketoprofen: Effect and Safety in Postoperative Pain Control after Hysterectomy (자궁적출술 후 통증관리를 위하여 투여된 Butorphanol과 Ketoprofen의 효과 및 안전성에 관한 비교연구)

  • Lim, Young-Jin;Lee, Sang-Chul
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.258-262
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    • 1998
  • Background: In view of the safety and effectiveness of butorphanol as a postoperative analgesic, we designed to compare its activity and side effects with those of ketoprofen, when administered intramuscularly. Methods: Ninety four patients, scheduled for elective total abdominal hysterectomy, received either ketoprofen 100 mg (ketoprofen group) or butorphanol 2 mg (butorphanol group) intramuscularly after surgery. For the first six hours after injection of butorphanol or ketoprofen, the patients were asked to reevaluate the intensity of pain, using numeric rating scale (NRS) and pain score. If the pain score was above 2, supplemental ketoprofen was administered IM. Incidence of side effects were also checked. Results: Butorphanol group showed lower NRS and pain score for the first four hours compared to ketoprofen group, but the incidence of drowsiness was higher in butorphanol group. There were no significant difference in the incidence of other side effects such as nausea and dizziness. In both group, there were neither respiratory depression nor pruritus. Conclusions: Butorphanol gave better relief of postoperative pain compared to ketoprofen. Butorphanol might be a useful drug for postoperative analgesia after hysterectomy with minor side effects.

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A COMPARATIVE STUDY ON POST-OPERATIVE ANALGESIC EFFECT FOR PATIENT-CONTROLLED AND INTRAMUSCULAR ANALGESIA IN MANDIBULAR FRACTURE PATIENTS (하악골 골절환자에서 술후 자가통증조절장치와 근주용 진통제의 효과에 관한 비교)

  • Lee, Seok-Jae;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.42-48
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    • 2006
  • Open reduction and rigid internal fixation is the most popular treatment method for maxillofacial fracture patients, and it is unevitable that postoperative pain can be developed. Many surgeons including oral & maxillofacial surgeons have made constant efforts to decrease postoperative pain. This study is a comparison of postoperative analgesia and intramuscular analgesia in patients with mandibular fractures. In this study, twenty-one patients (Experimental group) were randomly selected and they were injected with IV patient-controlled analgesia (PCA; Walkmed$^{(R)}$, USA). For control group another twenty-one patients were injected with intramusclar non-steroid anti-inflammatory drugs (Rheoma$^{(R)}$, Samsung Pharm. Co.). And then, we measured visual analogue scale (VAS) scores from first postoperative day to second day at regular time interval. The following results were uptained; 1. In patient group who with open reduction and rigid internal fixation, there was significant difference of postoperative analgesic effect during the first postoperative day(p<0.05). 2. In patient group with over 90 minutes surgery time, there was significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p<0.05). 3. In patient group with less than 90 minutes surgery time, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 4. In patient group with surgery of open reduction using rigid internal fixation at single fractured site, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 5. In patient group with surgery at two fractured sites, there was significant difference of postoperative analgesic effect during the first postoperative day when compared between experimental group and control group(p<0.05). As mentioned above, it suggest that patient-controlled analgesia is more effective for postoperative pain relief than intramuscular injection in patients with rigid internal fixation by open reduction after mandibular fracture occurred. Especially, it is considered that in patient with more than 90 minutes surgery time or in cases with multiple fractured sites had more effective results with PCA therapy than conventional intramuscular analgesics.

High Spinal Block following Epidural Block for Postoperative Pain Control -A case report- (수술후 통증조절을 위한 경막외 차단후 발생한 고위척추차단 -증례 보고-)

  • Chung, Sung-Su;Yoo, Kyung-Yeon;Chae, Young-Mi
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.260-263
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    • 1996
  • High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

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Effect of the pulmonary recruitment maneuver on pain after laparoscopic gynecological oncologic surgery: a prospective randomized trial

  • Gungorduk, Kemal;Asicioglu, Osman;Ozdemir, Isa Aykut
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.92.1-92.9
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    • 2018
  • Objective: To evaluate the effectiveness of the pulmonary recruitment maneuver (PRM) at the end of the operation to decrease laparoscopy-induced abdominal or shoulder pain after gynecological oncologic surgery. Methods: In total, 113 women undergoing laparoscopic surgery for malignant or premalignant gynecological lesions were assigned randomly to two groups: the PRM group (the patient was placed in the Trendelenburg position ($30^{\circ}$) and the PRM, consisting of two manual pulmonary inflations to a maximum pressure of $40cmH_2O$) (n=54) and the control group (n=52). Postoperative shoulder and abdominal pain was assessed 12, 24, and 48 hours later using a visual analog scale (0-10). In addition, the incidence of post-discharge nausea and vomiting was recorded until 48 hours after discharge. Results: Postoperative shoulder pain at 12 and 24 hours was significantly less severe in the PRM group ($2.2{\pm}0.5$ and $2.0{\pm}0.4$) than in the control group ($4.0{\pm}0.5$ and $3.9{\pm}0.4$; both p<0.001). The PRM significantly reduced the severity of upper abdominal pain at 12 and 24 h compared with the control group ($3.1{\pm}0.4$ and $2.9{\pm}0.4$ vs. $2.9{\pm}0.5$ and $4.9{\pm}0.5$; both p<0.001). The analgesic requirement during the postoperative period was similar in the two groups (control group, 78.8%; PRM group, 75.9%; p=0.719). Conclusion: The PRM effectively and safely reduced postoperative shoulder and upper abdominal pain levels in patients undergoing laparoscopic gynecological oncologic surgery. Trial registry at ClinicalTrials.gov, NCT01940042.