• Title/Summary/Keyword: Postoperative vomiting

Search Result 177, Processing Time 0.029 seconds

Postoperative Pain Management Status led by Nurse of Acute Pain Service (급성통증관리 간호사 주도의 수술 후 통증관리 현황)

  • Kang, Mi Ra;Ryu, Jeong Ok;Kim, Myung Hee;Yun, Hea Shin;Kwon, Jeong Soon
    • Journal of Korean Clinical Nursing Research
    • /
    • v.26 no.3
    • /
    • pp.296-304
    • /
    • 2020
  • Purpose: This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). Methods: A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with χ2test, and Correlation coefficient. Results: As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. Conclusion: With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies. Therefore, it is suggested that this system is safe and effective for pain management.

GENERAL ANESTHESIA AND DEEP SEDATION FOR THE SPECIAL NEED DENTAL PATIENTS (장애인의 치과치료 시 외래전신마취와 진정법)

  • Seo, Kwang-Suk
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.6 no.2
    • /
    • pp.77-83
    • /
    • 2010
  • This article discusses the issues of benefit and risk associated with outpatient general anesthesia and deep sedation for the special need dental patients. The purpose of administering anesthesia for patients with special needs is to provide effect dental treatment. But there are many complications such as sore throat, nausea and vomiting, airway trauma, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, before general anesthesia meticulous patient evaluation is much important. But, there are a number of factors that make it difficult to accurately assess the anesthetic risk for many people with special needs. These include limited medical workups, uncooperative behavior, and difficulties in postoperative cares, etc. But Judging from several years experience of many contries, it appears that the incidence of mortalities for people with special needs in dental setting is minimal and the incidence of morbidity is limited. In the long run, the delivery of general anesthesia and deep sedation for people with special needs can be considered a very safe and successful procedure.

  • PDF

Congenital Esophageal Hiatus Hernia (Report of a Case) (선천성(先天性) 식도렬공(食道裂孔) Hernia의 치험(治驗) 1례(例))

  • Chung, Yun Chae;Oh, Chul Soo;Rhee, Chong Bae;Jee, Heng Ok;Kim, Kun Ho;Lee, Keun Soo
    • Journal of Chest Surgery
    • /
    • v.9 no.2
    • /
    • pp.287-292
    • /
    • 1976
  • This is a report of a case of congenital esophageal hiatus hernia, occurring in a younger child at the age of one year and two months. The child was suffered from vomiting (intermittently coffee-ground vomitus or blood-flecked vomitus), coughing, and high fever for about 3 months.Diagnosis was confirmed by the radiologic barium study of the gastrointestinal tracts. The herniated organs were entire stomach and a part of the transverse colon. They were located in the right chest. The etiologic pathology was mainly congenital developmental defect of the musculature of the diaphragm, forming the posterior margin of the esophgeal hiatus, and additionally slight shorted esophagus. After reduction of herniated organs back to the abdominal cavity through abdominal approach, herniorrhaphy was performed through transthoracic approach with modified Allison's procedure. At the same time, any associated anomalies, such as hypertrophic pyloric stenosis, were not seen. Postoperative course was uneventful.

  • PDF

Rupture of the Trachea and the Esophagus Following Blunt Trauma: A Report of a Case (Blunt Trauma 에 의한 기관-식도 파열의 치험 1례)

  • 정윤채
    • Journal of Chest Surgery
    • /
    • v.8 no.2
    • /
    • pp.119-124
    • /
    • 1975
  • This is a case report of the rupture of the trachea and the esophagus following external blunt trauma without any associated injury. A 7 year old male patient was brought to the emergency room. Hanyang University Hospital, on 23 Jul, 1974 while he played under the pile of pingpong table A table was fall down over the patient accidentally. The patient was injured by the table and found lying in unconsciousness on the ground.There was subcutaneous emphysema on his anterior chest and neck. A contusion on the upper part of the sternum was noted. The breathing sound were diminished over the left side of the chest. Ronchi were heard over the right lung field. This patient was suffered from vomiting, dypsnea, and irritable mental state after this accident. On the chest roentgenogram in A-P view, hyperlucency at the mediastinum and parapericardiac area suggested the pneumomediastinum. On the next day, a diagnosis of the tracheal and esophageal rupture was confirmed by the esophagogram with Lipiodol swallowing. A right thoracotomy was performed and ruptured orifice of the trachea and the esophagus were closed with interrupted sutures. Postoperative course was uneventful and primary closure of the rupture of the trachea and the esophagus were succeeded.

  • PDF

Successful Management of Delayed Esophageal Rupture with T-Tube Drainage Using Video-Assisted Thoracoscopic Surgery

  • Do, Young Woo;Lee, Chang Young;Lee, Sungsoo;Kim, Ha Eun;Kim, Bong Jun;Lee, Jin Gu
    • Journal of Chest Surgery
    • /
    • v.49 no.6
    • /
    • pp.478-480
    • /
    • 2016
  • Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications.

Further Study on Pemetrexed based chemotherapy in Treating Patients with Advanced Gastric Cancer (AGC)

  • Liu, Jin;Huang, Xin-En;Feng, Ji-Feng
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.16
    • /
    • pp.6587-6590
    • /
    • 2014
  • Objective: To further observe the efficacy and safety of pemetrexed, combined with Irinotecan or oxaliplatin or cisplatin in treating patients with advanced gastric cancer as second-line or third-line chemotherapy. Methods: From September 2013 to February 2014 we recruited 50 patients with advanced gastric cancer, with stage IV disease or postoperative recurrence, or unresectable. Then treated with pemetrexed based chemotherapy. After two cycles of treatment, efficacy and toxicity were evaluated. Results: Pemetrexed based chemotherapy was used as second-line in 33 patients, RR(CR+PR) is 41.2%. And achieved 36.4% when used as third-line. Overall response rate of 50 patients treated with Pemetrexed based treatment was 38% (CR+PR). Treatment related side effects were bone marrow suppression, vomiting, hepatic dysfunction and malaise.No treatment related death occurred. Conclusions: Treatment with pemetrexed based chemotherapy is active and is well tolerated in patients with advanced gastric cancer.

Ultrasound-Guided Regional Nerve Block in Lower Extremity (하지에서의 초음파 유도 국소 신경 차단술)

  • Kang, Chan
    • The Journal of Korean Orthopaedic Ultrasound Society
    • /
    • v.5 no.1
    • /
    • pp.50-59
    • /
    • 2012
  • In the domain of orthopaedic surgery, application of regional nerve block for surgery or pain control in upper and lower extremities has been increased. By performing regional block of popliteal (sciatic), femoral, proximal saphenous nerve and ankle block under guidance of ultrasound, not only the safety, but also success rate of the procedure has increased, and amount of local anesthetics could be used less, too. Since the perineural single injection or continuous catheterization of diluted local anesthetics was performed more precisely and easily by the guidance of ultrasound, postoperative pain could be controlled without complications of PCA such as nausea, vomiting, etc. We will discuss about this ultrasound guided regional nerve block.

  • PDF

Primary Cerebellar Hodgkin's Lymphoma

  • Hwang, Chul-Yoon;Song, Young-Jin;Kim, Dae-Chul;Choi, Sun-Seob;Choi, Young-Min;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
    • /
    • v.42 no.2
    • /
    • pp.149-152
    • /
    • 2007
  • Authors report a very rare case of primary Hodgkin's lymphoma limited to the cerebellum. A 64-year-old female patient presented with headache, nausea, and vomiting. Magnetic resonance imaging of the brain revealed a nodular enhancing mass in the left cerebellar hemisphere. Tumor was removed totally with retromastoid suboccipital approach. Diagnosis was Hodgkin's lymphoma of mixed cellularity type, consisting of a dense mixed inflammatory infiltrate containing scattered large atypical mononuclear Hodgkin's cell and multinucleated Reed-Sternberg cells. Systemic work-up for the Hodgkin's lymphoma was followed with negative result. Postoperative radiation therapy was given and the patient is disease-free at 16 months after the operation.

Esophageal Hiatal Hernia in Infant -A Report of Case- (영아에서 발생한 식도열공탈장 수술치험 -1례 보고-)

  • Jin, Ung;Lee, Sun-Hee;Kim, Woo-Chan;Park, Jae-Kil;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
    • /
    • v.27 no.1
    • /
    • pp.72-75
    • /
    • 1994
  • The esophageal hiatal hernia is a rare disease in Korea especially in children and infant. We experienced a case of type III esophageal hiatal hernia in 9 months female. She had no specific past history and familial history except recurrent URI and postprandial habitual vomiting. The chest X-ray and Barium swallowing showed herniated stomach in Rt. thoracic cavity and posterior mediastinum. We performed modified Belsey Mark IV procedure with using the 3-0 and 4-0 Pledgeted Ticrons. In operative field, the stomach cardia portion was herniated into the Rt.thoracic cavity and posterior mediastinum with elevation of the esophagogastric junction above the diaphragm. But there was no evidence of short esophagus and combined anomaly. The postoperative courses were uneventful and good without specific complication for about 5 months to this point.

  • PDF

A Case of Adenomyoma of the Stomach in a Child Presenting Epigastric Pain (심와부 복통으로 내원한 5세 소아에서의 위 선근종 1례)

  • Heo, Mi-Young;Jung, Ji-A;Choi, Kum-Ja;Sung, Sun-Hee;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.4 no.1
    • /
    • pp.99-103
    • /
    • 2001
  • Adenomyomas of the stomach are rare tumors characterised by duct/gland-like structures embedded within a smooth muscle stroma. A 5-year-old female patient was admitted to the department of Pediatrics, Ewha Womans University MokDong Hospital with the history of severe epigastric pain and vomiting for 1 day. Esophagogastroduodenoscopy showed bridging fold with central dimpling on posterior wall of prepyloric antrum. Endoscopic biopsy was nondiagnostic. The patient complained epigastric pain continuously and underwent wedge resection. Pathologic examination showed an adenomyoma of the prepyloric antrum. After wedge resection, the patient did not complain epigastric pain during the postoperative follow-up. We report an unusual case of an adenomyoma of stomach.

  • PDF