• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.1
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• pp.49-52
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• 2013

Antral web is a rare cause of gastric outlet obstruction in neonate. It is a 2-4 mm thin mucous membrane that can be found anywhere from 1 to 7 cm proximal to the pylorus. The baby was born at gestational age of $32^{+1}$ weeks with 1,880 g as 2nd baby of dizygotic twin. After birth, the baby had constant non-bilious vomiting without feeding while he didn't show abdominal distension or discoloration. The infantogram showed distended stomach with distal small bowel gas. Upper gastrointestinal series revealed that the antrum was abruptly narrowed at 1 cm proximal to pylorus. We performed laparotomy at the 10th day after birth and excised the 2 mm-thick web circumferentially. He began milk feeding after 6 days and discharged uneventfully at postoperative 35 days with corrected age of $38^{+4}$ weeks with body weight 2,420 g. The antral web should be considered in the case of non-bilious vomiting in neonate.

• The Journal of Korean Obstetrics and Gynecology
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• v.22 no.3
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• pp.185-196
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• 2009

Purpose: This study aims to estimate the effects of on acustimulation for Gynecological surgery induced nausea and vomiting through reviewing the tendency of the studies. Methods: Literature searches were made through Pubmed, Koreanstudies Information Service System(KISS) and Korean Oriental medical Society database. Data were extracted according to pre-defined criteria. The methodological quality was assessed using Modified Jadad scale. Results: 8 studies were met the condition among the 43 searched studies. They were designed as double blind or observer blind and randomized controlled trial, and were analyzed statistically. 6 studies out of the 8 reported that acupuncture could prevent PONV effectively. Conclusion: The hypothesis that acustimulation may be effective for the prevention of Gynecological surgery induced PONV is supported by the data in recent literatures.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.235-243
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• 1995

A retrospective study was performed to evaluate the effects, and side effects, of epidural analgesia for postoperative pain relief of 2,381 surgical patients who received general-epidural, or epidural anesthesia only. Anesthesia records, patients charts, and pain control records were reviewed and classified according to: age, sex, body weight, department, operation site, epidural puncture site, degree of pain relief by injection mode & epidural injectate, and side effects(including nausea, vomiting, pruritus, urinary retention and respiratory depression). The results were as follows: 1) From the total of 2,381 patients, there were 1,563(66%) female patients; 1.032(43%) patients were from Obstetrics and Gynecology. 2) Lower abdomen, thorax, lower extremity and upper abdomen in the operation site; and lumbar, upper, lower thoracic in puncture site were order of decreasing frequency. Length of epidural injection for pain relief averaged $1.72{\pm}1.02$ days. 3) Ninety three percent of the patients experienced mild or no pain in the postoperative course. Analgesic quality was not affected by the kind of epidural injectate. 4) Nausea occurred in 3.2% of all patients, vomiting in 1.1%, pruritus 0.9%, urinary retention 0.6%, respiratory depression 0.08%. 5) Frequency of nausea was higher with female patients compared to male patients(p<0.05). 6) Pruritus frequency was higher with male patients than female patients(p<0.05); and more frequent with patients who received epidural injection with morphine than patients who received epidural injection without morphine(p<0.01). 7) Urinary retention was higher in female patients, and more frequent with patients who had received epidural injection with morphine than epidural injection without morphine(p<0.05). 8) There were two cases of respiratory depression. The course of treatment consisted of: cessation of epidural infusion, then administration of oxygen and intravenous naloxone. We conclude that postoperative epidural analgesia with a combination of local anesthetics and opiate is and effective method for postoperative pain relief with low incidence of side effects. However, patients should be carefully evaluated as rare but severe complications of respiratory depression may ensue.

• The Journal of Korean Medicine
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• v.30 no.3
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• pp.111-118
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• 2009

Hysterectomy can lead to various symptoms threatening decent quality of life. As the frequency of hysterectomy increases, there are many patients who want to take oriental medicine treatments for complications. Several clinical studies have reported the effectiveness of oriental medicine treatment for post-hysterectomy complications. Out of these symptoms, postoperative nausea and vomiting (PONV, hereafter) are indicated at about 20-40% of frequency within patients with general anesthesia, and they may occur not only during recovery from operation, but also after discharge. Although the incidence of PONV has decreased now thanks to the usage of antiemetics, PONV still causes some difficulties for patients returning to daily life. This study reports two cases of post-hysterectomy complications such as nausea, dizziness, vomiting, general weakness, and coldness of the limbs, which had good responses to herbal medication and acupuncture.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.276-282
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• 2017

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.171-176
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• 1998

Postoperative pain following tonsillectomy remains a significant obstacle to speedy recovery and smooth convalescence. Inadequate analgesia causes poor oral intake and influences the length of hospital stay and ability to return to normal activity. Patient Controlled Analgesia (PCA) is a method of analgesia adminstration that consists of a computer driven pump with a button that the patient may press to adminster a small dose of analgesic drug. The aim of this study was to examine whether Intravenous Patient Controlled Analgesia (IV-PCA) can reduce postoperative pain after tonsillectomy. The 100 patients undergoing tonsillectomy with general anesthesia were divided into two groups. The PCA group patients (n=80) received a mixture of nalbuphine and ketorolac by Walkmed PCA infusor during first 48 postoperative hours. In control group (n=20), the patients received oral acetoaminophen (Tyrenol) regularly and tiaprofenic acid (Surgam) intramuscularly on a p.r.n basis. Analgesic efficacy was evaluated with visual linear analogue scale (VAS) and the adverse effects were evaluated with 4 point scale. The patients of PCA group had less pain than those of control group. The adverse effects in the PCA group were nausea and vomiting. This study suggests that IV-PCA may be safe and effective method of pain control after adult tonsillectomy and is better accepted than oral or intramuscular pain medications.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.1
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• pp.18-28
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• 2007

Purpose: This study was to identify knowledge, attitude, use and state of the Patient Controlled Analgesics (PCA) in postoperative patients. Method: The research design was a descriptive research. From December 7, 2005 to January 6, 2006, 102 postoperative patients in a university hospital at Daegu were participated in the study Results: Analgesics with PCA were mainly morphine complex 73.5% and Demerol complex 26.5%. Previous experience of using PCA was only 28.4%, and the main sources of information were other post-op patients and families(43.1%). The most common reason of choice was a recommendation from other post-op patients and families(46.1%). The most common side effects of PCA were nausea and vomiting(20.6%). About 57% of the patients were satisfied with PCA, and pain scores decreased with PCA. Mean score for knowledge about PCA was 2.55 out of a possible 6, and for attitude related to pain medication. 2.31 out of possible 5. Conclusion: To increase the score on knowledge of PCA, a structured preoperative PCA education program should be developed by nursing staff.

• Journal of Veterinary Clinics
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• v.38 no.4
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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.

• Journal of Physiology & Pathology in Korean Medicine
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• v.37 no.1
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• pp.19-24
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• 2023

Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.