• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.70-74
• /
• 1999

Background: Preemptive analgesia has been suggested recently as an another technique of postoperative pain control. Combination of low dose opioid and NSAIDs was used to lessen systemic opioid side effect, however, the use of NSAIDs may hinder their side effects in perioperative period. The local application of small dose at the target site can be effective without systemic effect. The aim of this study is evaluating the additive effect and side effect of transdermal piroxicam as preemptive adjuvant to intravenous nalbuphine on pain relief after major abdominal surgery. Methods: We reviewed the records of patients received piroxicam patch for preemptive analgesia before operation and compared it with control group. Two sheets of piroxicam patch to the skin incision site for 12 hours before operation were attached (Group 1, n=20) and no patch were applied (Group 2, n=20). Both groups were received nalbuphine continuously after operation using two days infuser (2 ml/hr) containing 80 mg (96 ml). Pain is evaluated by VAS score at each time; 30 min, 1, 6, 12, 24, 36, 48 hours after operation and side effects of NSAIDs were observed for 3days postoperatively. Results: There was no significant VAS score difference between two groups following time in progress. And no significant side effect was noted in both groups, either. Conclusion: There is no preemptive or synergistic analgesic effect of piroxicam patch attached at planned operation site before operation.

• 대한기계학회논문집A
• /
• 제32권10호
• /
• pp.873-881
• /
• 2008

Weld overlay is one of the residual stress mitigation methods which arrest crack initiation and crack growth. Therefore weld overlay can be applied to the region where cracking is likely to be. An overlay weld used in this manner is termed a preemptive weld overlay(PWOL). In pressurized water reactor(PWR) dissimilar metal weld is susceptible region for primary water stress corrosion cracking(PWSCC). In order to examine the effect of PWOL on residual stress mitigation, PWOL was applied to a specific dissimilar metal weld of Kori nuclear power plant by finite element analysis method. As a result, strong compressive residual stress was made in PWSCC susceptible region and PWOL was proved effective preemptive repair method for weldment.

• 대한기계학회:학술대회논문집
• /
• 대한기계학회 2008년도 추계학술대회A
• /
• pp.88-93
• /
• 2008

Weld overlay is one of the residual stress mitigation method which arrest crack. An overlay weld sued in this manner is termed a preemptive weld overlay(PWOL). PWOL was good for distribution of residual stress of dissimilar metal weld(DMW) by previous research. Because range of overlay welding is wide relatively, residual stress distribution on PWR is affected by welding sequence. In order to examine the effect of welding sequence, PWOL was applied to a specific DMW of KORI nuclear power plant by finite element analysis method. As a result, the welding direction that from nozzle to pipe is better good for residual stress distribution on PWR.

• The Korean Journal of Pain
• /
• 제13권1호
• /
• pp.38-43
• /
• 2000

Background: Preemptive analgesia may decrease postoperative pain by preventing nociceptive inputs generated during surgery. The preemptive effect of intravenous nalbuphine was examined in gynecological surgery. Methods: Forty female patients scheduled for gynecological surgery were randomly allocated into two groups. Each patient received 10 mg of intravenous nalbuphine as a bolus dose at the closure of peritoneum in group I (n=20) and before the skin incision in group II (n=20). After the bolus dose, the intravenous patient controlled analgesia (IV-PCA) which contained 50 mg of nalbuphine, 120 mg of ketorolac, 0.25 mg of droperidol and 90 ml of 5% dextrose water was given continuously at the rate of 2 ml/min. The postoperative visual analogue scale pain score (VAS), the total amount of the analgesics used, the degree of satisfaction of the patients and the developement of side effects were examined for 2 days. Results: VAS were significantly lower in group II than in group I after 9 and 12 hours. The cumulative consumption of analgesics in group II was significantly less than in group I. Most patients were satisfied with this regimen. There were no remarkable side effects. Conclusions: Preemptive analgesia with intravenous nalbuphine decreased postoperative pain and analgesic requirement. The analgesic effect of IV-PCA with nalbuphine-ketorolac was effective in control of postoperative pain in gynecologic surgery.

• The Korean Journal of Pain
• /
• 제18권2호
• /
• pp.165-170
• /
• 2005

Background: It is difficult to treat tourniquet-induced hypertension despite adequate anesthesia, and the mechanism of that is not known. And it may be possible that intraoperative continuous infusion of opioid induces preemptive analgesia postoperatively. We investigated the effect of intraoperative continuous i.v. fentanyl on tourniquet induced cardiovascular changes and postoperative preemptive analgesia in total knee replacements. Methods: Sixty patients were randomly assigned to two groups; In study group ($1.5{\mu}g/kg$ loading and $0.5{\mu}g/kg/hr$ continuous infusion of fentanyl before skin incision and tourniquet inflation) and control group (no treatment). Anesthesia was maintained with enflurane (1-2 MAC) and 50% nitrous oxide in oxygen. Arterial pressure and heart rate were compared between two groups. They received postoperative pain treatment with patient-controlled analgesia (PCA) with fentanyl during the postoperative 48 hours after total knee replacement. Visual analog scale (VAS) scores at either rest or movement were used to assess pain. Total fentanyl dose delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. Results: There were no significant differences between the two groups on cardiovascular changes by tourniquet induced pain effect. VAS, PCA delivered dose and PCA demands at movement in the 24-48 hour decreased in study group compared with control group (P < 0.05). But there were no significant differences between the two groups on the other time periods except 24-48 hour's patient satisfaction and adverse events. Conclusions: We suggest that intraoperative continuous i.v. fentanyl infusion dose not affect cardiovascular change by tourniquet induced pain. But it may induce preemptive analgesia postoperatively.

• 대한기계학회:학술대회논문집
• /
• 대한기계학회 2008년도 추계학술대회A
• /
• pp.94-97
• /
• 2008

In the welding process, weldments usually include repair weld during the manufacturing process. Repair welds is supposed to cause strong tensile residual stress. Moreover weldments, usually made by Alloy 82/182, is susceptible to PWSCC. Therefore, mitigation of welding residual stress in weldments is important for reliable operating. PWOL is one of the methods for mitigation and verified for over twenty years. In this paper, residual stress distribution of repaired weldments and the effect of PWOL on mitigation is examined for surge nozzle.

• The Korean Journal of Pain
• /
• 제26권3호
• /
• pp.270-276
• /
• 2013

Background: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. Methods: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-${\mu}g$ fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. Results: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. Conclusions: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.

• The Korean Journal of Pain
• /
• 제24권3호
• /
• pp.137-140
• /
• 2011

Background: Although early reviews of clinical findings were mostly negative, there is still a widespread belief for the efficacy of preemptive analgesia among clinicians. In this study, we evaluated whether the preemptive use of ketamine decreases post operative pain in patients undergoing appendectomy. Methods: In double-blind, randomized clinical trials, 80 adult male patients undergoing an operation for acute appendicitis were studied. Patients were randomly assigned to two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In the control group, 0.5 mg/kg of normal saline was injected. The pain intensity was assessed at time 0 (immediately after arousal) and 4, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). Results: Eighty patients (40 for both groups) were enrolled in this study. For all of the evaluated times, the VAS score was significantly lower in the ketamine group compared to the control. The interval time for the first analgesic request was $23.1{\pm}6.7$ minutes for the case group and $18.1{\pm}7.3$ minutes for the control (P = 0.02). The total number of pethidine injections in the first 24 hours postoperatively was $0.6{\pm}0.6$ for the case group and $2.0{\pm}0.8$ for the controls (P = 0.032). There were no drug side effects for the case group. Conclusions: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.

• 대한치과마취과학회지
• /
• 제4권2호
• /
• pp.84-89
• /
• 2004

Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain. Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score ${\ge}$ 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours. Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups. Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.

• 한국전산구조공학회논문집
• /
• 제22권6호
• /
• pp.557-564
• /
• 2009

용접과정 중 발생되는 인장잔류응력은 원전 배관 이종용접부의 PWSCC가 발생되는 원인 중 하나라고 알려져 있다. 일반적으로 보수용접은 용접과정 중 흔히 일어나는 현상이다. 보수용접은 강한 인장잔류응력을 유도하기 때문에 이종용접부의 PWSCC를 유도하기 쉽다. 본 논문에서는 강한 인장잔류응력이 발생되는 보수용접부에 대해 보수용접 깊이에 따라 동종용접과 예방용접 overlay로 인하여 인장잔류응력의 크기가 변화하는 것을 정량적으로 확인하였다.