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

• The Journal of Korean Medicine
• /
• v.41 no.4
• /
• pp.120-132
• /
• 2020

Objectives: Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting during pregnancy (NVP) with weight loss, ketonuria, and electrolyte imbalance. Many NVP or HG patients get hard to take herbal medicine since the smell and taste of it. Therefore, the distilled herbal medicines are often used in clinical practice. A 32-year-old, 14-week pregnant female was admitted for 3 weeks at a Korean medicine hospital. She was experiencing HG accompanied by 19.61% (10 kg) weight loss, ketonuria, and electrolyte imbalance. The patient received Bosaeng-tang gagambang in its distilled form, acupuncture, electro-acupuncture, sticker needles, cupping, moxibustion, and hydration during admission. The severity and frequency of NVP, weight loss, and ketonuria significantly improved without any side effects. Before the therapy, she admitted to two obstetrics and gynecology hospitals, 1 week each, with no improvement. This case presents the therapeutic potential of Korean medicine including herbal medicine in its diluted form for HG and NVP.

• Journal of Pharmaceutical Investigation
• /
• v.40 no.3
• /
• pp.167-173
• /
• 2010

Repeated oral administration of hydrochlorothiazide, a loop diuretic, due to transient high blood levels, may cause adverse effects such as gastric disturbance, nausea, high blood sugar, and hyper lipidemia. Transdermal administration could avoid some of these systemic side effects and gastric disorders. We have developed a matrix using ethylene-vinyl acetate (EVA), a heat-processible and flexible material, for transdermal delivery of hydrochlorothiazide. Drug solubility was highest at 40% PEG-400 volume fraction. Drug release increased as concentration increased with a linear relationship between the release rate and the square root of loading dose. Increasing temperature increased drug release from the EVA matrix. The activation energy, measured from the slope of log P versus 1000/T, was 11.9 kcal/mol for a 2.5% loading dose from EVA matrix. Diethyl phthalate had the highest plasticizing effects on the release of hydrochlorothiazide. To increase the skin permeation of hydrochlorothiazide from the EVA matrix, enhancers such as the saturated fatty acids, the unsaturated fatty acids, and the non-ionic surfactants were added to the EVA matrix, and skin permeation was evaluated using a modified Keshary-Chien diffusion cell fitted with intact excised rat skin. Polyoxyethylene 23-lauryl ether showed the highest enhancing effects. In conclusion, transdermal delivery of hydrochlorothiazide could be improved from an EVA matrix containing plasticizer and permeation enhancer.

• Journal of Hospice and Palliative Care
• /
• v.4 no.1
• /
• pp.41-46
• /
• 2001

Background : Many analgesics are used to relieve the pain of various causes. Among these, $Myprodol^{(R)}$, a combination analgesic with codeine, ibuprofen and paracetamol, was recently used as a new analgesics. This study was performed to survey the kinds of diseases, side effects and pain relief effect of $Myprodol^{(R)}$ in clincal practice. Methods : This retrograde study surveyed the medical records of 183 patients treated with $Myprodol^{(R)}$ at Pain Clinic, Pusan National University Hospital. From medical records, the disease entities, the pain characteristics, duration of $Myprodol^{(R)}$ medication, the analgesic effect and side effects were evaluated. Results : $Myprodol^{(R)}$ is used in the treatment of cancer pain (64.3%) and non-cancer pain (35.7%). Among side effects of $Myprodol^{(R)}$ medication, nausea with vomiting, constipation and generalized edema were common in cancer pain, but epigatric pain was common in non cancer pain. $Myprodol^{(R)}$ was more effective in non cancer pain than cancer pain. Conclusions: $Myprodol^{(R)}$ was used in cancer and non-cancer pain patients. In cancer pain patients, $Myprodol^{(R)}$ was effective in early cancer pain but, not effective in advanced cancer. $Myprodol^{(R)}$ was also used and effective in non-malignant benign chest pain, lumbago, post-operative pain.

• Radiation Oncology Journal
• /
• v.19 no.2
• /
• pp.127-135
• /
• 2001

Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.23
• /
• pp.10445-10449
• /
• 2015

Objective: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. Methods: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. Results: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P>0.05). Baseline pain score of patients with moderate pain in treatment and control group was $4.9{\pm}0.8$ and $5.1{\pm}0.8$, respectively; and decreased to $1.8{\pm}1.1$ and $1.2{\pm}1.1$ after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P=0.028). Average daily consumption of oxycodone prolonged-release tablets was ($54.0{\pm}19.6$) mg and ($44.7{\pm}18.7$) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were $8.3{\pm}1.1$ and $8.3{\pm}1.1$, respectively; and pain intensity after treatment decreased to $2.9{\pm}1.0$ and $2.3{\pm}1.0$. Pain intensity was significantly reduced in the treatment group, with statistical significance (P=0.026). Average daily consumption of oxycodone prolonged-release tablets was ($132.0{\pm}42.2$) mg and ($110.7{\pm}33.9$) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). Conclusion: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

• The Korean Journal of Pain
• /
• v.11 no.2
• /
• pp.268-272
• /
• 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 Journal of Korean Obstetrics and Gynecology
• /
• v.32 no.4
• /
• pp.144-158
• /
• 2019

Objectives: The purpose of this study is to report the effect of Korean medical treatment in case of germ cell tumor patient treated by chemotherapy. Methods: The patient was treated with Korean medical treatment (herbal medicine, acupuncture) for 11 months. By taking computed tomography and laboratory testing, we could compare before and after. Results: The patient treated with combination of Korean medical treatment and Chemotherapy recovered after taking Korean medicine for 11 months. Panax ginseng, C.A. Meyer, Astragalus membranaceus, Rhus Verniciflua Stokes were main ingredient of the korean medical treatment. Conclusions: This report shows the Korean medical treatment is effective on Germ cell tumor patient. Korean medical treatment alleviates the side-effect of Chemotherapy such as nausea, vomiting, hot flush and anorexia. Also Blood test results prove long-term use of Korean medicine is safe for lung and kidney function.

• The Journal of Internal Korean Medicine
• /
• v.32 no.4
• /
• pp.610-615
• /
• 2011

Objectives : To observe the mitigating effects of a Traditional Korean Medicine treatment program, called Wheel Balanced Cancer Therapy (WBCT), with Adriamycin and 5-FU chemotherapy on a breast cancer patient. Methods : A 26 year old female patient diagnosed with stage IIb breast cancer was admitted to the East-West Cancer Center (EWCC) in February of 2010. She received Adriamycin and 5-FU from February 22nd, to July 20th, 2010 followed by WBCT consisting of herbal medicine, acupuncture, moxibustion and physiotherapy for 5 months. Her symptoms were measured by Common Terminology Criteria for Adverse Events (CTCAE) and her quality of life was measured by Eastern Cooperative Oncology Group (ECOG). Results : WBCT significantly alleviated chemotherapy-induced nausea, oral dryness, and peripheral neuropathy. Quality of life also significantly improved. Conclusions : This case study potentiates WBCT's significant efficacy in aiding breast cancer patients suffering from Adriamycin plus 5-FU chemotherapy induced adverse effects.

• The Korean Journal of Pain
• /
• v.31 no.2
• /
• pp.102-108
• /
• 2018

Background: Nefopam is a non-opioid, non-steroidal analgesic drug with fewer adverse effects than narcotic analgesics and nonsteroidal anti-inflammatory drugs, and is widely used for postoperative pain control. Because nefopam sometimes causes side effects such as nausea, vomiting, somnolence, hyperhidrosis and injection-related pain, manufacturers are advised to infuse it slowly, over a duration of 15 minutes. Nevertheless, pain at the injection site is very common. Therefore, we investigated the effect of warmed carrier fluid on nefopam injection-induced pain. Methods: A total of 48 patients were randomly selected and allocated to either a control or a warming group. Warming was performed by diluting 40 mg of nefopam in 100 ml of normal saline heated to $31-32^{\circ}C$ using two fluid warmers. The control group was administered 40 mg of nefopam dissolved in 100 ml of normal saline stored at room temperature ($21-22^{\circ}C$) through the fluid warmers, but the fluid warmers were not activated. Results: The pain intensity was lower in the warming group than in the control group (P < 0.001). The pain severity and tolerance measurements also showed statistically significant differences between groups (P < 0.001). In the analysis of vital signs before and after the injection, the mean blood pressure after the injection differed significantly between the groups (P = 0.005), but the heart rate did not. The incidence of hypertension also showed a significant difference between groups (P = 0.017). Conclusions: Use of warmed carrier fluid for nefopam injection decreased injection-induced pain compared to mildly cool carrier fluid.