• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.315-322
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• 2007

Purpose: The purpose of this study was to examine the effect of three kinds of modes using bolus button of PCA on level of pain and side effects of analgesic and amount of drug consumption in post-operative patients according to whether the medication is controlled by the patient, the caregiver or the nurse. Method: The participants were 684 patients using PCA after an operation. The data collection period was from March 19 to April 6, 2007. Results: It was found that there were statistical differences in gender, age, type of surgery, pain on first post-operative day, amount of drug consumption, nausea, and vomiting. The ratio for patient controlled medication was 55.7% for women, and 70.5% for men, and for care-giver controlled medication, 35.1% for women, and 20.0% for men. Average pain scores for the first post-operative day were $3.9{\pm}2.2$ for patient controlled medication and $4.5{\pm}2.3$ for care-giver controlled medication. There were statistical differences according to mode used for PCA for amount of drug consumptions, nausea and vomiting but not for pain, operation day or pruritus. Conclusion: This study was carried out to examine risks according to who controls the PCA for post-operative patients. The results can help to develop education program for everyone who is involved in PCA, patients, caregivers, nurses and doctors.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.43-50
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• 1995

The purpose of this study was to compare postoperative analgesic effect according to intravenous doses of ketorolac. The ninety-eight adult patients, scheduled for elective surgery under general anesthesia, were randomly assigned to receive saline or one of the five doses of ketorolac (10, 15, 30, 45, 60mg). After recoverg from anesthesia, saline or ketorolac was injected intravenously, and the visual analogue score, sedation secore, mean blood pressure, heart rate, and the incidence of nausea and vomiting were measured 30 minutes, 1 hour and 2 hours the injection. Saline or 10 mg of ketorolac had no postanalgesic effect. Above 15 mg of ketorolac had analgesic effect, but this analgesic effect was not increased with increasing doses of ketorolac (30, 45, 60 mg). Any side effects (nausea, vomiting, excessive sedation, cardiopulmonary depression, and renal and hematologic adverse events) was not observed associated with ketorolac administration. These results suggested that 15 mg of ketorolac is the most reliable dose for postoperative anlgesia in intravenous administration.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.6
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• pp.362-366
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• 2017

In this study, Banhasasim-tang extracts (BSTE) have an inhibitory effects on cisplatin-induced decrease of body weights in two mouse model. Cisplatin is the most widely used anticancer drug for treatment of various cancer. However, cisplatin treatment to cancer patients leads to many side effects such as nausea, vomiting and body weight decrease. BSTE has been used to decrease digestive disorders in South Korea. We hypothesize that BSTE improve the cisplatin-induced side effects in mouse models. We found that pre- and co-administration of BSTE inhibited decreases of body weights and food intake by cisplatin in mouse models. But BSTE had no synergistic effects for tumor shrinkage by cisplatin in xenograft model. Collectively, our data suggest that BSTE have great potential as a agent for having decrease effects on side effects by cisplatin in cancer patients.

• The Journal of Korean Medicine
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• v.17 no.2 s.32
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• pp.331-336
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• 1996

We have studied the effect of auricular acupuncture on postoperative nausea and vomiting (PONV). 100 female patients undergoing transabdominal hysterectomy were entered into the study. The patients were divided into two groups (auricular acupuncture treatment group and non-treatment group) to test the effectiveness of auricular acupuncture. acupuncture consisted of needle insertion in one ear at four points: sympathetic, stomach, shinmoon and occiput. Before the operation, the above points were punctured perpendicularly by the thumbtack-type needle, leaving its handle lying flat on the skin surface. There was no significant difference in age, weight, height and duration of anesthesia among the two groups of patients. There was a cignificant difference between the control group and auricular acupuncture treatment group in the incidence of vomiting at the first 12 h after surgery 68% and 30%, respectively, p<0.01) No noteworthy side effects fbom treatment were observed. auricular acupuncture is effective in reducing nausea and vomiting after transabdominal hysterectomy in female patients.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.91-95
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• 1998

Background: Quality of postoperative care may be improved by management of postoperative pain. Epidural anesthesia and analgesia have several advantages over general anesthesia and parenteral analgesics in managing the postoperative pain. We retrospectively reviewed records of obstetrical patients who underwent the cesarean sections under epidural anesthesia to evaluate perioperative analgesic use, side effects, and complications. Methods: All patients received epidural anesthesia consisting of 0.25% bupivacaine, 2% lidocaine and 100 ${\mu}g$ fentanyl, followed by epidural analgesia with 0.1% bupivacaine and 12.5 ${\mu}g$/ml fentanyl at rate of 2 ml/hr for 48 hours. Patients' records were reviewed for: medications administered for pain relief, incidence of nausea and vomiting and pruritus, and presence of respiratory or cardiovascular depression. Results: Over 18 months, 1,054 patients' records were reviewed. Average age was 27.8 years (18~43 years). 768 patients (72.9%) received no additional drugs for the pain relief. Intramuscular analgesics, ketoprofens, were one time administered to 247 patients (23.4%), 39 patients (3.7%) received two more dosages. The time of administration was $8.3{\pm}4.3$ hours postoperatively. Antiemetics, for example, low-dose droperidol, were administerd one time for 160 patients (15.2%), 5 patients (0.5%) received two or more administrations. The medication was administered $5.1{\pm}4.2$ hours postoperatively. Drugs for relief of pruritus, low-dose naloxone, were administered one time for 108 patients (10.2%), 10 patients (0.9%) received 2 or more dosages. The time of administration was $6.3{\pm}4.2$ hours postoperatively. None of the patients experienced cardiovascular nor respiratory (<8 breath/min) depression. Conclusions: Postoperative continuous epidural analgesia in combination with bupivacaine and fentanyl is an effective method of providing postoperative analgesia with low incidence of side effects.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.59-63
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• 1999

Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.119-121
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• 2021

Ketamine is used widely in emergency departments for a variety of purposes, including procedural sedation for facial laceration in pediatric patients. The major benefits are its rapid onset of effects, relatively short half-life, and lack of respiratory depression. The known side effects of ketamine are hallucinations, dizziness, nausea, and vomiting. Seizure is not a known side effect of ketamine in patients without a seizure history. Here, we present the case of a patient in whom ketamine likely induced a generalized tonic-clonic seizure when used as a single agent in procedural sedation for facial laceration repair. The aim of this article is to report a rare and unexpected side effect of ketamine used at the regular dose for procedural sedation. This novel case should be of interest to not only emergency physicians but also plastic surgeons.

• Journal of Korean Traditional Oncology
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• v.28 no.1
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• pp.45-53
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• 2023

Objectives: To report the reduction of adverse effects of chemotherapy and improvement in the quality of life in recurrent liver metastasis by Korean medicine treatments. Methods: In 2018, a 75-year-old male patient underwent surgery for primary cancer in the ampulla of Vater. In 2021, he was diagnosed with recurrent liver metastasis. Following the failure of tumor treatment with gemcitabine/cisplatin and the development of severe side effects, he decided to discontinue chemotherapy. Subsequently, with a significantly enlarged liver tumor, he resumed capecitabine/oxaliplatin treatment, alongside moxibustion, acupuncture, and herbal prescriptions from August 2021 to August 2023. The changes of chief complaints, abdominal CT, and laboratory findings were investigated. Results: After combined treatment of Korean traditional medicine and chemotherapy, the mass was decreased. Laboratory findings, and chief complaints of hand-foot syndrome, fatigue, abdominal distension, nausea and anorexia were improved. Conclustions: This case study suggests that Korean traditional medicine is effective in enhancing anticancer effects, suppressing the side effects of chemotherapy, and improving general conditions.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.91-95
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• 2006

Background: Opioid delivered by epidural patient-controlled analgesia (PCA) is effective in relieving pain after surgery, but it is associated with side effects, such as nausea, vomiting, pruritus, respiratory depression, and urinary retention. The purpose of this study was to compare hydromorphone related side effects and the quality of analgesia when naloxone was added to epidural PCA regimen. Methods: Fifty-two thoracotomy patients with PCA were allocated blindly into two groups. Patients in group H (n = 26) received continuous epidural hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine; patients in group N (n = 26) received an epidural infusion containing naloxone ($2{\mu}g/ml$) and hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine. The basal rate of PCA was 4 ml/hr and the demand dose was 1.5 ml with a lockout time of 15 min. Pain intensity, sedation, pruritus, nausea and vomiting, respiratory depression were checked at 6, 12, 24 hours postoperatively. Results: The Visual Analog Scale (VAS) scores were significantly lower in group H than in group N. There were no significant differences in the overall incidence of pruritus, nausea and sedation between the two groups. Conclusions: Continuous epidural infusion of naloxone combined with hydromorpho-ne is not effective in reducing the incidence and severity of pruritus induced by epidural hydromorphone.