• Title/Summary/Keyword: general pain

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Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

  • Zavras, Nick;Tsamoudaki, Stella;Ntomi, Vasileia;Yiannopoulos, Ioannis;Christianakis, Efstratios;Pikoulis, Emmanuel
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.244-253
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    • 2015
  • Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of $7.56{\pm}2.61$ years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results.

Sympathetic Ganglion Block for the Complication of Frostbite -A case report- (교감신경절 차단에 의한 동상합병증 환자의 치료 경험 -증례 보고-)

  • Yang, Seung-Kon;Lee, Hee-Jeon;Hwang, Hyun-Jung;Lee, Sang-Hun;Lee, Chong-Sung;Kim, Chan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.215-218
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    • 1996
  • Frostbite involves freezing of tissues and usually affects the distal aspects of the extremities or exposed parts of the face. such as the ears, nose, chin, and cheeks. It produces tissue injury by ice crystal formation between the cells, cellular dehydration, and microvascular occulsion. There are four degrees of frostbite. First degree is accompanied by erythema and edema; second degree, by vesiculation, blistering, and eschar formation; third degree, by hemorrhagic blistering and bluish gray discoloration; and fourth degree, by injury to subcutaneous tissue, muscle, tendon, and bone leading to mottled, dry, black, and necrotic changes. We successfully treated 2 patients suffering from frostbite by performing sympathetic ganglion block with pure alcohol. We concluded sympathetic ganglion block is one of the most effective treatments for frostbite.

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Clinical Nurses' Knowledge and Attitudes on Pain Management (임상간호사의 통증관리에 대한 지식과 태도)

  • Hyun, Ju;Park, Kyung Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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    • pp.369-383
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    • 2000
  • The purpose of this study was to understand clinical nurses' knowledge and attitudes on pain management. The subject of the study were 254 nurses working at two hospitals affiliated with a university in Seoul. The questionnaires included four areas: general knowledge on pain, knowledge on the use of analgesia, knowledge and implementation on the pain assessment scales and pain interventions and nurses' general characteristics. The data were analyzed with descriptive statistics, analysis of variance, LSD test and t-test using SPSS statistical package. The results were as follows. 1. The mean score of the general pain knowledge was 61.46 and that of knowledge on the use of analgesia was 52.19. 2. Most nurses(74%) answered with hesitation about injecting narcotic analgesia to patients. 3. The pain assessment scale which nurses knew (57.5%) and used(48.0%) extremely was a simple descriptive scale. 4. The pain intervention which nurses knew (94.5%) and implemented(92.1%) extremely was to inject analgesia. 5. The number of nurses who had learned about pain management was 49 of 254(19.3%). 6. Nurses' knowledge on the use of analgesia was of relevance to having learned pain management, but general pain knowledge was not so relevant. According to this research, I suggest the following. 1. It is necessary to develop an education program with actual practice and intervention which nurses can perform for themselves. 2. It is necessary to continuously educate about pain management in clinical wards.

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A Survey on Clinical Characteristics of patients Visiting Pain Clinics (통증클리닉 내원환자의 임상적 특성에 관한 분석)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myoung Hee
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.146-150
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    • 2005
  • Background: Recently, the number of patients visiting pain clinics has been increasing with the augmented concerns of those patients about the management of their pain. We conducted this study in order to elucidate the characteristics of patients visiting pain clinics and to determine a method to further raise their awareness about pain treatment. Methods: We reviewed 1,424 new patients who visited our pain clinic from March 2003 to December 2004. We analyzed these patients according to their age and sex, treatment method before visiting the pain clinic, coexisting disease, chief complaint and pain location, resident district, route of visiting pain clinic, and degree of impairment due to pain by use of questionnaire. Results: In age distribution, the largest proportion (23.5%) was in their 50's. Most patients (64.0%) had received treatment in an oriental medicine clinic before visiting the pain clinic. The most common coexisting disease was hypertension (20.3%) and low back pain was the most common chief complaint (68.3%). Most of the patients lived in Gyeonggido (87%) and most visited our pain clinic on the recommendation of other patients who had visited our pain clinic before. Conclusions: We need to guide pain patients to undergo proper treatment much earlier using patient education or a referral system. Moreover, we should be more careful in patients with diabetes mellitus, and should have greater concern in the treatment of low back pain.

The Effect of Sympathetic Ganglion Block on Hyperhidrosis (다한증 환자에서 교감신경절 차단의 임상적 고찰)

  • Kim, Chan;Lee, Hee-Jeon;Lee, Hyo-Keun;Yang, Seung-Kon;Choi, Bong-Choon;Chae, Jin-Ho;Kim, Boo-Seong
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.94-97
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    • 1996
  • Two hundred and eighty eight patients suffering from excessive sweating of palms, soles and axillae etc., visited our Neuro-Pain clinic from November 1991 to March 1996. The sex ratio was 1:1.2. the third decade of age was the major age group. the onset time of hyperhidrosis was prepubertal period (in 95.1% of them). the provocative factors fo excessive sweating were tension and stress from interpersonal relationship. they had the family history (30.9%) and the past history treated with herb medication (56.9%), medicine (30.6%), operation (1.4%), and no treatment (39.6%). We treated 113 patients by sympathetic ganglion block with pure alcohol. the average times of thoracic sympathetic ganglion block were 2.1 (left), 2.4 (right) and those of lumbar sympathetic ganglion block were 1.2 (left), 1.6 (right). Average admission period was 14.7 days. Recurrence rare was 7.1%. Most longstanding effective period was 45 months. We conclude from our results that sympathetic ganglion block is one of the most effective treatments for hyperhidrosis owing to its simple technique and low recurrence rate.

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Risk Factors of Low Back Pain in General Hospital Nurses (종합병원 간호사들의 요통 관련요인)

  • Kim, Soon-Lae;Oh, Jae-Min
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.213-222
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    • 1998
  • The prevalence rate of low back pain in nurses is higher than that of other jobs, because there are many more risk factors(for example, standing postures, lifting and carrying heavy loads, transfering patients, changing a patient's position etc.). This investigation is to provide basic data for prevention of low back pain by analyzing the prevalence rate and related factors of low back pain in nurses(esp. operating room staff) in general hospitals. A self-reported questionaire survey was carried out on three hundred and five nurses of three general hospitals in Seoul from June, 1996 to August, 1996. Subjects of the survey were divided into a low back pain group(LBP) and a cotrol group to investigate the association between low back pain and the general characteristics and work related factors of each group. The results were as follows: 1. In the subjects of the survey, the prevalence rate of low back pain was 60.0% for the last year. 2. 73.6% of operating room(OR) staff complained of low back pain. 3. Standing for a long time and working in twisting postures were associated with low back pain, and so were the shift, the type of work, and the frequency of transfering patients. 4. The weight loads which nurses frequently carried were, under 5kg, 5-10kg, 15-20kg, 15-20kg, over 20kg, and all, except for 10-15kg, were associated with LBP. 5. 76.9% of the LBP experienced low back pain within 3 years after starting nursing jobs. 6. Concerning the degrees of low back pain: 75.8% was limited to waist; 18.8% reached the knees; 4.2% reached ankles. In conclusion, the prevalence rate of low back pain in general hospital nurses was associated with the works in operating room and other work related factors, therefore it is necessary to develop on educational program for the prevention of low back pain as well as and to improve working environments.

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The Effect of Stellate Ganglion Block for Controlling Postoperative Pain after the Shoulder Joint Surgery (견관절 수술 시 성상신경절 차단이 술 후 통증에 미치는 영향)

  • Park, Chai Geun;Kim, Jong Sun;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.197-201
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    • 2006
  • Background: There are cases in which shoulder pain persists long after shoulder joint surgery and this pain can not be reduced by intravenous patient controlled analgesia (IVPCA). Our purpose was to evaluate the effect of stellate ganglion block (SGB) on postoperative shoulder pain and also to investigate the effect of preventive SBG on complex regional pain syndrome (CRPS). Methods: Forty patients, who were evaluated to ASA class 1 and 2 and who were scheduled for shoulder joint surgery under general anesthesia, were randomly divided into 2 groups. The experimental group of patients (n = 20) received SGB with 0.5% mepivacaine 8 ml after induction of general anesthesia. The control group of patients (n = 20) received only general anesthesia. Their postoperative pain was assessed using the visual analog scale (VAS) at 30 min, 1, 2, 6, 12, 24 and 48 hours postoperatively. Whenever patients wanted supplemental analgesia, diclofenac sodium 75 mg was injected intramuscularly and the need for supplemental analgesia was recorded. Results: The experimental group of patients had significantly lower pain scores at 30 min, 1, 2 and 6 hours and also significantly lower analgesic requirement at 1, 2 and 6 hours. Conclusions: We found SGB was effective for controlling postoperative pain after shoulder joint surgery. Also, we could expect that SGB reduced the incidence of CRPS.

Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction

  • Gao, Fei;Ma, Shuren;Zhang, Ning;Zhang, Yingchun;Ai, Meina;Wang, Bing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6823-6827
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    • 2014
  • Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.

Computer Controlled Local Anesthesia Delivery: Literature Review (컴퓨터를 이용한 속도 조절형 치과 국소마취 기구: 문헌고찰)

  • Kim, Young-Jin;Lee, Jun-Hyung;Lee, Kang-Hee;Kim, Kee-Deog;Jung, Bock-Young;Pang, Nan-Sim;Park, Wonse
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.179-188
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    • 2013
  • Background: Today, there are computer controlled local anesthesia devices used clinically. The main principle is to control injection speed by computer aided system, and it relieves pain. However, there are few objective data considering this subject. In this literature review, we researched studies about computer controlled anesthetic delivery. We compared pain control effect of computer controlled to conventional local anesthetic syringe system. Methods: A bibliographic search in PubMed was performed and we reviewed original articles. Results: There were 18 publications that compared pain control effect of computer controlled to conventional system. There were 8 articles reported of children, similar pain control effect was found in 7 of them. One study showed superior pain control effect of computer controlled anesthetic delivery. For adults, 10 studies showed superior pain control effect in computer aided system. Conclusions: Computer controlled anesthetic delivery has similar or superior pain control effect compared to conventional local anesthetic syringe system. For both children and adults, computer controlled anesthetic delivery could be clinically useful, still it may be more effective for adults.

Clinical Experiences at Pain Clinic (Pain clinic에서의 임상경험(臨床經驗))

  • Kim, In-Hyun;An, Dong-Ai;Lim, Kyung-Im
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.3-8
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    • 1988
  • Authors have experienced the treatment for the uppermost frequent cases, herpes zoster, frozen shoulder and low back pain among those who visited our pain clinic. 1. Herpes zoster The Patients who received the treatment within 4 weeks of the onset of the disease, not only healed herpes without leaving post herpetic neuralgia but also crust formation was fast. 2. Frozen shoulder Over 90% of the patients who received suprascapular nerve block accompanied with trigger points electric stimulation was very efficient procedure, futhermore, authors felt keenly the necessity each patients co-operation and individual endurance for this treatment. 3. Low back pain An epidural steroid administration to the patients who did not have any organic disturbances was effective treatment. If this non-effective, search other cause of the disease or operation was advisable one.

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