• Title/Summary/Keyword: interventional

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Complex Regional Pain Syndrome followed by Artery and Vein Puncture -A report of 2 cases- (동정맥 천자 후 발생한 복합부위통증증후군의 치료 -증례보고-)

  • Ahn, Gyu Yul;Han, Kyung Ream;Lee, Hyun Tak;Kim, Yeui Seok;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.66-70
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    • 2007
  • No definitive etiology or risk factors have been identified that predispose individuals to developing complex regional pain syndrome (CRPS). We experienced two cases of CRPS developed after arterial and venous puncture which were done in regular medical work. A 35-years old female patient was suffered from pain and allodynia with swelling at right hand and wrist after radial artery puncture for monitoring of blood pressure during general anesthesia. A 24-years old male patient had pain and swelling with allodynia at the right fingers and arm after median cubital vein puncture for blood sampling. They did not have proper pain management as CRPS patients in the past weeks and months after their pain occurred. They were diagnosed as CRPS and started undergoing various interventional procedures, which led to improve their pain condition. Our cases suggest that CRPS could develop without any proved tissue damage in routine medical practice. In conclusion, health care workers should be educated in knowledge about the uncommon medical condition and proper consultation to pain specialist when it happens.

A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume (경부 경막외 차단 시 약물의 용량에 따른 분포 양상 비교)

  • Jo, Dae hyun;Kim, Myoung hee;Ahn, Sun Yeon;Park, Sa Hyun;Lee, Kang Chang
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.46-49
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    • 2007
  • Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

Evaluation of an Experimentally Designed Stereotactic Guidance System for Determining Needle Entry Point during Uniplanar Fluoroscopy-guided Intervention

  • Lee, Jae-Heon;Jeon, Gye-Rok;Ro, Jung-Hoon;Byoen, Gyeong-Jo;Kim, Tae-Kyun;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.81-88
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    • 2012
  • Background: In discography performed during percutaneous endoscopic lumbar discectomy (PELD) via the posterolateral approach, it is difficult to create a fluoroscopic tunnel view because a long needle is required for discography and the guide-wire used for consecutive PELD interrupts rotation of fluoroscope. A stereotactic system was designed to facilitate the determination of the needle entry point, and the feasibility of this system was evaluated during interventional spine procedures. Methods: A newly designed stereotactic guidance system underwent a field test application for PELD. Sixty patients who underwent single-level PELD at L4-L5 were randomly divided into conventional or stereotactic groups. PELD was performed via the posterolateral approach using the entry point on the skin determined by premeasured distance from the midline and angles according to preoperative magnetic resonance imaging (MRI) findings. Needle entry accuracy provided by the two groups was determined by comparing the distance and angle measured by postoperative computed tomography with those measured by preoperative MRI. The duration and radiation exposure for determining the entry point were measured in the groups. Results: The new stereotactic guidance system and the conventional method provided similarly accurate entry points for discography and consecutive PELD. However, the new stereotactic guidance system lowered the duration and radiation exposure for determining the entry point. Conclusions: The new stereotactic guidance system under fluoroscopy provided a reliable needle entry point for discography and consecutive PELD. Furthermore, it reduced the duration and radiation exposure associated with determining needle entry.

Comparing the effectiveness of ultrasound guided versus blind genicular nerve block on pain, muscle strength with isokinetic device, physical function and quality of life in chronic knee osteoarthritis: a prospective randomized controlled study

  • Cankurtaran, Damla;Karaahmet, Ozgur Zeliha;Yildiz, Sadik Yigit;Eksioglu, Emel;Dulgeroglu, Deniz;Unlu, Ece
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.258-266
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    • 2020
  • Background: The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods: This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results: When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn't any significant improvement in isokinetic muscle strength for either group. Conclusions: This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn't an effective treatment for isokinetic muscle function. US-guided injections may yield more effective clinical results than blind injections.

A Meta-Analysis of Research Trends in Mathematics Learning Disabilities (수학학습장애 연구 동향 메타분석)

  • Jeon, Yoon-Hee;Chang, Kyung-Yoon
    • Journal of Educational Research in Mathematics
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    • v.26 no.3
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    • pp.543-563
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    • 2016
  • This study was designed as a meta-analysis to investigate the research trends in mathematics learning disabilities(MLD) area. The results of this study were as follows: The 201 researches targeted for the analysis can be categorized 4: characteristic of students with MLD, screening students with MLD, interventional teaching for students with MLD, and et cetera. Also, the outcomes of researches regarding intervention in MLD determined to have a large effect resulted in a total average of 0.958. Especially, as a result of analysing the effect size in accordance with teaching method variables in group-case designed researches, the effect was largest when direct instruction and strategy instruction was given. The effect was largest when the frequency of intervention was over 16 and under 20. The results in this study be summed up as follows. MLD can be served as a foundation in setting a direction for further research to improve in Korea.

Effects of Nurse's Second Victim Experiences on Third Victim Experiences: Multiple Mediation Effects of Second Victim Supports (간호사가 인식한 이차 피해 경험이 삼차 피해 경험에 미치는 영향과 이차 피해 지지의 다중 매개효과)

  • Kim, Eun-Mi;Kim, Sun-Aee;Kim, Ji-In;Lee, Ju-Ry;Na, Sun-Gyoung
    • Quality Improvement in Health Care
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    • v.23 no.2
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    • pp.23-34
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    • 2017
  • Purpose: Nurse's second victim experiences could influence organizational negative work-related outcome. The purpose of this study was to investigate the casual relationship between nurses' second victim experience and third victim experience and multiple mediation effects of second victim supports. Methods: A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) was conducted with 305 nurses working in a general hospital. Data were collected from October 20 to November 25, 2016 and analyzed using SPSS Win version 23.0. Results: The nurses' perceived second victim experience was $3.24{\pm}0.61$ and the third victim experience was $3.12{\pm}0.92$. Nurses' second victim experience was found to have a direct effect on increasing third victim experience and indirect effect of colleague support as mediator (p<.05). However, institutional support and supervisor support had not a partial and indirect effect on third victim experience. Conclusion:This study is one of the first to connect second victim experience to third victim experience in South Korea. This study broadens the understanding of the negative effects of a second victim experience influence third victim experience. When involvement in patient safety events, the important role of colleague support in limiting nurse's third victim experience have been acknowledged. This study reinforces the efforts health care leaders are making to develop interventional programs to colleague support their staff as they recover from adverse event involvement.

Effects of Work-Related Stress on Work Ability Index among Iranian Workers

  • Gharibi, Vahid;Mokarami, Hamidreza;Taban, Abrahim;Aval, Mohsen Yazdani;Samimi, Kazem;Salesi, Mahmood
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.43-48
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    • 2016
  • Background: Work Ability Index (WAI) is a well-known and valid self-report tool that has been widely used in various studies to identify and avoid early retirement and work-related disability. Nevertheless, very few studies have been carried out to evaluate work ability in Iran. We aimed to investigate the WAI and the effect of work-related stress on it among Iranian workers. Methods: A cross-sectional, descriptive and analytic study was carried out among 449 workers from five working sectors in three big cities of Iran. Work ability and work-related stress were measured using the Persian version of WAI and the Persian version of Health and Safety Executive Stress Indicator Tool. Results: More than a third of the workers surveyed (34.70%) did not have an appropriate level of work ability (WAI < 37). There was a significant correlation between subscales of work-related stress and the mean score of WAI. Furthermore, the variables of body mass index, sleep quality, exercise activity, job tenure, and three subscales of work-related stress including demands, supervisor support, and role were significant predictors of WAI. Conclusion: According to the results of this study, the interventional programs must be focused on improving supervisors support, eliminating ambiguity and conflicts in the role of workers in their job and organization, reducing job demands, improving sleep quality, and increasing exercise activity.

Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children

  • Nunna, Mahesh;Dasaraju, Rupak Kumar;Kamatham, Rekhalakshmi;Mallineni, Sreekanth Kumar;Nuvvula, Sivakumar
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.5
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    • pp.277-288
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    • 2019
  • Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

The Effect of Deep Neck Flexor Exercise and Thoracic Mobilization Exercise on Forward Head Posture and Neck Pain in Chronic Stroke (깊은목굽힘근 강화운동과 등뼈 관절가동운동이 뇌졸중 환자의 전방머리자세와 목통증에 미치는 영향)

  • Yang, Sun-ah;Seo, Dong-Kwon;Lee, Byoung-Kwon
    • Journal of Convergence for Information Technology
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    • v.9 no.12
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    • pp.208-215
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    • 2019
  • The purpose of this study was to investigate the effects of deep neck flexion exercise(DNFE) and thoracic range of motion exerecise(TROM) on the pain and forward head position(FHP) in stroke patients. Thirty-six patients were randomly assigned to DNFE group, TROM group, and control group. pre and post intervention, pain(VAS), Craniovertebral angle(CVA), cranial rotation angle(CRA), FHP, and TROM were measured. As a result. The DNFE group and the TROM group showed significant differences in VAS, CVA, CRA, FHP, and TROM pre and post intervention(p <.05), and the two groups showed VAS, CVA, CRA, FHP, and TROM compared to the control group (p <.05). In conclusion, in patients with stroke, DNFE and TROM were effective in restoring FHP and neck pain. We hope that they will be used in the interventional program for stroke patients in clinical practice.

Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System

  • Ahn, So Ra;Seo, Sang Hyun;Lee, Joo Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.191-197
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    • 2021
  • Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.