• 제목/요약/키워드: severe pain

검색결과 1,446건 처리시간 0.027초

Assessment of pain and adequacy of pain management in hospitalized cancer patients

  • Shin, Yeonghee
    • 대한간호학회지
    • /
    • 제29권5호
    • /
    • pp.1113-1122
    • /
    • 1999
  • The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of “worst pain” during the 24 hour period, 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% of the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes. systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.

  • PDF

중증장애인 활동보조인의 근골격계 통증과 삶의 질에 미치는 영향요인 (Factors Associated with Musculoskeletal Pain and Quality of Life among Personal Assistants for People with Severe Disabilities)

  • 송이슬;김기원
    • 한국산업보건학회지
    • /
    • 제29권4호
    • /
    • pp.530-540
    • /
    • 2019
  • Objectives: The purpose of this study was to identify factors related with demographic and work characteristics that affect musculoskeletal pain and quality of life among personal assistants for people with severe disabilities. Methods: The subjects were recruited among personal assistant for people with severe disabilities who participated in refresher training held in K-si, Gyeonggi-do Province through convenience sampling. Using a survey instrument developed by the authors, subjects responded to questionnaires concerning muscluloskeletal pain and quality of life. The collected data was analyzed using SPSS 21.0. Basically, collected data was analyzed in terms of frequency, t-test or ANOVA and multiple regression analysis. Results: Total years of work experience and subjective physical workload were associated with the number of pain sites and intensity. Additionally, for quality of life, subjective physical workload was related in the regression model. Conclusions: Based on this study, we identified that characteristics of work affected the musculoskeletal pain and quality of life of personal assistants for the severely disabled, and suggested improvement of the working environment, including musculoskeletal pain prevention education programs during the refresher education for assistants to the severely disabled.

HELLP 증후군 산모에서 무통분만을 위해 시행한 경막외 진통법 -증례 보고- (Epidural Analgesia for Labor Pain Management in a Parturient with HELLP Syndrome -A case report-)

  • 윤채식;이정윤;홍성주;이준학
    • The Korean Journal of Pain
    • /
    • 제12권2호
    • /
    • pp.253-257
    • /
    • 1999
  • Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, a variant presentation of severe preeclampsia/eclampsia is associated with high maternal morbidity and mortality. Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is relatively contraindicated in the presence of severe thrombocytopenia. Determining the pain management of choice depends on the parturient's condition, fetal well-being, and the urgency of the situation. We report a safe case of epidural analgesia in a HELLP syndrome parturient with severe thrombocytopenia for labor pain management without any neurologic complications or epidural hematoma.

  • PDF

Change in fibrinogen levels and severe postoperative bleeding in cardiac surgery

  • Kim, Eun-Jung;Kim, Joo-Yun;Kim, Hee Young;Hwang, Boo-Young;Cho, Ah-Reum;Jung, Young-Hoon;Baek, Seung-Hoon;Hong, Jeong-Min
    • International Journal of Oral Biology
    • /
    • 제45권2호
    • /
    • pp.51-57
    • /
    • 2020
  • Thromboelastography or rotational thromboelastometry, is being increasingly utilized in cardiac surgery of late. However, it is an indirect test and is not available in all centers. Low fibrinogen levels before and after cardiopulmonary bypass (CPB) have been described to be associated with postoperative bleeding in cardiac surgery. This study explored the usefulness of reduction ratio of the fibrinogen levels before CPB (preCPB) and after CPB (postCPB) in predicting postoperative hemorrhage. A retrospective, observational study of adult patients who underwent cardiac surgery with CPB between February 2014 and January 2016 was conducted, which included a total of 264 patients. The fibrinogen levels were measured twice, preCPB and postCPB, and the fibrinogen reduction ratio was acquired [(preCPB - postCPB)/preCPB]. Postoperative blood loss, which was defined as the blood collected from the chest drain for 12 hours following arrival at the intensive care unit, was considered severe if it was more than 1,000 mL. A multivariate analysis showed that fibrinogen reduction ratio, sex, and postCPB platelet count were significantly associated with severe postoperative bleeding. However, the pre- and postCPB fibrinogen levels were not significantly associated with severe bleeding. Furthermore, a fibrinogen reduction ratio of > 41.3% was independently associated with postoperative severe bleeding, with an odds ratio of 3.472 (1.483-8.162). These results suggest that the reduction ratio of pre- and postCPB fibrinogen levels may be utilized in predicting postoperative bleeding.

성상신경절 차단 후 발생한 심한 경부혈종 -증례 보고- (Severe Hematoma in the Neck Following the Stellate Ganglion Block -A case report-)

  • 강형창;김유재
    • The Korean Journal of Pain
    • /
    • 제11권2호
    • /
    • pp.346-349
    • /
    • 1998
  • The technique of the stellate ganglion block is widely used as it is relatively simple and safe. But it can cause severe complications because there are major blood vessels and nerves around the stellate ganglion. We practiced CPR because of the respiratory failure caused by severe hematoma in the neck following the stellate ganglion block. A 46-year-old male patient admitted to ENT department because of the both sudden sensorineural hearing loss that happened after URI. He was referred to Pain Clinic for further evaluation and treatment. We decided to block the stellate ganglion. We injected 6ml of 0.5% mepivacaine on both sides of the stellate ganglion. There were no blood aspiration and abnormal vital signs during the 30 minute observation, either. Three hours after he went to the private room, he had pain and edema in his neck, but no respiratory defficulty. But later, respiratory failure was suddenly followed. So we practiced CPR. We confirmed severe hematomas in the neck through CT scanning. Hematomas is removed and the ruptured blood vessels which is supposed to be muscular branch of vertebral artery is ligated under general anesthesia. The patient was discharged from hospital after the treatment of pneumonia and duodenal ulcer as complications. We recommand you to compress the block site more than five minutes and not to prick with the needle several times at one point to prevent the formation of hematomas.

  • PDF

Rare Odontalgia of Mandibular Teeth Associated with Migraine: A Case Report

  • Im, Yeong-Gwan;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
    • /
    • 제43권3호
    • /
    • pp.92-96
    • /
    • 2018
  • A 39-year-old male presented with severe pain in right posterior mandibular teeth and temporal area. Initially, the pain in the mandibular teeth was moderate, but the concomitant headache was unbearably severe. His medical history was non-contributory. The clinical and radiographic examination failed to reveal any pathology in the region. There was no tenderness to palpation in the temporalis and masseter muscles or temporomandibular joints. The clinical impression was migraine. The pain in the teeth and headache were aborted using ergotamine tartrate and sumatriptan succinate. Atenolol prevented further pain, while amitriptyline and imipramine had no effect. Migraine can present as non-odontogenic pain in the mandibular teeth, although not as frequently as in the maxillary teeth. A correct diagnosis is essential to avoid unnecessary dental treatments and to manage pain effectively. Clinicians should be able to identify migraine with non-odontogenic dental pain and establish a proper diagnosis through a comprehensive evaluation.

실명, 안구마비 및 반대측 수족마비를 동반한 Herpes Zoster Ophthalmicus -1예 보고- (Herpes Zoster Ophthalmicus Accompanying Blindness, Extraocular Motor Palsies and Contralateral Hemiplegia -A Case Report-)

  • 김동진;고준석;민병우
    • The Korean Journal of Pain
    • /
    • 제3권2호
    • /
    • pp.160-164
    • /
    • 1990
  • Herpes Zoster Ophthalmicus comprises 7% of all herpes zoster infection, 50% of those involving eyeballs, and is one disease entitiy with a very grave prognosis. We have experienced a 68-year-old man who visited the emergency room complaining of severe pain in his eye and headache with loss of vision. He was seen by neurosurgeons, dermatologists and ophthalmologists, and finally sent to the pain clinic for control of pain under the diagnosis of herpes zoster ophthalmicus. In spite of zealous treatment efforts, loss of vision, pain and infectious condition did not recover; and furthermore, due to severe infection, he had his eyeball extracted 100 days after the onset of diseases. 140 days after onset, contralateral hemiplegia accompanied the disease process. We present an unusual case of herpes zoster ophthalmicus with no treatment effect.

  • PDF

兩義供辰丹을 倂用한 한방치료가 重症度의 통증 환자에 미치는 진통 효과 : 후향적 연구 (Analgesic Effect of a Traditional Korean Medicine Yang Eui Gongjin-dan on Severe Pain: A Retrospective Study)

  • 이동혁;이영은;이보윤;김연진;조승연;박성욱;정우상;문상관;고창남;조기호;박정미
    • 대한한방내과학회지
    • /
    • 제36권3호
    • /
    • pp.265-275
    • /
    • 2015
  • Objectives: The aim of this study was to investigate the analgesic effect of Yang Eui Gongjin-dan (YEGJD), a traditional Korean medicine, on severe pain or numbness, including acute and chronic non-cancer pain. Methods: Records of patients visiting the Department of Traditional Korean Internal Medicine, Stroke and Neurological Disorders Center, from March 2011 to January 2015, were searched. Their chief complaint was severe numbness or pain (NRS≥7). We compared the NRS of pain pre- and post-YEGJD treatment in 34 patients; and analyzed changes in pain severity pre- and post-YEGJD treatment in 17 chronic non-cancer pain patients. We also investigated other accompanying symptoms, such as insomnia, anorexia, dyspepsia, fatigue, coldness, and excessive sweating, related to the deficiency state (虛症) in traditional Korean medicine. Results: The average pain NRS for the 34 patients significantly decreased from 8.04±1.08 to 3.75±2.54 after YEGJD treatment. The average pain NRS score in chronic non-cancer pain patients also significantly declined from 7.91±0.97 to 3.29±2.29. Conclusions: The traditional Korean medicine Yang Eui Gongjin-dan has an analgesic effect and is useful for treating severe pain or numbness. We recommend a randomized controlled trial using objective assessment scales and a large patient sample to further test the effects of Yang Eui Gongjin-dan.

Comparison of postoperative pain according to the harvesting method used in hair restorative surgery

  • Kim, Yang Seok;Na, Young Cheon;Park, Jae Hyun
    • Archives of Plastic Surgery
    • /
    • 제46권3호
    • /
    • pp.241-247
    • /
    • 2019
  • Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

A study on the correlation of VDT, posture and shoulder function in women with neck pain

  • Hee-won, Oh;Hyelim, Chun;Byounghee, Lee
    • 대한물리치료과학회지
    • /
    • 제29권4호
    • /
    • pp.1-16
    • /
    • 2022
  • Background: This study was conducted to examine the correlation of VDT, posture and shoulder function among each group divided by according to the neck pain disorder index (NDI) scores for female patients with neck pain. Design: Cross-sectional study. Methods: Fifty adult women with neck pain voluntarily participated in this study and the neck pain disorder index questionnaire, VDT syndrome assessment tool questionnaire, craniovertebral angle, thoracic kyphosis angle, round shoulder posture, pectoralis minor length, shoulder joint hypermobility, and serratus anterior strength tests were conducted respectively. Subjects were divided into two groups where 21 subjects were allocated to the mild pain group whom have rated below 14 points on the NDI scores, and 29 subjects were in the severe pain group, whom have rated above 15 on the NDI score. Results: The study found that in the mean difference between variables in each group, VDT syndrome showed a higher mean score in the severe pain group than the mild pain group (p<0.05). In the group correlation and regression analysis, the mild pain group showed a significant negative correlation between the craniovertebral angle and round shoulder posture (r=-0.467, p<0.05), and the round shoulder posture for craniovertebral angle was shown to have significant positive influence (B=10.162, p<0.05). The severe pain group showed that the NDI and the VDT syndrome had a significant amount of correlation (r=0.520, p<0.01), the VDT syndrome showed significant positive influence (B=0.330, p<0.05), and the craniovertebral angle showed significant negative influence (B=-0.809, p<0.05). It was also shown that shoulder joint hypermobility had a significant negative correlation with the serratus anterior strength (r=-0.437, p<0.01), and that serratus anterior strength had a significant negative influence on shoulder joint hypermobility (B=-4.175, p<0.05). Conclusion: This study is of clinical significance in that it presented variables that should be considered depending on the degree of neck pain in treating patients with neck pain and that it presented patients with not only posture but also the function of the shoulder joint as factors to consider.