• Title/Summary/Keyword: spinal anesthesia

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The Effects of Music Therapy on Anxiety, Sedation, and Stress Responses of Patients Undergoing Surgery with Spinal Anesthesia (음악요법이 척추마취 하 수술 대상자의 불안, 진정상태 및 스트레스 반응에 미치는 효과)

  • Jeong, Gye Seon;Kang, Younhee
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.525-535
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    • 2016
  • Purpose: This study was conducted to examine the effects of music therapy on anxiety, sedation, and stress responses of patients during surgery with spinal anesthesia. Methods: A quasi-experimental design with a non-equivalent control group pre-post test was used. There were 55 adults over 19 years of age scheduled for a lower leg surgery with spinal anesthesia: 27 in the treatment group and 28 in the comparison group. Each subject in the treatment group identified their music preference which was used during the period of surgery which usually lasted, 61 minutes. Data were analyzed using chi-square, Fisher's exact test, independent t-test and repeated measured ANOVA. Results: There were significant reported differences in levels of anxiety, sedation, and stress responses which were measured by plasma cortisol levels, heart rate, and respiratory rate. The findings of all the variables were effectively decreased among those in the treatment group than the comparison group. Conclusion: The preference based music therapy may be useful as a non-pharmacological intervention.

Effects of Types of Music in Music Therapy on Anxiety and Vital signs of Surgical Patients Undergoing Operation Using Spinal Anesthesia (음악요법 유형이 척추마취 수술환자의 수술 중 불안 및 활력징후에 미치는 영향)

  • Kim, Yeoun-Ok;Kim, Joo-Hyun
    • Journal of Korean Biological Nursing Science
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    • v.13 no.2
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    • pp.149-155
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    • 2011
  • Purpose: The purpose of this research is to examine types of music (relax music or preferred music that patients have chosen) can effects on anxiety, blood pressure and pulse, and whether there are differences depending on the kinds of music in order to reduce anxiety of surgical patients using spinal anesthesia. Methods: This research's design is quasi-experimental design and non-equivalent control group pretest-posttest experimental design conducted on 60 surgical patients(experimental group 1=relax music therapy group, experimental group 2=preferred music therapy group, and group 3=control group) using spinal anesthesia. The Variables were trait anxiety, state anxiety, blood pressure, and pulse. Results: 1) In the state anxiety, there was a significant difference among the experimental groups 1, group 2 and the control group. 2) There was a significant difference in systolic blood pressure among the experimental group 1, group 2, and the control group. 3) In pulse, no significant difference among the experimental group 1, group 2 and the control group was detected. Conclusion: Regardless of the types of music, music therapy is thought to be effective nursing mediation to mitigate the state anxiety of surgical patients undergoing spinal anesthesia.

A Clinical Case Study of Cauda Equina Syndrome Patient Induced Spinal Anesthesia (척추 마취 후 발생한 마미증후군 환자 1례에 대한 임상적 고찰)

  • Park, So-Hyun;Ro, Hae-Rin;Lee, Jae-Young;Han, Sang-Yup;Shin, Dong-Jae;Park, Jae-Young;Kim, Chang-Yeon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.2
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    • pp.91-100
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    • 2012
  • Objective : The purpose of this study is to report clinical effect of oriental meical treatments for Cauda Equina Syndrome Patient induced spinal anesthesia. Methods : The patient was treated by Oriental medical treatments including acupuncture, ShinBaro pharmacopuncture treatment, herbal medication. The improvement of the clinical symptoms was observed by Visual analog scale(VAS) and Oswestry disability index(ODI). Results : After treatments, VAS and ODI. were improved in case. Conclusions : Oriental medical treatment might be an effective method to improve the clinical symptoms of Cauda Equina Syndrome Patient induced spinal anesthesia.

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The Effect of Music Therapy on Anxiety and Vital Signs of Spinal Anesthesia Operative Patients (음악요법이 척추마취수술환자의 상태불안과 활력징후에 미치는 효과)

  • Lee, Ji-Min;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.10 no.2
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    • pp.113-120
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    • 2008
  • Purpose: The aim of this study is to evaluate the effect of music therapy according to preferred music and to identify the effect of duration time and starting point of music therapy on anxiety and vital signs in spinal anesthesia operations. Method: These subjects were categorized into three groups based on the order of the date of operation. Data on anxiety and vital signs for this study were collected from them. The collected data were analyzed by $X^2$-test, t-test, paired t-test and ANCOVA. Result: The results of this study showed that preferred music, differences of duration times and starting points of music therapy didn't make significant differences in anxiety and vital signs among the three groups. However for anxiety, there was a meaningful difference within three groups. This result indicates even randomly chosen music by nurses considering the patients' age makes a meaningful difference in anxiety. Conclusion: Based on the results of this study, the conclusion can be made that music therapy is a useful nursing implementation to reduce anxiety in patients undergoing operations with spinal anesthesia.

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The spinal neuronal activity induced by low power laser stimulation (저출력 레이저 자극에 의한 척수내 신경세포의 활성변화)

  • Oh, Kyung-Hwan;Choi, Young-Deog;Lim, Jong-Soo
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1005-1013
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    • 2001
  • The present study was designed to investigate the effect of low power GaAlAs laser on spinal Fos expression related to the anti-nociceptive effect of laser stimulation. Low power GaAlAs laser was applied to either acupoint or non-acupoint for 2 hour under light inhalation anesthesia. Spinal Fos expression in the dorsal horn was compared to that obtained in inhalation anesthesia control group. Furthermore, we analyzed the effect of the local treatment of lidocaine on the spinal Fos expression evoked by low power GaAlAs laser stimulation. The results were summarized as follows: 1. In the normal animals, only a few Fos like immunoreactive(Fos-IR) neurons were evident in the lumbar spinal cord dorsal horn. Similarly, following prolonged inhalation anesthesia, Fos-IR neurons were absent in the dorsal horn of the lumbar spinal cord. In animals treated with laser stimulation, Fos immunoreactive neurons were increased mainly in the medial half of ipsilateral laminae I-III at lumbar segments L3-5. These findings directly indicated that prolonged anesthesia used in this study did not affect the Fos expression in the spinal cord dorsal horn of intact animals and low power laser stimulation dramatically produced Fos expression in the spinal cord laminae that are related to the anti-nociceptive effect of laser stimulation. 2. In acupoint stimulated animals, 10mW of laser stimulation, not 3mW and 6mW intensity, significantly increased the number of Fos immunoreactive neurons in the spinal dorsal horn(p<0.05). However, laser stimulation on acupoint more dramatically increased the number of Fos immunoreactive neurons in the spinal cord rather than laser stimulatin on non acupoint. These result suggested that laser stimulatin on acupoint was more effective treatment to activate the spinal neuron than non acupoint stimulation. 3. The local treatment of lidocaine totally suppressed the activity of spinal neurons that were induced by lower power 1aser stimulation. These data indicated that the anti-nociceptive effect of laser stimulation was absolutely dependent upon the peripheral nerve activity in the stimulated location. In conclusion, these data indicate that 10mW of low power laser stimulation into acupoint is capable of inducing the spinal Fos expression in the dorsal horn related to the anti-nociceptive effect of laser stimulation, Furthermore, the induction of spinal Fos expression was totally related to the peripheral nerve activity in the laser stimulated area.

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Spinal α2 Adrenoceptor and Antiallodynic Effect by Clonidine after Chronic Administration of 4-Methylcatechol in Neuropathic Rat Pain Model (신경병증성 통증모델에서 신경영양인자 유도물질의 반복 투여가 척수 아드레날린계에 미치는 영향)

  • Chung, Kyu Yeon;Shin, Sang Wook;Choi, Bong Soo;Kim, Chul Hong;Kim, Kyung Hoon;Kim, Hae Kyu
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.179-186
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    • 2008
  • Background: The adrenergic nervous system in the spinal cord contributes to the development of neuropathic pain after nerve injury. Brain derived neurotrophic factor may facilitate the sympathetic change in the spinal cord and influence the state of neuropathic pain. We probed the effect of chronic repetitive administration of systemic 4-methylcatechol, which is known to be a neurotrophic factor inducer, in a spinal nerve ligation model. Methods: We made the rat neuropathic pain model by the ligation of the L5 spinal nerve. Intraperitoneal 4-methylcatechol ($10{\mu}g/kg$) or the same volume of saline wasadministrated twice daily just after the operation for 7 days. The tactile allodynia was measured by using von Frey filaments and its change was followed up from 3 days after SNL. The lumbosacral enlargement of the spinal cord was taken out and the mRNA contents of the ${\alpha}_2-adrenoceptor$ subtypes were measured by real time polymerase chain reaction and this was then compared with the control groups. The antiallodynic effect of intrathecal clonidine (3, 10, $30{\mu}g$) was evaluated and compared in the 4-methylcatechol treated rats and the control rats. Results: The expression of the ${\alpha}_{2A}$ and ${\alpha}_{2C}$ adrenoceptor subtypes did not change after 4-methylcatechol treatment. Intrathecal clonidine showed an earlier and better effect at the highest dose ($30{\mu}g$ intrathecal), but not with any other doses. Conclusions: Chronic intraperitoneal administration of 4-methylcatechol may improve the effect of intrathecal clonidine, but we could not prove the increase of ${\alpha}_{2A}$ and ${\alpha}_{2C}$ adrenoceptors in the spinal cord of 4-methylcatechol treated rats.

Prophylactic Intravenous Ephedrine Infusion during Spinal Anesthesia for Cesarean Section (제왕절개술을 위한 척추 마취시 Ephedrine의 예방적 정맥적주에 관한 연구)

  • Koo, Bon-Up
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.72-78
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    • 1991
  • Ephedrine sulfate was administrated 30 healthy parturients undergoing elective repeat cesarean section under spinal anesthesia. Fifteen patients received ephedrine infusion (0.01% solution, beginning with approximately 5 mg/min) immediately after induction of spinal anesthesia to maintain maternal systolic blood pressure between 90% and 100% of the baseline systolic blood pressure (mean dose of ephedrine 31.6mg). Fifteen patients (contral group) received 20mg of ephedrine as an intravenous bolus, and additional 10mg increments, if neccessary, when systolic blood pressure decreased to 80% of the baseline systolic blood pressure (mean dose of ephedrine 26.8 mg). Nausea and/or vomiting occurred in seven women in the control group and one patient in the infusion group (p<0.001). Apgar scores, fetal blood gas tension, and time for onset of respiration was comparable in the two groups. The results suggest that prophylactic ephedrine infusion is safe and desirable in healthy parturients undergoing cesarean section under spinal anesthesia.

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The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019

  • Kayir, Selcuk;Kisa, Alperen
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.82-93
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    • 2021
  • Background: This study used bibliometric analysis of articles published about the topic of regional anesthesia from 1980-2019 with the aim of determining which countries, organizations, and authors were effective, engaged in international cooperation, and had the most cited articles and journals. Methods: All articles published from 1980-2019 included in the Web of Science database and found using the keywords regional anesthesia/anaesthesia, spinal anesthesia/anaesthesia, epidural anesthesia/anaesthesia, neuraxial anesthesia/anaesthesia, combined spinal-epidural, and peripheral nerve block in the title section had bibliometric analysis performed. Correlations between the number of publications from a country with gross domestic product (GDP), gross domestic product (at purchasing power parity) per capita (GDP PPP), and human development index (HDI) values were investigated with the Spearman correlation coefficient. The number of articles that will be published in the future was estimated with linear regression analysis. Results: Literature screening found 11,156 publications. Of these publications, 6,452 were articles. The top 4 countries producing articles were United States of America (n = 1,583), Germany (585), United Kingdom (510), and Turkey (386). There was a significant positive correlation found between the GDP, GDP PPP, and HDI markers for global countries with publication productivity (r = 0.644, P < 0.001; r = 0.623, P < 0.001, r = 0.542, P < 0.001). The most productive organizations were Harvard University and the University of Toronto. Conclusions: This comprehensive study presenting a holistic summary and evaluation of 6,452 articles about this topic may direct anesthesiologists, doctors, academics, and students interested in this topic.

Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature

  • Baek, In-Yeob;Park, Ju-Yeon;Kim, Hyae-Jin;Yoon, Ji-Uk;Byoen, Gyeong-Jo;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.24 no.3
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    • pp.154-157
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    • 2011
  • Background: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. Methods: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. Results: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. Conclusions: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.

Comparison of preoperative ultrasound guided fascia iliaca block versus femoral nerve block for proximal femur fractures before positioning for spinal anesthesia: an observational study

  • Gupta, Meeta;Kamath, Shaila Surendra
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.138-143
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    • 2020
  • Background: Severe pain associated with proximal femur fractures makes the positioning for regional anesthesia a challenge. Systemic administration of analgesics can have adverse effects. Individually, both the fascia iliaca block (FIB) and femoral nerve blocks (FNB) have been studied. However, there is little evidence comparing the two. The aim of this study was to compare the overall efficacy of the two blocks in patients with proximal femur fracture before positioning for spinal anesthesia. Methods: ASA (American Society of Anesthesiologists) class I, II, and III patients scheduled for elective and emergency surgery with the diagnosis of proximal femur fracture between October 2018 and June 2019 were included in the study. The patients were assigned to two groups by convenience nonprobability sampling of 35 each. Results: Our study showed a reduction in visual analogue scale scores at 3, 4, and 5 minutes after administration of the FIB being 5.1 ± 1.1, 4.1 ± 1.3, and 2.8 ± 0.8, and those after the FNB as 4.4 ± 1.1, 3.3 ± 1.1, and 2.1 ± 1.4 with P < 0.05, which was statistically significant. The mean first rescue analgesia time for the FIB was 7.1 ± 2.1 hours, while for the FNB it was 5.2 ± 0.7 hours. The P value was less than 0.001, which was significant. Conclusions: Both ultrasound guided FNB and FIB techniques provide sufficient analgesia for patient's positioning before spinal anesthesia. However, the duration of postoperative analgesia provided by FIB was greater than that of the FNB.