• Title, Summary, Keyword: Analgesia

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The Effect of Epidural Analgesia for Labor Pain on the Cesarean Section (경막외차단에 의한 무통분만이 응급제왕절개율에 미치는 영향)

  • Chung, Sung-Won;Park, Tae-Kyu;Kim, Ae-Ra;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.108-113
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    • 1999
  • Background: There is some concern that the administration of epidural analgesia for pain relief during labor increases the likelihood of cesarean delivery. But, several investigators showed a decrease in the rate of emergency cesarean delivery after epidural analgesia. The purpose of this study was to compare the emergency cesarean rate between the two groups with and without epidural analgesia. Methods: We reviewed retrospectively the medical records for 7846 parturients admitted our hospital between January 1, 1995 and December 31, 1996 and whose attending physician anticipated a normal labor and vaginal delivery. The number of parturients with epidural analgesia using 0.25% bupivacaine with fentanyl were 2839 and parturients without epidural analgesia were 5017. Results: An administration of epidural analgesia was not associated with the incidence of cesarean rate. 149 (5.25%) of 2839 parturients in epidural group and 371 (7.31%) of 5017 parturients in non-epidural group underwent emergency cesarean section. Conclusions: Our retrospective study has shown that an administration of epidural analgesia neither decrease nor increase in the rate of emergency cesarean delivery when compared with a non-epidural analgesia.

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Programmed intermittent epidural bolus as compared to continuous epidural infusion for the maintenance of labor analgesia: a prospective randomized single-blinded controlled trial

  • Fidkowski, Christina W.;Shah, Sonalee;Alsaden, Mohamed-Rida
    • Korean Journal of Anesthesiology
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    • v.72 no.5
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    • pp.472-478
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    • 2019
  • Background: Programmed intermittent epidural bolus (PIEB) techniques are a new area of interest for maintaining labor analgesia due to the potential to decrease motor block and improve labor analgesia. This study compares continuous epidural infusion (CEI) to 2 PIEB regimens for labor analgesia. Methods: One hundred fifty patients undergoing scheduled induction of labor at term gestation having epidural labor analgesia were randomized to receive an epidural analgesia regimen of bupivacaine 0.125% with fentanyl 2 ㎍/ml at either PIEB 5 ml every 30 min (Group 5q30), PIEB 10 ml every 60 min (Group 10q60), or 10 ml/h continuous infusion (Group continuous epidural infusion [CEI]). The primary outcome is the pain scores throughout labor. Secondary outcomes include degree of motor block, dermatomal sensory levels, the number of physician-administered boluses, and patient satisfaction. Results: While the average pain scores throughout labor did not differ significantly between groups, fewer patients in group 10q60 received physician-administered boluses for breakthrough pain (34.9% in 10q60 vs. 61.0% in 5q30 and 61.9% in CEI, P = 0.022). Dermatomal sensory levels, degree of motor block, and patient satisfaction did not differ significantly between groups. Conclusions: Our study suggests that high volume PIEB regimens for labor analgesia decrease breakthrough pain and physician-administered boluses.

Differences in Physical Discomfort and Childbirth Satisfaction between Primiparous Women with and without having taken Epidural Analgesia (무통분만 여부에 따른 초산부의 신체불편감과 분만만족)

  • Ahn, Suk-Hee;Ryu, Kyung-Soon;Chung, Eun-Soon
    • Korean Journal of Women Health Nursing
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    • v.9 no.3
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    • pp.235-244
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    • 2003
  • Purpose: To examine the difference of physical discomfort and childbirth satisfaction between postpartum women with and without having taken Epidural Analgesia. Method: The subjects were divided into one group of 128 primipara taken Epidural Analgesia and the other of the same 70 women who were not taken it. Data were collected by questionnaires of their own physical discomfort and birth satisfaction at postpartum 1 to 2 days in OBGY hospitals, and data were analyzed using SPSS Program. Result: Women having taken epidural analgesia appealed higher physical discomfort than those without it in the lower limbs exercise discomfort, difficult urination, urinary retention, nausea & vomiting, whereas appeared vice versa in breast pain. Among indicators for childbirth satisfaction, women having taken epidural analgesia preferred the same delivery method later again more than those without it. Conclusion: It is confirmed that the method of epidural analgesia is not an absolute way to control labor pain, rather stir physical discomfort after childbirth and does not fully increase the women's childbirth satisfaction. Therefore, it is proposed that nurses should provide the pregnant women the right knowledge and information, thereby enabling them to select the useful method of childbirth to their own course of childbirth and health-recovering after the delivery.

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The Effects of Tramadol on Electroencephalographic Spectral Parameters and Analgesia in Rats

  • Jang, Hwan-Soo;Jang, Il-Sung;Lee, Maan-Gee
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.3
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    • pp.191-198
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    • 2010
  • The effects of different doses of tramadol on analgesia and electroencephalographic (EEG) spectralparameters were compared in rats. Saline or tramadol 5, 10, 20 or 40 mg/kg was administered. The degree of analgesia was evaluated by tail-flick latency, and the degree of seizure was measured using numerical seizure score (NSS). Additionally, band powers, median power frequency and spectral edge frequency 95 were measured to quantify the EEG response. All doses of tramadol produced spike-wave discharge. Tramadol significantly and dose-dependently increased the analgesia, but these effects did not correspond with the changes in the EEG spectral parameters. NSS significantly increased in the Tramadol 20 and 40 mg/kg treatment groups compared to the Control and TRA5 groups, and two rats given 40 mg/kg had convulsions. In conclusion, tramadol dose-dependently increased the analgesic effect, and the 10 mg/kg dose appears to be a reliable clinical dose for analgesia in rats, but dose-dependent increases in analgesia and seizure severity did not correlate with EEG spectral parameters.

Low concentration continuous femoral nerve block improves analgesia and functional outcomes after total knee arthroplasty in spinal anesthesia

  • Yun, So Hui;Choi, Yun Suk;Kim, Sang Rim
    • Anesthesia and Pain Medicine
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    • v.13 no.4
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    • pp.439-446
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    • 2018
  • Background: Total knee arthroplasty (TKA) is associated with severe pain postoperatively. Femoral nerve block is commonly used for pain control after TKA. This study investigated whether continuous femoral nerve block (CFNB) can improve postoperative analgesia and functional outcome as compared to intravenous patient controlled analgesia (PCA) in patients with TKA. Methods: We reviewed the electronic medical records of patients who underwent TKA with spinal anesthesia between March 2014 and February 2015. In Group IV, postoperative pain was managed by IV-PCA. Group CFNB received CFNB-PCA via a device. Thirty patients were enrolled per group. Patient outcomes were assessed by analgesia, functional outcomes, and health-related quality of life factors. Results: Additional analgesics and additional nerve block for adequate pain control were significantly more frequent in the IV than CFNB group (P = 0.015 and P = 0.012, respectively). Range of motion up to 105 degrees was prolonged in the IV group than CFNB group (P = 0.013). EuroQol five dimensions score was improved in the CFNB group than IV group postoperative 3 weeks (P = 0.003). The incidence of transfusion due to postoperative bleeding was significantly frequent in the IV group than CFNB group (P = 0.042). Conclusions: Postoperative low concentration continuous femoral nerve block for analgesia after TKA improves analgesia, functional outcomes, and incidence of transfusion without falling risk.

A Comparison of Patient-Controlled Analgesia and Conventional Intramuscular Opioid Regimen in Relation to their Post-Operative Pain Control and Side Effects (수술후 통증 관리의 Patient-Controlled Analgesia와 마약류의 전통적인 근육내 주사와의 비교)

  • Lee, Sang-Hun;Lee, Jin-Kyung;Lee, Kyn-Chang;Woo, Nam-Sik;Lee, Ye-Chul
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.55-59
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    • 1993
  • Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

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Comparison of Obstetric Pain, Anxiety, and Cervical Dilatation between Epidural Analgesia and No Analgesia group during Labor Stage I (경막외 마취제 투여 유무에 따른 분만 1기 산부의 분만 통증, 불안, 자궁경관 개대 정도 비교)

  • Han, Soo-Jung;Kim, Jeung-Im;Kim, Myo-Jin
    • Korean Journal of Women Health Nursing
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    • v.18 no.2
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    • pp.126-134
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    • 2012
  • Purpose: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. Methods: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. Results: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower post-analgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. Conclusion: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.

Studies on the Acupuncture Regional Analgesia of the Cattle (소의 전침국부마취법의 개발에 관한 연구)

  • Suh Doo-Seok;Lee Chai-Yong
    • Journal of Veterinary Clinics
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    • v.8 no.2
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    • pp.177-182
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    • 1991
  • In order to develop an effective methods of electroacupuncture regional analgesia for Cattle, six adult Korean-native cattle, which were healthy and had ordinary perception response, were examined on the study. Using them, there were treated with six different prescription applying on six mendian points including Samyang Rack, Keud Mun, Bu Yang, Sameum Kyo, Backhyo and Hu Hae. The results are summerized as follows. 1 In the case of the acupuncture treatment on Samyang Rack and Keuk Mun located on both fore-legs. the good effect of regional analgesia was obtained toward the anterior part of cattle; on the other hand, when treated with Bu Yang and Sameum Kyo at both hindlegs. the same result were represented toward the posterior part. 2. The level of the electronic current of each electro-acupuncture treatment for bovine regional analgesia was proved to necessitated the same amount of which had given body general electro-acupuncture analgesia. 3. Any significant changes could not find out the hematological and biochemical values of all acupuncture-treated cattle during the experiment. 4. Each elector-acupuncture prescription appeared to be considerably effective for bovine regional analgesia, and also showed the possibility on applying the standing position of cattle for various surgical treatment regardless its operation areas.

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Effect of Intravenous Patient Controlled Analgesia for Postoperative Pain in Adult Tonsillectomy (성인에서 편도적출술후 정맥내 동통자가조절법에 의한 동통조절 효과)

  • 정필섭
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.171-176
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    • 1998
  • Postoperative pain following tonsillectomy remains a significant obstacle to speedy recovery and smooth convalescence. Inadequate analgesia causes poor oral intake and influences the length of hospital stay and ability to return to normal activity. Patient Controlled Analgesia (PCA) is a method of analgesia adminstration that consists of a computer driven pump with a button that the patient may press to adminster a small dose of analgesic drug. The aim of this study was to examine whether Intravenous Patient Controlled Analgesia (IV-PCA) can reduce postoperative pain after tonsillectomy. The 100 patients undergoing tonsillectomy with general anesthesia were divided into two groups. The PCA group patients (n=80) received a mixture of nalbuphine and ketorolac by Walkmed PCA infusor during first 48 postoperative hours. In control group (n=20), the patients received oral acetoaminophen (Tyrenol) regularly and tiaprofenic acid (Surgam) intramuscularly on a p.r.n basis. Analgesic efficacy was evaluated with visual linear analogue scale (VAS) and the adverse effects were evaluated with 4 point scale. The patients of PCA group had less pain than those of control group. The adverse effects in the PCA group were nausea and vomiting. This study suggests that IV-PCA may be safe and effective method of pain control after adult tonsillectomy and is better accepted than oral or intramuscular pain medications.

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Postoperative Pain Control with Epidural Meperidine Infusion (경막외강 내 Meperidine 지속 주입에 의한 술 후 통증관리)

  • Lim, Tae Ha;Choi, Kyu Taek
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.192-196
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    • 2006
  • Background: Epidural opioids are commonly used for postoperative analgesia. However, the side effects of epidural opioids include respiratory depression, sedation, pruritus, nausea, vomiting and urinary retention. Meperidine, due to its intermediate lipid solubility and local anesthetic properties, permits postoperative analgesia. The aim of this study was to compare meperidine alone to meperidine coupled with bupivacaine, and to determine the effects of epidural meperidine without bupivacaine, when used for epidural analgesia following hepatectomy abdominal surgery. Methods: Patients received thoracic epidural analgesia with meperidine alone (3.5 mg/ml in saline) or with additional bupivacaine (0.15%) for 2 days after surgery. Postoperative pain was assessed using a visual analog scale (VAS) pain score 2 days after the operation, with the incidence and dose supplementation also evaluated. Postoperative side effects were assessed using a 3 grade system. Results: No significant difference was found between the two groups in terms of age and weight, or in the pain scores, side effects, incidence and dose supplementation. Conclusions: 3.5 mg/ml epidural meperidine at a dose of 2 ml/hr provides effective postoperative analgesia.