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1.
Journal of Korean Academy of Community Health Nursing ; : 260-267, 2015.
Article in English | WPRIM | ID: wpr-119766

ABSTRACT

PURPOSE: This study aimed to examine the effectiveness of the workshop on the nurses' knowledge about urinary incontinence (UI) self-management, attitudes toward UI, and self-efficacy to plan and implement a UI self-help group program for their clients. METHODS: A one-group pretest and posttest design was used to examine changes in knowledge, attitudes, and self-efficacy following a one-day training workshop. Twenty-seven community health nurses completed a questionnaire before and after the workshop. Before participating in the workshop, the participants were required to take a UI online continuing education program developed by the researchers. During the workshop, the participants took four sessions which consisted of an introduction of a self-help group program, demonstration of a 5-week UI self-management program contents, pelvic floor muscle training and biofeedback practice, and group discussions to plan the implementation in their workplaces. RESULTS: A significant improvement in knowledge of and attitudes toward UI were found (t=3.53, p=.002; t=2.83, p=.009, respectively) after the workshop. Participants also demonstrated improvement in their self-efficacy to plan and operate a UI self-help group program (Z=-2.64, p=.008). CONCLUSION: The one-day workshop for community health nurses is a feasible strategy to increase their abilities and confidence in operating a UI self-help group program.


Subject(s)
Biofeedback, Psychology , Education , Education, Continuing , Nurses, Community Health , Pelvic Floor , Program Evaluation , Self Care , Self-Help Groups , Urinary Incontinence
2.
Journal of Korean Academy of Community Health Nursing ; : 170-179, 2014.
Article in Korean | WPRIM | ID: wpr-177652

ABSTRACT

PURPOSE: This study investigated medication status by examining the effects of a medication management education program on the knowledge of medications and medication misuse behaviors in the elderly in a local community. METHODS: This study used a non-equivalent control group quasi-experimental design. For the study, 116 subjects were assigned to the control group and another 116 subjects were assigned to the experimental group. The medication management education program consisted of 1:1 education, practice in medication management, consultation, and discussion. Data were analyzed using the SPSS 21.0 program. RESULTS: Statistically significant differences were found between the experimental and control groups in terms of their knowledge of medications and medication misuse behaviors. CONCLUSION: The results indicate that the medical management education program is effective in improving the knowledge of medications and decreasing medication misuse behaviors. Therefore, this education program can be used as an intervention to improve the medication behaviors of the elderly in local communities.


Subject(s)
Aged , Humans , Education , Medication Therapy Management , Prescription Drug Misuse
3.
Korean Journal of Anesthesiology ; : 517-523, 2013.
Article in English | WPRIM | ID: wpr-102939

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) continues to be a major problem, because PONV is associated with delayed recovery and prolonged hospital stay. Although the PONV guidelines recommended the use of 5-hydroxy-tryptamine (5-HT3) receptor antagonists as the first-line prophylactic agents in patients categorized as high-risk, there are few studies comparing the efficacies of ondansetron, ramosetron, and palonosetron. The aim of present study was to compare the prophylactic antiemetic efficacies of three 5HT3 receptor antagonists in high-risk patients after laparoscopic surgery. METHODS: In this prospective, randomized, double-blinded trial, 109 female nonsmokers scheduled for elective laparoscopic surgery were randomized to receive intravenous 4 mg ondansetron (n = 35), 0.3 mg ramosetron (n = 38), or 75 microg palonosetron (n = 36) before anesthesia. Fentanyl-based intravenous patient-controlled analgesia was administered for 48 h after surgery. Primary antiemetic efficacy variables were the incidence and severity of nausea, the frequency of emetic episodes during the first 48 h after surgery, and the need to use a rescue antiemetic medication. RESULTS: The overall incidence of nausea/retching/vomiting was lower in the palonosetron (22.2%/11.1%/5.6%) than in the ondansetron (77.1%/48.6%/28.6%) and ramosetron (60.5%/28.9%/18.4%) groups. The rescue antiemetic therapy was required less frequently in the palonosetron group than the other groups (P < 0.001). Kaplan-Meier analysis showed that the order of prophylactic efficacy in delaying the interval to use of a rescue emetic was palonosetron, ramosetron, and ondansetron. CONCLUSIONS: Single-dose palonosetron is the prophylactic antiemetics of choice in high-risk patients undergoing laparoscopic surgery.


Subject(s)
Female , Humans , Analgesia, Patient-Controlled , Anesthesia , Antiemetics , Benzimidazoles , Incidence , Isoquinolines , Kaplan-Meier Estimate , Laparoscopy , Length of Stay , Nausea , Ondansetron , Postoperative Nausea and Vomiting , Prospective Studies , Quinuclidines
4.
The Korean Journal of Orthodontics ; : 209-217, 2013.
Article in English | WPRIM | ID: wpr-213121

ABSTRACT

OBJECTIVE: This study investigated whether temporomandibular joint (TMJ) condyle-fossa relationships are bilaterally symmetric in class III malocclusion patients with and without asymmetry and compared to those with normal occlusion. The hypothesis was a difference in condyle-fossa relationships exists in asymmetric patients. METHODS: Group 1 comprised 40 Korean normal occlusion subjects. Groups 2 and 3 comprised patients diagnosed with skeletal class III malocclusion, who were grouped according to the presence of mandibular asymmetry: Group 2 included symmetric mandibles, while group 3 included asymmetric mandibles. Pretreatment three-dimensional cone-beam computed tomography (3D CBCT) images were obtained. Right- and left-sided TMJ spaces in groups 1 and 2 or deviated and non-deviated sides in group 3 were evaluated, and the axial condylar angle was compared. RESULTS: The TMJ spaces demonstrated no significant bilateral differences in any group. Only group 3 had slightly narrower superior spaces (p < 0.001). The axial condylar angles between group 1 and 2 were not significant. However, group 3 showed a statistically significant bilateral difference (p < 0.001); toward the deviated side, the axial condylar angle was steeper. CONCLUSIONS: Even in the asymmetric group, the TMJ spaces were similar between deviated and non-deviated sides, indicating a bilateral condyle-fossa relationship in patients with asymmetry that may be as symmetrical as that in patients with symmetry. However, the axial condylar angle had bilateral differences only in asymmetric groups. The mean TMJ space value and the bilateral difference may be used for evaluating condyle-fossa relationships with CBCT.


Subject(s)
Humans , Cone-Beam Computed Tomography , Facial Asymmetry , Malocclusion , Mandible , Retrospective Studies , Temporomandibular Joint
5.
Journal of Korean Academy of Community Health Nursing ; : 91-101, 2012.
Article in Korean | WPRIM | ID: wpr-78700

ABSTRACT

PURPOSE: This study was conducted to examine the effects of exercise on physiological, physical and psychological functions of the frail elderly. METHODS: The research design was a nonequivalent control group pretest-posttest design. Data were collected from September 9 to October 10, 2009. The subjects were 56 frail elders who agreed to participate in this study and each subject was randomly assigned to either the experimental group (n=28) or the control group (n=28). The exercise program was provided to each subject in the experimental group twice in a week for 6 weeks. Data were analyzed with frequency, chi2-test, Kolmogorov-Smirnor test and independent t-test using SPSS/WIN 12.0. RESULTS: There was a significant improvement in psychological functions in the experimental group compared to the control group (t=1.726, p=.045). CONCLUSION: The exercise program showed the effects to improve the psychological functions of the frail elderly with chronic disease. In recommendation, this exercise program could be utilized as a health promoting program for the frail elderly.


Subject(s)
Aged , Humans , Chronic Disease , Depression , Frail Elderly , Quality of Life , Research Design
6.
Korean Journal of Anesthesiology ; : 435-440, 2012.
Article in English | WPRIM | ID: wpr-149830

ABSTRACT

BACKGROUND: To justify the use of the lidocaine/tetracaine medicated patch or peel as a preventive treatment for reducing pain and discomfort in adults and children. We reviewed randomized controlled trials (RCTs) to evaluate the efficacy and safety of the lidocaine/tetracaine medicated patch or peel compared with placebo. METHODS: Ten RCTs (574 patients) were included in this systemic review. Relevant studies were identified through searches of MEDLINE, SCOPUS and the Cochrane database library. The outcome was the adequacy of cutaneous anesthesia reflected in the patient's assessment of pain intensity during minor dermatologic procedures and adverse effects after application of the lidocaine/tetracaine medicated patch or peel versus placebo. RESULTS: The efficacy of the lidocaine/tetracaine patch or peel was consistently very significantly beneficial 30 or 60 minutes after the application compared to placebo (Relative risk, RR: 2.5; Number needed to treat, NNT: 2.2). We did not identify any difference in the effectiveness of adequate analgesia between the lidocaine/tetracaine patch and peel (the number needed to treat or to harm, NNT 2.4 vs. 2.0). No serious side effects or adverse events were observed with the lidocaine/tetracaine medicated patch or peel and placebo. Minor skin reactions were transient and resolved without treatment (Odd ratio, OR: 1.4 and 95% confidence interval, CI: 0.9-2.1; NNT: 14.9). CONCLUSIONS: The lidocaine/tetracaine medicated patch or peel is a well accepted, effective and safe method for minor dermatologic procedures based on pooled data of trials in terms of adequacy of cutaneous anesthesia and adverse effects.


Subject(s)
Adult , Child , Humans , Analgesia , Anesthesia , Lidocaine , Skin , Tetracaine
7.
Journal of the Korean Surgical Society ; : 155-161, 2012.
Article in English | WPRIM | ID: wpr-207795

ABSTRACT

PURPOSE: Many surgical patients are admitted to the intensive care unit (ICU), resulting in an increased demand, and possible waste, of resources. Patients who undergo liver resection are also transferred postoperatively to the ICU. However, this may not be necessary in all cases. This study was designed to assess the necessity of ICU admission. METHODS: The medical records of 313 patients who underwent liver resections, as performed by a single surgeon from March 2000 to December 2010 were retrospectively reviewed. RESULTS: Among 313 patients, 168 patients (53.7%) were treated in the ICU. 148 patients (88.1%) received only observation during the ICU care. The ICU re-admission and intensive medical treatment significantly correlated with major liver resection (odds ratio [OR], 6.481; P = 0.011), and intraoperative transfusions (OR, 7.108; P = 0.016). Patients who underwent major liver resection and intraoperative transfusion were significantly associated with need for mechanical ventilator care, longer postoperative stays in the ICU and the hospital, and hospital mortality. CONCLUSION: Most patients admitted to the ICU after major liver resection just received close monitoring. Even though patients underwent major liver resection, patients without receipt of intraoperative transfusion could be sent to the general ward. Duration of ICU/hospital stay, ventilator care and mortality significantly correlated with major liver resection and intraoperative transfusion. Major liver resection and receipt of intraoperative transfusions should be considered indicators for ICU admission.


Subject(s)
Humans , Critical Care , Hepatectomy , Intensive Care Units , Liver , Medical Records , Patients' Rooms , Retrospective Studies , Ventilators, Mechanical
8.
Korean Journal of Anesthesiology ; : 3-12, 2012.
Article in English | WPRIM | ID: wpr-95880

ABSTRACT

Clinical research has expanded tremendously in the past few decades and consequently there has been growing interest in the ethical guidelines that are being followed for the protection of human subjects. This review summarizes historical scandals and social responses chronologically from World War II to the Death of Ellen Roche (2001) to emphasize the lessons we must learn from history. International ethical guidelines for studies with human subjects are also briefly described in order to understand the circumstances of clinical research. The tasks and responsibilities of the institutions and investigators in human subject research to preserve the safety and welfare of research subjects are summarized. Next, several debated ethical issues and insights are arranged as controversial topics. This brief review and summary seeks to highlight important arguments and make suggestions to institutional review boards (IRBs) to contribute to the future evolution of ethics in clinical research as we advance forward.


Subject(s)
Humans , Ethics Committees, Research , Research Personnel , Research Subjects , World War II
9.
Korean Journal of Anesthesiology ; : 405-412, 2011.
Article in English | WPRIM | ID: wpr-172269

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) remains a challenge for patients and health professionals despite various newly developed prophylactic interventions. We reviewed the efficacy and safety of ramosetron in randomized controlled trials (RCTs) for the prevention of PONV. METHODS: We reviewed 18 randomized controlled trials investigating the efficacy and safety of ramosetron in comparison with placebo or any other drugs. Relevant studies were searched in the MEDLINE, SCOPUS, and the Cochrane database libraries. Our end points of concern were prevention of PONV and adverse effects as dichotomous data. RESULTS: The prophylactic effect of 0.3 mg ramosetron was observed in early PON (relative risk, RR: 0.4; 95% CI 0.3-0.6), early POV (RR: 0.3; 95% CI 0.1-0.6), late POV (RR: 0.3; 95% CI 0.1-0.6), but not late PON (RR: 0.7; 95% CI 0.5-1.0). Compared with placebo, the efficacy of 0.3 mg ramosetron in adults and 6 microg/kg in children were consistently beneficial in preventing PONV overall (RR: 0.4; 95% CI: 03-0.6). The effects of 0.3 mg ramosetron and 3 mg granisetron were similar. No serious side effects or adverse events resulted from ramosetron and other active drugs, and incidence was similar to those of the placebo group. CONCLUSIONS: Ramosetron is effective and safe in children and adults without serious adverse effects compared with placebo or other active drugs, as shown in pooled data of RCTs, in terms of the prevention of PONV.


Subject(s)
Adult , Child , Humans , Antiemetics , Benzimidazoles , Granisetron , Health Occupations , Incidence , Postoperative Nausea and Vomiting
10.
The Korean Journal of Pain ; : 96-98, 2009.
Article in Korean | WPRIM | ID: wpr-91931

ABSTRACT

Twelfth rib syndrome is thought to be due to intercostal nerve irritation by a mobile twelfth rib, and presents with upper abdominal pain, or low thoracic pain. This syndrome appears to be a fairly common entity and diagnosis is based on clinical findings. Patients with twelfth rib syndrome can be misdiagnosed when it has been overlooked. We report a case of a 34-year-old male along with a presentation of twelfth rib syndrome. One patient was transferred from urologic clinic to pain clinic due to right flank pain and admitted. The patient had direct tenderness on twelfth rib area and direct tenderness was reproducible. Pain increased when the patient flexed laterally, rotated trunk. There were no specific abnormal findings in laboratory test, electrocardiogram, and radiologic examination. After intercostal nerve block and epidural block, pain decreased and the patient was discharged.


Subject(s)
Adult , Humans , Male , Abdominal Pain , Electrocardiography , Flank Pain , Intercostal Nerves , Pain Clinics , Ribs
11.
The Korean Journal of Pain ; : 47-51, 2009.
Article in Korean | WPRIM | ID: wpr-116199

ABSTRACT

BACKGROUND: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. METHODS: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. RESULTS: The oblique angle was 5.4 +/- 2.9degrees. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were 3.8 +/- 0.8 cm and 0.9 +/- 0.6 cm, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were 3.4 +/- 0.7 cm and 3.9 +/- 0.6 cm, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). CONCLUSIONS: The measurements in this study can be used as a reference standards for the blind SIJ block.


Subject(s)
Female , Humans , Male , Informed Consent , Palpation , Prone Position , Sacroiliac Joint , Spine
12.
Journal of Korean Academy of Adult Nursing ; : 324-338, 2009.
Article in Korean | WPRIM | ID: wpr-111299

ABSTRACT

PURPOSE: The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. METHODS: The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. RESULTS: Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. CONCLUSION: The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.


Subject(s)
Humans , Head , Hospitals, General , Interdisciplinary Communication , Interpersonal Relations , Nurse Administrators , Nursing, Supervisory , Qualitative Research
13.
Journal of Korean Academy of Fundamental Nursing ; : 232-241, 2009.
Article in Korean | WPRIM | ID: wpr-656399

ABSTRACT

PURPOSE: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). METHOD: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). RESULTS: The mean score for importance was 2.58+/-0.29, for difficulty, 2.11+/-0.31, and for frequency, 2.18+/-0.31. OPD nurses recognized'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p= .026; F=4.089, p= .018) and hospital size (F=4.274, p= .006; F=3.154, p= .025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. CONCLUSION: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate'preparation for medical service', and'management of facility and environment' to nonmedical health-care workers.


Subject(s)
Humans , Health Facility Size , Job Description , Outpatients , Patient Education as Topic , Surveys and Questionnaires
14.
Korean Journal of Anesthesiology ; : 295-299, 2008.
Article in Korean | WPRIM | ID: wpr-82527

ABSTRACT

BACKGROUND: This study was conducted to investigate the optimal angle of needle insertion during caudal epidural injection in chronic low back pain patients using ultrasound imaging. METHODS: One hundred eight patients (40 male and 68 female patients) with low back pain and sciatica were studied.Soft tissue ultrasonography was performed to identify the sacral hiatus. The optimal angle of the needle to the skin was measured with an imaginary line drawn parallel to the sacral base using a protractor on a longitudinal plane. A 22-gauge caudal epidural needle was inserted and was guided by ultrasound to the sacral hiatus and into the caudal epidural space. RESULTS: The mean +/- SD for the intercornual distance, depth of the caudal space and the thickness of the sacrococcygeal membrane were 19.0 +/- 3.2 mm, 3.6 +/- 0.9 mm and 1.8 +/- 0.8 mm, respectively. The optimal angle showed a significant correlation with the depth of the caudal space and the thickness of the sacrococcygeal membrane. The mean +/- SD for the optimal angle of the needle insertion was 23.5 +/- 6.9 degrees. CONCLUSIONS: We conclude that the needle should be inserted at an angle of approximately 23.5 degrees to the skin in order to avoid injury to the periosteum and an inadvertent intra-osseous injection.


Subject(s)
Adult , Female , Humans , Male , Injections, Epidural , Low Back Pain , Membranes , Needles , Periosteum , Sciatica , Skin
15.
The Korean Journal of Pain ; : 111-115, 2007.
Article in Korean | WPRIM | ID: wpr-114835

ABSTRACT

BACKGROUND: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an alternative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. METHODS: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process. We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). RESULTS: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. CONCLUSIONS: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.


Subject(s)
Female , Humans , Male , Low Back Pain , Magnetic Resonance Imaging , Skin , Ultrasonography , Zygapophyseal Joint
16.
The Korean Journal of Pain ; : 40-45, 2007.
Article in Korean | WPRIM | ID: wpr-10764

ABSTRACT

BACKGROUND: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. METHODS: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. RESULTS: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were 134.1 +/- 10.1 seconds and 1.2 +/- 0.1, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were 17.1 +/- 0.4, 3.9 +/- 0.3, 2.3 +/- 0.1 and 24.9 +/- 0.9 mm, respectively. CONCLUSIONS: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.


Subject(s)
Humans , Anesthesia , Chronic Pain , Ethics Committees , Fluoroscopy , Ligaments , Needles , Nerve Block , Ultrasonography
17.
Korean Journal of Anesthesiology ; : 630-634, 2007.
Article in Korean | WPRIM | ID: wpr-218871

ABSTRACT

BACKGROUND: Facet joint is an important structure not only contributing to the stability of the lumbar motion segments but also causing low back pain. Hypothetically, the more lumbar lordosis decreases, the more corresponding facet joints orient axially and asymmetrically. Furthermore, the increased incidence of common diseases possessed of low back pain and radiologic findings such as wedging of vertebral body and spondylolisthesis were reported in the patients with asymmetric orientation of the facet joints and loss of lumbar lordosis at the same time. The purpose of our study is to define the relationship of asymmetry of the facet joints and loss of lumbar lordosis. METHODS: The asymmetry and average angle of facet joints with respect to sagittal plane were measured on the magnetic resonance images. The lumbar lordosis was measured on the lateral X-ray. The relevance of lumbar lordosis and facet orientation was analyzed through linear regression. RESULTS: There were no significant relationships between lumbar lordosis and asymmetrical orientation of facet joint. CONCLUSIONS: The loss of lumbar lordosis did not suggest asymmetrical and axial orientation of facet joints. Further investigation into pathology and consideration into individual differences of range of motion, body mass index, age, sex might be needed.


Subject(s)
Animals , Humans , Back Pain , Body Mass Index , Incidence , Individuality , Linear Models , Lordosis , Low Back Pain , Pathology , Range of Motion, Articular , Spondylolisthesis , Zygapophyseal Joint
18.
Korean Journal of Anesthesiology ; : 169-173, 2007.
Article in Korean | WPRIM | ID: wpr-206307

ABSTRACT

BACKGROUND: This study investigated the effect of type of surgery on consumption of propofol and remifentanil and recovery index. METHODS: Fifty female patients (ASA physical status 1, 2) scheduled for thyroidectomy (Group I) or mastectomy (Group II) received total intravenous anesthesia (TIVA) with propofol and remifentanil. The anesthesia was maintained with target-controlled infusion (TCI) of propofol and remifentanil under bispectral index (BIS) monitoring. The effect site concentration of propofol was controlled for maintaining BIS values within the range of 45-50. The effect site concentration of remifentanil was controlled for maintaining blood pressure and heart rate within 20% of baseline values. Blood pressure, heart rate, BIS, effect site concentration of propofol and remifentanil were measured before induction, during induction, at the beginning of operation, at the end of operation, and during recovery. The time from discontinuation of propofol to eye opening and regaining of orientation, total amount of propofol and remifentanil used, and the amount of drug per body weight kilogram per hour were investigated. RESULTS: There were no significant differences between Group I and II on the amount of remifentanil used. Although the amount of propofol consumed per body weight kilogram per hour was larger in Group II, there were no significant differences of recovery index between Group I and II. CONCLUSIONS: There were no significant differences in the amount of propofol and remifentanil consumed and recovery index in thyroidectomy and mastectomy under TIVA. The larger amount of propofol consumed per body weight per hour in Group II was thought as a result of shorter operation time than Group I.


Subject(s)
Female , Humans , Anesthesia , Anesthesia, Intravenous , Blood Pressure , Body Weight , Heart Rate , Mastectomy , Propofol , Thyroidectomy
19.
Korean Journal of Anesthesiology ; : 605-610, 2006.
Article in Korean | WPRIM | ID: wpr-85132

ABSTRACT

BACKGROUND: Measuring the distance between internal jugular vein (IJV) and external jugular vein (EJV) on ultrasound image can give the information of the whereabouts of the IJV. We compared the success rate between carotid artery (CA)-guided and EJV-guided cannulation based on the information gathered from ultrasound. METHODS: We studied 152 patients requiring central venous cannulation during anesthesia. Ultrasound images were obtained with 7.5 MHz probe on the right neck at 0 degree, 30 degrees, and maximum rotation of the head in flat and 15 degrees Trendelenberg (T) position. The horizontal diameter of the RIJV and % overlap of the CA with the RIJV at each position, and the horizontal distance of RIJV-REJV at 30 degrees were measured on ultrasound images. In EJV group, the distance of RIJV-REJV was drawn along the cricoid level and the point of IJV was marked as the needle insertion site. Cannulation was performed with palpation of the CA in CA group and performed at the marked point in EJV group without palpation of CA. RESULTS: Overall RIJV diameter was increased in T-position compared to flat position. Following head rotation, RIJV diameter was decreased and % overlap of CA was increased (P < 0.05). In 26.8% of patients at 30 degrees in T position, CA overlapped 26-50% of RIJV. The success rate of cannulation at the first trial was 97.4% in CA group and 96.1% in REJV group. CONCLUSIONS: With the IJV identified on ultrasound image, the distance between the IJV and the EJV can be used as another landmark for RIJV cannulation provided the EJV is visualized with the naked eye.


Subject(s)
Humans , Anesthesia , Carotid Arteries , Catheterization , Head , Jugular Veins , Neck , Needles , Palpation , Ultrasonography
20.
The Korean Journal of Pain ; : 292-295, 2006.
Article in Korean | WPRIM | ID: wpr-22391

ABSTRACT

The diagnosis of chronic abdominal pain due to abdominal cutaneous nerve entrapment can be elusive. Tenderness in patients with abdominal pain is naturally assumed to be of either peritoneal or visceral origin. Studies have shown that some patients suffer from prolonged pain in the abdominal wall and are often misdiagnosed, even after unnecessary and expensive diagnostic tests, including potentially dangerous invasive procedures, and treated as having a visceral source for their complaints, even in the presence of negative X-ray findings and atypical symptoms. Abdominal cutaneous nerve entrapment syndrome is rarely diagnosed, which is possibly due to failure to recognize the condition rather than the lack of occurrence. The accepted treatment for abdominal cutaneous nerve entrapment syndrome is a local injection, with infiltration of anesthetic agents coupled with steroids. Careful history taking and physical examination, in conjunction with the use of trigger zone injections, can advocate the diagnosis of abdominal cutaneous nerve entrapment and preclude any unnecessary workup of these patients. Herein, 3 cases of abdominal cutaneous nerve entrapment syndrome, which were successfully treated with local anesthetics and steroid, are reported.


Subject(s)
Humans , Abdominal Pain , Abdominal Wall , Anesthetics , Anesthetics, Local , Diagnosis , Diagnostic Tests, Routine , Nerve Compression Syndromes , Physical Examination , Steroids
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