The Effect of Preoperative Information on Post-Operative Anxiety, Cortisol and Pain of Patients Undergoing Total Knee Arthroplasty / 성인간호학회지

PURPOSE: The purpose of this study was to ascertain the effects of preoperative information on postoperative state anxiety, plasma cortisol, and pain for patients under total knee arthroplasty, and to provide generic data with nursing intervention for total knee arthroplasty. METHODS: Data were collected from 34 patients who had total knee arthroplasty from January 3, 2003 to January 15, 2004. An experiment group of 17 patients was provided with pre-operative information prepared by the researchers; a control group of another 17 patients was provided with general information. Data were analyzed through Chi-squared test, t-test, paired t-test and ANCOVA using SPSS WIN 11.0. RESULTS: There was no significant differences between the experiment group and the control group in post operative state anxiety(p=.612). However, there was statistically a significant difference between the above two groups in post operative plasma cortisol(p=.012). There was a statistically significant difference between the above two groups in post operative pain(p=.041). CONCLUSION: According to the results of the study, the authors concluded that the preoperative information for patients under total knee arthroplasty had the effect on the decrease of postoperative plasma cortisol and pain.

The Effects of Ketamine Preemptive Analgesia on Postoperative Pain in Patients undergoing a Hystrectomy / 간호학회지

PURPOSE: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. METHOD: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. RESULT: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. CONCLUSION: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.

The Effects of Ketamine Preemptive Analgesia on Postoperative Pain in Patients undergoing a Hystrectomy / 간호학회지

PURPOSE: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. METHOD: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. RESULT: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. CONCLUSION: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.

Effect of the Exchange of Saline Used in Surgical Procedures on Surgical Site Infection / 간호학회지

PURPOSE: The purpose of this study was to identify the effect of the exchange of saline used in surgical procedures on surgical site infections. METHOD: Patients with stomach cancer were assigned to the experimental group or to the control group by random sampling, respectively. The experimental group received an exchange of saline during the operation right after the excision of the stomach in a gastrectomy but the control group did not. Data were collected from the medical charts of 34 patients from Dec. 1, 2002 through May 31, 2003. RESULT: The surgical site infection rate of the experimental group was 5.9% while surgical site infection rate of the control group was 17.6%. In total, the surgical site infection rate was 11.8%. The experimental group maintained a normal level of WBC on post operative day 3; however, the control group, showed an increase of WBC on post operative day 3. CONCLUSION: The exchange of saline used in an operation immediately after the excision of the stomach in a gastrectomy decreases the contamination level of saline used in the operation, and can prevent surgical patients from a surgical site infection.

Microorganisms Isolated from Saline Used in Surgical Procedures / 병원감염관리

BACKGROUND: This study was undertaken to identify the contaminants of saline and classify microorganisms of saline used in surgical procedures so that an appropriate timing and method of saline exchange could be considered. Forty surgeries performed by a single surgeon at a 1,500-bed hospital were investigated. METHODS: Samples of 50 mL from the saline used in each operation were collected at each of three stages of the surgical procedure: pre-skin incision, post-specimen incision and skin suture, and the microorganisms of these samples were classified. RESULTS: The most frequently isolated microorganisms from saline after the exposure to air were coagulase-negative staphylococci, micrococci and non-enterococci. In case of exchanged saline used in surgical procedures, the numbers of coagulase-negative staphylococci, micrococci, Alcaligenes species were decreased than those of unexchanged saline, but Enterococcus, Escherichia coli. Enterobacter agglomerans, Klebsiella species and Pasteurella multocida appeared. Sampling demonstrated that saline used in biliary tract surgery had Enterococcus, Alcaligenes species, E. coli, Enterobacter agglomerans, Klebsiella species and Pasteurella multocida, but saline used in gastrectomy and mastectomy had coagulase-negative staphylococcus and micrococcus. CONCLUSIONS: The important risk factor for tile contamination of saline used in surgery is not the airborne bacteria of the operating room but contaminated operative tissues. This microbiological study has shown that saline may carry considerable loads of pathogenic organisms. To reduce the possibilities of contamination of saline used to surgery, therefore, both the timing and method of saline exchange should be reconsidered, especially for prolonged surgical procedures and clean-contaminated, contaminated, or dirty/infected operations.

Relationship Among Variables to Evaluate the Effect of Bladder Training and Pelvic Muscle Exercise on Female Urinary Incontinence / 성인간호학회지

This study was designed to investigate the relationship among variables to assess the effect of bladder training and pelvic muscle exercise on female urinary incontinence. A total of 50 women, recruited from Incheon area through a newsletter advertisement, were assigned to 3 groups : 13 to the control group, 19 to the bladder training group and 18 to the Kegel (pelvic muscle) exercise group. Treatment protocol lasted for 8 weeks, and study measurements were taken at the beginning, 5 week and 9 week of treatment. Peak pressure, average pressure and duration time of pelvic muscle contraction were evaluated by a perineometer ; urinary incontinence scores by the urinary incontinence scale ; amount of leaked urine and ratio (the amount leaked urine/single urinary volume after a pad test) by a 30-minutes pad test ; frequency of micturition, nocturia and single urinary volume through a urinary diary. Measurements of baseline, 5 week and 9 week were analyzed using Pearson's correlation. In conclusion, the important variables to assess the effect of bladder training and pelvic muscle exercise for 4 weeks are peak pressure, average pressure, duration, leaked urine amount, ratio, frequency of micturition and single urinary volume. The important variables to assess the effect of bladder training and pelvic muscle exercise for 8 weeks are duration, leaked urine amount, ratio, frequency of micturition, frequency of nocturia and single urinary volume.