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- 저자 : 조병진(Byang Jin Cho) (검색결과 2 건)
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Baxter R 를 이용한 Morphine 과 Bupivacaine 의 지속적인 경막외 투여가 술후 제통효과에 대한 임상적 고찰
조병진(Byang Jin Cho),윤영준(Young Joon Yoon),진상 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.2
N/A The analgesic efficacy and side-effects of combined continuous epidural infusion of bupivacaine and morphine, in comparison with intramuscular GM) administration of narcotics, for postoperative pain relief after cesarean section and hysterectomy were evaluated. We di- vided 60 patients into 4 groups randomly. IM (meperidine) group after cesarean section (Group 1, n=20); Continuous epidural group after cesarean section (Group 2, n=20g IM (meperidine) group after hysterectomy (Group 3, n=10g Continuous epidural group after hysterectomy (Group 4, n= 10). Following each operation, the epidural groups had an epidural catheter placed (L2-3 or L3-4), and a bolus of l.5mg of morphine was injected, and followed by continuous infusion of 0.3% bupivacaine 2ml/hour and morphine 2.5mg/day for 48 hours. The IM groups had received me- peridine 50mg IM injection every 4 hours as needed. We evaluated analgesic efficacy with VAS (visual analogue scale) at 1, 2, 24, 48, and 72 hours after operation. The side-effects (nausea Cr, vomiting, respiratory depression, pruritus and uri- nary retention) were evaluated with 4 points scale at day 1, 2, and 3 after operation. The results were as follows 1) The continuous epidural (bupivacaine+morphine) groups were superior to the IM (meperi- dine) groups with respect to postoperative analgesia at 1, 2, and 24 hours after cesarean section, and at 1, 2, 24, and 48 hours after hysterectomy. 2) Vomiting were more frequent in the epidural groups 2 days after cesarean section. 3) Pruritus was more frequent in the epidural groups 1 and 2 days after cesarean section
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한태형(Tae Hyung Han),조병진(Byang Jin Cho),신백효 대한통증학회 1999 The Korean Journal of Pain Vol.12 No.1
N/A Background: In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods: We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results: Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions: Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.
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