BACKGROUND AND OBJECTIVES: Pain and anxiety control is the most important factor for patients that have undergone endoscopic sinus surgery under local anesthesia. Monitored anesthesia care (MAC) technique has been applied to local anesthetic patients for anxiolysis and analgesia. This technique encompasses the use of sedatives, tranquilizers and analgesics in combination to local supplements. This study was performed to evaluate the effectiveness of MAC for intraoperative pain control in patients who have undergone endoscopic sinus surgery. MATERIALS AND METHODS: We studied 83 patients undergoing ambulatory endoscopic sinus surgery. Patients were randomly allocated into 2 groups of MAC (n=49) and placebo (n=34). We administrated alfentani1 and propofol intravenously at 2-3 minutes before local anesthesia for endoscopic sinus surgery. We evaluated the intraoperative pain with visual analogue pain score (VAS) and satisfactory score to pain control. RESULTS: Overall, MAC cases showed statistically significant better VAS than placebo cases. Satisfactory score to pain control was also higher in MAC cases than placebo cases. CONCLUSION: We conclude that MAC is an effective method using intravenous sedatives and analgesics for intraoperative sedation and pain control in patients undergoing endoscopic sinus surgery under local anesthesia.
Analgesia ; Analgesics ; Anesthesia* ; Anesthesia, Local ; Anxiety ; Humans ; Hypnotics and Sedatives ; Propofol

Purpose: Patients who have undergone gastrectomy have unique symptoms that are not appropriately assessed using currently available tools. This study developed and validated a symptom-focused quality of life (QoL) questionnaire for patients who have received gastrectomy for gastric cancer. Materials and Methods Based on a literature review, patient interviews, and expert consultation by the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS), the initial item pool was developed. Two large-scale developmental studies were then sequentially conducted for exploratory factor analyses for content validity and item reduction. The final item pool was validated in a separate cohort of patients and assessed for internal consistency, test-retest reliability, construct validity, and clinical validity. Results The initial questionnaire consisted of 46-items in 12 domains. Data from 465 patients at 11 institutions, followed by 499 patients at 13 institutions, were used to conduct item reduction and exploratory factor analyses. The final questionnaire (KOQUSS-40) comprised 40 items within 11 domains. Validation of KOQUSS-40 was conducted on 413 patients from 12 hospitals. KOQUSS-40 was found to have good model fit. The mean summary score of the KOQUSS-40 was correlated with the EORTC QLQ-C30 and STO22 (correlation coefficients, 0.821 and 0.778, respectively). The KOQUSS-40 score was also correlated with clinical factors, and had acceptable internal consistency (> 0.7). Test-retest reliability was greater than 0.8. Conclusion The KOQUSS-40 can be used to assess QoL of gastric cancer patients after gastrectomy and allows for a robust comparison of surgical techniques in clinical trials.

Purpose: Patients who have undergone gastrectomy have unique symptoms that are not appropriately assessed using currently available tools. This study developed and validated a symptom-focused quality of life (QoL) questionnaire for patients who have received gastrectomy for gastric cancer. Materials and Methods Based on a literature review, patient interviews, and expert consultation by the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS), the initial item pool was developed. Two large-scale developmental studies were then sequentially conducted for exploratory factor analyses for content validity and item reduction. The final item pool was validated in a separate cohort of patients and assessed for internal consistency, test-retest reliability, construct validity, and clinical validity. Results The initial questionnaire consisted of 46-items in 12 domains. Data from 465 patients at 11 institutions, followed by 499 patients at 13 institutions, were used to conduct item reduction and exploratory factor analyses. The final questionnaire (KOQUSS-40) comprised 40 items within 11 domains. Validation of KOQUSS-40 was conducted on 413 patients from 12 hospitals. KOQUSS-40 was found to have good model fit. The mean summary score of the KOQUSS-40 was correlated with the EORTC QLQ-C30 and STO22 (correlation coefficients, 0.821 and 0.778, respectively). The KOQUSS-40 score was also correlated with clinical factors, and had acceptable internal consistency (> 0.7). Test-retest reliability was greater than 0.8. Conclusion The KOQUSS-40 can be used to assess QoL of gastric cancer patients after gastrectomy and allows for a robust comparison of surgical techniques in clinical trials.