Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

No abstract available.
Cervix Uteri* ; Female ; Fibrin Tissue Adhesive*

PURPOSE: This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables. METHOD: The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year. RESULT: The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women. CONCLUSION: There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
Adult ; Aged ; Asian Americans/*psychology ; Attitude to Health/*ethnology ; Breast Neoplasms/*psychology ; Breast Self-Examination/*psychology ; Female ; Humans ; Korea/ethnology ; Middle Aged

BACKGROUND: Preemptive analgesia is an antinociceptive treatment that prevents the establishment of central sensitization, which amplifies the postoperative pain. In this study, we investigated the preemptive effect of local infiltration of bupivacaine on postoperative pain after inguinal herniorrhaphy. METHODS: Thirty adult patients scheduled for inguinal herniorrhaphy were randomly assigned to one of two groups. 0.25% bupivacaine 20 ml was infiltrated in the surgical wound site either 15 min before skin incision or immediately after skin closure. Postoperatively, visual analogue scale (VAS) at rest and movement were assessed. Also the time to the first request for postoperative analgesic and the total dose of postoperative analgesics were assessed. In addition, the number of patients who didn't require any analgesics during the postoperative period were assessed. RESULTS: The VAS at rest and movement was not significantly different between the two groups. The time to the first request for postoperative analgesic, the total dose of supplemental analgesics and the number of patients who didn't require any analgesics were not significantly different. CONCLUSIONS: In pain after inguinal herniorrhaphy, we could not demonstrate the pre-emptive analgesic effect of preincisional bupivacaine infiltration. Traction pain after inguinal herniorrhaphy was sustained during the study period and this kind of pain was not inhibited (or prevented) by local infiltration of bupivacaine.
Adult ; Analgesia ; Analgesics ; Bupivacaine* ; Central Nervous System Sensitization ; Herniorrhaphy* ; Humans ; Pain, Postoperative* ; Postoperative Period ; Skin ; Traction ; Wounds and Injuries

BACKGROUND: Ropivacaine is a new local anesthetic approved for epidural analgesia. The addition of fentanyl improves analgesia from epidural ropivacaine. We studied the effects of two solutions of ropivacaine/fentanyl for postoperative pain after a total abdominal hysterectomy. METHODS: Twenty five female patients scheduled for an elective total abdominal hysterectomy were prospectively randomized to receive one of two solutions. Group 1 (n = 13) received 0.2% ropivacaine and 5 microgram/ml of fentanyl at a rate of 2 ml/hour (bolus: 10 ml). Group 2 (n = 12) received 0.08% ropivacaine and 2 microgram/ml fentanyl at a rate of 5 ml/h (bolus: 25 ml) postoperative for two days. After an epidural bolus injection, we assessed the blood pressure, pulse rate, respiratory rate, visual analog scale (VAS), level of sensory block, motor block and sedation score among the two groups. Additional analgesic requirements and side effects such as nausea, itching and urinary retention were assessed for 48 hours post operation. RESULTS: There were no significant differences in the blood pressure, pulse rate and respiratory rate between the two groups. The sum of VAS for 48 hours, the level of sensory block after an epidural bolus injection, additional analgesics, and the number of patients showing motor blockade were similar. Although statistically insignificant, the incidence of nausea, and urinary retention in group 2 was higher than group 1. CONCLSIONS: Both the continuous epidural infusion of 0.2% ropivacaine with fentanyl (2 ml/hour) and 0.08% ropivacaine with fentanyl (5 ml/h) showed similar quality of analgesia on postoperative pain. To reduce the side effect of fentanyl, the volume of ropivacaine/fentanyl solution is important.
Analgesia ; Analgesia, Epidural* ; Analgesics ; Blood Pressure ; Female ; Fentanyl ; Heart Rate ; Humans ; Hysterectomy ; Incidence ; Nausea ; Pain, Postoperative ; Prospective Studies ; Pruritus ; Respiratory Rate ; Urinary Retention ; Visual Analog Scale

BACKGROUND: Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanisms. We evaluated the additive effects of ketamine (30 mg) on 0.5%, and 0.75% ropivacaine (total 30 ml) for an interscalene brachial plexus blockade (IBPB). METHODS: Thirty five adult patients scheduled for major forearm or hand surgery were prospectively randomized to receive one of the following solutions. Group 1 received 0.75% ropivacaine 28 ml with normal saline 2 ml, group 2 received 0.75% ropivacaine 28 ml with 5% ketamine 0.6 ml and normal saline 1.4 ml, group 3 received 0.75% ropivacaine 20 ml with normal saline 10 ml, and group 4 received 0.75% ropivacaine 20 ml with 5% ketamine 0.6 ml and normal saline 9.4 ml. At 1 minute intervals after IBPB, patients were assessed to determine loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the deltoid, radial, median, and ulnar dermatomes. At 5 minute intervals after IBPB, pulse rate, blood pressure, sedation score and level of discomfort were assessed. Before discharge, patients were asked to document when incisional discomfort began and when full sensation and motor control returned to the arm. RESULTS: The onset time of loss of pinprick and motor blockade were similar. Duration of sensory and motor blockade were similar in all groups. Hemodynamic changes and sedation scores were not significantly different in all groups. CONCLUSIONS: We demonstrated that 30 mg of ketamine didn't enhance the onset and duration of sensory or motor blockade of ropivacaine during the 0.75% or 0.5% ropivacaine IBPB.
Adult ; Arm ; Blood Pressure ; Brachial Plexus* ; Bupivacaine ; Elbow ; Forearm ; Hand ; Heart Rate ; Hemodynamics ; Humans ; Ketamine* ; Prospective Studies ; Sensation ; Shoulder ; Wrist

Objectives: ：Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. Methods: ：This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were an-alyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. Results: ：Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship be-tween shift work and alcohol in the case of men, but in the case of women, there was a significant positive relation-ship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. Conclusions ：The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.

BACKGROUND: It has been known that bed rest after spinal anesthesia for benign anorectal surgery helps to reduce the incidence of postdural puncture headache, but the bed rest position is thought to have a negative effect on urinary retention, as a result of anxiety, anal distention, bladder distention and pain-induced reflex inhibition of the urinary bladder detrusor muscle. We investigate the effect of early ambulation after spinal anesthesia on postdural puncture headache and on urinary retention compared with bed rest for 24 hours. METHODS: One hundred and fifty-three ASA Physical Status I patients received spinal anesthesia for scheduled benign anorectal surgery. We applied hyperbaric 0.5% tetracaine 6 mg (1.2 ml) using 25 gauge Quincke needles with the cutting bevel parallel to the dural fibers at the patients' sitting position. All patients were randomly divided into an early ambulation group or bed rest group. We investigated the incidence of urinary retention and headache. The duration of operation, the perioperative intravenous fluid volume, surgical technique and postoperative pain regimen were standardized. RESULTS: The incidence of urinary retention in the early ambulation group (16/75, 21.3%) was lower than that in bed rest group (32/78, 41.0%). There was no difference in any parameters between the two groups. CONCLUSIONS: To reduce the incidence of urinary retention, early ambulation after spinal anesthesia for benign anorectal surgery is recommended over bed rest with no increase in the incidence of postdural puncture headache.
Anesthesia, Spinal* ; Anxiety ; Bed Rest ; Early Ambulation* ; Headache ; Humans ; Incidence* ; Needles ; Pain, Postoperative ; Post-Dural Puncture Headache ; Reflex ; Tetracaine ; Urinary Bladder ; Urinary Retention*

BACKGROUND: Well-localized and noxious stimuli are found to produce long-lasting neuronal sensitization. Ketamine is a NMDA receptor antagonist and exerts antinociceptive effects in many pain tests. The aim of this study was to investigate the pre-emptive and analgesic sparing effect of intravenous ketamine in adults aged 30-53 after lumbar spinal instrumentation surgery. METHODS: We compared the effects of preoperative and postoperative intravenous ketamine 0.5 mg/kg on pain after lumbar spinal instrumentation in a double-blind, randomized study in 30 adult patients. After the induction of anesthesia, patients were allocated randomly to receive ketamine intravenously either before (n = 15) or immediately after (n = 15) surgery. Patients were instructed to ask for analgesics whenever they required pain relief and all demands were recorded. Intravenous patient-controlled analgesia (PCA) using butorphanol 16 mg and ketorolac 150 mg was introduced after recovery from general anesthesia. Visual analogue scale (VAS) pain scores were recorded at 1, 2, 3, 4, 5, 6, 9, 12, 24, 36 and 48 hours postoperatively and the total infusion dose of PCA drugs were assessed at 24 hours postoperatively. RESULTS: VAS scores in the preoperative group were significantly lower than in the postoperative group during the first 9 hours after cessation of the operation. The total infusion dose of PCA drugs was significantly lower in the preoperative group (butorphanol 9.1 +/- 0.3 mg, ketorolac 85.3 +/- 2.5 mg) than postoperative group (butorphanol 10.7 +/- 0.2 mg, ketorolac 100.3 +/- 2 mg) (P < 0.05). No serious adverse reactions occurred. CONCLUSIONS: Preoperative intravenous ketamine 0.5 mg/kg in lumbar spinal instrumentation is more effective in reducing postoperative analgesic requirements than it is when given after the operation.
Adult ; Analgesia, Patient-Controlled ; Analgesics ; Anesthesia ; Anesthesia, General ; Butorphanol ; Humans ; Ketamine* ; Ketorolac ; N-Methylaspartate ; Neurons ; Passive Cutaneous Anaphylaxis ; Spine*

The present study investigated the effects of QX-314 on inflammatory pain of the temporomandibular joint (TMJ). Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Under anesthesia, the TMJ of each animal was injected with 50 microL of formalin (5%). The number of noxious behavioral responses, including rubbing or scratching of the facial region including the TMJ area, was recorded over 9 sequential 5 min intervals for each animal. Although 2.5% QX-314 did not affect formalin-induced nociceptive behavior, administration of 5% QX-314 with formalin significantly decreased the number of scratches produced by the formalin injection. Co-administration of capsaicin, a TRPV1 agonist, with 2.5% QX-314 produced significant anti-nociceptive effects whereas 2.5% QX-314 alone did not. However, the co-administration of capsaicin did not enhance the anti-nociceptive effects in the 5% QX-314-treated rats. Moreover, the co-administration of capsazepine, a TRPV1 antagonist, did not attenuate anti-nociceptive effects in the 5% QX-314-treated rats. These findings suggest that TRPV1 is effective in the transport of low but not high doses of QX-314. Moreover, a high dose of QX-314, which is not mediated by peripheral TRPV1 activity, may be viable therapeutic strategy for inflammatory pain in the TMJ.
Anesthesia ; Animals ; Capsaicin* ; Formaldehyde ; Humans ; Male ; Pain Measurement ; Rats* ; Rats, Sprague-Dawley ; Temporomandibular Joint*