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Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review
( Jinseok Yeo ) 영남대학교 의과대학 2024 Yeungnam University Journal of Medicine Vol.41 No.1
Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.
근적외선 분광법을 이용한 열수 탄화 리그닌의 탄화 거동 예측 모델 개발
여환명 ( Hwanmyeong Yeo ),황성욱 ( Sung-wook Hwang ),이태경 ( Tae-kyeong Lee ),황운택 ( Un Taek Hwang ),김종찬 ( Jong-chan Kim ),최인규 ( In-gyu Choi ),박진석 ( Jinseok Park ),곽효원 ( Hyo Won Kwak ) 한국목재공학회 2021 한국목재공학회 학술발표논문집 Vol.2021 No.1
펄핑 공정의 부산물인 크라프트 리그닌을 이용하여 고성능 흡착재료를 개발하기 위한 전처리 단계로서 열수 탄화(hydrothermal carbonization, HTC)를 수행하였다. 열수 탄화는 유기성 폐기물 바이오매스를 일정 온도까지 승온시켜 탈수 반응을 유도하여 고형연료화를 도모하는 공정이다. 고액비 2/50의 리그닌 분말과 증류수의 현탁액을 온도 200℃에서 각각 1, 2, 3, 5, 10시간 동안 열수 탄화 후 자연 냉각하였다. 원소 분석기를 이용하여 HTC 리그닌 시료의 원소 조성을 조사하였으며, 근적외선(near-infrared, NIR) 스펙트럼을 측정하였다. NIR 스펙트럼은 2차 미분으로 전처리하였다. 탄소 함량은 열수 탄화 시간의 증가와 함께 증가하였으나 3시간 이후에는 유사한 수준이 유지되었다. 최소 제곱 회귀(partial least squares regression, PLSR)를 이용하여 NIR 스펙트럼을 입력 변수로 그리고 C(wt%), H/C, O/C를 각각 출력 변수로 하는 예측 모델을 수립하였다. 수립된 예측 모델은 모든 출력 변수를 결정 계수(R<sup>2</sup>) 0.9 이상의 높은 정확도로 예측하였다. NIR 스펙트럼의 전처리 여부에 상관없이 모델의 성능은 비슷하였다. PLSR 모델의 C 예측 성능은 R<sup>2</sup> 0.942였으며, 이 수치는 일반 최소 제곱 회귀 모델의 0.834를 크게 앞선다. 회귀 계수 분석으로부터 1450 nm 스펙트럼 영역에 할당된 리그닌의 페놀기가 탄화 거동을 설명하는 중요한 영역이라는 것이 확인되었다. NIR과 PLSR을 이용하여 HTC 리그닌의 탄화 특성을 빠르고 정확하게, 그리고 비파괴적으로 예측할 수 있었다.
( Jinyoung Oh ),( Jinseok Yeo ) 대한통증학회 2024 The Korean Journal of Pain Vol.37 No.1
Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.
Young Yeon Choi,Jun Seok Park,Soo Yeun Park,Hye Jin Kim,Jinseok Yeo,Jong-Chan Kim,Sungsik Park,Gyu-Seog Choi 대한외과학회 2015 Annals of Surgical Treatment and Research(ASRT) Vol.88 No.2
Purpose: Opioid-based intravenous patient-controlled analgesia (IV-PCA) is a popular method of postoperative analgesia, but many patients suffer from PCA-related complications. We hypothesized that PCA was not essential in patients undergoing major abdominal surgery by minimal invasive approach. Methods: Between February 2013 and August 2013, 297 patients undergoing laparoscopic surgery for colorectal cancer were included in this retrospective comparative study. The PCA group received conventional opioid-based PCA postoperatively, and the non-PCA group received intravenous anti-inflammatory drugs (Tramadol) as necessary. Patients reported their postoperative pain using a subjective visual analogue scale (VAS). The PCA-related adverse effects and frequency of rescue analgesia were evaluated, and the recovery rates were measured. Results: Patients in the PCA group experienced less postoperative pain on days 4 and 5 after surgery than those in the non-PCA group (mean [SD] VAS: day 4, 6.2 [0.3] vs. 7.0 [0.3], P = 0.010; and day 5, 5.1 [0.2] vs. 5.5 [0.2], P = 0.030, respectively). Fewer patients in the non-PCA group required additional parenteral analgesia (41 of 93 patients vs. 53 of 75 patients, respectively), and none in the non-PCA group required rescue PCA postoperatively. The incidence of postoperative nausea and vomiting was significantly higher in the non-PCA group than in the PCA group (P < 0.001). The mean (range) length of hospital stay was shorter in the non-PCA group (7.9 [6?10] days vs. 8.7 [7?16] days, respectively, P = 0.03). Conclusion: Our Results suggest that IV-PCA may not be necessary in selected patients those who underwent minimal invasive surgery for colorectal cancer.