Associated Factors with Pin-fixing & Pin removal Pain among Patients Undergoing Gamma Knife Radiosurgery

So Young Baek; Ja Yun Choi

doi:10.5388/aon.2012.12.4.323

Journal List > Asian Oncol Nurs > v.12(4) > 1081751

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Baek and Choi: Associated Factors with Pin-fixing & Pin removal Pain among Patients Undergoing Gamma Knife Radiosurgery

Original Article

Asian Oncology Nursing

Asian Oncology Nursing 2012; 12(4): 323-330.

Published online: 31 December 2012

DOI: https://doi.org/10.5388/aon.2012.12.4.323

Associated Factors with Pin-fixing & Pin removal Pain among Patients Undergoing Gamma Knife Radiosurgery

So Young Baek¹, Ja Yun Choi²

¹Hwasun Chonnam National University Hospital, Hwasun, Korea.

²College of Nursing, Chonnam National University · CRINS, Gwangju, Korea.

Address reprint requests to: Choi, Ja Yun. College of Nursing, Chonnam National University, 5 Hak-dong, Dong-gu, Gwangju 501-746, Korea. Tel: +82-62-220-4343, Fax: +82-62-225-3307, choijy@chonnam.ac.kr

Received 6 November 2012 Accepted 23 December 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Gamma knife radiosurgery (GKR) requires frame positioning because the treatment target should be as close as possible to the center of the frame. The purpose of this study was to identify the level of pin-fixing (PFP) and removal pain (PRP), and the associated factors with the pain undergoing GKR.

Methods

A total of 116 patients who underwent GKR for their brain tumor were recruited from C University hospital located in H city, J province. The level of pain was measured by the 10 cm VAS.

Results

The level of PFP and PRP were 6.36 and 3.26 points, respectively. Step-wise multiple regressions found that the group who have not perceived numbness after applying 5% EMLA cream was the highest associated factor with PFP, following the time from lidocaine injection to pin-fixation, which explained 21% of total variance of the level of PFP. On the other hand, a group who did not perceive numbness after applying 10% lidocaine spray was the highest factor with PRP, among female patients, which explained 27% of total variance of the level of PRP.

Conclusion

Both of PFP and PRP of the stereotactic frame were moderate so that nurses should consider diverse strategies to reduce pain among patients undergoing gamma knife radiosurgery.

Keywords: Gamma Knife Radiosurgery, Pain, Precipitating Factors

Figures and Tables

Table 1

Pin-fixing Pain and Pin-removal Pain according to General Characteristics (N=116)

Table 2

Pin-fixing Pain and Pin-removal Pain according to Disease and Procedural Characteristics (N=116)

GKR=gamma knife radiosurgery; EMLA=Eutectic mixture of local anaesthetics.

Table 3

Correlation of Pain related to Stereotatic Frame with Psychosocial Characteristics (N=116)

Table 4

Factors Associated with Pin Fixation Pain of Stereotatic Frame (N=116)

Adj=Adjustment; EMLA=Eutectic mixture of local anaesthetics.

Table 5

Factors Associated with Pin Removal Pain of Stereotatic Frame (N=116)

Adj=Adjustment.

Notes

This article is a condensed form of the first author's master's thesis from Chonnam National University.

References

1. Kwo Y. Stereotactic radiosurgery in Korea with the 1st Asian gamma knife unit. New Med J. 1992. 35:55–60.

2. Gerosa M, Nicolato A, Foroni R. The role of gamma knife radiosurgery in the treatment of primary and metastatic brain tumors. Curr Opin Oncol. 2003. 15:188–196.

3. Vesper j, Boike B, Wille C, Gerber PA, Matuschek C, Peiper M, et al. Current concepts in stereotatic radiosurgery: A neurosurgical and radiooncological point of view. Eur J Med Res. 2009. 14:93–101.

4. Chin LS, Lazio BE, Biggins T, Amin P. Acute complications following gamma knife radiosurgery are rare. Surg Neurol. 2000. 53:498–502.

5. Linzer D, Ling SM, Villalobos H, Raub W, Wu X, Ting J, et al. Gamma knife radiosurgery for large volume brain tumors: An analysis of acute and chronic toxicity. Stereotact Funct Neurosurg. 1998. 70:suppl 1. 11–18.

6. Jeong SS, Chung HT, Paek SH, Kim DG. A report to improve satisfaction and hospital length of stay of gamman knife surgery patients. J Korean Soc Qual Assur Health Care. 2001. 8:74–83.

7. Ha SY. The effect of Shinmun and Naegwan Semen Sinapsis Albae stimulus on state anxiety and pain of regional anesthesia patients during the gamma knife surgery [dissertation]. 2007. Busan: Busan Catholic Univ..

8. Carta G, Palermo P, Marinangeli F, Piroli A, Necozione S, De Lellis V, et al. Waiting time and pain during office hysteroscopy. J Minim Invasive Gynecol. 2012. 19:360–364.

9. Knežević MM, Vlajković GP, Stojković MŽ, Rašić D, Stanković BR, Božić MM. Comparison of postoperative pain and satisfaction after dacryocystorhinostomy in patients operated on under local and general anesthesia. Med Sci Monit. 2012. 18:CR265–CR270.

10. Lidén Y, Landgren O, Arnér S, Sjölund KF, Johansson E. Procedure-related pain among adult patients with hematologic malignancies. Acta Anaesthesiol Scand. 2009. 53:354–363.

11. Talamo G, Liao J, Joudeh J, Lamparella NE, Dinh H, Malysz J, et al. Perceived levels of pain asssociated with bone marrow sspirates and biopsies. J Support Oncol. 2012. 10:166–170.

12. Lee S, Rhim H, Kim YS, Choi D, Lee WJ, Lim HK, et al. Percutaneous radiofrequency ablation of hepatocellular carcinomas: factors related to intraprocedural and postprocedural pain. AJR Am J Roentgenol. 2009. 192:1064–1070.

13. Saraçoğlu T, Unsal A, Taşkın F, Sevinçok L, Karaman CZ. The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound-guided prostate biopsy. Diagn Interv Radiol. 2012. 18:195–199.

14. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007. 39:175–191.

15. Snyder-Halpern R, Verran JA. Instrumentation to describe subjective sleep characteristics in healthy subjects. Res Nurs Health. 1987. 10:155–163.

16. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983. 67:361–370.

17. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Korean. J Korean Neuropsychiatr Assoc. 1999. 38:289–296.

18. Park JY. A study to development a scale of social support [dissertation]. 1985. Seoul: Yonsei Univ..

19. Oh HS. The effect of topical EMLA cream on venipuncture related pain, anxiety and physiologic variables of preoperative autologous blood deposit patients [dissertation]. 2009. Seoul: Kyung Hee Univ..

20. Lee GN. The effects of aroma massage to arterio-venous fistula region on pain and anxiety in needling under hemodialysis [dissertation]. 2010. Gangneung: Kwandong Univ..

21. An SN. Effect of EMLA cream to relieve pain at venipuncture in preschooler [dissertation]. 2011. Daejun: Eulji Univ..

22. Kim KS. Comparison of local anesthetic ointment to warm pack therapy for pain relief during arteriovenous fistula puncture in hemodialysis patients [dissertation]. 2011. Suwon: Ajou Univ..

23. Lee YH, Kim NC. The comparison of effects of 2% lidocaine intradermal injection and 10% lidocaine spray for pain and anxiety relief on arteriovenous fistula punction in hemodialysis patients. J Korean Clin Nurs Res. 2007. 13:169–177.

24. Lee DI. Local anesthesia: Anesthesiology and pain medicine. 2004. eds. Seoul: Ryo Moon Gak.

25. Kim TK, Chung SM, Kim IB, Kim KH. Effect of local anesthesia for nasogastric tube placement. J Korean Soc Emerg Med. 2001. 12:433–438.

26. Tekaya R, Sahli H, Besghaier L, Saidane O, Abdelmoula L, Chaabouni L, et al. Procedural pain assessment after spinal injections of corticosteroid. Tunis Med. 2012. 90:219–222.

27. Stotts NA, Puntillo K, Stanik-Hutt J, Thompson CL, White C, Wild LR. Does age make a difference in procedural pain perceptiona and responses in hospitalized adult? Acute Pain. 2007. 9:125–134.

28. Perrot S, Laroche F, Marie P, Payen-Champenois C. Are there risk factors for musculoskeletal procedural pain? A national prospective multicentre study of procedural instantaneous pain and its recall after knee and spine injections. Joint Bone Spine. 2011. 78:629–635.

TOOLS

Similar articles