Journal of Yeungnam Medical Science

Original article

Anesthesiology and Pain Medicine
Effect of intraoperative music on quality of recovery after arthroscopic knee surgery: a prospective, double-blind, randomized controlled trial: Ji yong Yeom, Soomin Kim, Hyeon Seung Yi, Juhee Min, Eun Kyung Choi; J Yeungnam Med Sci. 2026;43:29. Published online April 9, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.29 [Epub ahead of print]

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Abstract PDF: Background
Various perioperative therapeutic strategies have been used to minimize postoperative complications and enhance recovery. Music intervention has attracted increasing attention as a safe, noninvasive, and cost-effective approach with potential benefits for patient-centered postoperative outcomes. Accordingly, this study investigated the effect of intraoperative music on postoperative recovery quality, as assessed using the Quality of Recovery-40 (QoR-40) questionnaire, as well as its potential analgesic and antiemetic effects in patients undergoing arthroscopic knee surgery.
Methods
Eighty-two patients were enrolled and allocated to either the music or control group. In the music group, patient-selected tracks were delivered intraoperatively via headphones. Postoperative recovery quality was assessed using the QoR-40 at 24 hours. Pain was evaluated 30 minutes, 2 hours, and 24 hours after arrival in the post-anesthesia care unit. The incidence of postoperative nausea and vomiting (PONV) was recorded at all time points.
Results
Although the total QoR-40 scores did not differ between the groups, the music group demonstrated significantly higher physical comfort scores (p=0.006). The incidence of PONV at 24 hours was lower in the music group (p=0.048), whereas the postoperative pain scores and rescue analgesic requirements showed no significant differences at any assessment point.
Conclusion
In patients undergoing arthroscopic surgery, intraoperative music was associated with improvements in physical comfort and PONV, despite no significant difference in the total QoR-40 score.

Review articles

Anesthesiology and Pain Medicine
Acute postoperative pain control in pediatric patients: a scoping review: Eun Kyung Choi, Sang-Jin Park, Seong Wook Hong; J Yeungnam Med Sci. 2026;43:1. Published online December 10, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.1

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Abstract PDF: Acute postoperative pain results from tissue injury during surgery and subsequent inflammatory responses. The incidence of chronic postsurgical pain ranges from 10% to 30%, and its development is influenced by various clinical factors, including psychological, biological, and social determinants. Optimal management of acute postoperative pain is crucial for enhancing patient satisfaction, preventing adverse outcomes in the immediate postoperative period, and minimizing progression to chronic postoperative pain. In particular, postoperative pain in pediatric patients is often underestimated and inadequately managed because of developmental differences in pain perception, expression, and challenges in assessment. Therefore, age-appropriate and validated assessment tools that consider cognitive development and situational factors are required. Given age-related variability in pharmacokinetics and pharmacodynamics, individualized multimodal analgesic strategies with careful dose adjustments should be utilized. These approaches have demonstrated improved analgesic efficacy and enhanced recovery outcomes in pediatric surgical patients. A comprehensive understanding of pediatric pain pathophysiology, combined with appropriate methods of pain assessment and management strategies, should be selected to promote postoperative recovery and reduce morbidity.

Anesthesiology and Pain Medicine
Regional analgesia for postoperative pain control after thoracic surgery: a narrative review: Sang-Jin Park, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:80. Published online December 4, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.80

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Abstract PDF: Effective management of post-thoracotomy pain is essential to prevent pulmonary complications and reduce the risk of developing chronic pain syndrome. Although systemic opioids remain a common option, their use is limited by significant adverse effects, making regional analgesia the cornerstone of postoperative pain management. Thoracic epidural analgesia, historically regarded as the gold standard, provides potent postoperative pain relief but carries risks of hypotension and, in rare cases, severe neurological events. Thoracic paravertebral block (PVB) has emerged as the primary alternative, offering comparable analgesic efficacy and an improved safety profile, particularly in maintaining hemodynamic stability. However, PVB is technically demanding and associated with a higher failure rate and localized procedural complications such as pneumothorax. Fascial plane blocks have recently been developed to prioritize safety. The erector spinae plane block is technically simpler, using the transverse process as a “bony backstop” to minimize the risk of pleural injury; however, its analgesic potency may be lower than that of PVB. The intertransverse process block seeks to combine the efficacy of PVB with enhanced safety; however, supporting evidence remains limited. Alternative regional techniques, such as serratus anterior plane block, intercostal nerve block, and continuous wound instillation, typically provide insufficient analgesia for the comprehensive pain associated with open thoracotomy. No regional analgesic technique has demonstrated universal superiority. The optimal approach should be individualized, balancing the distinct risk–benefit profile of each block with patient comorbidities, surgical factors, and institutional expertise.

Original articles

Anesthesiology and Pain Medicine
Comparison of the protective effects of infliximab and splenectomy on hepatic ischemia-reperfusion injury in rats: an experimental study: Shiback Lee, Deokhee Lee, Youngjun Jang, Dong Gun Lim, Kyung Hwa Kwak, Hoon Jung, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:72. Published online November 10, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.72

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Abstract PDF: Background
Hepatic ischemia-reperfusion injury (IRI) is a complex process involving multiple mediators that initiate inflammatory responses, ultimately leading to cell necrosis and apoptosis. During hepatic IRI, various inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), and reactive oxygen species (ROS) exacerbate liver injury. Infliximab is an antibody that neutralizes TNF-α, and suppression of TNF-α activity with infliximab treatment can protect the liver from IRI. Splenectomy also alleviates hepatic IRI by decreasing neutrophil infiltration, reducing the release of ROS into the hepatic sinusoids, and suppressing TNF-α release. This study aimed to evaluate the effects of infliximab on hepatic IRI based on inflammatory responses, oxidative stress, and apoptosis, and to compare these effects with those of splenectomy.
Methods
Twenty-four rats were randomly assigned to the following four groups: (1) sham, (2) hepatic ischemia-reperfusion (IR), (3) hepatic IR with 10 mg/kg infliximab, and (4) hepatic IR with splenectomy. Each group consisted of six rats. Hepatic ischemia was induced for 30 minutes, followed by 2 hours of reperfusion injury. Infliximab was administered intraperitoneally 1 hour before surgery and splenectomy was performed immediately before hepatic ischemia.
Results
Infliximab and splenectomy downregulated the levels of liver enzymes (aspartate aminotransferase [p<0.001 for all] and alanine aminotransferase [p<0.001 for all]), a prooxidant (malondialdehyde [p=0.006 for infliximab; p<0.001 for splenectomy]), inflammatory cytokines (TNF-α and nuclear factor kappa B [p<0.001 for all]), and an apoptotic mediator (caspase-3 [p=0.005 for infliximab; p=0.004 for splenectomy]) compared with those with hepatic IR alone.
Conclusion
Infliximab treatment and splenectomy mitigated hepatic IRI. These protective effects are likely mediated via anti-inflammatory, antioxidative, and antiapoptotic pathways within the pathophysiology of hepatic IRI.

Anesthesiology and Pain Medicine
Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial: Eun Kyung Choi, Saeyoung Kim, Do young Kim; J Yeungnam Med Sci. 2023;40(3):247-251. Published online March 30, 2022; DOI: https://doi.org/10.12701/jyms.2022.00129

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Abstract PDF

Background
While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia.
Methods
Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed.
Results
No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery.
Conclusion
PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.

Citations

Citations to this article as recorded by

Short-term and long-term effects of sevoflurane inhalation vs propofol total intravenous anesthesia in gastrectomy for gastric cancer
Zhi Wang, Ji-Wen Cheng, Kuai-Yun Yu
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery
Zhuolin Shu, Tiancheng Lin, Dingchen Xu, Shuyuan Zheng
Frontiers in Medicine.2024;[Epub] CrossRef

Review article

Anesthesiology and Pain Medicine
Hepatic ischemia-reperfusion injury with respect to oxidative stress and inflammatory response: a narrative review: Eun Kyung Choi, Dong Gun Lim; J Yeungnam Med Sci. 2023;40(2):115-122. Published online March 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00017

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Abstract PDF

Hepatic ischemia-reperfusion injury is a major complication of liver transplantation, trauma, and shock. This pathological condition can lead to graft dysfunction and rejection in the field of liver transplantation and clinical hepatic dysfunction with increased mortality. Although the pathological mechanisms of hepatic ischemia-reperfusion injury are very complex, and several intermediators and cells are involved in this phenomenon, oxidative stress and inflammatory responses are the key processes that aggravate hepatic injury. This review summarizes the current understanding of oxidative stress and inflammatory responses and, in that respect, addresses the therapeutic approaches to attenuate hepatic ischemia-reperfusion injury.

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Case report

Anesthesiology and Pain Medicine
Reverse Takotsubo cardiomyopathy with left bundle branch block after anesthesia induction in a patient with subarachnoid hemorrhage: a case report: Eun Kyung Choi, Jong-Hoon Kim, Minhyun Kim; J Yeungnam Med Sci. 2022;39(2):172-178. Published online October 25, 2021; DOI: https://doi.org/10.12701/yujm.2021.01354

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Abstract PDF

Cardiac dysfunction after subarachnoid hemorrhage (SAH) is described as Takotsubo or reverse Takotsubo cardiomyopathy that shows transient left ventricular wall motion abnormalities with electrocardiogram (ECG) changes. ST change followed by T inversion is a common ECG finding complicated with these disorders, left bundle branch block (LBBB) may be a potential ECG pattern which is seen. In this case, we describe the clinical profile and outcomes of a patient with LBBB and reverse Takotsubo cardiomyopathy after anesthetic induction, which was scheduled as an emergent external ventricular drainage after SAH. This is the first report of an LBBB pattern in reverse Takotsubo cardiomyopathy.

Citations

Citations to this article as recorded by

Diagnosis and Management of Takotsubo Syndrome in Acute Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review
Dorottya Szántó, Péter Luterán, Judit Gál, Endre V. Nagy, Béla Fülesdi, Csilla Molnár
Reviews in Cardiovascular Medicine.2023;[Epub] CrossRef

Case Report

Anesthesiology and Pain Medicine
Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome: Sang-Jin Park, Eun Kyung Choi, Suyong Park, Kunjin Bae, Deokhee Lee; Yeungnam Univ J Med. 2018;35(2):219-221. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.219

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Abstract PDF: Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Original Article

Anesthesiology and Pain Medicine
Effect of preoperative pregabalin on postoperative pain after gastrectomy: Chan Yoon Park, Sol Hee Park, Dong Gun Lim, Eun Kyung Choi; Yeungnam Univ J Med. 2018;35(1):40-44. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.40

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Abstract PDF

Background
Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.
Methods
Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period.
Results
The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.
Conclusion
A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

Citations

Citations to this article as recorded by

Treatment of acute postoperative pain in patients undergoing open abdominal aortic repair (current state of the problem)
Anzhelika V. Kozhanova, Georgy P. Plotnikov
Regional Anesthesia and Acute Pain Management.2022; 16(1): 45. CrossRef
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Indian Journal of Clinical Anaesthesia.2022; 9(4): 467. CrossRef

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