• Title/Summary/Keyword: 국소 마취

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THE TOPICAL ANESTHESIA WITH EMLA CREAM IN CHILDREN : A CASE REPORT (소아에서 EMLA cream을 이용한 도포마취 : 증례보고)

  • Kim, He-Jin;Ko, Sung-Back;Hong, Seong-Soo;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.1
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    • pp.69-75
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    • 2002
  • A number of techniques may be employed to reduce the discomfort of syringe or needle for dental care. The use of topical anesthesia is one such method. Topical anesthetics are applied to alleviate pain during many clinical procedures, such as injection of local infiltration anesthetics, primary tooth extraction, X-ray taking of sensitive patients, reducing gag reflex prior to impression taking. In children, placement of a rubber dam clamp, however, may cause significant discomfort for purpose of pit and fissure sealant and preventive resin restoration(PRR). A topical anesthetic would be beneficial to aid in rubber dam placement for this purpose. It has been suggested that all intra-oral topical anesthetics are equally effective on reflected mucosa, however EMLA(an acronym for eutectic mixture of local anesthetics), which was developed in the 1980s and produces surface anesthesia of skin, has been shown to be more effective than conventional topical anesthetics when used on attached gingivae. This report is topical anesthesized 4 case by EMLA cream, who showed better effect in reducing the pain of infiltration anesthesia, extraction of deciduous teeth, rubber dam clamp placement and reducing the pain of preformed crown adaptation.

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Paresthesia After Inferior Alveolar Nerve Block and Infiltration Anesthesia for Implant Surgery on Mandibular Left First Premolar (하악 좌측 제1소구치 부위의 임플란트 식립을 위한 하치조신경 국소마취 후 발생한 Paresthesia)

  • Jo, Ji-Hun;Lee, Kang-Hee;Pang, Nam-Sim;Park, Wonse;Kim, Kee-Deog;Jung, Bock-Young
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.2
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    • pp.39-44
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    • 2013
  • Most of the dental treatments have been routinely performed under the local anesthesia and the effectiveness has also been proved safe. However, even not frequently dentists face some complications associated with the local anesthesia. In this report, the experience of the paresthesia after mental nerve block anesthesia for an implant placement of the mandibular premolar was presented to raise awareness of the complications related with local anesthetic procedure and to discuss about the causes, the proper treatments and the preventive approach of the paresthesia.

Study on Effect of Pressure-Controlled Injection System in Dental Local Anesthesia (치과용 국소마취 주사시 압력조절형 주사장치 사용의 효과에 대한 연구)

  • Yun, Pil-Young;Kim, Young-Kyun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.6 no.2 s.11
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    • pp.98-102
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    • 2006
  • The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

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Bleeding & Infection Control by the Circumferential Suture & Drainage on Active Bleeding Extraction Socket under Sedation And Local Anesthesia in a Multiple Medically Compromised Patient with Anticoagulation Drug (항응고제 투여중인 다발성 전신질환자에서 과도한 발치창 출혈부의 진정요법과 국소마취 시행하에 창상주위 봉합과 배농술 통한 출혈과 감염조절)

  • Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.177-182
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    • 2011
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

Peripheral Nerve Injuries Related to Local Dental Clinic Anesthesia in the Dental Clinic (치과에서 발생하는 국소마취에 의한 신경손상)

  • Kim, Hyun Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.89-94
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    • 2014
  • Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

Implementation of The Drug Infuser with Active Pressure Control Method (능동적 압력조절이 가능한 약물주입기 구현)

  • Cho, Seong-Beom;Noh, Yun-Hong;Moon, Chang-Su;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2012.05a
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    • pp.817-818
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    • 2012
  • 본 연구에서는 치과에서 마취 시 환자들의 고통을 최소화 하기위하여 무통마취를 위한 치과용 약물주입기를 구현하였다. 약물의 주입 시 통증을 최소화하기 위해서 온도를 $36{\pm}2^{\circ}C$ 범위로 제어하여 체온과 유사한 온도로 유지하였다. 이를 위하여 필름히터 방식을 이용한 치과범용국소약물(36mg, 2% 리도카인) 앰플 가열부를 설계하였다. 또한 약물이 주입되는 양을 능동적으로 제어하기 위하여 약물주입 환부의 환자별 흡수 속도 차이에 차등 주입을 위한 압력 측정 시스템을 구현하였다. 필름 형태의 압력 센서를 통하여 전달 압력을 측정하였으며 측정된 압력을 바탕으로 능동적으로 모터의 동작을 제어함으로써 약물주입시 환자의 고통을 최소화 할 수 있도록 구현하고자 하였다.

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상완 이두 건 장 두의 부분 파열

  • 김영규
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.83-89
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    • 2004
  • 상완 이두 건 부분 파열은 관절경 검사를 시행하지 않는 한 진단이 매우 어렵다. 이학적 검사는 대체적으로 비특이적이나 이두 구 근처에서 압통의 유무를 확인하는 것이 중요하며 이두 구에 마취제 국소 주사가 진단에 도움이 될 수 있다. 치료로는 보존적 치료를 중요시하여야 하나 지속적인 동통이 존재할 경우에는 동통으로 인한 일상생활의 제한 및 견관절 기능의 소실을 고려하여 적극적인 수술적 치료가 요할 것으로 사료되며. 특히 고령의 경우 이두 구 근처에서의 상완 이두 건 부분 파열은 건 유리술이 도움이 될 것으로 생각된다.

Perioperative Pain Management Using Regional Nerve Blockades in Shoulder Surgery: Ultrasound-Guided Intervention (견관절 수술 시 국소신경 차단술을 이용한 통증 관리 - 초음파 유도하 중재술 -)

  • Oh, Joo Han;Lee, Ye Hyun;Park, Hae Bong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.67-75
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    • 2014
  • There are several kinds of regional nerve blockades, such as interscalene brachial plexus block, C5 root block, suprascapular nerve block, and axillary nerve block, which can be applied for anesthesia and postoperative pain control after shoulder surgeries. These regional nerve blockades have shown good results, but high failure rate and serious complications, such as phrenic nerve palsy, pneumothorax, and nerve injury, still remain. Ultrasound-guided intervention can increase the success rate of nerve blockades and reduce complications. We described the method of ultrasound-guided intervention for the regional nerve blockades around shoulder.

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A Preliminary Experiment and Analysis of Anesthetic-Lidocaine Drug Delivery by Iontophoresis (Iontophoresis를 이용한 국소마취제-Lidocaine의 기초 방출실험 및 분석)

  • Park, Gun-Woo;Ha, Sang-Wook;Song, Tae-Eun;Kim, Dae-Yun;Kim, Dong-Bok;Yang, Sang-Sik;Pak, Jung-Ho
    • Proceedings of the KIEE Conference
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    • 2004.07d
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    • pp.2696-2698
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    • 2004
  • Iontophoresis를 이용한 경피전달용 약물 패치를 제작하기 위해 고분자의 종류, 전류크기, 시간에 따른 약물방출 결과를 발표한다. 고분자 Hydroxy Propyl Methyl Cellulose(HPMC), Hydroxy Propyl Cellulose(HPC), Hydroxy Ethyl Cellulose(HEC)에 각각 국소마취제-Lidocaine을 넣어 시료를 제작하였다. 약물 방출은 Drug Delivery Cell(DDC)위에 Ag/AgCl 전극 (anode), Pt wire 전극(cathode)을 각각 설치하여 전압인가에 따른 이온 유동으로부터 시간에 따른 전압/전류변화 및 약물농도를 고찰하였다. 전압 15V 인가 시 고분자 막과 전해질 사이에 흐르는 전류 1.0mA는 15분간 유지되지만, Ag/AgCl 전극의 산화작용으로 인해 전류는 서서히 감소하며 26분 후 거의 흐르지 않았다. 따라서 안정적인 전류로 유지되는 시간을 15분으로 최적화하였다. 고분자 중 HPMC 막을 사용하여 약물방출 실험을 한 경우 UV 분석결과 파장 262.26nm에서 최대 흡광도 0.238이었고, 가장 높은 약물농도가 나타났다. 이러한 HPMC의 약물방출 실험결과 비교적 높은 전류 1.0mA일 때 약물 방출량이 많았고, 동일한 전류 0.4mA를 장시간 흐르게 하였을 경우, 농도가 축적되므로 치료 가능한 안정적인 특성임을 확인하였다.

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Preparation of Biodegradable PLGA Microspheres for Sustained Local Anesthesia and Their in vitro Release Behavior (지속적인 국소마취를 위한 생분해성 PLGA 미립구의 제조와 생체외 방출 거동)

  • 조진철;강길선;최학수;이종문;이해방
    • Polymer(Korea)
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    • v.24 no.5
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    • pp.728-735
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    • 2000
  • Fentanyl-loaded biodegradable poly(L-lactide-co-glycolide) (75 : 25 by mole ratio of lactide to glycolide, PLGA) microspheres (MSs) were prepared to study the possibility for long-acting local anesthesia. We developed the fentanyl base (FB, slightly water-soluble)-loaded PLGA MSs by means of conventional O/W solvent evaporation method. The size of MSs was in the range of 10~150 ${\mu}{\textrm}{m}$. The morphology of MSs was characterized by SEM, and the in vitro release amounts of FB were analyzed by HPLC. The lowest porous cross-sectional morphology and the highest encapsulation efficiency were obtained by using gelatin as an emulsifier. The influences of several preparation parameters, such as emulsifier types, molecular weights and concentrations of PLGA, and initial drug loading amount, etc., have been observed in the release patterns of FB. The release of FB in vitro was more prolonged over 25 days, with close to zero-order pattern by controlling the preparation parameters. We also investigated the physicochemical properties of FB-loaded PLGA MSs by X-ray diffraction and differential scanning calorimeter.

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