• Journal of the Korea Convergence Society
• /
• v.12 no.12
• /
• pp.573-581
• /
• 2021

This study aims to investigate the awareness, nursing needs, and nursing satisfaction of conscious sedation, and their relationships in the guardians of hospitalized children receiving conscious sedation. Data were collected from 120 guardians of children who were admitted to the pediatric ward of University Hospital C in D city from July 6 to October 6, 2016 and received conscious sedation as a pretreatment for diagnostic tests. The result showed that the guardians' awareness was relatively low (2.49±0.83) and nursing needs (4.53±0.40) was found to be significantly higher than nursing satisfaction (3.81±0.56)(p<.001). Awareness showed a significant positive correlation with nursing satisfaction (r=.18, p=.048) and there was a significant positive correlation between nursing needs and satisfaction (r=.20, p=.033). This result suggested that in order to improve the nursing satisfaction of the guardians, it is necessary to understand the awareness and nursing needs of the guardians on conscious sedation. In addition, the development of customized nursing intervention should be carried out based on the awareness and nursing needs.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.1
• /
• pp.13-17
• /
• 2007

At Sedation Clinic of Department of Dentistry in Hanyang University Medical Center, total 92 dental treatments under intravenous conscious sedation using midazolam alone for 80 patients were carried out from March 2006 to February 2007. Following the previous article concerning our sedation protocol, the retrospective analyses of our cases were presented in detail. By the evidence-based approach, we hope that our study will help the general dental practitioners perform the intravenous conscious sedation using midazolam alone safely and effectively.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.412-420
• /
• 2004

The purpose of this study was to assess the anterograde amnesic effect of Midazolam administrated by intranasal and oral route. Fifteen healthy volunteers(ASA I) were administrated with placebo, oral Midazolam(15mg), intranasal Midazolam(0.25mg/kg) every 2 weeks. First picture cards were shown to volunteers before medication. At 15, 30, 45 minutes, other picture cards were shown to volunteers. BP, $SpO_2$ and sedation scores were measured. After 24 hours, the volunteers were questioned about their memory of pictures. To assess amnesic effect, recall and recognition test were performed using a series of picture cards designed for this purpose. The obtained results were as follows; 1. Compared to placebo, Midazolam group(oral and intranasal) experienced a significant anterograde amnesic effect(P<0.01) 2. There was no difference between oral and intranasal Midazolam(P>0.01). 3. Anterograde amnesic effect of oral and intranasal Midazolam group began at 15minutes. It became increasingly, oral Midazolam group experienced extremely amnesic effect at 45minutes, intranasal Midazolam group was at 30minutes. 4. After 30minutes of Midazolam administration, anterograde amnesia of oral Midazolam group is more effective than intranasal Midazolam group.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.3
• /
• pp.430-440
• /
• 2001

Orally administered chloral hydrate is often used, because of it's wide margin of safety and relatively few sideeffects. Hydroxyzine is an antihistamine with sedative and anti-emetic properties. It has been used in conjunction with chloral hydrate to reduce the incidence of nausea and vomiting. But, it's therapeutic drug concentration has not been established. The purpose of this study was to assess the sedative effect and physiologic parameter of hydroxyzine of different doses in sedating young pediatric dental patients. Fifty uncooperative children, mean age 33.2 months, who needed at least four separate restorative visits, requiring local anesthesia participated in this study. On every visit, one of the following 4 different sedative regimen was given (1) 70mg/kg CH (2) 70mg/kg CH and 1mg/kg HD (3) 70mg/kg CH and 2mg/kg HD (4) 70mg/kg CH and 3mg/kg HD. Physiologic parameter was recorded and behavior was videotaped and rated using Ohio State University Behavior Rating Scale by one investigator, blind to the dose. The analyzed sedative effect of combined oral administration of 70mg/kg chloral hydrate and 2mg/kg hydroxyzine was superior to the other regimens. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.2
• /
• pp.126-130
• /
• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.431-438
• /
• 2004

The purpose of present study was to compare the sedative effect of intranasal and oral midazolam treatment. The study was conducted on twenty eight child patients who required at least two visits. All the patients showed a good physical status (ASA-I). The patient was randomly assigned to receive midazolam either intranasal (Group I, 0.25 mg/kg) or oral (Group II, 0.5mg/kg) route at each visit. Treatment procedure was divided into six stages. In each stage, sleep score, crying score, movement score and overall behavior score were evaluated. The overall results can be summarized as follows: 1. Through all treatment procedures, no significant difference was observed between Group I and Group II in terms of sleep, crying, movement and overall behavior index. 2. In a questionnaire to the parents, 67.8% of parents answered that the child suffered at intranasal administration, while only 17.7% of parents responded the same way at oral administration. 3. In a questionnaire regarding patients' behavior at home after midazolam treatment, 'Similar to normal behavior' was 78.6% in Group I and 57.1% in Group II, indicating that intranasal treatment of midazolam may be more effective for the recovery.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.27 no.4
• /
• pp.505-516
• /
• 2000

Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time of Chloral hydrate. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This study was designed to test the efficacy of one sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with mixed gas of Enflurane(2vol%) and $N_2O(50%)-O_2(50%)$ for $60\sim120$ seconds to 35 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The Result of this regimen was compare to those of two oral regimen of Chloral hydrate/Hydroxyzine and Chloral hydrate only Analyses of result on vital signs and behavior pattern were performed. The outcome of the study suggest that sleep induction by a short inhalation of low dose of $Enflurane/N_2O-O_2$ provide dentist with suitable condition for the completion of scheduled treatment in the patient who failed to oral Chloral hydrate. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.3
• /
• pp.441-446
• /
• 2001

Flumazenil is a competitive antagonist of benzodiazepines. It is usually administered intravenously. However, if the intravenous route is not available then other routes of drug administration should be considered. This study was designed to evaluate the reversal effects of flumazenil after nasal administration. Twenty-five young, healthy adult volunteers participated in this clinical trial. The dosage of 0.08mg/kg midazolam was administered intravenously to induce deep sedation. Ten minutes after midazolam administration, 0.5mg of flumazenil was dropped nasally, over a period of one minute. Blood samples were taken to measure the concentration of midazolam and flumazenil at 0, 5, 10, and 20min after nasal administration of flumazenil, using High Performance Liquid Chromatography. The degree of sedation was evaluated with sedation score and bispectral index (BIS), Statistical analysis was performed by multivariate ANOVA and correlation analysis (P<0.05). Peak serum flumazenil concentration was reached in 10min. Sedation score decreased after midazolam administration and showed a significant increase after flumazenil administration. However, BIS decreased during the first 10min after midazolam administration and then no significant changes after flumazenil administration. There were two instances representing rapid and complete reversal of midazolam after intranasal administration of flumazenil. In conclusion, intranasal flumazenil administration may be effective in some patients when intravenous route is not available in condition of benzodiazepine overdose.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.29 no.2
• /
• pp.204-209
• /
• 2002

The purpose of this survey was to investigate parental recognition and preference on pediatric dentist and their behavior management technique. The subjects were the parents of new children visiting the Department of Pediatric Dentistry, Pusan National University Hospital for 6 months. The questionnaire was performed over 2 times : at 1st visit and 1 month after that. The parental preference about pediatric dentist - one's sex, color of gown and glass-wearing - and about behavior management technique - parental separation, oral sedation, voice control and physical restraints-were asked through the questionaire and obtained the results were as fellows: 1. The preference on sex of dentists was not shown. 2. The parents recognized not so close relation between glass-wearing and children's anxiety level, but on color of gown, showed various opinions. 3. Most parents opposed to the separation from their children in operatory. 4. For the behavior management technique, parents accepted generally. 5. There was no significant difference between the first and second survey.