• Title/Summary/Keyword: 전달마취

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A CLINICAL STUDY OF ANESTHETIC EFFICACY OF ALKALINIZING LIDOCAINE IN INFERIOR ALVEOLAR NERVE BLOCKS (하치조신경 전달 마취 시 알칼리화 된 리도카인의 마취 효능에 관한 임상적 연구)

  • Kim, Tae-Hwan;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.3
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    • pp.276-282
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    • 2005
  • Inferior alveolar nerve block using lidocaine is the most frequent local anesthetic method in the dental treatment, but clinically it is not always successful. The 2% lidocaine cartridge has been used commonly in dental anesthesia. It contains vasoconstrictor and antioxidant, which presents low pH which provides chemical stability and longer shelf life. But alkalinized local anesthetics has less tissue trauma, easier dissociation of the non-ionized base which penetrates nerve sheath, rapid onset and more intensity. In this study, in inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate (experimental group) is compared with plain lidocaine (control group) about injection pain, anesthetic onset, duration and postinjection discomfort. In inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate showed lower injection pain. There was significant difference statistically from plain lidocaine(p=0.019). Comparing with plain lidocaine, alkalinized lidocaine produced more rapid onset (lip & pulp anesthetic onset), there was no significant difference(p>0.05). but there was boundary significance (0.050.05). These results suggest that addition of sodium bicarbonate to 2% lidocaine(1:100,000 epinephrine) for inferior alveolar nerve block is more effective for reduction of injection pain and onset time.

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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PULPAL ANESTHETIC EFFECT OF INFERIOR ALVEOLAR NERVE BLOCK AND GOW-GATES TECHNIQUE (하악공 전달마취법과 Gow-Gates법의 치수마취 효과)

  • Ahn, Sik-Hwan;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.22 no.1
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    • pp.278-290
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    • 1997
  • The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.

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A Study on the Neurotransmitters Acting on the Medullospinal Tract Cells Related to the Cardiovascular Activity (심맥관계 활동과 관련있는 연수 척수로 세포에 작용하는 신경흥분전달물질에 대한 연구)

  • Seo, Dong-Man;Kim, Sang-Jeong;Lim, Won-il;Kim, Jun;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.441-450
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    • 1998
  • The medullospinal tract cells are known to play an important role in the control of the cardiovascular activities. To clarify the modes of action of the neurotransmitters on these cells, glutamate, GABA(${\gamma}$-aminobutyric acid) and bicuculline were applicated iontophoretically into the rostral ventrolateral medulla in adult cats anesthetised with ${\alpha}$-chloralose. Followings are the results obtained : 1. The spontaneous activities of the cardiac-related neurons in rostral ventrolateral medulla (RVLM) were increased by the glutamate and decreased by the GABA. 2. Bicuculline, an antagonist of GABA, alone didn't increase the frequency of the action potentials, but could reverse the cellular response to the GABA, simultaneously applicated. 3. GABA seemed to decrease the peak as well as the basal discharge of the neurons in RVLM, but hardly changed their periodicities. 4. The cellular responses of RVLM evoked by the peripheral nerve stimulation could be inhibited by the iontophoretically released GABA. In conclusion, GABA seemed to act as an inhibitory neurotransmitter on the cardiac- related neurons in RVLM of the cats anesthetized with ${\alpha}$-chloralose. But the maintenance of the periodicities of these cells after the application of bicuculline suggested that the afferent activity of the baroreceptor didn't play a key role in the spontaneous activities of the RVLM neurons.

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시상하부의 심혈관 조절기전: 후시상하부의 세포외액의 monoamine 농도에 대한 전신 혈압변화의 영향

  • 이상복;김성윤;성기옥;조영진;이석용
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.156-156
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    • 1993
  • 본 연구에서는 생체 뇌 국소부위의 세포외액을 대상으로 실험할 수 있는 뇌 미세투석법을 이용하여 후시상하부에서 유리되는 monoamine의 세포외액 농도에 대한 전신 혈압변화의 영향을 관찰함으로써, 심혈관 조절에 대한 후시상하부의 monoamine성 뉴론의 생리적 역할을 규명하고자 하였다. 마취한 흰쥐의 머리를 뇌정위 고정장치에 고정시키고 미세투석관 (microdialysis probe)을 후시상하부에 위치시킨 후 링거액으로 관류하였다. 미세투석액내에 존재하는 monoamine성 신경 전달물질들과 그 대사체들의 정량분석은 고속액체크로마토그라피와 전기화학검출기를 이용하여 실시하였다. 전신 혈압을 40분 동안 약 40mmHg 상승 혹은 30mmHg 감소시키기 위하여 L-phenylephrine hydrochloride (800ng/100 g/min) 혹은 nitroprusside dihydrate (500 ng/100 g/min)를 대퇴정맥을 통하여 주사하였다. 후시상하부로 부터 20분 간격으로 얻은 투석액에서 신정화학물질들의 농도는 미세투석관 삽입후 2시간에 안정되었다. 관류액의 $K^{+}$ 농도를 90 mM로 증가시켰을 때 후시상하부의 투석액에서 norepinephrine (NE) 과 serotonin (5-HT)의 농도는 각각 기준치의 176.5 $\pm$ 14.8%, 149.1 $\pm$ 2.3%로 증가하였다. Phenylephrine (i.v.)으로 유발된 전신 혈압상승에 의하여 NE과 5-HT의 양은 각각 기준치의 79.3 $\pm$ 4.4%, 61.4 $\pm$ 10.3%로 유의하게 감소하였다. 또한 nitroprusside (i.v.)에 의하여 전신혈압이 감소하였을 때 투석액내 5-HT의 양은 기준치의 195.0 $\pm$ 23.0% 로 유의하게 증가하였다. 후시상하부의 투석액내 monoamine성 대사체들의 경우에는 전신 혈압의 변화에 대한 유의한 반응을 나타내지 않았다. 이상을 종합하면 전신 혈압이 증가되었을 때는 말초 압수용체의 흥분에서 기시한 신경충동이 후시상하부에 전달되어 신경말단에서 5-HT 과 NE 의 유리가 감소되고, 5-HT의 경우에는 전신 혈압이 감소되었을때 그 반대 현상이 일어난다는 가설을 제시할 수 있다. 본 연구의 결과는 생체상태에서 혈압변화에 대한 후시상하부의 monoamine성 조절양상을 규명한 것으로서 특히 후시상하부의 serotonin성 신경계를 통한 심혈관 중추조절의 가능성을 처음으로 제시한 것이다.

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슈밤머담의 개구라 해부학과 뢰벤훅의 정충관찰의 문제

  • Bae, Seon-Bok
    • 한국과학기술학회:학술대회논문집
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    • 2015.12a
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    • pp.313-326
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    • 2015
  • 데카르트는 사후에 출간된 1662년 "인간론"에서 자동기기의 유압체계모델을 이용하여 인간신체의 신경기능과 근육운동에 대하여 기계론적 설명을 제시하였다. 이것은 바로크 과학기술의 자동기기의 유압체계를 모델로 근육운동이 동물영혼에 의한 신경 전달로 진행된 것을 보여준 실험이었다. 근육운동은 동물영혼에 의한 신경 전달로 진행될 때 이를 기계론적으로 잘 설명될 수 있다고 본 데카르트의 동물영혼에 관한 견해는 출간 이후 3년 만에 네덜란드 자연학자, 해부학자, 현미경학자, 철학자 슈밤머담(Jan Swammerdam 1637-80)이 도전하였다. 그는 1664년 12월 8일 보르흐 앞에서 마취 없이 살아있는 개구리의 심장을 해부하고 두뇌 제거하는 전극실험으로 개구리의 근육운동이 데카르트가 가정하는 동물영혼과는 무관하다는 것을 보여주므로 반박하였다. 슈밤머담은 이 실험 이전에도 이미 라이덴 대학에서 여러 가지 실험으로 명성을 쌓았고 이 실험으로 해부학과 생리학의 출발을 알렸다. 뢰벤훅은 1673년 270배 확대 렌즈를 측정 대에 설치하여 눈에 가까이 갖다 대 고착시킨 첫째 동물이라는 뜻의 박테리아(${\pi}{\rho}\acute{\omega}{\tau}o$ ${\zeta}\acute{\omega}o{\nu}$)를 관찰하였다. 대학에서 전공하지 않았다는 비전문가로서 뢰벤훅이 이 연구에 뛰어들게 되는 것은 바로크 과학기술문명에 중요한 의미를 지닌다. 그라프는 그해 4월 왕립학회에 그가 빗물이나 연못물에서 채취하여 관찰한 미생물을 1677년에 아니말쿨레스(animalcules)라 불렀다는 것을 알렸고 이 관찰은 나중에 왕립학회 검증으로 확증되었다. 뢰벤훅이 명성을 얻게 된 것은 그라프가 그를 학문적으로 이끌어주었기 때문이다. 뢰벤훅에서 광학수업을 받은 하르췌커는 1694년 현미경으로 인간정액을 관찰하는 동안에 하르췌커는 정액 내에 수많은 아니말쿨레스로서 호문쿨리(homunculi)가 살고 있는 것을 보고 그 존재를 요청하였다. 하르췌커는 정규 학문과정에서 성장한 전문가로 뢰벤훅에서 렌즈닦는 기술을 습득하므로 정액주의 운동의 첨단에서 주목을 받게 되었지만 대중적 인기에 영합하였다. 이 발표는 17세기 후반 슈밤머담과 뢰벤훅이 실험철학에 기초한 곤충과 동물 및 미생물 세계의 연구 성과를 과학과 윤리 혹은 신학과의 상보적 관점에서 개관하고, 이들 연구방법을 이신론과 수사학의 입장에서 해명하고자 한다. 17세기 후반에 곤충학의 대가인 슈밤머담과 하르췌커에서 동물생성의 문제에 이신론의 물음은 물질과 정신과의 관계를 해명하려는 과학과 신학과 철학의 경계의 물음이다. 이 경계에서 이신론의 수사학적 접근은 개별분과에서 해결하지 못한 중요한 아포리아를 풀어가는 인문학적 역할에 기여를 할 수 있다.

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Assessment of the Position of the Mandibular Foramen and Mandibular Lingula in Children and Adolescents using CBCT (소아 청소년에서 하악공 및 하악소설의 위치에 대한 CBCT 분석)

  • Lee, Jihye;Choi, Namki;Kim, Byunggee;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.1
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    • pp.64-76
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    • 2021
  • The purpose of this study is to evaluate the position of the mandibular foramen and location and morphological characteristics of the mandibular lingula using Cone-Beam Computed Tomography (CBCT). Mandibular CBCT images of children aged 6 - 16 years were collected. A total of 180 patients were divided into 3 groups, 6 - 7, 10 - 11 and 15 - 16 years, with 30 male and female patients per group. Either side of the ramus was analyzed. The shortest distances from the anterior, posterior, superior and inferior border of the ramus to the mandibular lingula were measured. The shortest distance between the mandibular lingula and the mandibular foramen was also measured. The vertical distance from the mandibular lingula and the mandibular foramen to the occlusal plane was measured. The shapes of the mandibular lingula was classified into 4 types according to the criteria. The distances of the mandibular lingula from the anteroposterior and vertical reference points of the ramus increased in all directions with age. The distance between the mandibular lingula and the mandibular foramen also increased with age. The location of the mandibular lingula and the mandibular foramen in relation to the occlusal plane moved upwards with age. The most common shape of the mandibular lingula was triangular, followed by nodular, truncated and assimilated, and there was no difference in the shape according to age. It is recommended that the horizontal insertion point of the anesthesia from the anterior border of the ramus increased to 17 mm, 18 mm, and 19 mm according to the age groups. It is also suggested that the vertical insertion point increased by 2 - 3 mm, 5 - 6 mm and 9 - 10 mm above the occlusal plane according to the age groups.

Capsaicin Induces Acute Spinal Analgesia and Changes in the Spinal Norepinephrine Level (Capsaicin에 의한 척수 수준에서의 급성 진통효과와 Norepinephrine의 변화)

  • Park, Hyoung-SuP;Park, Kyung-Pyo
    • The Korean Journal of Pharmacology
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    • v.29 no.1
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    • pp.33-41
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    • 1993
  • Central analgesic effect of capsaicin was assessed by the tail flick reflex (TFR) test, using male Sprague-Dawley rats under anesthesia with pentobarbital sodium (induction with 40 mg/kg and maintenance with $4{\sim}8\;mg/kg/hr$). Level of norepinephrine in the spinal cord was also measured. Capsaicin, $35{\sim}150\;{\mu}g$, was injected intrathecally, and the TFR latency was measured before, 10, 30, and 60 minutes after the drug administration. TFR latency was increased 100% or more immediately by intrathecal capsaicin, from 2.9 seconds to the maximum of 7.0 seconds at 10 minute after the drug; P<0.01. The increase in TFR latency was maintained during the course of experiment of 2 hours. Concomitant reduction of NE content in the spinal cord was observed; from 16 ng/mg protein to 7 ng/mg protein. On the other hand, subcutaneous injection of capsaicin of 50 mg/kg did not change the TFR latency although the NE content reduced similarly to the case of intrathecal injection. Pretreatment of the animal with 0.5 mg/kg of MK-801 reversed the increase of TFR latency and NE reduction induced by intrathecal capsaicin. These results suggest that capsaicin causes analgesia at the spinal cord level by activating the excitatory amino acid-NE-dorsal horn interneurons axis of the descending inhibitory pain modulation pathway.

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Comparison of Heart Rate Variability with Pulse Transit Time during General Anesthesia (전신 마취 중 심박동변이도와 맥파전달시간 변화의 비교)

  • Baik, Seong-Wan;Kim, Tae-Kyun;Kim, Jae-Hyung;Jeon, Gye-Rok;Ye, Soo-Young
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.21 no.8
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    • pp.770-775
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    • 2008
  • Autonomic nervous system of the anesthetized patients can be influenced by the many kinds of stimulations such as intubation, surgical incision and so on. The changes of the heart rates and blood pressures are surrogates of responses of the autonomic system to the external stimulations. Recently, the power spectral analysis of the heart rate variability (HRV) made it easy to know the fractions and changes of sympathetic and parasympathetic autonomic systems. In this study, the changes of pulse transit time, one of the response of vessels to stimulations, was investigated in relation to the HRV. Ten patients were examined and average age is 22.5 $\pm$ 11.04, average weight is 63 $\pm$ 14.4 kg. The patients were anesthetized only by sevoflurane inhalation. Pulse transit time is determined by calculating the difference of the time between the R peak of ECG and the characteristic point of the plethysmography. Power spectral density (PSD) of the HRV was achieved in the frequency of 0.04-0.15 (LF) and 0.15-0.4 (HF). Compared to preanesthetic period the values of LF and LF/HF ratio of HRV were decreased (p<0.05). HF and PTT was increased in anesthetic state with sevoflurane. Otherwise, after intubation, the HF was decreased and LF, LF/HF ratio and PTT were increased. PSD of the HRV is well-known for the index of the autonomic nervous activity. Not only HRV but PTT analysis also is a useful index reflecting the autonomic responses to various stimulations. And this analysis is useful in bed side monitoring because the calculating method is simple and it takes shorter processing time compared to the HRV analysis.

Case report: Treatment of Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy (증례보고 : 양측 하악지 시상골 절단술 후 발생한 안면신경 마비)

  • Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.255-260
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    • 2013
  • Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.