• Title/Summary/Keyword: 전신 마취

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REGULATION OF PULPAL MICROCIRCULATION BY CALCITONIN GENE-RELATED PEPTIDE (Calcitonin Gene Related Peptide에 의한 치수미세순환 조절)

  • Kim, Sung-Kyo;Kim, Young-Kyung;Jin, Myoung-Uk
    • Restorative Dentistry and Endodontics
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    • v.30 no.6
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    • pp.470-476
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    • 2005
  • The purpose of this Study was to invest)gate the function or calcitonin gene-related peptide (CGRP) in regulatory mechanism of pulpal microcirculation with the aim of elucidating neurogenic inflammation. Experiments were performed on twelve cats under general anesthesia. CGRP was administered through the femoral vein to see the systemic Influence and through the external carotid artery to see the local effect. Sympathetic nerve to the dental pulp was stimulated electrically and pulpal blood flow (PBF) was measured with a laser Doppler flowmeter on the canine teeth to the drug administration. The paired variables of control and experimental data were compared by paired t-test and differences with p < 0.05 were considered statistically significant. Systemic administration of CGRP $(0.3{\mu}g/ka)$ exerted decreases in systemic blood pressure and caused changes in PBF with an initial increase i311owed by decrease and a move marked second increase and decrease. Close intra-arterial (i.a.) injection of CCRP $(0.03{\mu}g/kg)$ resulted in slight PBF increase. The effect of CGRP resulted in no significant increase in PBF in the presence of $CGRP_{8-37}$. The electrical stimulation of the sympathetic nerve alone resulted in PBF decreases. The j.a. administration of CGRP following the electrical stimulation of the sympathetic nerve compensated the decreased PBF. Therefore, CGRP effectively blocked the sympathetic nerve stimulation-induced PBF decrease. Results of the present study have provided evidences that even though the local vasodilatory function of CGRP are weak, CCRP is effectively involved in blocking the vasoconstriction caused by sympathetic nerve stimulation in the feline dental pulp.

The Prediction of Postoperative Pulmonary Complications in the Elderly Patients (고령환자에 있어서 술후 호흡기 합병증의 예측)

  • Suh, Kyong-Duk;Jeong, Yu-Seong;Kam, Bok-Kyoo;Lee, Jong-Myeong;Huh, Dong;Kim, Jin-Do;Lee, Ju-Hong;Koo, Dae-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.321-328
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    • 1997
  • Background : we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. Method : In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. Results : The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia($PaCO_2$ > 45mmHg) have more increased postoperative complications. The preoperative FEV1 less than $1\;{\ell}$, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. Conclusion : Age $\geq$ 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia ($\geq$45mmHg) on preoperative arterial blood gas analysis were predictive of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.

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DENTAL AND OPHTHALMOLOGICAL TREATMENT UNDER THE GENERAL ANESTHESIA OF THE PATIENT WITH MENTAL RETARDATION (정신지체 환자의 전신마취 하 치과치료 및 안과 협진)

  • Kim, Su-Youn;Lee, Keung-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.153-155
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    • 2006
  • Many patients with mental retardation need extensive dental treatment because they have much difficulty in maintaining their oral hygiene. However, because they are not cooperative and not manageable, they require physical restraints, drug induced sedation or general anesthesia. General anesthesia is useful in control of the patients who cannot be treated in other ways. Additionally, general anesthesia provides more safe environment for medically compromised patients. And medical treatment can be provided simultaneously under general anesthesia. Furthermore, almost all treatment can be provided without visiting several times. This case reports of periodontal, restorative and ophthalmological treatment of patient with mental retardation under general anesthesia.

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Causalgia After Cervical Discectomy (경추 추궁절제술후 발생한 Causalgia)

  • Choe, Huhn;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.80-84
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    • 1992
  • 49세 여자 환자가 경부 추간판 탈출증의 치료를 받기위하여 전신 마취하에 우측의 추궁 절제술과 전방 추체간 접합술을 받고난 즉시 회복실에서 부터 양측 상지에 작열통이 발생하였다. 환자는 양측 상지에 전형적인 작열통의 증상인 allodynia, 통각 과민(hyperalgesia), 통각 이상 과민증 (hyperpathia)을 보였으며 특히 우측 상지에는 심한 부종을 보이고 있었다. 환자는 일련의 성상 신경절 차단과 disposable $Daymate^{TM}$ portable elastomeric infusor를 이용한 연속적 상완신경총 차단으로 작열통이 완치되었다.

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SATISFACTION OF HANDICAPPED PATIENT TREATED UNDER OUTPATIENT ANESTHESIA (외래 전신마취를 이용한 치과치료에 대한 만족도 조사 -장애인환자 보호자를 대상으로-)

  • Lee, Song-Eun;Kim, Tae-Wan;Kim, Young-Jin
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.1
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    • pp.31-38
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    • 2006
  • 90 handicapped patients with dental problem treated under outpatient general anesthesia at one day operation room of kyungpook National University Hospital during 2000-2005 were analyzed. Following are the conclusions. 1. For those 90patients treated under general anesthesia, 62(68.9%)patients had autism or mental retardation. 2. The most difficult work for the preparation of general anesthesia was preoperative examination(53.3%). 3. The parent's satisfaction level after treatment under general anesthesia was high(75.6%). 4. 36(40%) of the patients responded to periodic recall check till now.

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A Study on the Treatment of Dentally Handicapped Patients under Outpatient General Anesthesia (외래 전신마취하의 치과장애인 치료에 대한 연구)

  • Lee, Jae-Ho;Shon, Heung-Kyu;Kim, Jin-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.581-589
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    • 1997
  • 42 dentally handicapped patients who require general dental treatments but behavioral managements had been an obstacle to proper treatments were chosen and the author conducted dental treatment under outpatient general anesthesia. Followings are the conclusions 1. The average time for the treatment procedure was 2 hours and 1 minute and the average of 9.52 teeth were treated for individual patient indicating its high efficiency. 2. The average time for the recovery was 3 hours and 14 minutes and none of the patients showed any specific serious complications. 3. Treatments under outpatient general anesthesia can be a proper patient management method for the dentally handicapped patients if the patient selection is proper.

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Tubular Hindgut Duplication with Rectovaginal Fistula, Dysplastic Kidney and Ectopic Ureter - case report - (직장-질 누공을 동반한 관형 뒤창자 중복)

  • Nam, So-Hyeon;Kim, Dae-Yeon;Kim, Seong-Cheol;Kim, In-Gu
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.58-63
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    • 2009
  • 환아는 4개월부터 직장 탈출증과 심한 변비를 보였으며, 9개월에 질로부터 대변이 배출되는 증상을 나타냈으나 검사상 우측 이상 형성 콩팥 및 이소성 요관 이외 특이 소견이 없어 경과 관찰을 시행하였다. 16개월에 전신 마취하에 이학적 검사를 시행하여 누공을 확인하였고 이를 통한 대장 조영술에서 직장 중복증을 진단하여 수술을 시행하였다. 수술 시야에서 직장부터 횡행 결장에 이르는 관형의 뒤창자 중복을 확인하고, 직장-질 누공을 분리하고 결장 및 직장에는 중격절개술을 시행하였으며, 동반된 기형인 이소성 요관과 무기능 우측 신장은 절제하였다. 환아는 수술 후 3년간 잘 지내고 있다. 직장-질 누공을 동반한 관형의 뒤창자 중복은 매우 드문 선천성 기형으로 저자들의 경험을 문헌 고찰과 함께 보고하는 바이다.

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Selective Bronchial Suction Catheter after Resection Surgery of Lung -Case report- (폐절제술 후 선택적 기관지내 흡인도관 유치 -증례 보고-)

  • 조정수;김종원;김영대
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.884-887
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    • 2004
  • We applied our technique of selective bronchial suctioning (SBS) for the treatment of atelectasis after resection surgery of lung in four patients with refractory atelectasis who were treated successfully. We considered that SBS using hydro-catheter insertion under local anesthesia above fourth tracheal ring is the effective technique for the treatment of refractory atelectasis when conventional respiratory therapy is not effective and a bronchoscopist is not available.

Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway -A case report- (후두 마스크를 이용한 전신 마취 후 발생된 흡인성 폐렴)

  • Lee, Deok-Hee;Park, Ki-Ho
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.127-131
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    • 2004
  • A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

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General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome (Lesch-Nyhan 증후군을 가진 소아의 체외충격파신쇄석술을 위한 전신마취 경험)

  • Park, Sang-Jin;Kwon, Il-Chi;Lee, Won-Ki;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.78-83
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    • 2008
  • Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.

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