• Title/Summary/Keyword: 전신 마취

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Future Tasks of the Law Forcing CCTV Installation in Operating Rooms (수술실 내 CCTV 설치 의무화 법안의 향후 과제)

  • Lim, Ji Yeun;Kim, Kye Hyun
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.185-210
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    • 2021
  • On September 24, 2021, the new provisions(Article 38-2 of the Medical Service Act) mandatory CCTV installation in operating rooms where the unconscious patient is operating such as general anesthesia. The revised medical law aims to effectively prevent illegal activities that may occur in the operating rooms and to promote appropriate resolution to medical dispute. According to the law, medical institutions operating unconscious patients, such as general anesthesia, must install CCTVs in the operating rooms by September 25, 2023, and film surgical scenes only at the request of patients and their guardians, regardless of the consent of the medical personnel. The bill delegated the legislative device to minimize infringement of fundamental rights to subordinate statutes without stipulating it in the law.(Article 38-2(10)) The most realistic policy plan to minimize the infringement of the fundamental rights of patients is to prepare specific regulations. Therefore, this study examines the legislative background and main contents of the amended CCTV installation bill, and suggests issues to be reviewed when preparing subordinate statutes by analyzing major issues. It was reviewed based on compliance with the principle of minimizing infringement of fundamental rights of information subjects in the operating rooms. The information subjects of CCTV are health professionals and patients. Suggesting issues should be considered when preparing subordinate statutes so that the purpose of the CCTV installation law can be achieved while minimizing infringement of right of self-determination of personal information, personality rights, and human rights. It is hoped that this paper will be referred when discussing subordinate statutes and regulations to contribute minimizing infringement of fundamental rights.

Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

The Effects of Gabapentin on Facial Formalin Test (백서에서 Gabapentin 전신투여가 Facial Formalin Test에 미치는 영향)

  • Kim, Chul-Hong;Baik, Seong-Wan;Kim, Hae-Kyu;Kwon, Jae-Young;Kim, Kyoung-Hun;Choi, Sung-Hwan
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.2 s.5
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    • pp.92-97
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    • 2003
  • Background: Gabapentin is a novel anti-epileptic drug, which is used in clinical practice to treat epilepsy. This drug is also used as an analgesic in pain patients. The antinociceptive effect of this drug was assessed using the formalin test in the rat. Methods: In order to investigate the effects of gabapentin on the trigeminal nerve territory, we injected 0.5% formalin into the upper lip. Adult, male, Sprague-Dawley rats received a $50{\mu}l$ subcutaneous injection of 5% formalin into one vibrissal pad and the consequent, facial grooming behavior was monitored. Consistent with previous investigations using tile formalin model, animals exhibited biphasic nocifensive grooming (phase 1, 0-12 min; phase 2, 12-60 min). Results: The intraperitoneal administration gabapentin 5 minutes prior to the formalin injection led to a significant, dose-dependent reduction in grooming time during phase 2. In high doses, gabapentin also reduced the time of grooming during phase 1. Conclusions: The Intraperitoneal injection of gabapentin has an analgesic effect in the facial formalin rat model and this analgesic effect increases dose-dependently.

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The Effect of Low Dose Lidocaine on Fentanyl-Induced Cough, Mean Arterial Pressure, Heart Rate, Oxygen Saturation and Dizziness in Inhalation Anesthesia (흡입성 전신마취에서 저용량의 리도카인이 펜타닐-유도성 기침, 평균동맥압, 심박동수, 산소포화도 및 어지럼증에 미치는 영향)

  • Lee, Keon Young;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.14 no.4
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    • pp.275-281
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    • 2012
  • Purpose: This study was performed to evaluate the effect of low-dose lidocaine on fentanyl-induced cough and hemodynamic changes under general anesthesia. This research was a randomized trial design and performed using a double-blind method. Methods: Data collection was performed from October 22, 2008, to May 4, 2009. One hundred and thirty two patients were randomly assigned to control group (Con G) and experimental group (Exp G) using a table of random numbers. Exp G (n=66) were administered 0.5 mg/kg lidocaine and Con G (n=66)) were administered saline. The occurrence of cough and vital sign were recorded within one minute after fentanyl bolus by an anesthesiologist. Collected data were analyzed using Repeated measures ANOVA using SPSS for Windows (Version 17.0). Results: The incidence of cough in Exp G was 13.6%, while Con G was 53%. The incidence cough in Exp G was significantly lower compared to Con G (p<.001). Lidocaine seemed not to suppress mean arterial pressure (p=.145), heart rate (p=.508), and oxygen saturation (p=.161). Conclusion: Intravenous administration of 0.5 mg/kg lidocaine seems to suppress fentanyl-induced cough without affecting mean blood pressure, heart rate and oxygen saturation. Therefore, we recommend intravenous 0.5 mg/kg lidocaine administration to suppress fentanyl-induced cough under general anesthesia.

Availability of peripheral inserted central catheters in severe hemophilia patients with inhibitors (중증 혈우병 항체 환자에서 시행한 말초삽입 중심혈관 카테터의 유용성)

  • Park, Youngshil
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1359-1362
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    • 2008
  • The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of inhibitors. They experienced frequent bleeding episodes and required replacement therapy, which eventually resulted in difficulty in acquiring venous line access. Factor VIII activity was below 1%, and inhibitor titers were 160 and 26.3 BU/ml. In an outpatient setting, PICC lines are easily placed by radiological guidance and require local anesthesia alone. PICC has been feasible, in particular, for hemophilia patients with frequent bleeding episodes.

Development of Parameters on Depth of Anesthesia using Power Spectrum Density Analysis during General Anesthesia (전신 마취 중 전력스펙트럼 분석을 이용한 마취심도 파라미터 개발)

  • Baik, Seong-Wan;Ye, Soo-Young;Park, Jun-Mo;Jeon, Gye-Rok
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.22 no.6
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    • pp.537-545
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    • 2009
  • In this paper, new parameters were developed to estimate the depth of anesthesia during a general anesthesia using EEG. Power spectral density(PSD) analysis was used for these parameters because EEG became slow wave during anesthesia. The new parameters were DTR, ATR, TDR, ADR, BTR and BDR applied to PSD. These parameters were compared with SEF which is conventionally used at clinic and confirmed clinical value. As the results, DTR, ATR, TDR, ADR among parameters were not useful compared with SEF but BTR and BDR is valuable for clinic. 15 patents, at pre-operation BDR the value is $265.36{\pm}25.29$, at induction the value is $129.23{\pm}34.92$, at operation the value is $154.99{\pm}38.34$, at awaked the value is $283.83{\pm}39.80$ and at post-operation the value is $234.80{\pm}23.46$. Also at pre-operation BTR value is $183.38{\pm}13.59$, at induction the value is $104.09{\pm}25.11$, at operation the value is $115.38{\pm}23.42$, at awaked the value is $190.33{\pm}23.31$ and at post-operation the value is $172.38{\pm}19.08$. Trend of BDR and BTR is similar to change of SEF, so two parameters are useful. to estimate the depth of anesthesia.

A Case of Huge Vocal Polyp in a Patient With Difficult Laryngeal Exposure Treated by Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia (전신마취 하 후두미세수술이 불가능한 경추 손상 환자에게서 국소마취 하 굴곡내시경 후두 레이저 수술로 치료한 거대한 성대 폴립 1예)

  • An, You Young;Lee, Jeong Hyun;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.153-156
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    • 2021
  • Indications of fiberoptic laryngeal laser surgery (FLS) procedure have broadened by the development of flexible fiberoptic endoscopes and flexible laser systems. FLS procedure performed under local anesthesia and it is the unique value of FLS. The surgery can be performed on patients who are impossible to undergo general anesthesia and difficult to be exposed by laryngeal microsurgery. Main indication of FLS procedure was small to moderate sized hemorrhagic vocal polyp, but we experienced a case of huge vocal polyp with difficult laryngeal exposure treated by FLS procedure under local anesthesia. The vocal polyp was removed successfully without vocal fold scar through fiberoptic laryngeal laser surgery under local anesthesia.

The Effects of Leukocyte Depleted Priming Solution on the Gastric Mucosal $Co_{2}$ Partial Pressure and Serum IL-8 Level during Cardiopulmonary Bypass in Korean Mongrel Dogs (한국산 잡견에서 백혈구 제거 충진액이 체외순환 중 위점막 이산화탄소 농도와 IL-8 수준에 미치는 영향)

  • Park Kuhn;Lee Jong Ho;Kim Jin Ho;Jin Ung;Kwon Jong Bum;Kim Chi Kyeong;Wang Young Pil
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.807-814
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    • 2005
  • Background: Cardiopulmonary bypass is an essential process to maintain circulation for saving life during the cardiac surgery, But it is a process in which systemic inflammation was evoked inevitably because of the exposure of blood to foreign surface. The injuries to distal organs during the cardiopulmonary bypass were resulted from systemic inflammation and the disturbances of micro-circulations in the organs. We designed this study to research the effects of leukocyte depletion from pump-oxygenator priming solution on the systemic inflammation, and the micro-circulation of gastric mucosa that is suggested by the gastric mucosal $CO_{2}$ partial pressure and acidity. Material and Method: The dogs were divided into three groups according to the different pump-oxygenator priming solutions; non-hemic crystalloid solution; leukocyte-depleted homologous blood; and non leukocyte-depleted homo-logous blood. Each priming solution group contained five dogs. In all three groups, 2 hours of cardiopulmonary bypass, and 4 consecutive hours of general anesthesia was maintained on the mechanical ventilation. Each dog was evaluated for the gastric mucosal pH, $CO_{2}$ partial Pressure, arterial pH, $CO_{2}$ partial pressure, the exhaled air $CO_{2}$ partial pressure and the level of IL-8 on before the cardiopulmonary bypass, 1 hour after the cardiopulmonary bypass, 2 hours after the cardiopulmonary bypass, 2 hours after the restoration of normal circulation, and 4 hours after the restoration of normal circulation after the cardiopulmonary bypass. The levels of IL-8 were measured with ELISA (enzyme linked immunosorbent assay) technique. Result: 1. There were significant differences of gastric mucosal $CO_{2}$ partial pressure between the leukocyte-depleted homologous blood group and other two groups(vs non leukocyte-depleted homologous blood group; P=0.02, vs non-hemic crystalloid solution group; P=0,01). 2. The gastric mucosal pH of leukocyte-depleted homologous blood group was significantly different from non leukocyte-depleted homologous blood group (p=0.01). 3. The levels of IL-8, which examine the systemic inflammation, showed signi- ficantly better results in leukocyte-depleted homologous blood group and non-hemic crystalloid solution group than non leukocyte-depleted homologous blood group (p=0.01, 0.01). Conclusion: Based upon these results, we concluded that the leukocyte depletion from the pump-oxygenator priming solution has a beneficial effects in reducing systemic inflammation and the preserving of gastric mucosal micro-circulation.

Retrospective study on three-dimensional characteristics of mesiodens using CBCT in pediatric dentistry (치과용 Cone-beam CT를 이용한 상악 정중과잉치의 3차원적 특성에 관한 후향적 연구)

  • Ryu, GiYoun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.1
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    • pp.77-94
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    • 2021
  • The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019. The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient's age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications. These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.

Postoperative Analgesic Effect of Intraarticular Bupivacaine or Morphine After Arthroscopic Knee Surgery (슬관절경 수술 후 관절강 내 주입한 Bupivacaine 및 Morphine이 통증에 미치는 영향)

  • Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.445-450
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    • 1993
  • Recent studies have shown that opiods can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. This study sougt to compare the effects of morphine with those of bupivacaine administered intraarticularly upon pain after arthroscopic knee surgery. In a ramdomized manner, 60 healthy patients received either morphine(3 mg in 20 ml NaCl ; n=20), bupivacaine(20 ml, 0.25% ; n=20) intraarticularly at the completion of surgery, and others were not administered(n=20) under general anesthesia after 1, 2, 4, 6, 12 and 24h of postoperative day, pain was assessed by a visual analogue pain scales, time to first analgesic use were recorded. Pain scores were significantly greater in the morphine group than two groups at 1h. From 4th until the end of the study period, pain scores were significantly greater in the bupivacaine group than in the other two group. Anagesic requirements were significantly greater in the morphine group than two groups at 1h but were significantly greater in the bupivacaine group than in the other groups throughout the remainder of the study period. The results suggest that intraarticular morphine produces an analgesic effect of delayed onset but of remarkably long duration.

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