• Title/Summary/Keyword: 전신 마취

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INTRAVENOUS SEDATION WITH MIDAZOLAM (Midazolam을 이용한 정주진정요법)

  • Lee, Jun-Seok;Kim, Jong-Soo;Kim, Seung-Oh
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.142-146
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    • 2006
  • Oral administration of chloral hydrate with hydroxyzine, nitrous oxide inhalation and intramuscular or intranasal administration of midazolam is the most commonly used pharmacological behavior management methods for the children in pre-cooperative stage or show negative behavior in pediatric dentistry. For oral administration of chloral hydrate with hydroxyzine, it is hard to apply to the patient refused to intake and with overweighted or elderly children and the effect of the drug decrease. Nitrous oxide and midazolam is anxiolytic agents and have limitation for properly managing the behavior of the children refuse to dental treatment. These occasions, deep sedation or general anesthesia can be considered. Although intravenous sedation with midazolam has many advantages such as, rapid onset and recovery, possible to titration and few side effect, no rebound effect by metabolites, the reports for, intravenous sedation with midazolam is insufficient in pediatric dentistry. We report the case in pre-cooperative stage. He is treated successfully under intravenous sedation with midazolam.

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SATISFACTION OF PATIENTS WITH DISABILITIES ABOUT OUTPATIENT GENERAL ANESTHESIA AND NURSING CARE FOR DENTAL TREATMENT (외래전신마취 하 치과치료를 시행한 성인 치과장애인의 치과마취과 간호사에 대한 만족도 조사)

  • Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Kim, Hyun-Jeong;Yum, Kwang-Won;Seo, Kwang-Suk
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.136-141
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    • 2006
  • The purpose of this study is to survey the status of oral care of adult patients with disabilities and satisfaction degree of outpatient general anesthesia for dental treatment. 30 adult patients who underwent general anesthesia for dental treatment at clinic for the disabled in Seoul National University Dental Hospital enrolled for telephone survey. Many patients (83.3%) had mental problems to do social communication. And someone of family members (mainly mother) had cared for the patient but there was only one patient who got regular oral care. The satisfaction level of outpatient general anesthesia and nursing care for dental treatment was very high(100%).

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A SURVEY OF DENTAL TREATMENT UNDER GENERAL ANESTHESIA (조선대학교 치과병원 소아치과에서 시행한 전신마취에 대한 연구)

  • Bak, Seung-Hyo;Lee, Nan-Young;Lee, Sang-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.1
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    • pp.1-6
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    • 2008
  • This study describes the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chosun University dental hospital in Gwangju, between August 2004 and March 2008. The conclusion runs as follows : 1. Most patients(64.8%) were young (under 10 years of age) and mean age was 8.6 years. 2. The primary reason(31.1%) why they chose general anesthesia was lack of child's cooperation (normal but unmanageable). Following in order are mental retardation, Autism and cerebral palsy etc. 3. Resin restorations were performed most frequently(87.8%) followed by pulp treatment, preformed crown, extraction and sealant. 4. It takes 3 hours 10 minutes for general anesthesia on the average. The mean treatment time under general anesthesia was 2 hours 52 minutes. 5. 29 children(39.7%) visited again after general anesthesia for recall check.

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ESOPHAGEAL FOREIGN BODY REMOVAL WITH FIBEROPTIC ESOPHAGOSCOPY (식도이물의 굴곡형 내시경을 이용한 치료)

  • 박수헌
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.182-193
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    • 1996
  • 식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

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DENTAL TREATMENT OF A PATIENT WITH PERSISTENT HYPERINSULINEMIC HYPOGL YCEMIA OF INFANCY UNDER GENERAL ANESTHESIA - A CASE REPORT - (지속 고인슐린성 저혈당증 환자의 전신마취 하 치과치료 - 증례보고 -)

  • Jeon, Myong-Sook;Seo, Kwang-Suk;Kim, Hyun-Jeong;Yum, Kwang-Won;Yi, Young-Eun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.22-25
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    • 2007
  • Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) characterized by severe hypoglycemia caused by inappropriate over secretion of insulin is the most common cause of hypoglycemia in early infancy. The symptoms of hypoglycemia in neonate and infancy are neonatal sepsis, respiratory difficulty, tachypnea, apnea, cyanosis, and seizure. Especially the recurrent and severe hypoglycemia within $1^{st}$ year of life is responsible for severe and irreversible brain damage. To prevent it aggressive treatment is required. Due to severe and irreversible brain damage these children frequently require anesthesia during imaging procedures such as MRI or during various dental surgical procedures. Because of frequent hypoglycemia and dental phobia in children with neurologic disorder, anesthesiologists should pay attention to patient. We report a successful anesthetic management in a patient with PHHI for dental procedures.

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Effects of Preoperative Video Education on Delirium and Anxiety in Elderly Patients with General Anesthesia (수술 전 동영상 교육이 전신마취수술 노인환자의 섬망과 불안에 미치는 효과)

  • Min, Gyung Eun;Seo, Eunju;Shin, Sung Hee
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.52-62
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    • 2020
  • Purpose: This study aimed to verify the effects of preoperative video education on delirium and anxiety in elderly patients with general anesthesia. Methods: This study used quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 elderly patients who had undergone of surgery under general anesthesia (35 in the experimental group and 35 in the control group). Preoperative video education was given to the experimental group. Subjective anxiety, blood pressure, pulse and delirium were measured. Data were analyzed using descriptive statistics, test of homogeneity in pretest, independent t-tests, and two-way repeated measures ANOVA with the SPSS/Win 22.0 program. Results: Delirium of the experimental group was significantly lower than that of the control group. Subjective anxiety measured using visual analogue scale was not significantly different between the two groups. However, there was a significant difference in the interaction between the group and time. There was no significant difference in physiological anxiety measured using systolic blood pressure, diastolic blood pressure and pulse between the two groups. Conclusion: The findings suggest that preoperative video education may contribute to reducing delirium and subjective anxiety for elderly patients after surgery.

Factors Affecting Intraoperative Body Temperature in Surgical Patients with Laparotomy under General Anesthesia (전신마취하 개복술 환자의 수술중 체온에 영향을 미치는 요인)

  • Lee, Seohyun;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.236-244
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    • 2015
  • Purpose: The study was conducted to identify factors affecting the intraoperative core body temperature (CBT) of surgical patients under general anesthesia. Methods: This study was performed through a prospective descriptive research design. The sample consisted of 138 patients who had undergone elective laparotomy surgery. Age, weight, height, the basal preoperative CBT, blood pressure, and heart rate were collected. CBT was again measured at induction of anesthesia, 1 hour, 2 hours, and 3 hours following induction of general anesthesia. Results: Factors affecting intraoperative hypothermia < $36^{\circ}C$ at 1 hour following induction, were CBT at induction and total body fat (TBF) ($R^2=.569$, p<.001); at 2 hours after induction, CBT at induction and TBF ($R^2=.507$, p<.001); at 3 hours after induction, CBT at induction (${\beta}=0.34$), TBF, age and the ambient temperature in the operating room ($R^2=.449$, p<.001). Conclusion: CBT at induction and TBF appear to be factors affecting intraoperative CBT within 2 hours after induction of anesthesia; CBT at induction, TBF, advanced age and the ambient temperature after 3 hours following induction. We recommend keeping surgical patients warm before induction of anesthesia and providing intraoperative warming for surgical patients of advanced age with low TBF and when the duration of general anesthesia will last more than 3 hours.

DENTAL TREATMENT OF A PATIENT WITH TUBEROUS SCLEROSIS ASSOCIATED WITH ESRD AND MENTAL RETARDATION UNDER GENERAL ANESTHESIA (정신지체와 만성신부전을 동반한 결절성경화증 환자의 전신마취 하 치과치료)

  • Seo, Kwang-Suk;Lee, So-Young;Baek, Kyung-Won;Kim, Hyun-Jeong;Yum, Kwang-Won
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.1 no.1
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    • pp.33-36
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    • 2005
  • Manifestations in tuberous sclerosis such as seizure, mental retardation, end-stage renal disease (ESRD), and heart problems present a number of challenges to the dentist and anesthesiologist. Lack of cooperation in addition to the severe medical condition makes dental treatment more difficult. General anesthesia is often required for mentally and physically handicapped patients undergoing extensive dental treatment. We experienced a case of dental treatment under general anesthesia in a 36-year-old male patient with tuberous sclerosis associated with ESRD and mental retardation. He was treated on an outpatient basis followed by hemodialysis without any complications.

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Acute Temporary Visual Loss after General Anesthesia in a Cat (전신 마취 후 발생한 고양이의 일시적인 급성 시력상실 1례)

  • Son, Won-Gyun;Jung, Bo-Young;Kwon, Tae-Eog;Seo, Kang-Moon;Lee, In-Hyung
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.480-482
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    • 2009
  • A 2-year-old, castrated male, Scottish fold cat was referred to Veterinary Medical Teaching Hospital of Seoul National University (VMTH-SNU) for evaluation of acute bilateral blindness after general anesthesia. For dental prophylaxis in local animal hospital, general anesthesia had been induced with intravenous acepromazine and ketamine, and maintained with isoflurane after intubation. At VMTH-SNU on next day, complete blood count, electrolytes and serum chemistry values were within normal ranges. On neurologic examination, visual placing and postural reactions like as hopping, hemiwalking and wheelborrowing were reduced on right hindlimb. On ophthalmic examination, menace responses were absent on both eyes and pupillary light reflex (PLR) reduced on right eye, but other reflex and fundus were normal. Prednisolone (2 mg/kg sid for 3 days) was administrated orally and tapered. Visual placing was possible on 2nd day, and postural reactions were recovered on 4th day after dental prophylaxis. Based on the process and recovery, this case was considered as postoperative visual loss (POVL) after general anesthesia.

A Case Report of Injection Laryngoplasty Who have Difficulty in Neck Extension Using, an I-Gel Laryngeal Mask Airway (경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례)

  • Jo, Kwang-Hee;Jung, Chan-Min;Jang, Chul-Ho;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.96-98
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    • 2014
  • Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

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