• Title/Summary/Keyword: 전신 마취

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Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report - (유경나사를 이용한 견갑골 관절와 골절의 관절경적 정복 및 내고정 - 증례 보고 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.127-131
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    • 2010
  • Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

Efficacy of Isoproterenol as a Marker of Epidural Test Dose in Patients Anesthetized with Enflurane (Enflurane 전신마취중 경막외 시험용량의 표식자로서 Isoproterenol의 효율성)

  • Kim, Keon-Sik;Kang, Wha-Ja;Lee, Doo-Ik
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.186-192
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    • 2001
  • Background: Epidural test doses containing epinephrine are an incomplete marker for the detection of inadvertent intravascular injection. Therefore, many investigators have attempted to find a more reliable marker as an alternative to epinephrine in adult patients anesthetized with enflurane. The present study was designed to test whether two different simulated intravenous test doses of isoproterenol could be used as a reliable marker for the detection of inadvertent intravascular injection in adult patients anesthetized with $O_2-N_2O$-enflurane. Methods: Forty healthy adult patients were anesthetized with 1% end-tidal enflurane and nitrous oxide after endotracheal intubation and were randomized to one of two groups according to the dose of isoproterenol. Group 1 and 2 (n = 20 each) received 3 ml of 1.5% lidocaine with 3 and 5 g isoproterenol intravenously, respectively, to simulate an intravascularly administered test dose. Heart rate (HR) and systolic blood pressure (SBP) were measured at 20-second intervals for 4 min after injection. Results: Mean maximal HR increases were $24{\pm}17$, $35{\pm}11$ bpm (P < 0.05), mean maximal SBP increases were $14{\pm}8$, $13{\pm}9$ mmHg and mean maximal SBP decreases $20{\pm}11$, $22{\pm}9$ mmHg following the IV injection of 3, $5{\mu}g$ isoproterenol, respectively. The incidence of hypotension was similar in both groups. Isoproterenol 3 and $5{\mu}g$ produced 75%, 100% sensitivity in the HR criteria ($\geq$ 20 bpm increase) and 60%, 70% sensitivity in the SBP criteria ($\geq$ 15 mmHg), respectively. Conclusions: These results indicate that based on the HR response, the epidural test dose containing $5{\mu}g$ isoproterenol to simulate an intravascular administration is a more reliable marker than $3{\mu}g$ isoproterenol in adult healthy patients during enflurane anesthesia.

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Change in Pulpal Blood Flow of Heat-induced Neurogenic Inflammation in Feline Dental Plup (고양이 치수에서 열 자극으로 유도된 신경병증 염증에서 치수 혈류량 변화)

  • Park, Min-Kyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.12
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    • pp.6340-6345
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    • 2013
  • This study examined the involvement of histamine in heat-induced changes in pulpal blood flow(PBF) to determine the mechanism of neurogenic inflammation in feline dental pulp. The experiments were carried out in 10 felines anesthetized with sodium pentobartial and histamine injected into the dental pulp through the external carotid artery. The change in the pulpal PBF was measured using a laser Doppler flowmeter(Periflux 4001, Stockholm, Sweden). The probe of laser Doppler flowmeter was placed on the buccal surface of the ipsilateral canine teeth. Heat was applied to the tooth using a heat stimulator controlled script file with an input/output device. The application of heat ($40-65^{\circ}C$) induced a significant increase in PBF. The application of histamine($5{\mu}g/kg/1ml$) followed by heat($45^{\circ}C$) resulted in an increase in PBF. Therefore, the results of the present study showed that heat and histamine are capable of vasoconstriction caused by neurogenic inflammation in feline dental pulp. In addition, neurogenic inflammation plays an active role in modulating the microcirculation of the dental pulp.

Acute Gastric Dilatation in Rhesus (Macaca mulatta) and Cynomolgus (Macaca fascicularis) Monkeys (Rhesus 및 Cynomolgus 원숭이에서 급성위확장 증례)

  • Lee, Jae-Il;Kang, Byeong-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.314-316
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    • 2008
  • Acute gastric dilatation (AGD), one of the common causes of emergency occurs in macaca monkeys that are accommodated as laboratory-housed nonhuman primates. This report introduces some cases of occurrence in raising primates. The primates revealed an acute gastric dilatation, including the histories that were trained by monkey chair, anesthetized for the study or intact case. The clinical signs were comatose condition with sever abdominal distension, dehydration, cyanosis and apnea. One case died by deterioration of systemic body condition and performed necropsy. The other cases recovered from the AGD by the emergency treatment using the gastric tube and fluid therapy. Necropsy revealed the huge stomach filled with water, gas and ingesta. This report suggests that etiologic factors of AGD may include non-specific factors like these cases, with special emphasis on the incidence and management of AGD in nonhuman primates.

CASE REPORT OF PULMONARY EDEMA DURING TWO JAW SURGERY (양악 수술 중 발생한 폐부종의 치험례)

  • Choi, Hee-Won;Kim, Kyoung-Won;Lee, Eun-Young;Kang, Ji-Yeon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.178-182
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    • 2006
  • Pulmonary edema is a well known phenomenon in medicine, physical findings indicative of this condition include frothy pink sputum, dispnea, and chest X-ray may present cephalization of vessels, perihilar edema, or diffused increase of density. It is one of the most serious, life threatening situation and should be diagnosed and managed instantly. Early diagnosis and intensive treatment are mandatory in order to effectively resolve the situation. The most common etiology for this pathology is cardiogenic, such as left ventricular failure and valvular disease. The one following is noncardiogenic, such as transfusion, infectious pneumonia, inhaled toxins, shock lung in association with trauma. Other forms of pulmonary edema which have not been clearly explained result from pulmonary embolism, drug overdose, after anesthesia, epinephrine overdose, exposure to high altitude, neurogenic, etc. We experienced two cases of pulmonary edema during two jaw surgeries(Le Fort I Osteotomy & BSSRO). These patients were young and physically healthy individuals on preoperative evaluation. Thus we report and discuss the etiology, diagnosis, prognosis, and treatment with journals review.

A SURVEY OF GENERAL ANESTHESIA IN PEDIATRIC DENTAL CLINIC AT PUSAN NATIONAL UNIVERSITY (부산대학교병원 소아치과에서 시행한 전신마취에 대한 연구)

  • Kum, Jin-Eun;Noh, Hong-Seok;Kim, Jae-Moon;Jeong, Tae-Sung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.11-16
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    • 2007
  • The use of general anesthesia as a special method of behavior management is necessary if certain handicapped or disabled child patient to receive dental treatment. This study was designed to report the results of 53 cases of complete oral rehabilitation under general anesthesia. The data were obtained from patients who were provided with dental treatment under general anesthesia for last 3years managed at the Dept. of pediatric dentistry in PNU Hospital. The distribution of age, gender, primary reason for general anesthesia, duration of dental procedure, number of treated tooth and periodic recall check-up were surveyed. In distribution of age, most(78%) were younger than 10 years and mean was 13.0 years. The reasons for providing general anesthesia were lack of cooperation due to various mental and physical handicapped situation(74%), congenital heart disease(13%), combined with medically compromised and behavior problem and others. The average duration of the treatments was 2 hours and 41 minutes and average duration of the anesthesia was 3 hours and 6minutes. The mean number of treated with restoration a children were 16.7 teeth. From the results, total dental rehabilitation under general anesthesia is a favorable modality to improve for disabled children's oral condition.

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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.

Ketamine Decreases Phagocytic Capacity of Canine Peripheral Blood Phagocytes In Vitro (In Vitro에서 개 말초혈액 탐식세포의 탐식능에 대한 케타민의 효과)

  • Kang, Ji-Houn;Kim, Min-Jun;Yang, Mhan-Pyo
    • Journal of Veterinary Clinics
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    • v.25 no.2
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    • pp.73-78
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    • 2008
  • Ketamine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist and a short-acting general anaesthetic agent for human and veterinary use. We previously reported that treatment with ketamine impairs oxidative burst activity of canine peripheral blood leukocytes. In this study, the effect of ketamine on phagocytic capacity of canine peripheral blood leukocytes was examined in vitro. Phagocytic capacity was analyzed by using a flow cytometry. Ketamine directly decreased the phagocytic capacity of peripheral blood polymorphonuclear cells (PMN) and monocytes but not total peripheral blood mononuclear cells (PBMC). In addition, the phagocytic capacity of PMN and monocytes was inhibited by the ketamine-treated PBMC but not PMN culture supernatant. These results suggest that ketamine has a direct inhibitory effect on the phagocytic capacity of canine peripheral blood phagocytes and involves the production of soluble factor(s) from canine PBMC, which may suppress the phagocytic capacity.

Post-extubation Negative Pressure Pulmonary Edema Complicating Partial Rib Resection -A case report- (늑골 절제술 환자에서 기관 내 튜브 발관 후 발생한 음압성 폐부종 -1예 보고-)

  • Kim, Jae-Jun;Jo, Min-Seop;Cho, Kyu-Do;Park, Yeon-Jin;Kim, Yong-Shin;Cho, Deog-Gon
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.313-316
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    • 2007
  • Negative pressure pulmonary edema (NPPE) during anesthetic recovery is a rare, but potentially serious complication for patients who are undergoing different surgical procedures. The proposed mechanism is the generation of high negative pressure during markedly respiratory effort and upper airway obstruction from glottis closure and laryngospasm, and this all leads to pulmonary edema. We report here on a case of a healthy 26-year-old male who immediately developed NPPE and hemoptysis following extubation after partial rib resection due to benign rib tumor; the patient was treated conservatively. We also include a review of the review literatures.

Effects of Normal Saline and Essential Oil Gargling on Bacterial Colonization in Intubated Patients for General Anesthesia (생리식염수와 에센셜오일을 이용한 가글링이 전신마취를 위한 경구 기관 내 삽관 환자의 균집락화에 미치는 영향)

  • Ko, Sang Jin;Na, Yeon Kyung;Hong, Hae Sook
    • Journal of Korean Biological Nursing Science
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    • v.16 no.2
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    • pp.123-132
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    • 2014
  • Purpose: The purpose of this study was to compare and analyze the effects of gargling using normal saline or essential oil on oral bacterial colonization of the subjects who did transoral endotracheal intubation for general anesthesia. Methods: A repeated measures, non-equivalent control group pretest-posttest design was used in this study. The subjects of the study included 58 people; the gargling group with normal saline (n=19); the gargling group with essential oil (n=20); and the control group (n=19). Data were collected from University hospitals in a Korean province from August 13-31, 2012. The collected data were analyzed with $X^2$-test, t-test, ANOVA and Scheff$\acute{e}$ test using SPSS 19.0. Results: Although statistically significant differences among the three groups did not appear in the change of the aerobic bacterial colony before and after the experiments, the aerobic bacterial colony of the gargling group with normal saline ($71.58{\pm}143.39$) and the group with essential oil ($6.95{\pm}332.07$) have increased less compared to the control group ($145.42{\pm}385.01$). The change of the anaerobic bacterial colony before and after the experiments, the control group was ($167.58{\pm}483.58$) and the gargling group with essential oil was ($169.70{\pm}291.60$) and increased, while the gargling group with normal saline ($-42{\pm}331.09$) reduced, but statistically significant differences have not appeared. Conclusion: These findings indicated that oral gargling with normal saline is effective in reducing anaerobic bacterial colonization.