• Title/Summary/Keyword: 전신 마취

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BEHAVIOR MANAGEMENT TECHNIQUE FOR AUTISTIC CHILDREN (자폐의 심도에 따른 치과치료시 행동 조절법)

  • Chang, Che-Rry;Kim, Ji-Hun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.2
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    • pp.181-186
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    • 2011
  • Autism is characterized by pervasive impairments in social interaction, verbal and non-verbal communication and restricted and stereotyped behavior. It is difficult for autism patients to receive dental treatment as lack of cooperation, so various behavior management method have been tried for dental treatment in clinic. The patients with mild autism can be managed by conventional behavior modification method and phamaco-logical conscious sedation. But the patients with severe autism and multiple dental caries can be treated by deep sedation or general anesthesia. The benefits of children's dental care in general anesthesia are full-mouth rehabilitation in one single appointment. We reported three cases of autism patients who were treated by various behavior management method as to severity of autism.

DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

DENTAL TREATMENT IN A PATIENT WITH LENNOX-GASTAUT SYNDROME UNDER GENERAL ANESTHESIA (레녹스-가스토 증후군 (Lennox-Gastaut syndrome) 환자의 전신마취 하 치과치료)

  • Baik, Minkyung;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.1
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    • pp.51-55
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    • 2013
  • Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. LGS seizures are often treatment resistant and the long term prognosis is poor. A 14-year-3-month old, 20.5 kg girl with LGS was scheduled for dental treatment under general anesthesia. The patient presented with multiple caries and heavy calculus. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. And caries treatment, scaling, subgingival curretage were performed. LGS patients usually have poor oral hygiene due to mental retardation and have high risk of seizure during dental treatment. In dental treatment under general anesthesia for LGS, it must be considered of seizure control during peri-operative period. Also periodic recall check, instruction of oral hygiene must be performed.

DENTAL TREATMENT IN A PATIENT WITH HYDROCEPHALUS ASSOCIATED BRAIN TUMOR UNDER GENERAL ANESTHESIA (뇌종양과 연관된 수두증(hydrocephalus) 환자의 전신마취 하 치과치료)

  • Han, Jeong-Hwa;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.86-90
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    • 2017
  • Hydrocephalus is characterized by accumulation of cerebrospinal fluid in the ventricles of the brain causing progressive ventricular dilatation. Accumulation of cerebrospinal fluid typically causes increased pressure inside the skull, this may result in headaches, vomiting, nausea, seizures, sleepiness and mental impairment. Patients with hydrocephalus may have dental manifestations such as changes in the occlusion and greater accumulation of plaque. The prevalence of dental caries is high due to the difficulty of oral care. The purpose of this case report is to describe the dental care for an uncooperative child with hydrocephalus under general anesthesia.

A Clinical Study about Comparison of Inhalation Anesthesia and Intravenous Anesthesia in Oral and Maxillofacial Patients (구강악안면외과 환자의 전신 마취에 있어서 흡입 마취와 정맥 마취의 차이에 대한 임상적 고찰)

  • Kim, Jin;Lee, Mi-Joung;Song, Hyun-Chul
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.15-20
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    • 2002
  • Intravenous anesthesia was compared with inhalation anesthesia in 20 patients of oral and maxillofacial surgery. The patients were randomly assigned to two treatment groups so that 20 patients were injected ketamine and propofol and 20 patients were administered enflurane. The hemodynamic responses of patients and recovery profile of the two groups were compared. Intravenous anesthesia group awoke significantly faster than inhalation anesthesia after operation. Time to full recovery in intravenous anesthesia group was significantly shorter than that of inhalation anesthesia group. We conclude that intravenous anesthesia is a practical technique for oral and maxillofacial surgery patients and intravenous anesthesia may be more preferable because of the significant shortness of recovery time.

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The Current Evaluation State of Post-Anesthetic Recovery after General Anesthesia (전신마취 후 회복 평가도구 활용 실태)

  • Lee, Hwa In
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.691-698
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    • 2006
  • Purpose: This research was conducted to evaluate, analyze, and determine the limitation of the anesthesia that is used in there covery room in order to provide the foundation for developing the effectiveness of it. Method: There covery records of this study were collected from 41 hospitals in Seoul, Kyung Kii-Do, and Inchon province. The post anesthetic recovery records consisted of the evaluation of type, evaluative items, frequency, time, score and $SaO_2$. These records were collected from September to December of 2005. Results: The most commonly used post anesthetic evaluation tool was Alderete Score, which was used in 73% of hospitals. The second was Aldrete Score with $SaO_2$(17%). Also, 5% of the hospitals used the modified AS form. There were 2.5% of the hospitals applying the adult and child in the evaluation separately. Also, the last 2.5% of the hospitals did not use AS but measured BP, pulse, respiration, temperature, and $SaO_2$ with observing nausea, vomiting, urinary retention, backache, laryngitis, shock, and neurologic assessment. Conclusion: It is necessary to develop a post-anesthetic recovery evaluation tool including the application of $SaO_2$, so that the early-diagnosis of hypoxia can be possible. In addition, it is necessary to develop a post- anesthetic recovery evaluating method that can distinguish a difference between adults and children.

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A Study on Anesthesia and Operating Room (OR) Nurses' Perception and Performance of Privacy Protection Behavior for Patients Undergoing General Anesthesia Surgery and Patients' Satisfaction with Operating Room Hospitalization Experience (프라이버시 보호 행동에 대한 전신마취 수술환자와 마취⋅수술실 간호사의 인식, 실천 정도 및 전신마취 수술환자의 입원경험 만족도 연구)

  • Park, Suk Jong;Ham, Sang Hee;Baek, Gum Sun;An, Soomin
    • Journal of East-West Nursing Research
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    • v.29 no.1
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    • pp.24-32
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    • 2023
  • Purpose: This study aims to examine level of perception and performance of privacy protection behavior of anesthesia and operating room (OR) nurses for patients who underwent general anesthesia surgery. Methods: Data collection was conducted from August 2020 to January 2021 for a total of 101 participants, consisting of 49 patients and 52 nurses. Independent t-test and Pearson's correlation were conducted using SPSS 21. Results: Anesthesia and OR nurses showed the highest score in patient privacy, followed by patient information management, body privacy, and the lowest score in communication. There was a significant difference between the patient information and the communication. Conclusion: Anesthesia and OR nurses had the highest level of perception and performance of patient privacy protection behavior for body privacy, and the lowest for communication. In addition, there was a significant difference in patient information management and communication. In order to protect the privacy of patients undergoing general anesthesia surgery, efforts are needed to learn standardized nursing knowledge, attitudes, and practice.

단기간 기관내 삽관전, 후 음성지표의 측정

  • 서영일;남순열
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1997.04a
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    • pp.116-116
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    • 1997
  • 배경 및 목적: 전신마취를 위하여 시행한 기관내 삽관은 삽관튜브와 성대내면의 접촉에 의한 압력과 마찰로 후두 미세한 손상을 주게된다. 저자들은 단기간 기관내 삽관 전,후의 음성분석을 통하여 손상의 유무와 회복을 측정할 수 있는 객관적인 음성지표를 찾아보고자 하였다. 대상 및 방법: 만성 중이염 수술시 전신마취를 목적으로 경구기관 튜브를 거치한 성인 남자 10명과 여자 15명 환자를 대상으로 수술 1일전과 술후 24시간 후 각각 "a"음을 연장 발성시켜 CSL 4300B (KAY elemetrics Corp)의 MDVP(multidimensional voice program)을 이용하여 harmonic to noise ratio(NHR), Jitter, Shimmer, Fundamental frequency를 측정 비교하였다. 결 과: 남녀 모두에서 Jitter, Shimmer는 각각 평균 0.70%에서 1.06%, 1.92%에서2.28%로 증가되는 경향을 보였으나 통계학적 유의성은 없었다. Fundamental frequency는 여자에서 평균 220Hz에서 221Hz로 남자는 125Hz에서 128Hz로 변화를 보이지 않았고 harmonic to noise ratio(NHR)또한 평균 0.11로 수술 전, 후 변화를 관찰할 수 없었다. 결 론: 이상의 결과로 2내지 6시간의 단기간 삽관으로 인한 성대의 손상은 경미하여 24시간 이내에 회복되는 것으로 판단된다. 향후 6시간 이상의 기관내삽관이나 수일이상의 장기간 삽관후의 음성지표의 측정등의 연구가 필요할 것으로 사료된다.

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MANAGEMENT OF ADULT DENTAL PHOBIC PATIENTS (성인 치과공포증 환자의 치료)

  • Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.341-348
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    • 2007
  • We dentists perform many of routine dental procedures and must deal with much of the population's dental anxiety and fear. Dentists have used many non-pharmacological modalities initially to overcome anxiety and fear, including distraction, empathy, desensitization, and so on. However, certain patients need pharmacological backup of anxiety and fear to conquer dental treatment. This article presents four cases to introduce the methods from nitrous oxide and oxygen inhalation to general anesthesia for difficult adult dental phobic patients to deal with.

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