• Title/Summary/Keyword: Anesthesia, Conduction

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The Effect of Topical and Conduction Anesthesia by Phonophoresis with Lidocaine (Lidocaine 음파영동에 의한 표면마취 및 전달마취 효과)

  • Jeong, Dae-In;Yoon, Se-Won;Choi, Sug-Ju;Lee, Jung-Woo;Jeong, Jin-Gyu;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.4 no.1
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    • pp.63-83
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    • 2006
  • This study conducted the following experiment to examine anesthetic effects of 500 kHz ultrasound with lidocaine. Clinical experiment was conducted to compare local anesthetic effects by ultrasound frequencies and drugs with 40 normal adults and it divided subjects into experimental group (I) applying only ultrasound, ointment group (II) applying only lidocaine, phonophoresis group of 1 MHz (III), phonophoresis group of 500 kHz lidocaine (IV) for pain threshold and nerve conduct experiments. Mechanical threshold was measured with von Frey monofilament, thermal pain threshold with halogen lamp and digital thermometer, action potential in median nerve with diagnostic electromyography before and after treatment, and at 30 min., 60 min., 90 min., and 120 min. after treatment. Results of this study can be summarized as follows. Topical anesthesia experiment showed that pain threshold of phonophoresis groups was significantly increased, but there were little differences in ultrasound frequency and drugs among phonophoresis groups. Conduction anesthesia experiment showed that phonophoresis group of 500 kHz using lidocaine had significant difference in pain threshold and sensory nerve conduction compared to ointment group and ultrasound group, but there was no great difference from other phonophresis groups and light nerve block effect was found. It was considered that application of 500 kHz ultrasound using lidocaine will be more effective in deep anesthesia or nerve block than 1 MHz ultrasound. However, researches considering various frequencies, intensities and application hours in low frequency areas including kHz ultrasound are needed to increase deep permeation of drugs.

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Local Anesthetics for Dental Procedure (치과시술에 사용되는 국소마취제)

  • Kim, Cheul Hong;Yoon, Ji Young
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.71-79
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    • 2013
  • Local pain management is the most critical aspect of patient care in dentistry. Local anesthesia is a reversible blockade of nerve conduction in an applied area that produces loss of sensation. The chemical agents used to produce local anesthesia stabilize neuronal membranes by inhibiting the ionic fluxes required for the propagation of neural impulses. Proper local anesthesia permits the dental surgeon to perform the necessary surgical procedure in a careful, gentle fashion that will be less stressful for both the operator and the patient. The improvements in agents for local anesthesia are probably the most significant advances that have occurred in dental science. Today's anesthetics are safe, effective, and can be administered with insignificant soft tissue damage and minimal concerns for allergic reactions. This article reviews the widely used local anesthetic agents for obtaining local anesthesia, and also discusses some frequently seen complications.

Epidural Infection during Continuous Epidural Block (지속적 경막외차단중 발생한 경막외 감염증)

  • Sa, Hee-Soon;Kim, Tae-Heon
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.97-99
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    • 1989
  • Epidural block is used extensively in each of the fields of surgical anesthesia, obstetric anesthesia, and diagnosis and management of acute and chronic pain. New developments in the understanding of pain conduction have extended the use of continuous epidural blockade to the administration of drugs that selectively block pain conduction while leaving sensation and motor power essentially unchanged. The safety and the reliability of spinal epidural catheter techniques have permitted relief of acute and chronic pain. However, one of the important aspects of the management of the epidural catheter is the possibility of epidural infection. We have experienced a case of epidural infection during control of post-herpetic neuralgia and discuss management of the epidural catheter in this article.

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The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019

  • Kayir, Selcuk;Kisa, Alperen
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.82-93
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    • 2021
  • Background: This study used bibliometric analysis of articles published about the topic of regional anesthesia from 1980-2019 with the aim of determining which countries, organizations, and authors were effective, engaged in international cooperation, and had the most cited articles and journals. Methods: All articles published from 1980-2019 included in the Web of Science database and found using the keywords regional anesthesia/anaesthesia, spinal anesthesia/anaesthesia, epidural anesthesia/anaesthesia, neuraxial anesthesia/anaesthesia, combined spinal-epidural, and peripheral nerve block in the title section had bibliometric analysis performed. Correlations between the number of publications from a country with gross domestic product (GDP), gross domestic product (at purchasing power parity) per capita (GDP PPP), and human development index (HDI) values were investigated with the Spearman correlation coefficient. The number of articles that will be published in the future was estimated with linear regression analysis. Results: Literature screening found 11,156 publications. Of these publications, 6,452 were articles. The top 4 countries producing articles were United States of America (n = 1,583), Germany (585), United Kingdom (510), and Turkey (386). There was a significant positive correlation found between the GDP, GDP PPP, and HDI markers for global countries with publication productivity (r = 0.644, P < 0.001; r = 0.623, P < 0.001, r = 0.542, P < 0.001). The most productive organizations were Harvard University and the University of Toronto. Conclusions: This comprehensive study presenting a holistic summary and evaluation of 6,452 articles about this topic may direct anesthesiologists, doctors, academics, and students interested in this topic.

Foot Drop of Contralateral Limb after Deformity Correction in a Polio Patient: A Case Report

  • Seo, Sang Gyo;Park, Jae Young;Kim, Jin-Tae;Kim, Ji-Beom;Lee, Dong Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.83-86
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    • 2014
  • Postpoliomyelitis syndrome is a common neurological disorder that occurs in patients who have experienced paralytic poliomyelitis. Recently, as a result of vaccination against poliovirus, incidence of poliomyelitis is exceedingly low. However, many patients with postpolio syndrome may encounter anesthesia when undergoing surgery, such as for correction of foot deformity and other operations. We report on a 45-year-old woman who experienced paralysis of her contralateral limb after operation on the left foot under spinal anesthesia. Postoperative electromyography/nerve conduction study (EMG/NCS) was performed in order to determine the cause of paralysis. Motor power of the sequelae involved leg showed improvement with time and recovered fully to the preoperative level at six months after the index operation. A precise evaluation, including a physical examination and EMG/NCS, should be performed preoperatively when spinal anesthesia is planned for postpolio syndrome patients.

Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold

  • Park, Joong Hyun;Won, Jong Chul
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.519-528
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    • 2018
  • Background: Clinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements. Methods: We retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ${\geq}3$) and abnormal NCS results. Results: A total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia. Conclusion: NCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.

Changes of ECG and Electrolyte in Dogs with Experimental Obstruction of Duodenum (개에 있어서 실험적 십이지장 폐색시 심전도와 전해질의 변화)

  • 최인혁;조영숙
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.432-441
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    • 1998
  • The electrocardiogram (ECG) and electrolytes were measured to obtain diagnostic data after experimental obstruction of duodenum in 8 dogs. Clinical signs of these appeared lower heart rate, temperatures respiration and blood pressure than signs of preoperation. In changes of electrolytes and acid-base balances, all dogs appeared hyponatremiai hypochloremia, metabolic alkalosis, and increased pHi HCO3, scot in blood, but potassium values appeared to increase in 3 cases fl-inc.) and to decrease in 5 cases (K- dec.) Two of three in K-inc. and three of five in K-dec. died at 60 hrs and 72 hrs after obstruction respectly. In changes of ECGI amplitudes of the K-inc cases appeared high in T wave and low in R wave, but amplitudes of the K-dec cases appeared low T waver 57 segment and high in R wave. Conduction times of the K-inc appeared the shorted PR intervals but the K-dec appeared the prolonged PR interval. The changes of these appeared apparently in lead II.

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Atropine Induced Paradoxical Atrioventricular Conduction Block in a Jindo Dog (진도종 개에서 아트로핀에 의해 발생한 역설적 방실 전도 차단)

  • Lee, Moo-Hyun;Lee, Seung-Gon;Moon, Hyeong-Sun;Lee, Joon-Seok;Lee, Lyon;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.422-425
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    • 2007
  • A 6-month-old intact male Jindo dog was underwent surgery for hip fracture caused by hit by a car. Routine laboratory tests performed prior to surgery found no significant abnormalities, which might increase risks associated with general anesthesia. The dog was premedicated with atropine, induced general anesthesia with thiopental sodium and maintained with isoflurane. Forty minutes after surgery, the dog was suddenly bradycardic. Atropine (18 ug/kg) was slowly infused intravenously to normalize heart rate. However, paradoxically the dog showed slower heart rate with intermittent atrioventricular block ($2^{nd}$ degree type I) after atropine infusion. The dog's rhythm was returned to normal rate 7 minutes after ephedrine was infused. This is a rare case of paradoxical atrioventricular block induced by high dose of atropine in a dog.

EFFECT OF LOW - POWER LASER IRRADIATION ON PAIN RESPONSE (저출력 레이저조사가 동통반응에 미치는 영향)

  • Kim, Sung-Kyo;Yoon, Soo-Han;Lee, Jong-Heun
    • Restorative Dentistry and Endodontics
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    • v.16 no.2
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    • pp.85-98
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    • 1991
  • The aim of this study was to investigate the effect of low - power laser used in the medical field for various purposes to suppress pain responses evoked by noxious electrical or mechanical stimuli. After both inferior alveolar nerves and the left anterior digastric muscle of cats under general anesthesia were exposed, a recording electrode for the jaw opening reflex was inserted into the anterior digastric muscle. The right inferior alveolar nerve was dissected under a surgical microscope until the response of the functional single nerve could be evoked by the electrical stimulation of the dental pulp or oral mucosa. The electrical stimulus was applied with a rectangular pulse of 10 ms duration for measuring the threshold intensity of a single nerve fiber in the inferior alveolar nerve which responds to stimulation of dental pulp and oral mucosa. Then a pulse of 1 ms duration was applied for determination of conduction velocity. A noxious mechanical stimulus to the oral mucosa was applied by clamping the receptive field with an arterial clamp. The Ga-As diodide laser(wave length, 904 nm ; frequency, 1,000 Hz) was irradiated to the prepared tooth cavity, inferior alveolar nerve and oral mucosa as a pulse wave of 2 mW for 6 minutes. This was followed by a continuous wave of 15 mW for 3 minutes. The action potential of the nerve and EMG of the digastric muscle evoked by the noxious electrical stimulus and nerve response to noxious mechanical stimulus were compared at intervals of before, immediately after, and at 5, 10, 20, 40, 60 minutes after laser irradiation. The results were as follows: The conduction velocity of the intrapulpal $A{\delta}$- nerve fiber recorded from the inferior alveolar nerve before irradiation had a mean value of $6.68{\pm}2.07m/sec$. The laser irradiation did not affect the conduction velocity of the AS - nerve fiber and did not change the threshold intensity or amplitude of the action potential either. The EMG of the digastric muscle evoked by noxious electrical stimulation to the tooth was not changed by the laser irradiation, whether in latency, threshold intensity or amplitude. The laser irradiated to the receptive field of the oral mucosa which was subjected to noxious stimuli did not affect the amplitude of the action potential or the frequency either.

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Effects of Anesthetics on Somatosensory Evoked Potentials (SEPs) in Dogs (마취제가 개의 Somatosensory Evoked Potentials (SEPs)에 미치는 영향)

  • Hong, Yeon-Jung;Jeong, Seong-Mok;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.277-282
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    • 2002
  • This study was designed to evaluate the effects of anesthetics on waveform of SEPs and to authorize possible anesthetic protocol for measurement of the somatosensory evoked potentials (SEPs). Thirteen anesthetic methods were used. The SEPs were recorded on two channels (between the 5th and 6th lumbar vertebra as the channel 1 and between the 11th and 12th thoracic vertebra as the channel 2) following stimulation of posterior tibial nerve. ID analyze SEPs wave, latency and conduction velocity were measured. Among thirteen anesthetic methods, standard SEPs waveforms were observed in dogs anesthetized with following six methods: Acepromazine + Thiepfntal Na + Isoflurane, Acepronazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion and Propofol infusion. Above six methods could be used with sufficient anesthetic depth. The differences of latency and conduction velocity among six groups were minimal compared to general waveform of SEPs. These results indicate that the six anesthetic methods can be used for recording SEPs in the dog. In particular, Diazepam + Xylazine and XylaBine + Ketamine as injectable anesthesia are considered more convenient than other four methods in veterinary medicine.