• Journal of Yeungnam Medical Science
• /
• 제35권1호
• /
• pp.45-53
• /
• 2018

Background: Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA. Methods: Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay. Results: There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group ($13.3{\pm}4.6days$ in the GA group vs. $8.5{\pm}2.4days$ in the RA group, p<0.001). Conclusion: In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

• 대한치과마취과학회지
• /
• 제12권4호
• /
• pp.223-227
• /
• 2012

Autism patients in general have bad oral hygiene. It is hard for autism patients to get dental treatment as poor communication. Therefore, they may have to be treated by deep sedation or general anesthesia in numerous cases. However, this process requires induction with mask, so it is not easy to do for disobliging autism patient. Midazolam is a water-soluble benzodiazepine, has been used in pediatric dentistry or dentistry for the handicapped because of rapid onset. Midazolam can be administered through oral, rectal, intramuscular,intravenous, and intranasal (IN) routes. IN route of midazolam may be considered as effective way to allay for uncooperative autism patients before general anesthesia. In this case report, two autism patients required dental treatment. Intranasal spray of midazolam before general anesthesia was safe and effective procedure of behavioral management.

• 대한치과마취과학회지
• /
• 제12권3호
• /
• pp.183-191
• /
• 2012

In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.

• 성인간호학회지
• /
• 제17권4호
• /
• pp.612-621
• /
• 2005

Purpose: This study aims at confirming the effects of the chest meridian massage on the post-anesthetic recovery of general anesthesia appendectomy patients. Method: The research was post-test designed as a nonequivalent control group among quasi-experiments tested. The data was collected from June 20, 2003 to October 14, 2003 at a hospital in P city. In the collected data, using SPSS Win 10.0 program, these general features were analyzed by real numbers and percentages; the homogeneity among variables by $X^2-test$ and t-test and the research hypothesis by the t-test. Result: Hypothesis 1; The experimental group receiving the treatment of the chest meridian massage will have a much higher post-anesthetic recovery score than that of the control group not receiving it was supported(t=2.544, p=.014). Hypothesis 2; The experimental group receiving the treatment of the chest meridian massage will have a much shorter time of stay in the recovery room than that of the control group not receiving it was supported(t=-4.919, p=.000). Conclusion: According to these results, it may be concluded that Chest Meridian Massage is effective in producing a higher level of post-anesthetic recovery score and helps appendectomy patients reduce the time of stay in the recovery room. Therefore the chest meridian massage can be considered as an intervention therapy for directly nursing general anesthesia appendectomy patients.

• 한국임상수의학회:학술대회논문집
• /
• 한국임상수의학회 2009년도 추계학술대회
• /
• pp.218-218
• /
• 2009

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제24권2호
• /
• pp.137-138
• /
• 2024

• 대한두개안면성형외과학회지
• /
• 제9권2호
• /
• pp.77-80
• /
• 2008

Purpose: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. Methods: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. Results: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. Conclusion: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.

• 사물인터넷융복합논문지
• /
• 제3권2호
• /
• pp.21-32
• /
• 2017

본 연구는 노인 전신마취 환자의 회복실 체류시간에 영향을 미치는 융합적 요인들을 파악하기 위한 서술적 조사연구이다. 경기도 소재 C대학병원에서 2014년 1월 1일부터 2014년 12월 31일까지 전신마취하에 수술을 받고 회복실에 입실하였던 환자 중 65세 이상인 환자 300명을 대상으로 후향적으로 자료 수집을 하였다. 회복실 체류시간은 평균 48.4분으로 나타났으며, 회복실 체류시간 30-59분이 58.0%로 가장 많았다. 수술중 요인에 따른 회복실 체류시간 정도는 근이완제, 수혈, 동맥혈가스 검사, 체온 그리고 총 마취시간에 따라 유의한 차이가 있는 것으로 나타났다. 수술후 요인에 따른 회복실 체류시간 정도는 합병증, 자가 통증 조절기, 순환기계 약물사용에 따라 유의한 차이가 있는 것으로 나타났다. 회복실 체류시간에 영향을 미치는 요인을 알아보기 위해 다중 회귀분석을 실시한 결과 수술 후 '순환기계 약물사용', '수술 중 저체온'이 회복실 체류시간에 영향을 미치는 것으로 확인되었고 설명력은 13%로 나타났다. 이러한 결과를 토대로 회복실 체류시간 관련요인들을 모니터링하고 신속하게 처치하여 교정하는 것이 노인 전신마취 환자의 회복실 체류시간의 단축에 기여할 것으로 사려된다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제18권3호
• /
• pp.169-175
• /
• 2018

Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

• Journal of Yeungnam Medical Science
• /
• 제36권1호
• /
• pp.50-53
• /
• 2019

Awareness during general anesthesia occurs in approximately 0.1-0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0-5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7-1.3 MAC, awareness during anesthesia occurred.