• Title/Summary/Keyword: Anesthesia, General

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Analysis of Biosignal Variations caused by Epidural Anesthesia (경막외마취에 따른 생체신호 변화의 분석)

  • 전영주;임재중
    • Journal of Biomedical Engineering Research
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    • v.22 no.3
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    • pp.275-283
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    • 2001
  • This study was performed to extract and analyze the biosignals to find the relationship between the level of anesthesia and the variations of physiological parameters during epidural anesthesia. Seven male and twenty female patients(ages from 45 to 70 years old) were participated for the experiment, and ECGs, PPGs, SKTs, SCRs were obtained during anesthesia. As results, the HF/LF ratios of HRV were decreased after the injection anesthetics. For skin temperatures, values measured from the palm was reduced and the temperatures from four channels, measured from armpit through the right side of the body, were increased. SCRs were decreased for all channels after the injection of anesthetics. However the heart rate and PPGs showed no significant changes. It was concluded that the injection of anesthetics result the changes in biosignals, and it could be explained by the degree of the sympathetic and/or parasympathetic nerve activities. Results of this study could provide the valuable information for the estimation of level for the spinal and general anesthesia, and could be extended to the development of a system which could quantify the level of anesthesia.

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Comparison of Nursing Workload Associated with Patient and Anesthetic Factors in the Post-anesthesia Care Unit (회복실에서의 환자 및 마취 관련 요인에 따른 간호업무량 비교)

  • Lee, Yoon-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.4
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    • pp.432-439
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    • 2008
  • Purpose: The purpose of this study was to examine nursing workload associated with patient and anesthetic factors in the post-anesthesia care unit(PACU). Method: The data used in this study were collected from February 26th, 2008 to May 16th, 2008. The subjects were 828patients and collected data were analyzed by using SPSS program. Results: It was found that there were statistical differences in gender, age, past history, type of anesthesia, duration of anesthesia, type of surgery. The mean PRN for nursing workload was 25 for below 17 years, and 27.5 for above 61 years. The mean PRN for nursing workload was 27 for general anesthesia, and 16 for regional anesthesia. The mean PRN for nursing workload was 29 for orthopedic surgery and neurosurgery, and 23 for ophthalmology. The mean PRN for nursing workload was 24.6 for below 1hour in duration of anesthesia, and 27.5 for above 2hours in duration of anesthesia. Conclusion: This study was carried out to examine nursing workload in the PACU. The results from this study will be help to improve nursing in PACU through efficient distribution of nursing workload in PACU.

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Effects of Family Presence Intervention on Anxiety, Delirium, Pain and Length of Time in Recovery Room of Post-operative Elderly Patients in Post-anesthesia Care Units (회복실 보호자 상주가 전신마취 노인수술환자의 수술직후 상태불안, 각성섬망, 통증 및 회복실 체류시간에 미치는 영향)

  • Kim, Kyunghee;Lee, Sookhee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.2
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    • pp.149-157
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    • 2015
  • Purpose: The objectives of this study were to assess the influence of family presence in the PACU (Post Anesthesia Care Unit) on anxiety, emergency delirium, pain and length of stay in the recovery room for elderly patients undergoing surgery for which general anesthesia has been used. Methods: The study was a nonequivalent control group pre-post test design. Eighty elderly patients over 65 years who underwent surgery under general anesthesia were recruited. Forty were assigned to the experiment group, patients together with a family member and 40 to the control group, with no family member present. Patients' anxiety, emergency delirium, pain and length of time in the recovery room were evaluated at 10 minute and 30 minute after arrival in the PACU. Results: Patients with family members in the PACU showed significantly decreased levels of anxiety at 10 and 30 minutes and significantly lower levels of emergency delirium and pain at 30 minutes. However there was no difference between the 2 groups for length of time in the recovery room. Conclusion: The results of this study indicate that being with family members in the PACU after surgery under general anesthesia is effective for reducing elderly patients' anxiety, delirium and pain during time in the recovery room.

Primary Closure of Deep Penetrating Wounds under Local Anesthesia with Dental Lidocaine HCL 28 Ampules in Maxillofacial Regions -Report of two cases - (치과용 Lidocaine 28 앰플로 국소마취 하에 1차 봉합한 악안면 심부 관통성 열창 -증례 보고-)

  • Kim, Jong-Bae;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.26-31
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    • 2001
  • The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{\mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{\mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.

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Clinico-statistical Analysis of Cooperation and Anesthetic Induction Method of Dental Patients with Special Needs (장애인 환자의 치과치료를 위한 전신마취 시 협조도와 마취 유도 방법에 대한 통계적 고찰)

  • Seo, Kwang-Suk;Shin, Teo-Jeon;Kim, Hyun-Jeong;Han, Hee-Jeong;Han, Jin-Hee;Kim, Hye-Jung;Chang, Ju-Hea
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.1
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    • pp.9-16
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    • 2009
  • Background: This study aimed to evaluate the cooperative levels of dental patients requiring general anesthesia during dental treatments. Anesthetic induction methods for patients were also recorded and analyzed using descriptive statistics. Methods: Total 566 patients who visited Seoul National University Dental Hospital Clinic for Persons with Disabilities were reviewed on pre-anesthetic review and anesthesia records. The cooperative levels of patients were graded by 4 levels and induction methods used for the patients during general anesthesia application were analyzed. Results: More than half of patients(55.8%) were willing to receive the anesthetic induction(cooperative level 1), 18.6% were minimally cooperative(level 2), 20.8% needed physical restraint prior to induction(level 3), and 4.8% was poorly cooperative and induction procedure was performed under an unconscious condition after ketamine intramuscular injection(level 4). There was no gender difference in cooperative levels(P=0.11). Patients over 30 years revealed better cooperation levels compared to other age groups(P<0.05). For patients of level 1, 53.5% were anesthetized in a way of intravenous induction, while 77.1% out of patients of level 3 were anesthetically induced through inhalation method. Conclusion: Many dental patients with special needs were not cooperative to receive anesthetic induction. Additional behavioral support may be applied to poorly cooperative patients for the safe and successful clinical outcome.

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585-nm Pulsed Dye Laser Treatment of Vocal Polyp (585-nm Pulsed Dye LASER를 이용한 성대 폴립의 치료)

  • Choi, Hong-Shik;Lee, Kun-Wayn;Kim, Min-Ho;Kwon, Soon-Ho;Jeon, Ju-Hyun;Kim, Kwang-Moon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.1
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    • pp.44-50
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    • 2007
  • Background and Objectives: The 585-nm pulsed dye laser (PDL) has recently been adopted by otolaryngologists because of its epithelial-sparing properties. Many authors have reported the use of PDL for treatment of various vocal cord lesions. This purpose of this study is to examine the effectiveness of 585-nm PDL in the treatment of vocal polyp. Materials and Methods: Eight patients with vocal polyp were treated with 585-nm PDL from Sep. 2006 to Nov. 2006 in Yong-dong Sevrance hospital. 5 of them went through local anesthesia and 3 of them went through general anesthesia. In order to control laser fiber, flexible digital transnasal laryngoscope was applied under local anesthesia and general anesthesia using LMA, and micromanipulator was used under general anesthesia using endotracheal tube. The evaluations of vocal function was done at pre-and postoperation. Results: All patients improved in the perceptual evaluation of voice after PDL surgery. The aerodynamic study revealed that 5 of 8 patients showed improvement in maximal phonation time, and 6 of 8 showed improvement in mean airflow rate during phonation. The acoustic analysis revealed that all patients showed improvement in Jitter and Shimmer, and 7 of 8 showed improvement in noise to harmony ratio. Conclusion: This study demonstrates promising results in the efficacy of 585-nm PDL for the treatment of vocal polyps, and it illustrates a new option for vocal polyp treatment as well as the advantage of PDL surgery.

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MESIODENS EXTRACTION OF A PATIENT WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA (로비노 증후군(Robinow syndrome) 환자의 전신마취 하 과잉치 발치)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.1-5
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    • 2016
  • Robinow syndrome is skeletal dysplasia with both autosomal dominant and recessive inheritance patterns. It is characterized by short-limbed dwarfism, abnormalities in the head and face, as well as vertebral segmentation. A 2-year-7-month old boy with Robinow syndrome had visited Seoul National University Dental Hospital, for the evaluation of tooth palatal eruption on maxilla. He had micrognathia, delayed tooth eruption, cleft lip with bifid uvula. He also had an erupted mesiodens on the palatal side of maxillary primary incisors, which was tuberculated and 8mm in major diameter. The patient was scheduled for mesiodens extraction under general anesthesia. He was a young child with delayed development, so general anesthesia was inevitable. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. There were no postoperative complications related to anesthesia and dental treatment. Robinow syndrome patients have craniofacial dysmorphism and eruption disorders. Therefore, he requires regular check-ups as well as dental managements.

Diplopia after inferior alveolar nerve block: case report and related physiology

  • You, Tae Min
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.93-96
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    • 2015
  • Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

High stakes anesthesia: Anesthetic considerations and implications for complete dental extraction in a patient with complex comorbidities

  • Panchamia, Rohan K.;Samuels, Jon D.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.3
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    • pp.167-173
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    • 2019
  • This case report describes a frail, middle-aged woman with multiple comorbidities who was scheduled to undergo extraction of all remaining teeth in anticipation of cardiac quadruple valve intervention. Dental and anesthetic management of the patient are discussed. Medical care of the patient with a high burden of comorbidities requires a multidisciplinary approach even for a routine dental procedure.

Anesthetic Experience for Trans-Sphenoidal Surgery of Pituitary Adenoma on a Patient with Brugada Syndrome - A Case Report - (Brugada 증후군 환자의 경접형동 선종절제술을 위한 마취 경험)

  • Heo, Min-Jung;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.26 no.2
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    • pp.148-155
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    • 2009
  • Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in the right precordial leads ($V_1-V_3$) without structural heart disease. It is also characterized by sudden cardiac death that's caused by ventricular fibrillation. This is a familial syndrome with an autosomal dominant inheritance pattern and it may be considerably more common in Southeast Asia. Many factors during anesthesia can precipitate malignant dysrrhythmia in these patients, so careful choice of anesthetics is required. We experienced a case of Brugada syndrome in a 59-year-old male patient who was under general anesthesia for trans-sphenoidal surgery to treat a pituitary adenoma, and the patient was diagnosed as having Brugada syndrome without any untoward cardiovascular events.

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