• Journal of Korean Biological Nursing Science
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• v.17 no.3
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• pp.236-244
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• 2015

Purpose: The study was conducted to identify factors affecting the intraoperative core body temperature (CBT) of surgical patients under general anesthesia. Methods: This study was performed through a prospective descriptive research design. The sample consisted of 138 patients who had undergone elective laparotomy surgery. Age, weight, height, the basal preoperative CBT, blood pressure, and heart rate were collected. CBT was again measured at induction of anesthesia, 1 hour, 2 hours, and 3 hours following induction of general anesthesia. Results: Factors affecting intraoperative hypothermia < $36^{\circ}C$ at 1 hour following induction, were CBT at induction and total body fat (TBF) ($R^2=.569$, p<.001); at 2 hours after induction, CBT at induction and TBF ($R^2=.507$, p<.001); at 3 hours after induction, CBT at induction (${\beta}=0.34$), TBF, age and the ambient temperature in the operating room ($R^2=.449$, p<.001). Conclusion: CBT at induction and TBF appear to be factors affecting intraoperative CBT within 2 hours after induction of anesthesia; CBT at induction, TBF, advanced age and the ambient temperature after 3 hours following induction. We recommend keeping surgical patients warm before induction of anesthesia and providing intraoperative warming for surgical patients of advanced age with low TBF and when the duration of general anesthesia will last more than 3 hours.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.7.3-7
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• 1982

Endotracheal intubation is common practice for either general anesthesia or keeping artificial airway in various conditions. Despite of its great usefulness, however, laryngeal edema, ulceration, and granuloma are occasionally developed following endotracheal intubation as posttraumatic complications. Vocal cord paralysis is also rarely developed. Recently we experienced a case of left vocal cord paralysis with accompanying hoarseness following endotracheal general anesthesia for appendectomy. The symptoms of hoarseness and sore throat developed immediately after the general anesthesia. Periodic check revealed gradual return to normal function of the paralyzed cord with the complete function about 3 months after the anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.25-29
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• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.237-242
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• 2002

Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney and nervous system, and occurs predominantly in mostly males. The patients with Lowe syndrome are characterized with prominent forehead, thin and sparse hair, protruding ears, congenital cataracts, glaucoma, mental retardation, stunted growth, hypotonia, decrease in muscle mass and tendon reflexes, renal tubular dysfunction, and metabolic bone disease. A 6-year-old boy with Lowe syndrome was admitted to our clinic, with multiple caries and a chief complaint of intermittent pain on the left mandibular molar area. Because of difficulty in management of behavior and his medical problem, general anesthesia was performed for dental care. No specific complication was noticed during dental treatment procedure under general anesthesia and also during periodic recall-checks. General anesthesia itself, however, could be a potentially life-threatening procedure due to patient's biomedical problems. When a dental procedure under general anesthesia is to be required in patient with Lowe syndrome, it may be advisable being teamed with physicians, and general anesthesia duration should be as short as possible.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.173-179
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• 2015

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.2
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• pp.39-44
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• 2013

Most of the dental treatments have been routinely performed under the local anesthesia and the effectiveness has also been proved safe. However, even not frequently dentists face some complications associated with the local anesthesia. In this report, the experience of the paresthesia after mental nerve block anesthesia for an implant placement of the mandibular premolar was presented to raise awareness of the complications related with local anesthetic procedure and to discuss about the causes, the proper treatments and the preventive approach of the paresthesia.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.131-134
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• 2007

Inferior alveolar nerve block anesthesia is one of the most common procedures in dental clinic. Although it is well known as safe procedure, complications always can be occurred. Ocular complications such as diplopia, loss of vision, opthalmoplegia are very rare, but once it happens, dentist and patient can be embarrassed and rapport will be decreased between them. We experienced one diplopia case after inferior alveolar nerve block anesthesia and treated without any further complication. We report this case and describe the cause, diagnosis, and treatment objectives of diplopia caused by inferior alveolar nerve block anesthesia.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.205-213
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• 2017

Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.