• 대한소아치과학회지
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• 제30권1호
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• pp.92-101
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• 2003

연세대학교 치과대학병원에서 1997년 7월부터 2000년 7월까지 외래 전신마취하에 치과치료를 시행한 235명의 치과 장애인 환자를 대상으로 연령 분포, 전신마취 선택이유, 소요시간, 마취시간, 치료내용과 합병증 등을 분석하고, 우편 설문 조사에 응답한 109명을 대상으로 보호자의 연령과 교육정도, 보호자의 전신마취 경험 유무, 환자의 연령, 치과치료 경험의 유무 등에 따른 보호자의 불안정도와 만족도를 조사하여 다음과 같은 결과를 얻었다. 1. 아동의 전신마취시 보호자가 느끼는 불안정도는 아버지보다 어머니가 더 높았으며, 보호자의 학력이 높을수록 불안정도는 감소하는 경향을 보였다.(P<0.05) 2. 보호자의 학력이 높을수록 전신마취 치료의 만족도는 높았다.(P=0.05) 필요하다면 다시 전신마취하에 치과치료를 받겠냐는 설문에 95명(87.2%)이 받겠다고 응답하였다. 이상의 결과로 볼 때 외래 전신마취하의 치과치료는 환자 보호자에게 통상의 치과치료보다 불안을 야기하지만 치료에 대한 만족도는 높았으며 행동조절의 어려움으로 인해 치과 치료받기가 어려운 환자에게 양질의 치과 서비스를 제공할 수 있는 방안임을 알 수 있었다.

• 한국임상수의학회지
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• 제15권2호
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• pp.399-403
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• 1998

To clarify the anesthetic effect of acupoint injection(aquapupuncture) using general anasthetics in dogs, 18 mongrel dogs were divided into control and two experimental groups(Tian-ping+Bai-hui : Tian-ping group and San-yang-luo+Gong-sun group : San -yang- lux group). Control group was intramuscularly injected with ketamine hydrochloride, 22 mg/ kg of body weight into the thigh and experimental groups were injected into each acupoint with half volume of dosage, respectively. Clinical findings(recumbency time, induction time of anesthesia, time of head lift and standing time) and changes of vital sign(temperature, heart rate and respiration rate) were investigates at pre-anesthesia, during anesthesia and poststanding, respectively. In recumbency time San-yang-luo groupui<0.05) and Tian-ping group (p<0.05) were faster than that of control, respectively and Tian-ping group was the fastest. In induction time of anesthesia San-yang-luo group was similar to that of control, however, Tian-ping group was faster than that of control(p

• 대한치과마취과학회지
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• 제4권2호
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• pp.100-103
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• 2004

Spinal muscular atrophies are inherited neurodegenerative disorders affecting anterior hem cells. There are various problems, especially weakness of respiratory muscle and abnormal reaction to muscle relaxants during the general anesthesia. And gingival hyperplasia can make the proper airway management difficult. Experience with anesthetic management in a patient with spinal muscular atrophy combined with gingival hyperplasia has been very rare. We report the anesthetic experience of a wheel-chair-bound child, who underwent gingivectomy under general anesthesia. The child was safely managed with fibroscopic nasotracheal intubation under sevoflurane without muscle relaxants. Also, there was no deterioration of her underlying neurologic conditions.

• 대한치과마취과학회지
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• 제8권1호
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• pp.35-39
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• 2008

Patients with seizures tend to demonstrate a poor oral condition and gingival hyperplasia due to some antiepileptic drugs. Although most patients attain good control of their seizures with anticonvulsant drugs, seizures can occur during dental treatment for various reasons. Sedation can be recommended for anxiety control, and general anesthesia should be considered for uncooperative patient such as patients with intellectual disability or autism. The purpose of this case report was to describe the dental treatment for a patient with seizure history and intellectual disability under general anesthesia.

• 대한장애인치과학회지
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• 제3권2호
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• pp.75-79
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• 2007

Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권1호
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• pp.5-10
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• 2015

Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.

• 대한치과마취과학회지
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• 제11권2호
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• pp.146-152
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• 2011

Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

• 대한장애인치과학회지
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• 제14권2호
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• pp.71-77
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• 2018

This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.

• 성인간호학회지
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• 제12권4호
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• pp.666-677
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• 2000

The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

• 한국의료질향상학회지
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• 제7권1호
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• pp.6-17
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• 2000

Background : This study was attempted to provide a basic information necessary for the development of measures evaluating perceived discomfort of the patients under local anesthesia and the developments of nursing intervention and nursing standard. Method : The study subjects were a convenience sample of 100 surgical patients under local anesthesia. The researcher visited the patients directly and explained the purpose of the study to them. Then they were asked to fill out questionnaires which were developed and structured by the researcher, under their prior permission. Out patient's data were collected at recovery room after operation. Results : Factor analysis on measures evaluating the patients under local anesthesia showed that the measures consisted of eight factors including "explanation", "humane treatment", "motion limitation", "pain", "no togetherness", "waiting", "the environment of operating room", and "unkindness". When analyzing each of the factors regarding their degree of contribution to perceived discomfort, it was found that "waiting" was highest in terms of the degree. According to general chara-cteristics of the sampled patients, the factor of "explanation" contributed to perceived discomfort more in male patients than female ones. Regarding parts of medical examination, the patients of otorhinolaryngology felt perceived discomfort most because of the factor of "pain". Conclusion : To relieve perceived discomfort the patients under local anesthesia require providing individually systematized nursing services which can reduce perceived discomfort according to each of the factors. In doing so, an unlimited attention and much effort should be given to realize CQI reaching the dimension of increase in comfort as well as decrease perceived discomfort.