• The Korean Journal of Pain
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• 제19권1호
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• pp.77-80
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• 2006

Background: Painful experiences during procedures such as prolotherapy and intramuscular stimulation are stressful to patients and can affect the treatment outcome. We present a method for relieving pain and increasing the level of patient comfort during the procedure. Methods: Twenty six patients who requested sedation anesthesia during the procedure were examined. All patients were injected with 500 ml of 0.9% normal saline and were monitored by electrocardiography, blood pressure and pulse oximetry. The patients were supplied with oxygen (3 L/min) through a nasal cannula. Midazolam (0.02 mg/kg) and alfentanil ($8{\mu}g/kg$) was injected before the procedure and a bolus injection was administered during the procedure if patients felt any pain. The duration of the procedure, the total amount of drugs, the changes in the systolic blood pressure, heart rate, pulse oxygen saturation, sedation and pain level during procedure, satisfaction scale after the procedure, complications and the incidence of amnesia were evaluated. Results: Twenty one patients had a moderate level of sedation, 15 patients did not feel any pain during the procedure, 17 patients had high level of satisfaction (8-10). No patient experienced complications after the procedure, or unstable vital signs, and 6 patients could not remember the procedure. Conclusions: Sedation anesthesia is a safe method for relieving pain during the procedure, and most patients had a high level of satisfaction.

• 임상간호연구
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• 제23권1호
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• pp.30-39
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• 2017

Purpose: The aim of this study was to evaluate the effects of favorite music therapy on the stress response of hysterectomy patients undergoing general anesthesia. Methods: Date were collected from June 29, 2015 to January 18, 2016 and the participants were 79 hysterectomy patients (experimental group 40 and control group 39). The experimental group listened to their favorite music through earphones from the moment they entered the surgical waiting room until they exited from the post anesthesia care unit. Results: There were statistically significant differences in anxiety (F=15.92, p<.001), systolic blood pressure (F=4.23, p=.008), diastolic blood pressure (F=3.07, p=.033), and heart rate (F=19.93, p<.001) between participants in the experimental group and the control group according to measurement times. Conclusion: The study results show that favorite music therapy considering patients' preferences is effective in reducing anxiety among patients undergoing a hysterectomy under general anesthesia, thus leading to a stable change in their blood pressure and heart rate.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.117-122
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• 2016

Background: The aim of this study was to compare the effectiveness and duration of action of two concentrations of bupivacaine with adrenaline for postoperative pain in patients undergoing surgical removal of four third molars under general anesthesia. Methods: Sixty patients undergoing surgical removal of four wisdom teeth received bupivacaine 0.5% (n = 30) or 0.25% (n = 30). The severity of pain in the immediate recovery period and at 2 and 24 h after surgery was recorded using the visual analogue scale. Differences were assessed by box and whisper plot and the Student's t-test. Results: The analgesic effects of the 0.25% and 0.5% doses were significantly different (P = 0.022) at 30 min after surgery but not after 2 and 24 h. The difference of mean of 0.25% and 0.5% was much higher after 0.5 h but less after 2 and 24 h. Conclusions: Bupivacaine 0.5% was statistically better for pain control during the immediate postoperative period, but there was no significant difference in pain control between the two dose strengths at 2 and 24 h after surgery.

• 대한치과마취과학회지
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• 제8권1호
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• pp.22-28
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• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP 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 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ 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.

• 대한장애인치과학회지
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• 제15권1호
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• pp.50-54
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• 2019

본 증례는 다수의 치아우식증을 주소로 내원한 근이영양증 환자의 전신마취 하 치과치료에 대한 보고이다. 근이영양증 환자들은 진행성 근육 약화로 인해 구강위생 관리하기가 힘들고 치아우식이 호발할 수 있다. 따라서 정기적으로 치과를 내원하고 올바른 구강 위생 습관을 확립할 수 있도록 환자 및 보호자교육을 실시하여야 한다. 치과치료 시에는 흡인으로 인한 호흡기 합병증이 발생하지 않도록 액체의 흡입을 주의 깊게 하여야 한다. 비협조적이거나 매우 어린 근이영양증 환자에서는 전신마취가 필요할 수 있다. 전신마취 시에는 악성 고열증의 위험 때문에 휘발성 마취제를 피해야 한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.235-244
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• 2018

Background: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. Methods: Seventeen patients (mean age, $9.6{\pm}2.9years$) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. Results: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. Conclusion: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.

• 대한치과마취과학회지
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• 제6권1호
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• pp.1-5
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• 2006

Background: The aim of this study was to evaluate the preventive effect of propofol on postoperative nausea and vomiting (PONV) following general anesthesia to the patients having oral and maxillofacial surgery. Methods: In a prospective, randomized. case-controlled study. 200 patients were divided into two groups (n = 100 in each). In propofol (P) group, patients received 0.5 mg/kg of propofol intravenously at the end of anesthesia. In control (C) group, no antiemetics was given. Emetic symptoms like nausea, retching and vomiting were assessed by a blind nurse at 1 hour and at 24 hours after anesthesia respectively. Also level of sedation was checked by a blind anesthesiologist at 1 hour after anesthesia. Results: There were no significant differences in frequencies of nausea, retching and vomiting between C group and P group at 1 hour after anesthesia. However, nausea, retching and vomiting were all decreased in P group compared with C group at 24 hours after anesthesia (P < 0.05). Also there was no significant difference in level of sedation at 1 hour after anesthesia between C group and P group (P > 0.05). Conclusions: From the results, prophylactic use of subhypnotic dose of propofol could be effective for preventing PONV without change in level of sedation to the patients undergoing general anesthesia for oral and maxillofaical surgery.

• Journal of Korean Biological Nursing Science
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• 제17권2호
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• pp.114-122
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• 2015

Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.209-212
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• 2016

Lidocaine, a local anesthetic commonly used in dental treatments, is capable of causing allergies or adverse effects similar to allergic reactions. However, the frequency of such occurrences in actual clinical settings is very rare, and even clinical tests on patients with known allergies to local anesthetics may often show negative results. When adverse effects, such as allergy to lidocaine, are involved, patients can be treated by testing other local anesthetics and choosing a local anesthetic without any adverse effects, or by performing dental treatment under general anesthesia in cases in which no local anesthetic without adverse effects is available. Along with a literature review, the authors of the present study report on two cases of patients who tested positive on allergy skin tests for lidocaine and bupivacaine and subsequently underwent successful dental treatments with either general anesthesia or a different local anesthetic.

• 대한소아치과학회지
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• 제42권2호
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• pp.158-163
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• 2015

치과치료를 위해 진정법 또는 전신마취를 시행하는 목적은 일반적인 방법으로 치과 의료를 제공받기 어려운 환자에게 양질의 치과치료를 제공하기 위해서이다. 본 연구는 전북대학교 치과병원에서 외래전신마취 하에 치료받은 소아 및 장애인 환자들의 임상진료 실태를 분석하고 향후 일반적인 치과진료가 어려운 환자들의 외래전신마취 치료에 대한 지침을 마련하고자 하였다. 2005년 1월부터 2014년 3월까지 전북대학교 치과병원에 내원한 소아 및 장애인 환자들을 대상으로 조사한 결과, 총 325명의 환자들이 외래전신마취 하에서 치과치료를 받았다. 남자 환자의 비율이 62.2%로, 여자 환자의 비율(37.8%)보다 높았으며, 10세 이하의 환자가 151명(46.5%)로, 소아 및 청소년 환자가 높은 비율을 차지하고 있었다. 치료내용을 보면 수복치료와 발치가 주를 이루고 있었으며 2회 이상 전신마취를 시행한 환자가 43명(13.2%)이었다. 본 연구는 일반적인 치과치료가 어려운 소아 및 장애인 환자들을 위해 효율적이며 안전한 전신마취 시스템을 확충해서 환자들에게 보다 편안한 치료 환경을 제공해야 할 필요성을 제시하고 있다.