• 대한의용생체공학회:의공학회지
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• 제22권3호
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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.

• 간호행정학회지
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• 제14권4호
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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.

• 기본간호학회지
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• 제22권2호
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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.

• 대한치과마취과학회지
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• 제1권1호
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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.

• 대한치과마취과학회지
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• 제9권1호
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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.

• 대한후두음성언어의학회지
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• 제18권1호
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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.

• 대한장애인치과학회지
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• 제12권1호
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• pp.1-5
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• 2016

저자는 과잉치로 인한 불편감을 호소하며 서울대학교치과병원 소아치과에 내원한 2세 7개월의 로비노 증후군 증례를 치료하였기에 문헌 고찰과 함께 보고하는 바이다. 환자의 전신 소견으로는 대두증, 전두부 돌출, 양안격리증, 넓은 안검렬, 들창코, 콧등 함몰, 삼각형의 입술을 포함하는 특이한 안모와 짧은 손,발가락, 소음경을 포함한 잠복고환 및 발달지연이 관찰되었다. 구내 소견으로는 수술받은 구순열과 하악골 저성장, 치아맹출지연, 치은비대, 과잉치가 관찰되었다. 로비노 증후군 환아는 전신마취 하에서 성공적으로 치과 치료가 가능했다. 치과의사는 치과 치료에 의한 스트레스로 인해 근육의 긴장저하, 발달, 호흡, 섭식 등 의 전신적인 상태를 항상 고려해야 한다. 또한, 로비노증후군 환자가 두개 안면부의 이형성과 맹출장애를 가진다는 사실을 알고 접근해야 하며, 환자가 성장함에 따라 적절한 시기에 필요한 치료를 할 수 있도록 주기적인 관찰이 필요하다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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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.

• Journal of Yeungnam Medical Science
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• 제26권2호
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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.