• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.27-35
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• 2016

The present study aimed to assess the perception of a child's primary caregiver on the oral health-related quality of life (OHRQoL) of dental treatment under general anesthesia (GA) or intravenous sedation (IV-SED) in pediatric dental patients. Self-administered questionnaires were completed before dental treatment under GA or IV-SED by 52 primary caregivers of healthy pediatric patients (10 years old or younger), and 43 (84%) of these caregivers completed the same questionnaires within 6 months after treatment. The Korean version of Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were used to assess OHRQoL in the questionnaires. The scores of COHIP and FIS improved after dental treatment. Demographic variables such as gender did not affect the improvement of COHIP and FIS, and age did not affect that of COHIP. However, baseline FIS score of younger patients was better than that of older patients before dental treatment. Regardless of the treatment variables, all COHIP and FIS scores were improved after dental treatment. COHIP score improved more in cases with pulp treatments compared to those without the treatments. On the other hand, FIS score improved less in cases with posterior stainless steel crown restorations compared to those without them. Anterior esthetic restorations and anterior teeth extractions did not affect the degree of improvement. Based on the primary caregiver's perceptions, the OHRQoL of healthy pediatric patients was improved by dental treatment under GA or IV-SED.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9505-9509
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• 2014

Objective: To investigate the effects of stellate ganglion block (SGB) on the peri-operative vasomotor cytokine content and intrapulmonary shunt in patients with esophagus cancer who underwent thoracotomy. Materials and Methods: Forty patients undergoing elective resection of esophageal cancer patients who had I~II American Society of Anesthesiologist (ASA) were randomly divided into total intravenous anesthesia group (group N, n=20) and total intravenous anesthesia combined with SGB group (group S, n=20, 0.12 mL/kg 1% lidocaine was used for SGB 10 min before induction). Heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (MPAP) and continuous cardiac output (CCO) were continuously monitored. The blood from internal jugular vein was drawn respectively before induction ($T_0$), and 30 min ($T_1$), 60 min ($T_2$) and 120 min ($T_3$) after one-lung ventilation (OLV), and 30 min (T4) after two-lung ventilation. The contents of plasma endothelin (ET), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) were detected with enzyme linked immunosorbent assay (ELISA). Meanwhile, arterial and mixed venous blood samples were collected for determination of blood gas and calculation of intrapulmonary shunt fraction (Qs/Qt). Results: During OLV, ET contents were increased significantly in two groups (P<0.05), and no significant difference was presented (P>0.05). NO content in group S was obviously higher than in group N at T3 (P<0.05), whereas CGRP content in group N was markedly lower than in group S at each time point (P<0.05). Qs/Qt was significantly increased in both groups after OLV, but there was no statistical significant regarding the Qs/Qt at each time point between two groups. Conclusions: Total intravenous anesthesia combined with SGB is conducive to regulation of perioperative vasomotor cytokines in thoracotomy, and has little effect on intrapulmonary shunt at the time of OLV.

• Journal of Korea Multimedia Society
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• v.20 no.3
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• pp.482-490
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• 2017

Early detection of infiltration is one of the most important tasks of nurses to minimize skin damage due to infiltration. For subjects receiving invasive intravenous treatment, the bioelectrical impedance (impedance) were measured in the frequency range of 5 to 500 kHz using bioelectrical impedance spectroscopy (BIS). After attaching electrodes at both ends of a transparent dressing mounted on the skin in which IV solution was infused into the vein, the change in impedance was measured as a function of time and frequency before and after infiltration. The experimental results are described as follows. When IV solution was properly infused into the vein, the impedance was nearly constant over time and decreased with increasing frequency. However, when infiltration occurred, the impedance decreased significantly and thereafter gradually decreased with time. In addition, impedance decreased with time for all applied frequencies. In this study, when IV solution penetrated into the surrounding skin and subcutaneous tissue by infiltration, impedance was quantitatively analyzed for as a function of time and frequency. This suggests a method for early detection of infiltration using BIS.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.171-176
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• 1998

Postoperative pain following tonsillectomy remains a significant obstacle to speedy recovery and smooth convalescence. Inadequate analgesia causes poor oral intake and influences the length of hospital stay and ability to return to normal activity. Patient Controlled Analgesia (PCA) is a method of analgesia adminstration that consists of a computer driven pump with a button that the patient may press to adminster a small dose of analgesic drug. The aim of this study was to examine whether Intravenous Patient Controlled Analgesia (IV-PCA) can reduce postoperative pain after tonsillectomy. The 100 patients undergoing tonsillectomy with general anesthesia were divided into two groups. The PCA group patients (n=80) received a mixture of nalbuphine and ketorolac by Walkmed PCA infusor during first 48 postoperative hours. In control group (n=20), the patients received oral acetoaminophen (Tyrenol) regularly and tiaprofenic acid (Surgam) intramuscularly on a p.r.n basis. Analgesic efficacy was evaluated with visual linear analogue scale (VAS) and the adverse effects were evaluated with 4 point scale. The patients of PCA group had less pain than those of control group. The adverse effects in the PCA group were nausea and vomiting. This study suggests that IV-PCA may be safe and effective method of pain control after adult tonsillectomy and is better accepted than oral or intramuscular pain medications.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.3
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• pp.153-162
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• 2023

Background: Recent animal studies have suggested the role of GABA type A (GABA-_A) receptors in salivation, showing that GABA-_A receptor agonists inhibit salivary secretion. This study aimed to evaluate the effects of propofol (a GABA-_A agonist) on salivary secretions from the submandibular, sublingual, and labial glands during intravenous sedation in healthy volunteers. Methods: Twenty healthy male volunteers participated in the study. They received a loading dose of propofol 6 mg/kg/h for 10 min, followed by 3 mg/kg/h for 15 min. Salivary flow rates in the submandibular, sublingual, and labial glands were measured before, during, and after propofol infusion, and amylase activity was measured in the saliva from the submandibular and sublingual glands. Results: We found that the salivary flow rates in the submandibular, sublingual, and labial glands significantly decreased during intravenous sedation with propofol (P < 0.01). Similarly, amylase activity in the saliva from the submandibular and sublingual glands was significantly decreased (P < 0.01). Conclusion: It can be concluded that intravenous sedation with propofol decreases salivary secretion in the submandibular, sublingual, and labial glands via the GABA-_A receptor. These results may be useful for dental treatment when desalivation is necessary.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.65-69
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• 2017

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.126-130
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• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.109-115
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• 1995

High frequency Jet ventilation (HFJV) via cricothyroid membrane puncture contols frequency of ventilation as 20-200/min and persuits adequate gas exchange. HFJV was known to have advantages such as improvement of PaO$_2$, lesser barotrauma, stable hemodynamic effects, good operative field and lesser movement of head. The purpose of this study was to clarify the advantages of HFJV in cases of microlaryngeal surgery which operating time was expected even within 30 minutes. Twenty-eight patients were divided two groups : 1)control group : general endotracheal Intubation anesthesia. 2)experimental group : HFJV via cricothyroid membrane puncture with intravenous anesthesia, frequency 40/min, I/E ratio 40%, driving pressure 40 psi. We analyzed blood pressure, arterial blood gas, score of general condition and recovery time after operation. In conclusion, HFJV via cricothyroid membrane puncture had a good score of general condition and rapid recovery of consciousness, although some accumulation of P$CO_2$and elevation of blood pressure.

• Korean Journal of Veterinary Research
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• v.46 no.1
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• pp.47-55
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• 2006

To evaluate method for monitoring anesthetic depth with quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) and pain score till 100 minutes in beagle dogs anesthetized for 60 minutes with propofol (n = 5, PRO group), isoflurane (n = 5, ISO group) and propofol-ketaminefentanyl (n = 5, PFK group). Raw EEG was converted into 95% spectral edge frequency (SEF) by fast Fourier transformation (FFT) method. We investigated anesthetic depth by comparing relationship (Pearson's correlation) between q-EEG (95% SEF) and pain score. Pearson's correlation coefficients are +0.2372 (p = 0.0494, PRO group), +0.79506 (p < 0.001, ISO group) and +0.49903 (p = 0.0039, PFK group).

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.67-71
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• 2016

Eisenmenger syndrome (ES) is characterized by pulmonary arterial hypertension and right-to-left shunting. The signs and symptoms of ES include cyanosis, shortness of breath, fatigue, hemoptysis, and sudden death. In patients with ES, it is important that the systemic and pulmonary circulations be properly distributed and maintained. General dental treatment is not known to be particularly dangerous. To control pain and anxiety, local anesthetics without epinephrine are usually recommended. However, in cases of difficulty of cooperation, general anesthesia for dental treatment makes the condition worse. In the present case, intravenous deep sedation with propofol and remifentanil was administered for behavioral management during dental treatment successfully.