• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.167-171
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• 2021

We describe the successful insertion of a nasotracheal tube following repeated cuff rupture. The patient was a 55-year-old woman with a history of nasal trauma and multiple rhinoplasties, who underwent elective Lefort I osteotomy and bilateral sagittal split osteotomy for correction of skeletal facial deformity. During fiberoptic bronchoscope-guided nasal intubation after the induction of general anesthesia, the tracheal tube repeatedly ruptured in both nares, despite extensive preparation of the nasal airways. We covered the cuff with a one-inch tape, intubated to the level of the oropharynx, pulled the tracheal tube out through the mouth, and removed the tape. The tracheal tube was then backed out to the level of the uvula, and was successfully advanced.

• Korean Journal of Veterinary Service
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• v.39 no.2
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• pp.93-99
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• 2016

The anesthetic depth and cardiovascular effect of alfaxalone constant rate infusion in dogs premedicated with xylazine or acepromazine were evaluated. Ten dogs were randomly allocated into 2 groups. In group AA, dogs were premedicated with 0.02 mg/kg of intravenous acepromazine at 15 min before induction. In group XA 1.1 mg/kg of intravenous xylazine was premedicated at 5 min before induction. The anesthesia was maintained with 6 mg/kg/hr of alfaxalone after induction with 2 mg/kg alfaxalone in both groups. In both of groups, the qualities of induction were satisfactory without any adverse event, but adequate analgesia could not be provided, according to the withdrawal test. $PaO_2$ and $SaO_2$ implied a slight hypoxemia state in XA group, while those values of group AA were not significantly changed. The acepromazine and alfaxalone combination induce mild tachycardia. The bispectral index score were significantly decreased in group XA, compared with that in group AA. The premedication of xylazine before alfaxalone constant rate infusion in this study could provide adequate analgesia during 30 min, while the premedication with acepromazine could not.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.89-93
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• 1984

This study included 38 children patients of less than 4 years old and 18kg body weight. 93 After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr values after induction was significantly increased than control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.130-134
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• 2009

Background: The advances in surgical technology, anesthesia and perioperative care have made it possible to perform laparoscopic cholecystectomy on an outpatient basis. This study was conducted to assess the analgesic effect and the adverse events of different dosing methods when using transdermal fentanyl patches (TDFPs) after laparoscopic cholecystectomy. Methods: Sixty patients who were to undergo laparoscopic cholecystectomy under general anesthesia were divided into two groups. Group 1: 2 TDFPs that released $12{\mu}g/h$ were applied after the induction of anesthesia and these 2 patches were removed after 24 hours. Group 2: 2 TDFPs that released $12{\mu}g/h$ were applied after the induction of anesthesia and one patch was removed after 7 hours and the other patch was removed after 24 hours. The intensity of the postoperative pain was assessed by using a visual analogue scale (VAS) and assessing the adverse events, including dizziness, pruritus and nausea/vomiting, were recorded for 48 hours postoperatively. Results: The VAS score of postoperative pain was not significantly different between the two groups at all times. The incidence of dizziness in groups I and II was 10 and 3, respectively, and the incidence of nausea/vomiting in group I and II was 4 and 0, respectively. The incidences of dizziness and nausea/vomiting in group II were significantly lower than those of group I (P<0.05). Conclusions: A dosing method that removes half of the TDFPs ($24{\mu}g/h$) after 7 hours of application caused a lower incidence of dizziness and nausea/vomiting without any significant difference of postoperative analgesic efficacy, as compared to leaving on both the TDFPs (24$\mu$g/h) for 24 hours after laparoscopic cholecystectomy.

• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1061-1072
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• 2007

Purpose: The purpose of this study was to compare the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of abdominal surgical patients under general anesthesia. Method: Data collection was performed from January 4th, to May 31, 2004. The intravenous fluid warming(IFW) group(30 elderly patients) was warmed through an IV line by an Animec set to $37^{\circ}C$. The skin surface warming(SSW) group(30 elderly patients) was warmed by a circulating-water blanket set to $38^{\circ}C$ under the back and a 60W heating lamp 40 cm above the chest. The warming continued from induction of general anesthesia to two hours after completion of surgery. Collected data was analyzed using Repeated Measures ANOVA, and Bonferroni methods. Results: SSW was more effective than IFW in preventing hypothermia(p= .043), preventing a decrease of $HCO_3{^-}$(p= .000) and preventing base excess(p= .000) respectively. However, there was no difference in pH between the SSW and IFW(p= .401) groups. Conclusion: We conclude that skin surface warming is more effective in preventing hypothermia, and $HCO_3{^-}$ and base excess during general anesthesia, and returning to normal body temperature after surgery than intravenous fluid warming; however, skin surface warming wasn't able to sustain a normal body temperature in elderly patients undergoing abdominal surgery under general anesthesia.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.312-316
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• 2003

This study was performed to investigate the reverse effects of Jen Chung(Ren Thong, Shui Gou, GV-26) electroacupuncture after tiletamime-zolazepam administration in dogs. Seven healthy dogs ranging in weigh from 3.5 to 6.5 kg were used in this experiment. The treatment group was electrostimulated to Jen Chung(+) and Su Liao(Shan Gen, GV-25, -) for 20 minutes after 10 minutes of anesthesia. The control group I was anesthetized with tiletamine-zolazepam. The control group II was electrostimulated to nonacupuncture point for 20 minutes after 10 minutes of anesthesia. Various parameters were evaluated including the onset and recovery time of anesthesia, heart rates, body temperature, respiratory rates and electrocardiogram. The recovery time of the treatment group was shorter than that of the control group I and the control group II(p < 0.05). The treatment group had an increase in the heart rate from 20 minutes to 30 minutes after administration of tiletamime-zolazepam compared to the control group I and control group II(p < 0.05). The decrease in the body temperature was observed in all groups, but the body temperature of the treatment group was higher than the body temperature of the other groups. Respiratory rates gradually increased in all groups, but the treatment group had an increase in the respiratory rates from 20 minutes to 30 minutes after administration of tiletamime-zolazepam compared to the other groups. In the three groups, there was no specific finding on the electrocardiogram. In the result, the electroacupuncture on Jen Chung in dogs was effective for the reversed effects the tiletamine-zolazepam anesthesia 20 minutes after induction.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.2
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• pp.1189-1199
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• 2015

This study examined the effects of favorite music therapy on the anxiety and vital signs at each point in gynecologic surgery using the general anesthesia. The research design was a non-equivalent control group non-synchronized design. The data were collected from May 1 to July 30, 2013 and the participants were 44 patients (experimental group, 21, control group, 23) received music therapy while waiting for anesthetic induction and PACU (Post Anesthesia Care Unit). Repeated measures ANOVA was performed to analyze the data by SPSS 18.0. Music therapy reduced the anxiety level at inducing the anesthetic time, and awakening time (p=.003; p=.011). The systolic blood pressure maintained stability at discharge from the PACU (p=.023), and pulse rate was stable at the awakening time (p=.016). This findings support the use of music as a nursing intervention to reduce anxiety and maintain the vital signs for gynecologic surgery patients under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.129-137
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• 2021

Background: Inappropriate use of intravenous and inhaled anesthetics may be dangerous in infants undergoing facial cleft surgeries. This study primarily aimed to compare the effect of infraorbital nerve block on sevoflurane requirement in infants undergoing cheiloplasty. Intraoperative opioid consumption, hemodynamics, blood glucose levels, extubation time, and delirium were also compared. Methods: This prospective, randomized, double-blinded study was conducted in 34 infants undergoing cheiloplasty under general anesthesia. After induction, group A received bilateral infraorbital nerve block with 0.5 mL of 0.5% bupivacaine and group B 0.5 mL saline. An increase in heart rate or blood pressure > 20% was managed by increasing sevoflurane by 2-2.5%, followed by fentanyl 0.5 ㎍/kg bolus. The chi-square test and independent-sample t-test were used where applicable. Results: Demographics, duration of surgery, and intravenous fluids used were comparable between the groups. Compared to group A, patients in group B had significantly higher consumption of fentanyl (14.2 ± 4.4 ㎍ vs. 22.1 ± 6.2 ㎍) and sevoflurane (14.2 ± 4.8 mL vs. 26.8 ± 15.6 mL). Intraoperative hemodynamic parameters were significantly lower in group A, the number of times increases in hemodynamic parameters occurred, and fentanyl supplemental bolus was required remained significantly lower in group A than in group B. Intraoperative glycemic levels remained higher in group B, and the extubation time was significantly shorter in group A than in group B (4.40 ± 1.60 min vs. 9.2 ± 2.18 min). Group A had a lesser occurrence of postoperative delirium. Conclusion: Supplemental infraorbital block in infants undergoing cheiloplasty under general anesthesia resulted in significantly decreased anesthetic requirements and optimal hemodynamic and glycemic levels with faster extubation and lesser delirium.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.195-202
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• 2020

Background: Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. Methods: Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. Results: The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. Conclusion: Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce₅₀, 3.22 ng/ml; Ce₉₅, 4.25 ng/ml).

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.175-184
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• 2016

Background: This study investigated the effect of remifentanil pretreatment on Cos-7 cells exposed to oxidative stress, and the influence of remifentanil on intracellular autophagy and apoptotic cell death. Methods: Cells were divided into 4 groups: (1) Control: non-pretreated cells were incubated in normoxia (5% $CO_2$, 21% $O_2$, and 74% $N_2$). (2) $H_2O_2$: non-pretreated cells were exposed to $H_2O_2$ for 24 h. (3) RPC+$H_2O_2$: cells pretreated with remifentanil were exposed to $H_2O_2$ for 24 h. (4) 3-MA+RPC+$H_2O_2$: cells pretreated with 3-Methyladenine (3-MA) and remifentanil were exposed to $H_2O_2$ for 24 h. We determined the cell viability of each group using an MTT assay. Hoechst staining and FACS analysis of Cos-7 cells were performed to observe the effect of remifentanil on apoptosis. Autophagy activation was determined by fluorescence microscopy, MDC staining, and AO staining. The expression of autophagy-related proteins was observed using western blotting. Results: Remifentanil pretreatment increased the viability of Cos-7 cells exposed to oxidative stress. Hoechst staining and FACS analysis revealed that oxidative stress-dependent apoptosis was suppressed by the pretreatment. Additionally, fluorescence microscopy showed that remifentanil pretreatment led to autophagy-induction in Cos-7 cells, and the expression of autophagy-related proteins was increased in the RPC+$H_2O_2$ group. Conclusions: The study showed that remifentanil pretreatment stimulated autophagy and increased viability in an oxidative stress model of Cos-7 cells. Therefore, we suggest that apoptosis was activated upon oxidative stress, and remifentanil preconditioning increased the survival rate of the cells by activating autophagy.