• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.177-182
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• 2011

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.175-180
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• 2023

Objectives : The purpose of this study is to report a case of lipoma removed by surgical method. Methods : A 69-year-old female was diagnosed with lipoma on the left upper shoulder. Bufonis venenum pharmacopuncture was used for local anesthesia. The 11th blade and the CO₂ laser was used for incision. After removal of lipoma, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were carried out. For 7 days, Yeonkyopaedok-san was given and the suture was removed after 14 days. At last, saengkigo was applied. Results : Local anesthesia was maintained. Lipoma sized 3.0×1.0×1.0cm was clearly removed. Adverse effects were not reported until the clear skin adhesion. Conclusions : Lipoma were surgically removed without any complications by using pharmacopuncture and oral herbal medicines that have anti-inflammatory effects. Korean medicine has the potential for surgery and needs to extend the range of surgical treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.3
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• pp.173-177
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• 2023

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.203-208
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• 2010

Tremors are trembling movements and are seen in association with alcoholic intoxication, certain drugs, thyrotoxicosis, multiple sclerosis, hysteria, and nervous tension. Dental fears, such as, pain, drill, unknown, dependency, helplessness, mutilation and oral change, induce the neuroendocrine response (release of epinephrine and norepinephrine, etc). The clinical manifestations of epinephrine or other vasopressor overdose include : anxiety, tenseness, restlessness, throbbing headache, tremor, perspiration, weakness, dizziness, pallor, palpitation and respiratory difficulty. Signs of local anesthetic overdose appear clinically whenever the anesthetic level in the blood rises to an appropriate level in an individual. The clinical signs of moderate overdose levels include : talkativeness, apprehension, excitability, slurred speech, tremor and muscular twitching. This is a case report about the severe tremor care after the endodontic treatment under right mandibular block anesthesia in a 56-years old female patient.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.197-202
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• 2010

Multiple sclerosis is a degenerative disease prevalent in northern climates, and its cause is unknown. The histopathological lesion in multiple sclerosis is the sclerotic "plague", a discrete focus of myelin loss with maintenance of axon segments and glial proliferation. The plaques may be seen in widely different brain and spinal tissues. The common causes of low back pain are psychosomatic disorder, myofascial pain dysfunction syndrome and herniation of nucleus pulposus. Local anesthetics cross the blood-brain barrier and the signs of CNS toxicity appear at a level between 4.5 and $7.0\;{\mu}g/ml$. This is a case report of acute back pain care after mandibular block anesthesia for the surgical extraction of mandibular root rests in an old aged woman with multiple sclerosis.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.37-44
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• 2019

Objective: Arthrocentesis is a minimally invasive surgical procedure that is used to alleviate the symptoms of temporomandibular joint (TMJ) disorders. The aim of this study was to investigate the effect of arthrocentesis on the blood supply to the retinal structures. Materials and Methods: Arthrocentesis was performed on 20 patients with TMJ disorders, and choroidal thickness (CT) in patients was measured to evaluate retinal blood circulation. The blood volume of the retinal structures was evaluated ipsilaterally before and after arthrocentesis, and these measurements were then compared with measurements obtained from the contralateral side. Results: Before arthrocentesis, there were no differences in retinal blood volumes between the ipsilateral and contralateral sides (P = 0.96). When ipsilateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was found to have significantly decreased after arthrocentesis (P = 0.04). When contralateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was also found to have decreased after arthrocentesis, but not significantly (P = 0.19). Conclusion: The solution of local anesthesia with epinephrine applied before the arthrocentesis procedure was found to reduce the blood volume of the retinal structures. To the best of our knowledge, this is the first study that has investigated the blood volume of the retinal structures following arthrocentesis.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.633-637
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• 2001

Local anesthesia procedure in pediatric dentistry using needle-tipped syringes is stressful and painful for the child patients The Syrijet Mark II (Mizzy Inc. USA) is a jet injection instrument, which uses high pressure to propel fluids into soft tissue without the use of a hollow neeldle, so it seems to be able to reduce the injection phobia of the child patients. The authors compared the Syrijet with the conventional syringe by assessing the pain level after local anesthetic procedures using CAS(color analogue scale) which was developed from VAS(visual analogue scale). The result showed that the pain was reduced by the use of syrijet. The advantages of syrijet were no use of neeldes, the reuse of the anesthetic cartridge, and the safety to nerves and vessels. The disadvantages were the large size, the high price, and the need of skill to use.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.266-269
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• 1999

This article discusses the vascular change of dorsal surface of tongue following inferior alveolar nerve block of 2% lidocaine HCl with 1:100,000 epinephrine. Twenty-two rats were randomly allocated to three groups: control group; without mandibular nerve block, experimental group 1; 2% lidocaine HCl, experimental group 2; 2% lidocaine HCl plus 1:100,000 epinephrine. The assessments were performed at 1-, 5-, 30-, 60-, 120-minute after inferior alveolar nerve block. Vessel diameters using the micrometer were measured and compared. Results showed that the increase in vascular constriction in group 3 was greater than those in groups 1 and 2. In conclusion, local anesthesia combined with epinephrine assures safer anesthesia for hemostasis.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.151-155
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• 2012

A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.