• Title/Summary/Keyword: Anesthesia local

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Effect of surgical site instillation after laparoscopic urologic surgery (비뇨기과 복강경 수술 후 국소마취제 점적의 효과)

  • Hwang, Yong;Shin, Sangyol;Oh, Tae Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.7
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    • pp.200-206
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    • 2018
  • The aim of this study was to evaluate the effect of Ropivacaine on pain following laparoscopic surgery. Between March 2015 and June 2017, all 97 patients with renal mass who elected to receive laparoscopic nephrectomy were reviewed, retrospectively. Normal saline (0.9%) was used as a control in 45 patients while Ropivacaine was used for local anesthesia in the instillation group (n=52). Pain score (visual analog scale) of the shoulder and upper abdominal area between the two groups was significantly different between recovery time and 24 h (p<0.05), with no significant differences between 48 and 72 h (both p>0.05). In the instillation group, pain score of shoulder and abdominal pain in the two groups according to the amount of CO2 used was not significantly different between recovery time and 24, 48, and 72 h (all p>0.05). Ropivacaine reduced shoulder and upper abdominal pain that occurred within 24 h after surgery. Effective pain control with Ropivacaine is needed in the early postoperative period when a large amount of CO2 is used in laparoscopic surgery.

A Study on the Confidence of Dry Eye Diagnosis Methods (건성안 검사 방법의 신뢰도에 대한 연구)

  • Lee, Byeong Jun;Hong, Jae Hyeon;Jung, Dai;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.1
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    • pp.15-20
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    • 2008
  • Purpose: To study on the confidence of dry eye diagnosis methods which need to prescribe contact lens. Methods: Non-invasive tear film break-up time (NIBUT) and tear film break-up time (TBUT) were measured in forty healthy subjects in their 20s, and then the subjects were classified into normal eye and dry eye. The results of McMonnies questionnaire, tear prism height measurement, Hardtack test, blink rate measurement and Schirmer test were compared with the results of NIBUT and TBUT. Results: The results of NIBUT and TBUT were as follows; 20 subjects had normal eyes, 10 subjects had dry eyes in both NIBUT and TBUT, and 10 subjects showed different results. In McMonnies questionnaire, the score of normal eye group averaged 8.2 and that of dry eye group averaged 18.5, which showed statistically significant difference. Furthermore, 100% of normal eye group classified by the results of NIBUT and TBUT corresponded with the result of McMonnies questionnaire and 90% of dry eye group showed the correspondence. Tear prism height of normal eye group averaged 0.32 mm and that of dry eye group averaged 0.23 mm, which were significantly different. Hardtack test, blink rate measurement and Schirmer test without local anesthesia showed no statistically significant difference between normal eye group and dry eye group. Conclusions: On dry eye diagnosis methods, the results of McMonnies questionnaire and tear prism height measurement had close correlation with the results of NIBUT and TBUT.

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Pharmacological Studies on Human Vas Deferens -Coexistence of Adrenergic and Cholinergic Receptors, and Effect of Diazepam- (인체 정관의 약리학적 검색 -아드레날린성 및 콜린성 수용체의 공존과 Diazepam의 작용-)

  • Kim, Won-Joon;Lee, Kwang-Youn;Ha, Jeoung-Hee;Park, Tong-Choon
    • The Korean Journal of Pharmacology
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    • v.24 no.2
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    • pp.189-195
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    • 1988
  • This study aimed to investigate the autonomic innervations of human vas deferens and the effect of diazepam, a benzodiazepine sedative antianxiety drug, on the smooth muscle contractility of vas deferens. The specimens were obtained from healthy volunteers undergoing elective vasectomy with local anesthesia. The muscle preparation did not show any spontaneous contraction, but showed a good contraction induced by norepinephrine exerting the strongest response at $33^{\circ}C$. Phentolamine inhibited the norepinephrine-induced contraction concentration-dependently. Isoproterenol, a beta-adrenergic agonist evoked a considerable extent of contraction, and this contractile activity was antagonized by propranolol, a beta-adrenergic blocking agent. Acetylcholine induced a dashing contraction of the human vas deferens, and atropine, a muscarinic receptor blocking agent abolished the acetylcholine-induced contraction. Diazepam inhibited the norepinephrine-induced contraction in a concentration dependent manner. These results suggest that the smooth muscle of human vas deferens has cholinergic muscarinic and beta adrenergic receptors as well as the predominant alpha adrepergic receptor. Diazepam inhibits the motility, especially norepinephrine-induced contraction of human vas deferens.

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Management of Traumatized Gingival Wound Using Tissue Adhesivein Dental Hygiene Practice (치위생 임상에서 조직접착제를 활용한 외상성 치은열창의 처치)

  • Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.1-4
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    • 2003
  • The purpose of this paper is to present the potential application of tissue adhesive in the management of traumatized gingival wound in clinical dental hygiene practice. Cyanoacrylate adhesive has been used for closure of superficial laceration without suturing, which is available in periodontal and oral surgery. Small gingival or mucosal lacerations may occur by improper or excessive instrumentation of the dental hygienist during scaling and root planing procedure. In this circumstances, tissue adhesive is very effective, simple, and convenient method as an alternative to conventional wound closure by suturing. The tissue adhesive consists of monomeric n-butyl-2-cyanoacrylate, which polymerizes quickly in contact with tissue fluid. The sutureless treatment of gingival laceration with tissue adhesive has advantages of good esthetic results, less trauma, time saving, antibacterial and hemostatic effects. In addition, local anesthesia as well as re-visit for dressing and removal of suture are not required. Use of tissue adhesive could be beneficial to both dental hygienist and patient in the management of procedural error.

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IDIOPATHIC GINGIVAL FIBROMATOSIS AT BIRTH (출생 시 발생한 특발성 치은섬유종증)

  • Lee, Hyo-Seol;Choi, Hyung-Jun;Choi, Byung-Jai;Sohn, Hyung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.766-770
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    • 2008
  • Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe gingival enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.

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CHANGES OF SENSORY AND SOMATOSENSORY EVOKED POTENTIALS FOLLOWING A NEEDLE INJURY ON THE INFERIOR ALVEOLAR NERVE IN RATS (백서 하치조 신경 손상에 따른 감각 유발전위와 체성감각 유발전위의 변화에 관한 연구)

  • Woo, Seung-Chel;Kim, Soo-Nam;Lee, Dong-Keun;Cheun, Sang-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.652-672
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    • 1996
  • Dysfunction of the inferior alveolar nerve may result from trauma, diseases or iatrogenic injury. The development and refinement of an objective method to evaluate this clinical problem is highly desirable and needed, especially concerning for an increasing medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nerve pathways. The purpose of this study was to characterize the Sensory Evoked Potentials(SEPs) and Somatosensory Evoked Potentials(SSEPs) elicited by electrical stimulation of mental nerve. SEPs and SSEPs were measured and analyzed statistically before and after needle injury on the inferior alveolar nerve of Sprague-Dawalye rats. Measuring SEPs was more sensitive in evaluation of the recovery of sensory function from inferior alveolar nerve injury then measuring SSEPs but we measured SSEPs in the hope of providing a safe, simple and objective test to check oral and facial sensibility, which is acceptable to the patient. We stimulated mental nerve after needle injury on the inferior alveolar nerve and SEPS on the level of mandibular foramen and SSEPs on the level of cerebral cortex were recorded. Threshold, amplitude, and latency of both of SEPs and SSEPs were analyzed. The results were as follows ; 1. Threshold of SEPs and SSEPs were $184{\pm}14{\mu}A$ and $164{\pm}14{\mu}A$ respectively. 2 SEPs were composed of 2 waves, i.e., N1 N2 in which N1 was conducted by II fibers and N2 was conducted by III fibers. 3. SSEPS were composed of 5 waves, of which N1 and N2 shower statistically significant changes(p<0.01, unpaired t-test). 4. SEPs and SSEPs were observed to be abolished immediately after local anesthesia and recovered 30 minutes later. 5. SEPs were abolished immediately after injury. N1 of SSEPs was abolished immediately and amplitued of N2 was decreased($20.7{\pm}12.2%$) immediately after 23G needle injury, but N3, N4 and N5 did not change significantly. Recovery of waveform delayed 30 minutes in SEPs and 45 minutes in SSEPs. 6. The degree of decrease in amplitude of SEPs and SSEPs, after 30G needle injury was smaller than those with 23G. SEPs recorded on the level of mandibular foramen were though to be reliable and useful in the assessment of the function of the inferior alveolar nerve after injury. Amplitude of SSEPs reflected the function and integrity of nerve and measuring them provided a safe, simple and abjective test to check oral and facial sensibility. These results suggest that measuring SEPs and SSEPs are meaningful methods for objective assessment in the diagnosis of nerve injury. N1 and N2 of SSEPs can be useful parameters for the evaluation of the nerve function following a needle injury.

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DENTIGEROUS CYST ASSOCIATED WITH FORMOCRESOL PULPOTOMY (Formocresol pulpotomy와 연관된 함치성 낭종의 치험례)

  • Ju, Tae-Joon;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.481-488
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    • 2009
  • Buckley's formocresol was first introduced as a pulp medicament in 1904, and since 1930, it has been the treatment of choice for primary molar pulpotomies. Formocresol has fixation effect of pulp tissue and high clinical success rate. But side effect such as displacement and loss of permanent successor, amelogenesis imperfecta, cyst formation, mutation by general absorption, possibility of cancer induction have been reported. Of those, dentigerous cyst can form in the periradicular region after formocresol pulpotomy caused by an alteration of the reduced enamel epithelium, which result in fluid accumulation between the epithelium and the tooth crown. The present case describes a 6-year-old girl who had accidentally discovered in the panoramic radiograph a single, well-defined, radioluscent area enclosing the second unerupted mandibular premolar. The second left primary molar had been pulpotomizied 3 year before. Surgical treatment was carried out, the primary molar was extracted and cystectomy was performed under local anesthesia. In the extracted second primary molar, formocresol cotton pellet was left in the pulp chamber. Histologic study confirmed the suspected diagnosis of dentigerous cyst. This report present a case of dentigerous cyst associated with inadequate formocresol pulpotomized deciduous molar.

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Balloon Dilatation of Bronchial Stenosis in Endobronchial Tuberculosis (기관지결핵에 의한 기도협착에서 풍선카테터를 이용한 기도확장요법)

  • Chung, Hee-Soon;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol;Kim, Woo-Sung;Im, Jung-Gi
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.236-244
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    • 1991
  • The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

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In vivo verification of regional hyperthermia in the liver

  • Noh, Jae Myoung;Kim, Hye Young;Park, Hee Chul;Lee, So Hyang;Kim, Young-Sun;Hong, Saet-Byul;Park, Ji Hyun;Jung, Sang Hoon;Han, Youngyih
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.256-261
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    • 2014
  • Purpose: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. Materials and Methods: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. Results: As the animals were anesthetized, the baseline temperature at the start of each session decreased by $1.3^{\circ}C$ to $2.8^{\circ}C$ (median, $2.1^{\circ}C$). The mean increases in temperature measured by the intrahepatic sensors were $2.42^{\circ}C$ (95% confidence interval [CI], 1.70-3.13) and $2.67^{\circ}C$ (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were $2.10^{\circ}C$ (95% CI, 0.71-3.49) and $2.87^{\circ}C$ (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. Conclusion: We observed mean $2.67^{\circ}C$ and $2.87^{\circ}C$ increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.

Recovery of lingual nerve injury: retrospective observational study (설신경 손상 환자의 회복에 대한 후향적 연구)

  • Hong, Dong-Hwan;Lim, Ho-Kyung;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.355-364
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    • 2011
  • Introduction: This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage. Patients and Methods: The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold. Results: The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001). Conclusion: The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.