• The Korean Journal of Pain
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• v.11 no.2
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• pp.283-287
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• 1998

Background: Recently, pain clinic is attracting attention and interest of both physicians and laymen. It is the purpose of this article to analyze our 10 years' experience to seek and improve better protocol of treating pain. Methods & Materials: We analyzed retrospectively 11,235 patients who visited the clinic during 10 years from 1986 to 1996. Total number of hospital visits was 51,908. Male to female ratio was 35：65(3910：7325). Treatment modalities employed were SGB(stellate ganglion block), TPI(trigger point injection), etc. Results: Yearly distribution showed a gradual upward curve until 1992 and remains in a horizontal pattern thereafter. Of age distribution, 6th decades occupied the largest proportion(27.29%). As of disease entities, Low back pain & lower extremities pain comprised of the majority(34.01%) and the epidural block was most frequently given as a treatment. Conclusion: Pain clinic is improving rapidly as an important part of medical science in Korea and outpatients of clinic are on an increasing trend. So, anesthesiologists should be make every efforts to research for treatment of good quality.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.379-386
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• 2013

Background: Shivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section. Methods: This was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer. Results: There were no significant differences between the two study groups regarding the demographic and surgical data (P > 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups. Conclusions: Low-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.1
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• pp.22-25
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• 2007

Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) characterized by severe hypoglycemia caused by inappropriate over secretion of insulin is the most common cause of hypoglycemia in early infancy. The symptoms of hypoglycemia in neonate and infancy are neonatal sepsis, respiratory difficulty, tachypnea, apnea, cyanosis, and seizure. Especially the recurrent and severe hypoglycemia within $1^{st}$ year of life is responsible for severe and irreversible brain damage. To prevent it aggressive treatment is required. Due to severe and irreversible brain damage these children frequently require anesthesia during imaging procedures such as MRI or during various dental surgical procedures. Because of frequent hypoglycemia and dental phobia in children with neurologic disorder, anesthesiologists should pay attention to patient. We report a successful anesthetic management in a patient with PHHI for dental procedures.

• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.231-238
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• 2016

Purpose: The study aimed to evaluate the changes of body temperature and to identify the factors related to changes during surgery in burned patients. Methods: A retrospective study was conducted by reviewing the medical records of 439 adult burned patients who had a surgery under general anesthesia at the Burn Center of a university hospital. Results: After surgery, body temperature of the burned patients declined from $36.6^{\circ}C$ to $35.2^{\circ}C$; 52.2% were hypothermia. There were significant differences in the changes of body temperature according to the participants' characteristics including American society of anesthesiologists physical status, type of burn injury, total burn surface area, range of exposure, operation time, anesthesia time, amount of fluid, blood transfusion, use of tourniquet, and the method of warming therapy. Factors that influence the temperature changes were total burn surface area (${\beta}=0.26$), operation time (${\beta}=0.25$), amount of fluid (0.20), and warming therapy including 'Room temperature setting + Heated circuit + Hot line'(${\beta}=0.09$) and 'Room temperature setting+one of others'(${\beta}=0.08$). Conclusion: Burned patients experienced a decrease of their body temperature during surgery despite of warming therapy. A nursing protocol is needed to provide an appropriate warming therapy based on their characteristics in burned patients.

• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.193-202
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• 2016

Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.112-122
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• 2014

Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• Korean Journal of Anesthesiology
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• v.71 no.6
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• pp.483-485
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• 2018

A 34-year-old man who previously underwent a craniotomy due to oligodendroglioma was admitted with a diagnosis of recurrent brain tumor. An awake craniotomy was planned. Approximately 15 minutes after completing the scalp nerve block, his upper torso suddenly moved and trembled for 10 seconds, suggesting a generalized clonic seizure. He recovered gradually and fully in 55 minutes without any neurological sequelae. The emergency computed tomography scan revealed a localized fluid collection and small intracerebral hemorrhage nearby in the temporoparietal cortex beneath the skull defect. He underwent surgery under general anesthesia at 8 hours after the seizure and was discharged from the hospital after 10 days. This report documents the first case of generalized seizure that was caused by the accidental intracerebral injection of local anesthetics. Although the patient recovered completely, the clinical implications regarding the scalp infiltration technique in a patient with skull defects are discussed.

• Kosin Medical Journal
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• v.33 no.3
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• pp.468-476
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• 2018

Perioperative anaphylaxis, although rare, is a severe, life-threatening unexpected systemic hypersensitivity reaction. Simultaneous administration of various drugs during anesthesia, the difficulty of communicate with patients in sedation and anesthesia, and coverage of the patient with surgical drapes are considered to be factors that impede early recognition of anaphylactic reactions. It is very important to perform an intradermal skin test because antibiotics are the most common cause of perioperative anaphylaxis. We report a case of negative-intradermal skin test antibiotic anaphylaxis mistaken for local aesthetic systemic toxicity without increase of serum tryptase for confirmative diagnostic biomaker during surgery under brachial plexus block. It is not possible to exclude the danger of anaphylaxis completely, even if it is negative-intradermal skin test and normal tryptase level. Therefore, anesthesiologists should be closely monitored and treated early for antibiotics related hypersensitive reaction, like other medicines during anesthesia.