• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.5
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• pp.281-285
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• 2023

Background: Dentists bend needles prior to certain injections; however, there are concerns regarding needle fracture, lumen occlusion, and sharps handling. A previous study found that a 30-gauge needle fractures after four to nine 90° bends. This fatigue life study evaluated how many 90° bends a 30-gauge dental needle will sustain before fracture when bent using a needle guide. Methods: Two operators at Element Materials Technology, an independent testing, inspection, and certification company tested 48 30-gauge needles. After applying the needle guide, the operators bent the needle to a 90° angle and expressed the anesthetic from the tip. The needle was then bent back to a 0° angle, and the functionality was tested again. This process was repeated until the anesthetic failed to pass through the end of the needle due to fracture or obstruction. Each operator tested 24 needles (12 needles from each lot), and the number of sustained bends before the needle fracture was recorded. Results: The average number of sustained bends before needle failure was 40.33 (95% confidence interval = 37.41-43.26), with a minimum of 20, median of 40, and a maximum of 54. In each trial, the lumen remained patent until the needle fractured. The difference between the operators was statistically significant (P < 0.001). No significant differences in performance between needle lots were observed (P = 0.504). Conclusion: Our results suggest that using a needle guide increases the number of sustained bends before needle fracture (P < 0.000001) than those reported in previous studies. Future studies should further evaluate the use of needle guides with other needle types across a variety of operators. Furthermore, additional opportunities lie in exploring workplace safety considerations and clinical applications of anesthetic delivery using a bent needle.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.63-68
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• 1996

Background; Epidural analgesia for controlling labor pain has recently gained world-wide popularity. However, many patients scheduled for continuous epidural analgesia voice concern over harmful effects to their fetus and other possible complications such as hemodynamic changes, back pain and neurologic sequelae etc. The aim of this study was to evaluate the hemodynamic changes with and without epidural block as a measure to determine the safety of epidural analgesia during labor and delivery. Methods: Twenty healthy subjects were divided equally into two groups(Group 1 without epidural block, and Group 2 with epidural block) and serial hemodynamic measurements were taken in all subjects with transcutaneous impedence cardiography. The epidural catheter was inserted at the level of $L_{3,4}$ in Group 2 and analgesia was maintained using 0.25% bupivacaine mixed with fentanyl. Results: Cardiac output increased slightly with cervical dilatation in both groups, but no significant differences were found between the two groups. Similarly, no significant differences were found in blood pressures between the two groups. Stroke volume and end-diastolic volume indices were slightly decreased in group 1 and slightly increased in group 2. However, there were no significant differences between the two groups. The ejection fraction was nearly constant and ranging 56~59%. Conclusion: We concluded epidural analgesia for labor and delivery is a safe technique for the parturients since results indicated no significant differences in hemodynamic changes, as compared to the control group.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.65-68
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• 1998

Background: Epidural steroid injection(ESI) is often adminstered to treat lower back pain, but its effect iveness on postepidural backache have not yet been determined. Methods: Sixty patients scheduled for cesarean section under epidural anesthesia were randomly assigned to receive, 1 ml of normal saline(Group 1), or 5 mg of dexamethasone (Group 2), epidurally via indwelling catheter after delivery. Results: The incidences of postepidural backache occured significantly more often in Group 1(56.7%) than in Group 2(26.7%)(P<0.05). There was a significant association between postepidural backache and multiple attempts at epidural needle placement. Conclusion: Epidural dexamethasone has a preventive effect on postepidural backache.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.63-66
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• 1986

Maternal and fetal effects of anesthesia for 423 cesarian section, performed during the past three and quarter years period in this hospital, have been evaluated. It is emphasized that the selection of anesthetic agent and method should depend upon the physical status of the patients and the ability of both obstetrician and anesthesiologists. Author results were as follows: 1. The incidence of c-section was 13.9% of total deliveries. 2. More than about three fourths of total cases were emergency cases. 3. Almost all cases were operated under general anesthesia. 4. The good physical states of patients resulted in better Apgar score of infants. 5. The shorter the interval from induction of anesthesia to delivery, the better was the Apgar score of infants.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.5
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• pp.287-294
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• 2018

Mandibular third molar extraction is commonly performed in dental clinics. However, the optimal method of anesthesia has not been established for this procedure. The conventional inferior alveolar nerve block is the most widely used method. However, its success rate is not high and it may lead to complications, such as aspiration and nerve injury. Therefore, various anesthesia methods are being investigated. Articaine has been proven to be efficacious in a number of studies and is being used with increasing frequency in clinical practice. In this review article, we will briefly review various local anesthesia techniques, anesthetics, and a computer-controlled local anesthetic delivery (CCLAD) system, which reduces pain by controlling the speed of drug injection, for mandibular third molar extraction.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.97-102
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• 1990

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62(83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents(65 cases). Of 57 smaller calculi than 1Cm(radiographic largest diameter) 50(88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications durinf or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.

• Journal of Veterinary Clinics
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• v.21 no.3
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• pp.270-275
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• 2004

Anesthetic machines may be equipped with either a precision or nonprecision vaporizer. A precision vaporizer is designed to deliver an exact concentration of anesthetic agent. Goldman vaporizer is a low-flow, closed-circle circuit with a low resistance vaporizer, in circuit. Vaporizers used within circle system(VIC) are not usually temperature compensated and this is generally thought to be a disadvantage. As the volatile agent is vaporized, heat is extracted from the liquid and temperature decreases. This cooling of the liquid leads to a decrease in concentration of the anaesthetic agent delivered by the vaporizer. The purpose of this study is to examine the mechanical consistency of the delivery of isoflurane from Goldman vaporizer and precision vaporizer at various gas flow rates and temperatures. And we first studied isoflurane concentration according to room temperature changes delivered by a Goldman vaporizer and precision vaporizer using different gas flow. The room temperature of $15^{\circ}C,$ $20^{\circ}C,$ $28^{\circ}C$ and fresh gas flow rates of 0.5, 1.0, 1.5, 2.0, 3.0 l/min were used. The inspired agent concentration was measured using a Datex-Ohmeda multigas analyzer. As rose in room temperature, the isoflurane concentration of precision vaporizer approximated the dial setting. On the other hand, at a dial setting concentration of 5.0 percent the delivered isoflurane concentration of precision vaporizer was more than the dial setting in high temperature. The isoflurane concentration of precision vaporizer remained constant despite the increase in temperature. The isoflurane concentration of Goldman vaporizer was increased with rise in room temperature and decreased with rise in gas flow.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.1
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• pp.37-45
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• 2024

Background: The delivery of profound local anesthetics helps children receive successful treatment by reducing fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the most anticipated stimuli in dental surgery. Children's perceptions of pain can be altered by applying cryotherapy to precool the oral mucosa or by diverting their minds through taste distractions before administering local anesthetic injections. This study aimed to evaluate the efficacy of cryoanesthesia and xylitol sweet-tasting solution at the injection site in 7-10-year-old children. Methods: A total of 42 participants, aged 7-10 years, who underwent dental treatment requiring local anesthesia, were enrolled in the study. The children were randomly divided into three groups. In group I, sterile water was held in the mouth for 2 minutes before anesthetic administration, similar to group II, and in group III, a xylitol sweet-tasting solution was used for 2 minutes before needle insertion. The analysis of pain perception was carried out based on the Visual Analog Scale (VAS) and the Sound, Eyes, and Motor (SEM) scale. For VAS analysis, a one-way analysis of variance (ANOVA) was performed for intergroup comparison, and a post hoc Tukey test was performed for subgroup analysis. For the categorical SEM scale, the Kruskal-Wallis test followed by the post hoc test was performed for intergroup comparison. Where a P value of <0.05 was considered statistically significant at 95% confidence intervals. Results: Cryoanesthesia significantly reduced pain scores on VAS (4.21 ± 1.42) when compared to those on VAS with xylitol sweet-tasting solution (5.50 ± 1.40) and that with sterile water (6.14 ± 2.47). Intergroup comparison of the VAS scores among the three groups was performed using one-way ANOVA, which demonstrated statistically significant differences (P value <0.026) on the VAS scale. Intergroup comparison of the SEM scale was performed using the Kruskal-Wallis test, followed by post hoc comparison, which exhibited statistically significant differences (P < 0.007) among the three groups for the SEM scale. Conclusion: Cryoanesthesia demonstrated higher efficacy in reducing injection pain than that exhibited by the xylitol sweet-tasting solution.

• Proceedings of the KIEE Conference
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• 2004.07d
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• pp.2696-2698
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• 2004

Iontophoresis를 이용한 경피전달용 약물 패치를 제작하기 위해 고분자의 종류, 전류크기, 시간에 따른 약물방출 결과를 발표한다. 고분자 Hydroxy Propyl Methyl Cellulose(HPMC), Hydroxy Propyl Cellulose(HPC), Hydroxy Ethyl Cellulose(HEC)에 각각 국소마취제-Lidocaine을 넣어 시료를 제작하였다. 약물 방출은 Drug Delivery Cell(DDC)위에 Ag/AgCl 전극 (anode), Pt wire 전극(cathode)을 각각 설치하여 전압인가에 따른 이온 유동으로부터 시간에 따른 전압/전류변화 및 약물농도를 고찰하였다. 전압 15V 인가 시 고분자 막과 전해질 사이에 흐르는 전류 1.0mA는 15분간 유지되지만, Ag/AgCl 전극의 산화작용으로 인해 전류는 서서히 감소하며 26분 후 거의 흐르지 않았다. 따라서 안정적인 전류로 유지되는 시간을 15분으로 최적화하였다. 고분자 중 HPMC 막을 사용하여 약물방출 실험을 한 경우 UV 분석결과 파장 262.26nm에서 최대 흡광도 0.238이었고, 가장 높은 약물농도가 나타났다. 이러한 HPMC의 약물방출 실험결과 비교적 높은 전류 1.0mA일 때 약물 방출량이 많았고, 동일한 전류 0.4mA를 장시간 흐르게 하였을 경우, 농도가 축적되므로 치료 가능한 안정적인 특성임을 확인하였다.