• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.305-314
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• 2022

Introduction: This clinical trial aimed to evaluate the anesthetic effect of the addition of 2 mg (4 mg/ml) of dexamethasone to 2% lidocaine (plain or with 1:80,000 epinephrine). The solutions were injected for a primary inferior alveolar nerve block (IANB) to provide mandibular anesthesia for the endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. Methods: In a double-blinded setup, 124 patients randomly received either of the following injections: 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, or plain 2% lidocaine mixed with 2 mg dexamethasone, which were injected as a primary IANB. Ten minutes after injection, patients with profound lip numbness underwent electric and thermal pulp sensibility tests. Patients who responded positively to the tests were categorized as "failed" anesthesia and received supplemental anesthesia. The remaining patients underwent endodontic treatment using a rubber dam. Anesthetic success was defined as "no pain or faint/weak/mild pain" during endodontic access preparation and instrumentation (HP visual analog scale score < 55 mm). The effect of the anesthetic solutions on the maximum change in heart rate was also evaluated. The Pearson chi-square test at 5% and 1% significance was used to analyze anesthetic success rates. Results: The 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, and plain 2% lidocaine mixed with 2 mg dexamethasone groups had anesthetic success rates of 34%, 59%, and 29%, respectively. The addition of dexamethasone resulted in significantly better results (P < 0.001, 𝛘² = 9.07, df = 2). Conclusions: The addition of dexamethasone to 2% lidocaine with epinephrine, administered as an IANB, can improve the anesthetic success rates during the endodontic management of symptomatic mandibular molars with irreversible pulpitis.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.275-281
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• 2010

The lateral pterygoid muscle is one of the masticatory muscles basic to jaw function. Because of its deep location in the masticatory system, digital palpation of the muscle is usually difficult to perform and unreliable. Therefore, diagnosis of the myalgic disorders involving the lateral pterygoid muscle is a perplexing problem for clinicians. Local anesthetic injection can be a more effective method to examine the lateral pterygoid muscle for the purpose of discriminating the source of pain. Furthermore, immediate elimination of muscle pain facilitates stretching of the muscle in the full range. We report two cases of lateral pterygoid myalgia that were diagnosed and managed successfully through the use of intramuscular local anesthetic injection.

• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.352-360
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• 2013

Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

• Korean Journal of Veterinary Research
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• v.54 no.2
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• pp.101-105
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• 2014

This study was conducted to investigate actual conditions associated with veterinary anesthetic drug use in Korea, and to obtain responses from Korean veterinarians and researchers pertaining to the use of anesthetic drugs. To accomplish this, a nationwide survey was issued to veterinarians working at animal hospitals and to researchers in the Korean Association for Laboratory Animal Science (KALAS). A self-administered questionnaire-based survey was then conducted in which respondents were asked questions about actual conditions associated with the use of animal anesthetic drugs. The survey revealed that the distribution and management of animal medicines in Korea was quite vulnerable to misuse or abuse due to a variety of factors. Therefore, a relevant regulatory system should be strictly enforced to protect vulnerable individuals from abuse or misuse.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.161-171
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• 2024

The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.1
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• pp.57-62
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• 2014

Background: The aim of this study was to analyze outpatient anesthesia for dental treatment in handicapped patients with behavior disorder in order to use data for carrying out better and safe anesthetic management. Methods: The data were drawn from the 100 patients with behavior disorder who visited CNUDH dental clinic for disabled based on anesthesia record to investigate patient's systemic condition, cooperative level, anesthesia method according to patients cooperation, and side effects after recovery time. Results: Mental retardation (58%) is the most reason to choose general anesthesia. The methods of induction according to cooperative level are intravenous propofol injection in 22 cases and inhalation of sevoflurane in 78 cases. Induction time of anesthesia were within 10 seconds in cases of propofol induction and average $48.8{\pm}18.5$ seconds in cases of inhalation induction. The time spent on dental treatment was average $3.2{\pm}1.1$ hours. After the end of treatment, average time to move from unit chair to recovery bed, to recliner, and to discharge from hospital are $10.4{\pm}5.1$, $36.9{\pm}17.1$ and $72.4{\pm}16.0$ minutes, respectively. During recovery, there are nausea with 9%, vomiting with 4%, dizziness with 2%, finger injury with 1%. Conclusions: This study showed our successful anesthetic outcomes without any severe side effects or complications. Through this study, it will be used for safe anesthetic management as useful reference data.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.277-288
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• 2018

Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.155-157
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• 1987

A 25 years old male patient was experienced Trough method operation to correct of Tracheal stenosis following Tracheostomy. After admission, a No.3 Magill plastic portex tube had been placed in the previous tracheostomy opening. Stenotic narrowing portion was noted low trachea (about 3.5cm above carina) Despite of narrowing of the lesion, anesthetic course was uneventful with oxygen, halothane and non depolarized muscle relaxant by controlled respiration. Postoperative coures were also favorable With adequate respiratory cares and blood gas analyzed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.5
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• pp.251-253
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• 2013

Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.67-72
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• 2019

Myasthenia gravis (MG) is a neuromuscular autoimmune disorder which clinically presents as muscular weakness and fatigue due to autoantibody formation against acetylcholine receptors (AChR), leading to their subsequent destruction. Due to the neuromuscular implications of MG, certain considerations must be taken into account when providing anesthesia to MG patients. In the following case report, we have outlined procedural considerations for the anesthetic management of a patient with MG undergoing deep sedation for an elective oral surgery in an outpatient setting, as well as a discussion of relevant literature.