• 제목/요약/키워드: Anesthetic Management

검색결과 133건 처리시간 0.029초

외래치료실에서의 근위축성 측삭경화증 환자(ALS)의 전신마취 하치과 치료시 마취관리 (Anesthetic Management of an Amyotrophic Lateral Sclerosis Patient Undergoing Dental Care in Daysurgery Center)

  • 김한수;이숙영;최은혜;김승오
    • 대한치과마취과학회지
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    • 제13권4호
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    • pp.195-201
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    • 2013
  • Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the degeneration of upper and lower motor neurons. The disorder causes muscle weakness and atrophy in airway muscles including pharyngeal, laryngeal and other respiratory muscles. The response to muscle realxant is also altered in patients with ALS. Because of the inherent muscle weakness and associated respiratory insufficiency, particular attentions are needed in anesthetic management of ALS patients. We used proper doses of inhalation anesthetics and opioids under EEG-entropy (electroencephalography-entropy)-monitoring without the use of muscle realxants in the anesthetic management of a patient with ALS. The patient early recovered and was discharged on the same day without any respiratory complications.

Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

  • Ghai, Babita;Kumar, Muthu;Makkar, Jeetinder Kaur;Goni, Vijay
    • The Korean Journal of Pain
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    • 제35권2호
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    • pp.183-190
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    • 2022
  • Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

High stakes anesthesia: Anesthetic considerations and implications for complete dental extraction in a patient with complex comorbidities

  • Panchamia, Rohan K.;Samuels, Jon D.
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제19권3호
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    • pp.167-173
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    • 2019
  • This case report describes a frail, middle-aged woman with multiple comorbidities who was scheduled to undergo extraction of all remaining teeth in anticipation of cardiac quadruple valve intervention. Dental and anesthetic management of the patient are discussed. Medical care of the patient with a high burden of comorbidities requires a multidisciplinary approach even for a routine dental procedure.

Kimura병 환자의 전신마취 사례 (Anesthetic Management of a Patient with Kimura's Disease)

  • 최은지;박상진
    • Journal of Yeungnam Medical Science
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    • 제26권1호
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    • pp.38-43
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    • 2009
  • Kimura's disease is an idiopathic chronic condition, associated with a high-titer of IgE and peripheral eosinophilia. It frequently presents as a solitary or multiple lesions in the head and neck area. During the perioperative period, anesthesiologists should understand the anatomical structures of the patient who has Kimura's disease involvement of the head and neck, especially the airway. It is important to pay attention to the occurrence of signs and symptoms of acute allergic reactions related to a high-titer of IgE and eosinophilia. We report our experience with anesthetic management in an 18-year-old patient with multiple neck masses due to Kimura's disease.

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혈우병 환아에서의 구강외과 수술 마취관리 -증례 보고- (Anesthetic Management of the Oral Surgery in a Child with Hemophilia A - A case report -)

  • 박창주;이종호;염광원;김현정
    • 대한치과마취과학회지
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    • 제2권1호
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    • pp.27-32
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    • 2002
  • Hemophilia A is the most common congenital bleeding disorder, which is sex-linked disease, caused by a deficiency of clotting factor VIII. We experienced a case of alveolorrhaphy using iliac bone graft under general anesthesia for the correction of bilateral cleft alveolus in 10-year-old boy with hemophilia A. Factor VIII activity in this patient was 0.7%, on the severely deficient level, and aPTT was 100 seconds. Just before operation, he received 1,750 units of factor VIII intravenously for loading dose. After we confirmed his factor VIII activity improved to 95% and aPTT to 38.4 seconds, operation was begun. No more transfusion was needed during the operation. In his postoperative care, he received 50 units/kg a 12 hours for 3 days and 30 units/kg a 12 days for 2 days. His factor VIII activity was maintained at 57-139% during his hospitalization. He was discharged without any anesthetic complication. So we report this successful case of anesthetic management for the oral surgery in a child with hemophilia A.

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마취과적 수술전 평가 (Preoperative Evaluation)

  • 이봉재
    • 정신신체의학
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    • 제16권2호
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    • pp.87-94
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    • 2008
  • 마취는 수술전 환자평가로부터 시작된다. 환자평가의 목적은 수술에 앞서 환자가 정신적으로나 신체적으로 최상의 상태에 있도록 하여 수술과정에 발생할 수 있는 이환율(morbidity)과 사망률(mortality)을 감소시키는데 있다. 환자의 정보를 수집하고 신체상태를 평가하여 마취계획을 세우기 위해서는 환자를 직접 만나야 한다. 수술전 환자방문은 안전과 효과적인면에 있어서 수술중 환자 관리만큼이나 중요하다.

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Does the presence and amount of epinephrine in 2% lidocaine affect its anesthetic efficacy in the management of symptomatic maxillary molars with irreversible pulpitis?

  • Singla, Mamta;Gugnani, Megha;Grewal, Mandeep S;Kumar, Umesh;Aggarwal, Vivek
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권1호
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    • pp.39-47
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    • 2022
  • Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, 𝛘2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

Alexander씨 병 환아의 마취 관리 (Anesthetic Management of a Patient with Alexander's Disease -Case Report-)

  • 김범수;지대림;송선옥
    • Journal of Yeungnam Medical Science
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    • 제27권1호
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    • pp.47-51
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    • 2010
  • We present here the case of a 13-year-old male patient with Alexander's disease who underwent surgical correction of a femur fracture. Alexander's disease is a rare and fatal disorder that affects the white matter in the brain and it causes developmental delay, psychomotor regression, spasticity, megaloencephaly and seizure. The patient had the possibility of a seizure attack during the perioperative period. We discuss the anesthetic management of a patient with Alexander's disease and we review the relevant literature.

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치은비대를 동반한 척수성 근위축증 환자의 마취관리 -증례보고- (General Anesthesia in a Child with Possible Spinal Muscular Atrophy Combined with Gingival Hyperplasia -A Case Report -)

  • 서광석;박창주;김현정;염광원
    • 대한치과마취과학회지
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    • 제4권2호
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    • pp.100-103
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    • 2004
  • Spinal muscular atrophies are inherited neurodegenerative disorders affecting anterior hem cells. There are various problems, especially weakness of respiratory muscle and abnormal reaction to muscle relaxants during the general anesthesia. And gingival hyperplasia can make the proper airway management difficult. Experience with anesthetic management in a patient with spinal muscular atrophy combined with gingival hyperplasia has been very rare. We report the anesthetic experience of a wheel-chair-bound child, who underwent gingivectomy under general anesthesia. The child was safely managed with fibroscopic nasotracheal intubation under sevoflurane without muscle relaxants. Also, there was no deterioration of her underlying neurologic conditions.

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부신백질이영양증 환자의 치과치료를 위한 외래전신마취 -증례 보고- (Ambulatory Anesthesia Management of the Patient with Adrenoleukodystrophy for Dental Treatment -A Case Report-)

  • 서광석;박소연;신터전;김현정
    • 대한치과마취과학회지
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    • 제10권1호
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    • pp.45-49
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    • 2010
  • Adrenoleukodystrophy (ALD) is a rare X-linked genetic disorder associated with various central nervous system problems and adrenal insufficiency. It is common in childhood and symptoms include loss of previously acquired neurological abilities, seizures, ataxia, Addison's disease as well as degeneration of visual and auditory function. These children frequently require anesthesia during imagining procedure such as MRI or during some surgical procedures like gastrostomy. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, seizure disorders, life-threatening airway obstruction, copious oral secretion and possibility of aspiration. In addition, adrenal involvement and hypofunction must be considered for safe anesthesia management. We report a successful anesthetic management in a patient with ALD for dental procedures.