• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.241-251
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• 2017

Devices that monitor the depth of hypnosis based on the electroencephalogram (EEG) have long been commercialized, and clinicians use these to titrate the dosage of hypnotic agents. However, these have not yet been accepted as standard monitoring devices for anesthesiology. The primary reason is that the use of these monitoring devices does not completely prevent awareness during surgery, and the development of these devices has not taken into account the neurophysiological mechanisms of hypnotic agents, thus making it possible to show different levels of unconsciousness in the same brain status. An alternative is to monitor EEGs that are not signal processed with numerical values presented by these monitoring devices. Several studies have reported that power spectral analysis alone can distinguish the effects of different hypnotic agents on consciousness changes. This paper introduces the basic concept of power spectral analysis and introduces the EEG characteristics of various hypnotic agents that are used in sedation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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• pp.159-165
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• 2019

Background: Dental procedures commonly involve the injection of local anesthetic agents, which causes apprehension in patients. The objective of dental practice is to provide painless treatment to the patient. The purpose of this study was to evaluate the effect of Low Level Laser Therapy (LLLT) in reducing the pain due to local anesthetic injection. Materials and Methods: A prospective, split-mouth study was conducted on 25 patients. In Condition A, LLLT was administered followed by the administration of a standard local anesthetic agent. Patients' perception of pain with use of LLLT was assessed based on a Visual Analogue Scale (VAS). In Condition B, LLLT was directed to the mucosa but not activated, followed by the administration of local anesthesia. VAS was used to assess the pain level without the use of LLLT. Results: Comparison between Condition A and Condition B was done. A P value < 0.001 was considered significant, indicating a definite statistical difference between the two conditions. Conclusion: In our study, we observed that LLLT reduced pain during injection of local anesthesia. Further multi-centric studies with a larger sample size and various modifications in the study design are required.

• International journal of advanced smart convergence
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• 제9권4호
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• pp.8-15
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• 2020

This study was conducted in order to determine the effect of intraoperative hemoglobin changes on intraoperative neuromonitoring (IONM). This was a retrospective study that included 339 participants who underwent cerebrovascular surgery. We compared anesthetic agents, intraoperative hemoglobin, hematocrit, blood transfusion, and blood loss. We examined motor evoked potential and sensory evoked potential to patients. There were significant differences in hemoglobin changes, bleeding levels, transfusion, anesthesia time, and postoperative mobility disorders. Moreover, compared with patients who received transfusions, those who did not receive transfusion had a lower average hemoglobin level, as well as a higher bleeding amount, and a need of higher anesthesia time and anesthetic dose. Also, we found vasospasm occurred while surgery can bring adverse results after operation. This study showed that an intraoperative decrease in hemoglobin levels affects the function of cerebral perfusion, which could result in abnormal nerve monitoring results. However, as this study could not find a relation of anesthetics to IONM, there is a need for further research regarding the association between anesthetics and hemoglobin changes and IONM.

• Biomolecules & Therapeutics
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• 제6권3호
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• pp.303-311
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• 1998

The general pharmacological properties of new platinum (II) coordination complexes, SA : [Pt(trans-ι-DACH)(DPPE)] . 2NO$_3$, SB : [Pt(cia-DACH)(DPPP)] 2NO$_3$ and SC : [Pt(cia-DACH)(DPPE)] 2NO$_3$on central nervous, respiratory, cardiovascular and digestive systems were studied in various experimental animals. These platinum (II) anticancer agents had no effects on analgesia, thiopental-induced sleeping time, body temperature, strychnine-induced convulsion, inflammation and local anesthetic action in mice and rats. Intestinal motility, stomach-ulcer induced by serotonin and bile-secretion of rats were not influenced by the dose of 30 mg/kg. However SB and SC induced a mild decrease in heart rate in anesthetized rats. Based on these results, these new platinum (II) complexes may be regarded as a valuable lead compound in the development of new anticancer chemotherapeutic agents with marked antitumor activity and low toxicity.

• 대한치과마취과학회지
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• 제13권3호
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• pp.71-79
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• 2013

Local pain management is the most critical aspect of patient care in dentistry. Local anesthesia is a reversible blockade of nerve conduction in an applied area that produces loss of sensation. The chemical agents used to produce local anesthesia stabilize neuronal membranes by inhibiting the ionic fluxes required for the propagation of neural impulses. Proper local anesthesia permits the dental surgeon to perform the necessary surgical procedure in a careful, gentle fashion that will be less stressful for both the operator and the patient. The improvements in agents for local anesthesia are probably the most significant advances that have occurred in dental science. Today's anesthetics are safe, effective, and can be administered with insignificant soft tissue damage and minimal concerns for allergic reactions. This article reviews the widely used local anesthetic agents for obtaining local anesthesia, and also discusses some frequently seen complications.

• 대한소아치과학회지
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• 제45권3호
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• pp.393-399
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• 2018

치과치료 중에 통증을 유발할 수 있는 요소를 차단함으로써 환자의 공포와 두려움을 줄여줄 수 있다. 이를 위해 벤조케인을 함유한 도포마취제가 광범위하게 사용되고 있다. 그러나, 2018년 5월 28일 식품의약품안전처는 의약품 안전 서한을 통해 24개월 미만의 소아 및 영아에서 벤조케인 함유 제제의 사용을 금지하고 그 이상의 경우라 하더라도 메트헤모글로빈혈증(Methemoglobinemia, MHb)의 발생가능성이 있으므로 신중한 사용을 권고하였다. 이는 지난 5월 23일 미국 식품의약국(Food and Drug Administration, FDA)의 권고의 후속 조치로 시행된 것이다. 벤조케인을 함유한 제제를 사용하는 경우, 치과의사는 MHb의 발생가능성을 반드시 고려해야 하며 MHb의 조기 진단과 적절한 조치가 시행될 수 있도록 준비하고 있어야한다. MHb의 치료제는 메틸렌블루가 1930년대부터 이용되고 있다. 치과의사는 메틸렌블루의 적절한 사용법과 용량을 숙지하고, MHb의 조기 진단을 위한 방법과 진단 장비에 익숙해야 한다. 무엇보다도 환자의 안전에 대한 적절한 대비와 훈련이 필요할 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.233-240
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• 2020

Background: Palatal injection of local anesthetics is the most painful injection. To obviate the need for palatal injections, local anesthetic agents with diffusibility are being investigated. Hence the present study was designed to analyze the anesthetic efficacy of 2% lidocaine hydrochloride (HCl) with 1:100,000 adrenaline and 4% articaine hydrochloride (HCl) with 1:100,000 adrenaline using single buccal infiltration for the extraction of maxillary premolars. Methods: A prospective, double-blind, crossover, randomized clinical study was performed on 60 consecutive systemically healthy patients with an age range of 15-30 years, requiring extraction of asymptomatic bilateral maxillary premolars for orthodontic purposes. They received 1ml buccal infiltration of 4% articaine HCl with 1:100,000 adrenaline on one side and 2% lidocaine HCl with 1:100,000 adrenaline on the other side. The extraction procedure on either side was scheduled 14 days apart. Parameters assessed were the time of onset of anesthesia, intraoperative discomfort, hemodynamic parameters, and the duration of analgesia. Analysis of the data was done using the Mann-Whitney test, the Wilcoxon test, the Kruskal-Wallis ANOVA test, and the chi-square test. Statistical significance was established at P < 0.05. Results: Articaine showed a faster time of onset and longer duration of analgesia than lidocaine. However, the difference in the intraoperative discomfort and hemodynamic parameters was statistically insignificant. Conclusion: Within the limitations of the study, it can be concluded that the extraction of maxillary premolars can be performed with a single buccal infiltration of 2% lidocaine HCl with 1:100,000 adrenaline, which is one of the most commonly used local anesthetic agent.

• 한국수산과학회지
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• 제50권6호
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• pp.824-828
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• 2017

We investigated the anesthetic effects of MS-222 (tricaine methanesulfonate), clove oil, 2-phenoxyethanol, $NaHCO_3$, lidocaine-HCl and lidocaine-$HCl/NaHCO_3$ in the glass catfish Kryptopterus vitreolus. Based on the efficacy criteria of complete anesthetic induction from 60 s to 120 s, recovery within 300 s, the lowest effective concentrations at $24^{\circ}C$ were determined to be 60 ppm (induction $82.8{\pm}17.6s$, recovery $80.2{\pm}34.7s$) for MS-222, 40 ppm (induction $70.5{\pm}8.2s$, recovery $83.4{\pm}17.7s$) for clove oil, 250 ppm (induction $64.3{\pm}24.0s$, recovery $62.8{\pm}15.6s$) for 2-phenoxyethanol, 300 ppm (induction $127.3{\pm}13.3s$, recovery $107.5{\pm}4.8s$) for lidocaine-HCl and 200/100 ppm (induction $81.2{\pm}17.2s$, recovery $98.3{\pm}19.7s$) for lidocaine-$HCl/NaHCO_3$. Thus, 200/100 ppm of lidocaine-$HCl/NaHCO_3$ was found to be an effective anesthetic agent.

• 한국패류학회지
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• 제25권1호
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• pp.15-22
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• 2009

Because it is known that bivalve hearts contain various modulatory systems activated by neuroendocrine substances, it was examined whether different classes of endogenous and synthetic drugs of neuroendocrinological importance can influence cardiac functions of the Pacific oyster Crassostrea gigas. Cholinergically active agents acetylcholine and carbachol increased heart rates while diminishing cardiac contractility. Adrenergically active substances norepinephrine (NE) and epinephrine (Epi) also induced heart rate increase and contractility decrease. An $\alpha_1$-adrenergic receptor-selective agonist phenyephrine (PE) failed to modulate either parameter. The Epi-induced heart rate increase and contractile depression were both blocked significantly by non-selective $\beta_1/\beta_2$-adrenergic antagonist propranolol. A $\beta_1$-selective antagonist atenolol prevented Epi-induced heart rate decrease but not the contractile depression, suggesting possible $\beta_2$ receptors for Epi-induced contractile depression. The three autacoids examined exerted discrete responses: histamine increased heart rate and depressed contraction; $\gamma$-amino-butyric acid increased both parameters; serotonin failed to change either parameter. The 5 piscine anesthetic agents examined, MS-222, benzocaine, quinaldine, urethane, pantocaine and pentobarbital, all failed to influence the cardiac function of oysters. Collectively, activities of neuroendocrinologically acting agents in mammals showed unexpected and distinct activities from those in mammalian cardiovascular systems. These results obtained from substances of different physiological functions can serve as a basis for understanding neuroendocrine control of the heart function in Pacific oyster.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.21-25
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• 2016

Purpose: Burning mouth syndrome (BMS) is a chronic pain condition involving the oral and perioral regions, often characterized by a burning sensation and pain in elderly patients. In this study, we investigated the effectiveness of pharmacological agents for the treatment of BMS patients through a retrospective chart review. Methods: We enrolled 61 BMS subjects (57 females, 4 males; $66.4{\pm}10.9$ years of age) from among consecutive patients treated pharmacologically from January 2014 to June 2015 at Chonnam National University Dental Hospital. Patients with secondary BMS associated with local factors were excluded. The treatment period, number of pharmacological agents tried, and effectiveness of the drugs administered to each subject were analyzed. Results: The mean treatment period for the management of BMS was 2.5 months. More than three agents were tried to control BMS symptoms in 17 subjects (27.9%); two agents were used in 10 subjects (16.4%), and a single agent in 24 subjects (39.3%). Clonazepam was prescribed most frequently and was effective at relieving symptoms in 30 of 39 subjects (76.9%). Paroxetine was moderately effective, relieving symptoms in 7 of 17 subjects (41.2%). Some of the subjects benefited from tricyclic antidepressants, gabapentin, and lipoic acid. A topical local anesthetic used to supplement other systemic agents had ameliorating effects in four of six subjects. Conclusions: Within the study limitations, clonazepam was the most effective drug and antidepressants were efficacious in some subjects for relieving the symptoms of BMS. These pharmacological agents could be considered as first-line drugs for the management of BMS.