• Title/Summary/Keyword: Anesthetic induction

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Effect of favorite music therapy on anxiety and vital sign in patients undergoing gynecologic surgery using the general anesthesia (선호 음악요법이 전신마취 산부인과 수술 환자의 불안과 활력 징후에 미치는 효과)

  • Yang, Jung-Lim;Noh, Min-Young;Yang, Kyung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.1189-1199
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    • 2015
  • This study examined the effects of favorite music therapy on the anxiety and vital signs at each point in gynecologic surgery using the general anesthesia. The research design was a non-equivalent control group non-synchronized design. The data were collected from May 1 to July 30, 2013 and the participants were 44 patients (experimental group, 21, control group, 23) received music therapy while waiting for anesthetic induction and PACU (Post Anesthesia Care Unit). Repeated measures ANOVA was performed to analyze the data by SPSS 18.0. Music therapy reduced the anxiety level at inducing the anesthetic time, and awakening time (p=.003; p=.011). The systolic blood pressure maintained stability at discharge from the PACU (p=.023), and pulse rate was stable at the awakening time (p=.016). This findings support the use of music as a nursing intervention to reduce anxiety and maintain the vital signs for gynecologic surgery patients under general anesthesia.

Effect of bilateral infraorbital nerve block on intraoperative anesthetic requirements, hemodynamics, glycemic levels, and extubation in infants undergoing cheiloplasty under general anesthesia

  • Rajan, Sunil;Mathew, Jacob;Kumar, Lakshmi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.2
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    • pp.129-137
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    • 2021
  • Background: Inappropriate use of intravenous and inhaled anesthetics may be dangerous in infants undergoing facial cleft surgeries. This study primarily aimed to compare the effect of infraorbital nerve block on sevoflurane requirement in infants undergoing cheiloplasty. Intraoperative opioid consumption, hemodynamics, blood glucose levels, extubation time, and delirium were also compared. Methods: This prospective, randomized, double-blinded study was conducted in 34 infants undergoing cheiloplasty under general anesthesia. After induction, group A received bilateral infraorbital nerve block with 0.5 mL of 0.5% bupivacaine and group B 0.5 mL saline. An increase in heart rate or blood pressure > 20% was managed by increasing sevoflurane by 2-2.5%, followed by fentanyl 0.5 ㎍/kg bolus. The chi-square test and independent-sample t-test were used where applicable. Results: Demographics, duration of surgery, and intravenous fluids used were comparable between the groups. Compared to group A, patients in group B had significantly higher consumption of fentanyl (14.2 ± 4.4 ㎍ vs. 22.1 ± 6.2 ㎍) and sevoflurane (14.2 ± 4.8 mL vs. 26.8 ± 15.6 mL). Intraoperative hemodynamic parameters were significantly lower in group A, the number of times increases in hemodynamic parameters occurred, and fentanyl supplemental bolus was required remained significantly lower in group A than in group B. Intraoperative glycemic levels remained higher in group B, and the extubation time was significantly shorter in group A than in group B (4.40 ± 1.60 min vs. 9.2 ± 2.18 min). Group A had a lesser occurrence of postoperative delirium. Conclusion: Supplemental infraorbital block in infants undergoing cheiloplasty under general anesthesia resulted in significantly decreased anesthetic requirements and optimal hemodynamic and glycemic levels with faster extubation and lesser delirium.

Anesthetic efficacy of supplemental intraligamentary injection in human mandibular teeth with irreversible pulpitis: a systematic review and meta-analysis

  • Gupta, Alpa;Wadhwa, Jitesh;Aggarwal, Vivek;Mehta, Namrata;Abraham, Dax;Aneja, Kritika;Singh, Arundeep
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.1-10
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    • 2022
  • Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

Studies on the Antidotal Effect of Panax ginseng The Therapeutic Effect of Ginseng on the Acute Alcoholism (인삼의 해독작용에 관한 연구 급성 알코을 중독에 대한 인삼의 치료 효과)

  • 신만륜
    • Journal of Ginseng Research
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    • v.1 no.1
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    • pp.59-78
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    • 1976
  • In order to investigate the influences of Panax ginseng (white ginseng and red ginseng) on the anesthetic effect and toxic effect of alcohol, experimental studies .had been carried out with albino rabbits, mongolian dogs and mice. The anesthetic effect of alcohol was observed by measuring the induction time, .anesthetic time, recovery time and duration from the beginning of induction to , the recovery of anesthesia (total time), respectively. and toxic effect ($LD_{50}$) of alcohol was measured. In addition to these experiments, al cohol concentration in .blood, blood sugar level, serum transaminase (GOT and GPT) activities and serum alkaline phosphatase activity were measured. Also in order to study the clinical effect of alcohol in healthy students, code .substitution, response time and muscle coordination were tested. The results were obtained as follows. 1. In the rabbits and mongolian Jags, the induction time of anesthesia by the administration of alcohol was delayed by the pretreatment of ginseng but recovery time and total time of anestksia were markedly shortend. 2. The bleed alcohol concentration was decreased by the pretreatment of ginseng , but not affected in mongolian dogs. 3. The blood sugar level, serum transaminase (GOT and GPT) activities and alkaline phoshatase activity in rabbits and dogs induced by the administration of alcohol were affected by the Pretreatment of ginseng. Because those were included within normal ranges, the differnces have no remarkable significance. 4. Liver alcohol dehydrogenase activity of rabbit was increased by the treatment of ginseng, especially it was markedly increased by the treatment of red ginseng 5. The average lethal dose of alcohol to mice was increased by the pretreatment. of ginseng, especially it was markedly increased by the pretreatment of red .ginseng. 6. In the clinical experiments, the blood alcohol concentration induced by alcohol administration was not affected by the pretreatment of ginseng whereas the bleed sugar level was increased. Blood alcohol concentration and bleed sugar level were measured after three hours alcohol administration. 7. The response time of healthy students administered with alcohol was markedly shortened by the pretreatment of ginseng but the experiments on the code substitution and muscle coordination were not affected.

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Dental Treatment of a Patient with Cerebral Palsy under General Anesthesia (뇌성마비 환자의 전신마취 하 치과치료)

  • Chung, Jun-Min;Seo, Kwang-Suk;Yi, Young-Eun;Han, Hee-Jung;Han, Jin-Hee;Kim, Hye-Jung;Shin, Teo-Jeon;Kim, Hyun-Jeong;Yum, Kwang-Won;Chang, Ju-He
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.22-28
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    • 2008
  • Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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The Significance of Electroencephalography in the Hypothermic Circulatory Arrest in Human (인체에서 저체온 완전 순환 정지 시 뇌파검사의 의의)

  • 전양빈;이창하;나찬영;강정호
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.465-471
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    • 2001
  • Background: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. Material and Method: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). Result: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11$^{\circ}C$ -$25^{\circ}C$, nasopharynx 7.7$^{\circ}C$ -23$^{\circ}C$). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). Conclusion: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest. :

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Effects of Propofol and Thiopental Sodium on the Maturation, Fertilization and Development of Porcine Oocytes (Propofol(2,6-disoprooylphenol)과 Thiopental Sodium이 돼지 난자성숙, 수정 및 발생에 미치는 영향)

  • 김주영;유정민;유성진;김주란;윤용달;정철회;김현찬;강성구
    • Development and Reproduction
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    • v.6 no.1
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    • pp.17-23
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    • 2002
  • In oocyte retrieval, a vein anesthetic drug is commonly used for induction and maintenance of general anesthesia. Propofol and Thiopental sodium are frequently used for ultrasound-guided transvaginal oocyte retrieval. The present study aimed to assess the effects of Propofol and Thiopental on in vitro fertilization(IVF). Immature porcine oocytes were exposed to various concentrations ot Propofo1 and Thiopental sodium. The rates of oocyte maturation, fertilization and development were observed. The parthenogenetic effects of the anesthetics were also evaluated. The rate of oocyte maturation after exposure to high concentrations of the anesthetics for long time was significantly higher than that of the control. But the rate of fertilization after long-time exposure to the high concentration of the anesthetic drugs was significantly lower than that of the control. The results support that Propofo1 serves like other anesthetics described, as a parthenogenetic activator. Oocytes exposed to Thiopental sodium showed decreased rates of maturation and fertilization. These results suggest that usage of optimum concentration of anesthetic drug is important in increasing the rates of oocyte maturation, fertilization and development in IVF.

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USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT- (기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료)

  • Yi, Young-Eun;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Teo-Jeon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.88-91
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    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

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Development for the Index of an Anesthesia Depth using the Power Spectrum Density Analysis (뇌파 스펙트럼 분석에 의한 마취 심도 지표 개발)

  • Ye, Soo-Young;Baik, Swang-Wan;Kim, Jae-Hyung;Park, Jun-Mo;Jeon, Gye-Rok
    • Journal of Biomedical Engineering Research
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    • v.30 no.4
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    • pp.327-332
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    • 2009
  • In this paper, new index was developed to estimate the depth of anesthesia during general anesthesia using EEG. Analysis of the power spectral density(PSD) of EEG was used to develop new parameters because EEG signal tends to have slow wave during anesthesia. Classifier for index creator was developed by using SEF, BDR and BTR parameters, which are calculated by power spectral density. EEG data were obtained from 7 patients (ASA I, II) during general anesthesia with Sevoflurane. The anesthetic depth evaluation indexes ranged from 0 to 100. The average were $86.05{\pm}10.1$, $36.98{\pm}20.2$, $15.33{\pm}13.6$, $50.87{\pm}16.5$ and $87.72{\pm}11.7$ for the states of pre-operation, induction of anesthesia, operation, awaked and post-operation, respectively. The results show that while the depth of anesthesia was evaluated, more accurate information can be provided for anesthetician.

A Case of Successful Use of C-MAC® Video Laryngoscope in 'Cannot Ventilate' Situation Due to Unexpected Severe Narrowing of Laryngeal Inlet (예기치 못한 후두 입구 협착으로 인한 환기 부전 상황에서의 비디오 후두경의 유용성 1예)

  • Moon, Jeong Hwan;Lee, Sun Hong;Kang, Bong Jin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.122-125
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    • 2016
  • Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

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