• The Korean Journal of Pain
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• 제34권3호
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• pp.304-314
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• 2021

Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.119-128
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• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• 대한치과마취과학회지
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• 제10권2호
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• pp.172-177
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• 2010

Background: Damages of trigeminal nerve, particularly inferior alveolar nerve and lingual nerve, could occur following dental procedures. In some cases, nerve damage may happen as a complication of the local anesthetic injection itself and not of the surgical procedure. Methods: From September 2006 to August 2010, 5 cases of inferior alveolar nerve and lingual nerve damages, which were assumed to happen solely due to local anesthesia, were reviewed. All cases were referred to Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University Medical Center for legal authentication in the process of criminal procedure. Results: In all five cases, patients complained of altered sensation occurred in the distribution of the inferior alveolar or lingual nerve following block anesthesia. The local anesthetics were 2% lidocaine with 1 : 100,000 epinephrine and the amount of local anesthetics, which were used during injection, were varied. Most of patients experienced the electric stimulation during injection. Recovery was poor and professional supportive care was mostly absent. Conclusions: Dental practitioners should consider that the surgical procedure caused the trigeminal nerve damage, however, dental local anesthesia for inferior alveolar nerve and lingual nerve could be one of the causes for damages. The various mechanisms for nerve damages by local anesthesia are thoroughly discussed.

• 기본간호학회지
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• 제18권1호
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• pp.46-53
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• 2011

Purpose: The purpose of this study was to identify the effects of EMLA cream (eutectic mixture of local anesthetics, lidocaine and prilocaine) on pain during ampicillin sodium intradermal (ID) skin test, and also to assess skin reaction after the skin test. Methods: Forty-three nurse-volunteers had skin tests with 0.01ml-0.05ml ampicillin sodium antibiotics. Skin tests were done on each forearm to compare the pain level of the skin test site after application of EMLA cream with the pain level when no EMLA cream was applied. EMLA cream was applied at the ID skin test site with an occlusive dressing for one hour. Pain was evaluated using a visual analogue scale and pain sensation using the short form McGill Pain Questionnaire. The transverse diameter of the wheal and redness was read right after and at 15 minutes after the skin test. The results were compared using independent t-tests. Results: Pain score and sensation with EMLA cream treatment were significantly lower than when EMLA cream was not applied. There was no difference in skin reactions; reading of the skin test was not affected by EMLA cream. Conclusions: EMLA cream was found to be an effective local anesthetic to relieve the pain of clients having ampicillin sodium antibiotics ID skin tests.

• Restorative Dentistry and Endodontics
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• 제31권4호
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• pp.257-262
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• 2006

에피네프린을 함유한 국소마취제가 치수혈류량에 미치는 영향을 관찰하고, 이 국소마취가 와동 형성에 의해 야기되는 치수의 혈류변화에 미치는 영향을 평가하고자 전신마취 된 아홉 마리의 고양이 견치에서 1 : 100.000 에피네프린이 함유된 2% 리도카인 용액으로의 국소 침윤마취 전후 및 와동형성 전후의 치수혈류를 laser Doppler flowmetry (Periflux 4001, Perimed Co.. Sweden)를 사용하여 측정하고 paired t-test 로 통계 분석하였다 . 상아질 와동의 형성은 치수혈류의 현저한 증가를 초래하였다 (p < 0.05). 에피네프린을 함유한 리도카인의 침윤마취는 치수혈류를 유의하게 감소시켰다 (p < 0.05). 국소마취 한 치아에서는 마취되지 않은 치아에 비해 와동형성 시 유의하게 적은 치수혈류의 증가를 나타내었다 (p < 0.05). 따라서 본 연구에서는 혈관수축제를 포함한 국소마취가 와동 형성에 의해 초래되는 혈류량의 증가를 효과적으로 억제할 수 있음을 보여주고 있다.

• The Korean Journal of Pain
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• 제34권2호
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• pp.193-200
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• 2021

Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

• The Korean Journal of Pain
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• 제18권2호
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• pp.176-180
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• 2005

Background: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. Methods: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. Results: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. Conclusions: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.

• 대한정형외과 초음파학회지
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• 제5권1호
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• pp.50-59
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• 2012

정형외과 영역에서 상지와 하지의 수술을 위한 부위 마취나 통증 조절을 목적으로 한 신경 차단술에서도 근골격계 초음파의 활용도가 증가하고 있다. 하지에서 슬관절 원위부의 수술을 위해 시행하던 기존의 슬와 신경 차단술, 대퇴 신경 차단술, 근위 복재 신경 차단술, 족관절 차단술 등의 부위 마취를 초음파 유도 하에 시행함으로서 시술의 안전성뿐만 아니라 국소 마취의 성공률을 높일 수 있게 되었고, 또한 사용되는 국소 마취제의 용량도 줄일 수 있게 되었다. 수술 후 통증조절을 목적으로 한 단발적인 국소 마취 희석액 신경 주위 주사나 카테터 삽입을 통한 지속적인 국소 마취 희석액 신경주위 주사도 초음파를 이용하여 정확하게 시행할 수 있어 PCA에서 나타나는 오심, 구토 등의 부작용 없이 통증 조절을 이룰 수 있게 되었다. 이러한 초음파 유도 국소 신경 차단술에 대하여 알아보고자 한다.

• The Korean Journal of Pain
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• 제1권2호
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• pp.181-187
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• 1988

경막외 천자는 마취과 의사는 누구나 쉽게 시행할 수 있는 수기이므로 요통으로 고생하는 많은 환자들중에 얼마만큼이라도 우리들의 손으로 치유하는 보람을 가졌으면 좋겠다. 또한 좀 더 요통치료에 대한 연구가 많았으면 한다.

• Journal of Chest Surgery
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• 제15권2호
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• pp.230-237
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• 1982

Malignant hyperthermia has been reported by many authors since Denborough [1960] first described concerning anesthetic death in a family. Malignant hyperthermia is characterized by a hypermetabolic state [tachycardia, tachypnea, hypercarbia, hypoxia, cyanosis, hypotension, high fever and muscle rigidity] and is related to a hereditary defect of skeletal muscle. In susceptible individuals, it is triggered by potent inhalational anesthetics, depolarizing muscle relaxant [Succinylcholine], amide type local anesthetics [prototype lidocaine] and occasionally by stress due to emotional and environmental factors. Unrecognized and untreated malignant hyperthermia is associated with a very high mortality rate. Recently authors have experienced malignant hyperthermia in 5 year old male child who was diagnosed to have patent ductus arteriosus and interatrial septal defect associated with congenital physical deformities such as short stature, hypotrophic muscles and genu valgus deformity of lower extremity, indirect inguinal hernia and Ramphant caries.