• The Korean Journal of Pain
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• v.1 no.2
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• pp.181-187
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• 1988

Since the introduction of epidural corticosteroid injections for the management of sciatica, lumbosacral radiculopathy has become one of the most common pain problems encountered by anesthesiologists. In order to function effectively, anesthesiologists should be able to: (1) recognize those syndromes which may respond to nerve block; (2) understand the pathophysiology of the conditions being treated and (3) be familiar with alternate therapeutic pathways for patients not responding to merre block. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production. The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The results are as follows: Excellent pain relieved group: 27 patients (25.5%) Good pain relieved group: 49 patients (46.1%) Fair pain relieved group: 15 patients(14.2%) Not effective group: 15 patients(14.2%).

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.209-212
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• 2016

Lidocaine, a local anesthetic commonly used in dental treatments, is capable of causing allergies or adverse effects similar to allergic reactions. However, the frequency of such occurrences in actual clinical settings is very rare, and even clinical tests on patients with known allergies to local anesthetics may often show negative results. When adverse effects, such as allergy to lidocaine, are involved, patients can be treated by testing other local anesthetics and choosing a local anesthetic without any adverse effects, or by performing dental treatment under general anesthesia in cases in which no local anesthetic without adverse effects is available. Along with a literature review, the authors of the present study report on two cases of patients who tested positive on allergy skin tests for lidocaine and bupivacaine and subsequently underwent successful dental treatments with either general anesthesia or a different local anesthetic.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.1
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.1-10
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• 2019

Periodontal procedures require adequate anesthesia not only to ensure the patient's comfort but also to enhance the operator's performance and minimize chair time. In the maxilla, anesthesia is often achieved using highly traumatic nerve blocks, apart from multiple local infiltrations through the buccal vestibule. In recent years, anterior middle superior alveolar (AMSA) field block has been claimed to be a less traumatic alternative to several of these conventional injections, and it has many other advantages. This critical review of the existing literature aimed to discuss the rationale, mechanism, effectiveness, extent, and duration of AMSA injections for periodontal surgical and non-surgical procedures in the maxilla. It also focused on future prospects, particularly in relation to computer-controlled local anesthetic delivery systems, which aim to achieve the goal of pain-free anesthesia. A literature search of different databases was performed to retrieve relevant articles related to AMSA injections. After analyzing the existing data, it can be concluded that this anesthetic technique may be used as a predictable method of effective palatal anesthesia with adequate duration for different periodontal procedures. It has additional advantages of being less traumatic, requiring lesser amounts of local anesthetics and vasoconstrictors, as well as achieving good hemostasis. However, its effect on the buccal periodontium appears highly unpredictable.

• Development and Reproduction
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• v.23 no.2
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• pp.183-191
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• 2019

The objective of this study is to evaluate the anesthetic effects of clove oil and tricaine methanesulfonate (MS-222) on the Far Eastern catfish, Silurus asotus, by measuring the times to anesthesia and recovery. Each anesthetic effect of clove oil and MS-222 was tested in two groups of fish with different body sizes: a group of small fish (mean body length: $15.5{\pm}1.58cm$, mean body weight: $50.1{\pm}5.91g$, n=20) and a group of large fish (mean body length: $31.5{\pm}4.19cm$, mean body weight: $302.1{\pm}15.22g$, n=20). The anesthetics were used at concentrations of 200, 300, 400, 500, and 600 ppm. The results showed significant relationships between the concentration of the anesthetic and the body size of the fish. Each of these variables showed statistical significance (p<0.05). The time to anesthesia decreased linearly with increasing concentration in the large fish for both clove oil and MS-222 (p<0.05). Based on an optimal anesthetic time of approximately 1 min, the preferred concentrations of the anesthetics were 500 ppm for clove oil and 600 ppm for MS-222. Both the anesthetic time and the recovery time were shorter for the small fish than for the large fish (p<0.05). Our study showed that the smaller-sized Far Eastern catfish was more easily anesthetized and recovered more rapidly from anesthesia than the larger-sized fish.

• Journal of Veterinary Clinics
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• v.40 no.4
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• pp.260-267
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• 2023

Specialized hearing tests for pets are currently in demand. A brainstem auditory evoked response (BAER) test is an objective, non-invasive, and practical electrophysiological method that records electric signals from the peripheral auditory system to the brainstem when an auditory stimulation is provided. In veterinary medicine, sedation or anesthesia is essential for a successful examination. In human medicine, research has established the indications for various sedatives, anesthetics, and drugs according to the depth of anesthesia required. However, in veterinary medicine, there are very few comparative studies on propofol or isoflurane, which are the most common anesthetics used. Therefore, the present study aimed to analyze the difference in BAER test results between sedation with medetomidine, anesthesia using propofol, and inhalation anesthesia with isoflurane after propofol administration. The test was conducted on four healthy adult dogs. There was no statistically significant difference in latency, interpeak latency, or amplitude between the various drugs. The results suggest that a sedative or anesthetic for the administration of a BAER test can be selected according to the patient's needs.

• Journal of Korean Clinical Nursing Research
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• v.15 no.2
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• pp.67-75
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• 2009

Purpose: Postoperative nausea and vomiting(PONV) is a common problem after general anesthesia. The aim of this prospective, double-blind randomized study was to compare the effect of Propofol-Remifentanil vs. Sevoflurane inhalational anesthetics on PONV after laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery participated in the study. Twenty of them received total intravenous anesthesia (TIVA group) with Propofol-Remifentanil, and the rest were given Sevoflurane inhalational anesthetics (inhalation group). The TIVA group was induced with Propofol 5mcg/ml and Remifentanil 3~4mcg/ml. The anesthesia was maintained with the continuous infusion of Propofol 2~3mcg/ml and Remifentanil 2~3mcg/ml IV. The inhalation group was induced with Pentotal Sodium 5mg/kg and 3~4mcg/kg/hr IV Remifentanil. Maintenance was obtained with 1.5~2.0 vol% Sevoflurane. Results: The subjects in TIVA group reported less PONV than those in Sevoflurane inhalation anesthesia group. Conclusion: Propofol-Remifentanil anesthesia (TIVA group) was considered a satisfactory anesthetic technique in reducing PONV in patients with laparoscopic cholecystectomy.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.44-48
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• 2000

Background: The continuous epidural analgesia is a popular method in the management of postoperative pain. However, the exact regimen for the optimal analgesia is still in dispute. In this study, we evaluated the effect of an initial loading dose prior to the continuous epidural infusion after a brief surgery, which may have some residual effects of local anesthetics that is used for the intraoperative epidural anesthesia. Methods: Seventy five patients required epidural anesthesia with 15 ml of 2% mepivacaine for the perianal surgery were randomly divided into three groups: Group 1, being the control group (n=25) did not received postoperative epidural pain control. But, group 2 (n=25) and 3 (n=25) received continuous epidural analgesia with local anesthetics and morphine immediately after surgery. In Group 2, the patients received continuous epidural infusion without initial loading dose. In Group 3, the patients received initial loading dose (1% mepivacaine 6 ml and morphine 1 mg) and followed by continuous epidural infusion. We evaluated the number of patients who needed adjuvant analgesics, the pain score, and incidence of side effects for the postoperative 48 hours. Results: At postoperative 12 hours, in group 3, the two variables, the number of patients who needed analgesics and the pain score showed a statistical significance with low scores compared with group 1 and 2. At postoperative 24 and 48 hours, the two variables indicated above did not show any differences in group 2 and 3. The incidence of side effects is not different among the three groups. Conclusions: The loading dose prior to continuous epidural infusion is necessary after a brief surgery which may have some residual effects of local anesthetics that is used for the intraoperative epidural anesthesia.

• Archives of Plastic Surgery
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• v.42 no.1
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• pp.28-33
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• 2015

Background Topical anesthetics, such as eutectic mixture of local anesthetics (EMLA) cream, can be applied to reduce pain before minor procedure. This trial evaluated EMLA as pretreatment for facial lacerations and compared pain, discomfort and overall satisfaction. Methods This trial included consecutive emergency department patients ${\geq}16years$ of age who presented with simple facial lacerations. At triage, lacerations were allotted to either the routine processing group or EMLA pretreatment group according to date of admission. Initially, the emergency department doctors inspected each laceration, which were dressed with saline-soaked gauze. In the pretreatment group, EMLA cream was applied during wound inspection. The plastic surgeon then completed primary closure following the local injection of an anesthetic. After the procedure, all patients were given a questionnaire assessing pain using the 10-point visual analog scale (VAS) ("no pain" to "worst pain"). All questionnaires were collected by the emergency department nurse before discharge. Results Fifty patients were included in the routine processing group, and fifty patients were included in the EMLA pretreatment group. Median age was 39.9 years, 66% were male, and the average laceration was 2.67 cm in length. The EMLA pretreatment group reported lower pain scores in comparison with the routine processing group (2.4 vs. 4.5 on VAS, P<0.05), and lower discomfort scores during the procedure (2.0 vs. 3.3, P=0.60). Overall satisfaction was significantly higher in the EMLA pretreatment group (7.8 vs. 6.1, P<0.05). Conclusions Pretreating facial lacerations with EMLA topical cream aids patients by reducing pain and further enhancing overall satisfaction during laceration treatment.

• 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.