• 제목/요약/키워드: Awake

검색결과 171건 처리시간 0.028초

바이코히어런스 분석 기법을 이용한 마취 단계별 뇌파의 특성 분석 (EEG Signal Characteristic Analysis for Monitoring of Anesthesia Depth Using Bicoherence Analysis Method)

  • 박준모;박종덕;전계록;허영
    • 대한전기학회논문지:시스템및제어부문D
    • /
    • 제55권1호
    • /
    • pp.35-41
    • /
    • 2006
  • Although reachers have studied for a long time, they don't make criteria for anesthesia depth. anesthetists can't make a prediction about patient's reaction. Therefor, patients have potential risk such as poisonous side effect late-awake, early-awake and strain reaction. EEG are received from twenty-five patients who agreed to investigate themselves during operation with Enflurane-anesthesis in progress of anesthesia. EEG are divided pre-anesthesia, before incision of skin, operation 1, operation 2, awaking, post-anesthesia by anesthesia progress step. EEG is applied pre-processing, base line correct, linear detrend to get more reliable data. EEG data are handled by electronic processing and the EEG data are calculated by bicoherence. During pre-anesthesia and post anesthesia, appearance rate of bicoherence value is observed strong appearance rate in high frequency range($15\~30Hz$). During the anesthesia of patient, a strong appearance rate is revealed the low frequency area(0~10Hz). After bicoherence is calculated by percentage of a appearance rate, that is, Bicpara$\#$1, Bicpara$\#$2, Bicpara$\#$3 and Bicpara$\#$4 parameter are extracted. In result of bicoherence analysis, Bicpara$\#$2 and Bicpara#4 are considered that the best parameter showed progress of anesthesia effectively. And each separated bicoherence are calculated by average bicoherence's numerical value, divide by 2 area, appear by each BicHz$\#$1, BicHz$\#$2, and observed BicHz$\#$1/BicHz$\#$2's change. In result of bicoherence analysis, BicHz$\#$1, BicHz$\#$2 and BicHz$\#$1/BicHz$\#$2 are considered that the best parameter showed progress of anesthesia effectively. In conclusion, I confirmed the anesthesia progress phase, concluded to usefulness of parameter on bispectrum and bicoherence analysis and evaluated the depth of anesthesia. In the future, it is going to use for doctor's diagnosis and apply to protect an medical accident owing to anesthesia.

굴곡건 수술에서 각성마취의 유용성 (Usefulness of Awake Anesthesia in Flexor Tendon Surgery)

  • 심병관;정성균;최환준;박은수;탁민성
    • Archives of Plastic Surgery
    • /
    • 제37권6호
    • /
    • pp.795-800
    • /
    • 2010
  • Purpose: According to various medical publications, it is believed that epinephrine should not be injected in fingers. However numerous articles show the successful use of local anesthetic with epinephrine in the digits. Epinephrine-mixed lidocaine solution enables to maintain a bloodless field for operation and provides long duration of local anesthesia when patient was wide awake. Methods: From May 2009 to December 2009, ten patients underwent flexor tendon reconstruction with local anesthesia using epinephrine. No tourniquet was necessary. Before operation, all patients were injected with local anesthetics using 1% lidocaine 20 mL and 0.1% epinephrine 0.1 mL. Results: There was no case of digital necrosis nor gangrene in the epinephrine injection. All 10 patients actively could move the finger through a full range of motion. All procedures were performed without sedation nor tourniquet and we could obtain a good vision of operative field and patients were comfortable. The patient make his or her fingers move through a full range of active motion before the skin is closed. Phentolamine was not required to reverse the vasoconstriction in any patients. Conclusion: The assertation that epinephrine should not be injected into the fingers is clearly no longer valid. The epinephrine injection allowed the authors to adjust flexor tendon surgery without risks associated with general anesthesia. It also enables to ensure longer anesthetic duration and bloodless operative field, and prevent post operative complications. In case of flexor tendon surgery, the use of epinephrine injection is recommended because of the advantages of local anesthesia.

교량감시를 위한 무선 센서 네트워크 구조 및 보안 프로토콜 (A Wireless Sensor Network Architecture and Security Protocol for Monitoring the State of Bridge)

  • 임화정;전진순;이헌길
    • 한국컴퓨터산업학회논문지
    • /
    • 제6권3호
    • /
    • pp.465-476
    • /
    • 2005
  • 무선 센서 네트워크는 물리적인 제약을 가진 수많은 센서 노드들로 구성되어 있다. 각 센서 노드는 주변의 상태를 감지하고, 감지된 정보를 싱크(Sink)로 보내는 역할을 한다. <중략> 본 논문에서는 교량과 같은 인공구조물에 적합한 비 계층적 무선 센서 네트워크 구조를 제시하였다. 또한, 센서 노드들의 휴면(Sleep)과 활동(Awake) 상태를 이용한 효율적인 보안 라우팅 프로토콜과 센서 노드의 키와 위치 정보를 사전에 노드에 분배하는 사전 키 분배 방식 및 2계층 인증 기법을 제안하였다. 제안하는 방식은 대체 경로 수의 증가로 인한 데이터 전송률의 증가와 에너지 소모율의 감소 효과를 보였다.

  • PDF

WALANT: A Discussion of Indications, Impact, and Educational Requirements

  • Shahid, Shahab;Saghir, Noman;Saghir, Reyan;Young-Sing, Quillan;Miranda, Benjamin H.
    • Archives of Plastic Surgery
    • /
    • 제49권4호
    • /
    • pp.531-537
    • /
    • 2022
  • Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

개의 성문폐쇄반사에 미치는 중추조절의 영향에 관한 연구 (Glottic Closure Reflex in an Anesthetized and Awake Canine Model)

  • 강주완;김광문;김영호
    • 대한후두음성언어의학회지
    • /
    • 제14권2호
    • /
    • pp.83-87
    • /
    • 2003
  • Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

  • PDF

Multi-Valued Decision Making for Transitional Stochastic Event: Determination of Sleep Stages Through EEG Record

  • Nakamura, Masatoshi;Sugi, Takenao
    • Transactions on Control, Automation and Systems Engineering
    • /
    • 제4권3호
    • /
    • pp.239-243
    • /
    • 2002
  • Multi-valued decision making for transitional stochastic events was newly derived based on conditional probability of knowledge database which included experts'knowledge and experience. The proposed multi-valued decision making was successfully adopted to the determination of the five levels of the vigilance of a subject during the EEG (electroencephalogram) recording; awake stage (stage W), and sleep stages (stage REM (rapid eye movement), stage 1, stage 2, stage $\sfrac{3}{4}$). Innovative feature of the proposed method is that the algorithm of decision making can be constructed only by use of the knowledge database, inspected by experts. The proposed multi-valued decision making with a mathematical background of the probability can also be applicable widely, in industries and in other medical fields for purposes of the multi-valued decision making.

교량감시를 위한 센서 네트워크 보안프로토콜 (A Sensor Network Security Protocol for Monitoring the State of Bridge)

  • 임화정;전진순;이헌길
    • 산업기술연구
    • /
    • 제25권B호
    • /
    • pp.211-220
    • /
    • 2005
  • The wireless sensor network consists of a number of sensor nodes which have physical constraints. Each sensor node senses surrounding environments and sends the sensed information to Sink. The inherent vulnerability in security of the sensor nodes has promoted the needs for the lightweight security protocol. In this paper, we propose a non-hierarchical sensor network and a security protocol that is suitable for monitoring the man-made objects such as bridges. Furthermore, we present the efficient way of setting the routing path by storing IDs, MAC(message authentication code) and the location information of the nodes, and taking advantage of the two node states, Sleep and Awake. This also will result in the reduced energy consuming rate.

  • PDF

Benzodiazepine withdrawal syndrome에 의한 Status Epilepticus 1례 (Status Epilepticus as a Benzodiazepine withdrawal syndrome)

  • 오영민;최경호
    • 대한임상독성학회지
    • /
    • 제6권1호
    • /
    • pp.45-48
    • /
    • 2008
  • A 57-year-old man was transferred to our emergency department with decreased mental status after organophosphate intoxication. He had a four year history of benzodiazepine and hypnotic medication use for chronic insomnia and a depressive mood disorder. He had no previous history of seizures, diabetes mellitus, and hypertension. By hospital day 5, the patient was noted to be awake and to have repetitive jerking movements involving the left upper extremity, and appeared apathetic, depressed and less responsive to external stimuli. A benzodiazepine withdrawal syndrome was subsequently apparent when he developed several generalized tonic clonic seizures and status epilepticus. Using a continuous midazolam intravenous infusion, we successfully controlled the refractory seizure without complications. We present a rare case of status epilepticus from a benzodiazepine withdrawal that developed during the treatment for organophosphate intoxication.

  • PDF

경비삽관 시도 중 발생한 심각한 비출혈 (Massive Epistaxis during Nasotracheal Intubation)

  • 전대근;송재격;김석곤;지승헌
    • 대한치과마취과학회지
    • /
    • 제13권2호
    • /
    • pp.51-54
    • /
    • 2013
  • A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

카페인이 인체에 미치는 영향 및 섭취량 감소 방안에 관한 연구 (A study on Caffeine containing foods and the effect of caffeine in humans)

  • 이혜원
    • 한국조리학회지
    • /
    • 제6권3호
    • /
    • pp.343-355
    • /
    • 2000
  • Caffeine is widely consumed ingredient and it belongs to alkaloids. Many foods that we intake contain caffeine ; coffee, tea cocoa, chocolate, and coke. And it is also added to many commercial remedies ; cold tablets, headache tablets, etc. Effect of caffeine that is known to us so far is as follows; 1. Remaining awake for long hours 2. Increasing concentration and decreasing fatigue 3. Increasing basal metabolic rate 4. decomposing glycogen and body fat and providing energy 5. Stimulating gastric acid 6. Increasing urinary excretion. Caffeine containing beverages(especially, coffee)are also favorite food in adult. In case of children and youth, chocolate and coke are favorite food. So, to intake caffeine containing foods moderately can be a vitality of life. But, a long-term intake or overdose of caffeine can result in many side effects. For example, headache, irritability, restlessness, hypertension, fetal abnormality, etc. Therefore, it is desirable that caffeine intake is under 300-400mg per day. To decrease intake of caffeine, 1. Use decaffeinated coffee 2. Product of decaffeinated coffee bean through gene transformation 3. Indicate content and function of caffeine on caffeine-food container 4. Provide an information of caffeine to public.

  • PDF