• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.121-128
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• 2015

Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.

• The Korean Journal of Pain
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• 제18권2호
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• pp.198-203
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• 2005

Background: This study was designed to demonstrate the peripheral effect of ketamine on the synovia of the knee joint and evaluate the analgesic effect of an intraarticular ketamine injection following knee arthroscopy. Methods: In a double blind randomized study, 80 ASA class 1 or 2 patients were selected for elective arthroscopic knee surgery. The patients received either 20 ml of normal saline (Group C, n = 19), 20 ml of 0.5% ropivacaine (Group R, n = 21), 1 mg/kg of ketamine mixed with 20 ml of normal saline (Group K, n = 20) or 1 mg/kg of ketamine mixed with 20 ml of 0.5% ropivacaine (Group RK, n = 20), intraarticularly, just prior to wound closure. Postoperative pain was evaluated using a visual analogue scale (VAS 0 to 100) score at 1, 2, 6, 12, 24 and 48 hours after the intraarticular injection, with the side effects found in the four groups also evaluated. The patients' requests for rescue analgesic were recorded, total doses of tarasyn calculated and the overall patient satisfaction also evaluated. Results: The difference in the VAS scores for all time periods was not significant. The number of patients receiving rescue analgesics and the total doses received in Group C were greater than those for the other groups, but this was not significant. No side effects were observed in any of the patients. Conclusions: Ketamine and local anesthetics have been reported to have peripheral analgesic effects, with variable duration in the measurements of pain and hyperalgesia. However, we failed to demonstrate a peripheral analgesic effect on postoperative arthroscopic pain.

• 대한약침학회지
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• 제11권1호
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• pp.55-69
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• 2008

Objective : We investigated the effects of distilled Wild Ginseng Herbal Acupuncture on autonomic nervous system with the Heart Rate Variability(HRV) in adult man. as well as we tried to observe how distilled Wild Ginseng Herbal Acupuncture on the balance of the autonomic nervous system. Method : We investigated the effects of distilled Wild Ginseng Herbal Acupuncture on autonomic nervous system with the Heart Rate Variability(HRV) in adult man. as well as we tried to observe how distilled Wild Ginseng Herbal Acupuncture on the balance of the autonomic nervous system. 1 healthy volunteers consisted of 31 subjects in experiment(distilled Wild Ginseng Herbal Acupuncture) group and 30 subjects in control(Normal Saline) group. Study form was a randomized, placebo-controlled, double-blind clinical trial. 31 subjects in experiment group were injected distilled Wild Ginseng Herbal Acupuncture at $GB_{21}$(Kyonjong) and 30 subjects in control group were injected Normal Saline at $GB_{21}$(Kyonjong). except of 2 subjects(in control group) who can't be measured and 11 subjects(7 in experiment group and 4 in control group) who move or make unforceable error during measuring. Finally 24 subject in experiment group and 24 subject in control group are studied. We measured HRV by PolyG-I on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 10.0 for windows was used to analyze the data and the paired t-test(in group) and Student t-test(between two groups) were used to verify the result. Result : 1. After distilled Wild Ginseng Herbal Acupuncture injection, Mean HRV is significantly low only for first 5 minute, SDNN is significantly high after 5 minute, Complexity is significantly low after 5 minute, HRV index is significantly high after 10 minute and pNN50 is significantly low after 5 minute. 2. SDNN of distilled Wild Ginseng Herbal Acupuncture Group significantly increased from 20minute to 25minute, and pNN50 of distilled Wild Ginseng Herbal Acupuncture Group significantly decreased from 10minute to 15minute and 20 minute to 30 minute compared with those of Normal Saline group. 3. After distilled Wild Ginseng Herbal Acupuncture injection, Ln(TP), Ln(VLF) and Ln(LF) are significantly high after 5 minute, normalized LF is significantly high after 5 minute and normalized HF is significantly low after 5 minute. 4. Ln(TP) and Ln(VLF) of distilled Wild Ginseng Herbal Acupuncture Group significantly increased from 20minute to 25 minute compared with those of Normal Saline group. Conclusion : The results suggest that distilled Wild Ginseng Herbal Acupuncture in healthy adult man tend to activate the autonomic nervous system and sympathetic nervous system compared to Normal Saline within normal range.

• 동의신경정신과학회지
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• 제19권1호
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• pp.107-124
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• 2008

We investigated the effects of distilled Astragali Radix Herbal Acupuncture on autonomic nervous system with the Heart Rate Variability(HRV) in adult man. as well as we tried to observe how distilled Astragali Radix Herbal Acupuncture on the balance of the autonomic nervous system. Methods : We investigated on 61 healthy volunteers consisted of 31 subjects in experiment(distilled Astragali Radix Herbal Acupuncture) group and 30 subjects in control(Normal Saline) group. Study form was a randomized, placebo-controlled, double-blind clinical trial. 31 subjects in experiment group were injected distilled Astragali Radix Herbal Acupuncture at GB21(Kyonjong) and 30 subjects in control group were injected Normal Saline at GB21(Kyonjong). except of 2 subjects(in control group) who can't be measured and 10 subjects(6 in experiment group and 4 in control group) who move or make unforceable error during measuring. Finally 25 subject in experiment group and 24 subject in control group are studied. We measured HRV by PolyG-I on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 10.0 for windows was used to analyze the data and the paired t test(in group) and Student t test(between two groups) were used to verify the result. Results : I. After distilled Astragali Radix Herbal Acupuncture injection, SDNN is significantly high from 5 minute to 10 minute and from 15 minute to 30 minute, Complexity is significantly low from 20 minute to 30minute. HRV index is significantly mgb for first 20 minute and from 25 minute to 30 minute, RMSSD is significantly high only from 15 minute to 20 minute. 2. HRV index of distilled Astragali Radix Herbal Acupuncture Group significantly increased from 25 minute to 30 minute, pNN50 of distilled Astragali Radix Herbal Acupuncture Group significantly decreased from 25 minute to 30 minute and RMSSD of distilled Astragali Radix Herbal Acupuncture Group significantly increased from 25 minute to 30 minute compared with those of Normal Saline group. 3. After distilled Astragali Radix Herbal Acupuncture injection, Ln(TP) is significantly high from 5 minute to 10 minute and from 15 minute to 30 minute. Ln(VLF) is significantly high after 5 minute, Ln(LF) is significantly high after 15 minute and Ln(HF) is significantly high from 5 minute to 10 minute and 25 minute to 30 minute, but significantly low for first 5 minute and from 10 minute to 20 minute. Normalized LF is significantly high after 20 minute and Normalized LF is significantly low after 20 minute. Conclusions : The results suggest that distilled Astragali Radix Herbal Acupuncture in healthy adult man tend to activate the autonomic nervous system within normal range. This result is derived from that parasympathetic nervous system was continuously activated and sympathetic nervous system was activated a little later.

• 대한간호학회지
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• 제36권6호
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• pp.1033-1041
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• 2006

Purpose: Glass particle contamination of the contents of single-dose glass ampules can occur upon opening. Different aspiration techniques, different sizes of needles, different sizes of ampules, and different cutting methods were studied to determine if they had any effect on glass particle contamination. Method: Different aspiration techniques(with filter, without filter), different sizes of needles(18G, 25G), different sizes of ampules(2ml, 20m1), and different cutting methods(with cotton, without cotton) were evaluated. Method: Twenty ampules were randomly assigned in each group. Three slides containing glass particles for each ampule were made and counted under a microscope by 3 study blind persons. Result: The number of glass particle contamination is much less when using a filter rather than without a filter. The number of glass particle contamination is much less when using a 25G needle rather than on 18G needle. The number of glass particle contamination is much less when using 2ml ampules rather than 20m1 ampules. The number of glass particle contamination is much less when using cotton rather than without cotton. Conclusion: It was shown that using a filter, a small size needle, smaller sized ampules and using cotton when cutting the ampule will decrease the risk of parenteral injection of glass particles.

• The Korean Journal of Physiology
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• 제9권2호
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• pp.17-22
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• 1975

Adult nonpregnant female rabbits were subjected to the study of the effects of carbon monoxide inhalation on the uterine motility. Animals were anesthetized with intravenous injection of nembutal, 35 mg/kg, and the uteri were exposed. Polyethylene tubing which had a small hole near the blind tip was inserted in the loop and normal saline was infused at a constant rate of 1.5 ml/min. On the other end of the loop, an outlet of fluid was made. When a peristaltic wave proceeded to the hole, a rise of the pressure was ensued and it was transmitted to the pressure transducer, making an upward deflection of the recording pen on the physiograph. Carbon monoxide, 1,000 ppm in the concentration, was inhaled through a tracheal cannula for 30 minutes, following fresh air for 30 minutes. In some cases, pure oxygen was also supplemented for another 30 minutes. Uterine motility was expressed in terms of the impulse that was the time integral of the pressure and of the frequency of the peristaltic waves. The results obtained were as follows. 1. When 1,000 ppm carbon monoxide was inhaled for 30 minutes, the impulse dropped to $72{\pm}16.5%$ and the frequency to $75{\pm}22.7%$ of the values obtained before the gas administration. 2. By fresh air for 30 minutes, the impulse and the frequency restored to $77{\pm}25.7%$ and $92{\pm}21.1%$, respectively. 3. By the supplement of pure oxygen for 30 minutes, no remarkable improvement were revealed, showing $89{\pm}35.2%$ in the impulse and $91{\pm}10.8%$ in the frequency, respectively. 4. There was an appreciable discrepancy in the recovery courses of the impulse and the frequency, suggesting different mechanisms attributable to the alteration by carbon monoxide inhalation.

• The Korean Journal of Pain
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• 제19권1호
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• pp.87-90
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• 2006

Background: There are many ways to provide superior analgesia for postoperative pain after abdominal surgery of which epidural analgesics with opioids and local analgesics are the most useful. In an effort to maximize the level of analgesia and to minimize the side effects, ketamine, midazolam, clonidine, and adrenalin can be co-administrated as an adjuvant. This study examined the analgesic effect and side effects of midazolam compared with those given an epidural injection of bupivacaine, fentanyl and ketamine. Methods: In a double blind randomized controlled trial, 50 patients received either fentanyl $0.3{\mu}g/kg/h$ and ketamine 0.1 mg/kg/h (Group FK) or fentanyl $0.3{\mu}g/kg/h$, ketamine 0.1 mg/kg/h and midazolam 0.4 mg/h (Group FKM), added to 0.125% of bupivacaine at a rate of as much as 2 ml/h, for patient controlled epidural analgesia (PCEA) after low abdominal surgery. Ten minutes before surgery, the patients received either 10 ml of 0.125% bupivacaine with 0.5 mg/kg of ketamine or 10 ml of 0.125% bupivacaine with the same amount of normal saline, added to fentanyl $50{\mu}g$. The pain score and the side effects were recorded at 1, 3, 6, and 24 hours after surgery. Results: There was no difference in the pain score except for the VAS on coughing 1 hour after surgery. FKM group had fewer side effects. Conclusions: There was a better analgesic effect and fewer side effects with the addition of epidural midazolam to bupivacaine and fentanyl with ketamine formula. However, more study on the dose and route of administration will be needed.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.213-221
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• 2020

Background: Complications following impacted third molar surgery significantly affect patients' quality of life during the immediate postoperative period. This study aimed to achieve the proper anesthesia method by comparing the effect of the application of lidocaine alone with the application of lidocaine and articaine simultaneously in reducing the complications during and following impacted mandibular third molar surgery. Methods: The study design was a split-mouth double-blind randomized clinical trial. The study was conducted on 13 patients (26 samples) referred for elective surgical removal of bilateral impacted mandibular third molar with similar difficulty on both sides. Each patient underwent similar surgical procedures on two separate appointments. Each patient randomly received 2% lidocaine for conventional inferior alveolar nerve block and 4% articaine for local infiltration before the surgery on one side (group A) and 2% lidocaine alone (for both block anesthesia and infiltration) before the surgery on the other side (group B). Intraoperative and postoperative variables for both groups were established and statistically analyzed. Results: The findings showed that pain on the first day after surgery in group A was significantly lower than that in group B. The patients in group A mentioned experiencing less discomfort following the surgery. The increased horizontal swelling on the first and third days following surgery and oblique swelling on the seventh day in patients in group B were statistically significant. Conclusion: Choosing an appropriate anesthetic drug for oral surgery, specifically impacted third molar surgery, is dependent on the clinician's opinion, however; it seems that the combination of lidocaine and articaine may control the patient's pain significantly better than lidocaine alone.

• 한국지구물리탐사학회:학술대회논문집
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• 한국지구물리탐사학회 2003년도 Proceedings of the international symposium on the fusion technology
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• pp.142-149
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• 2003

Blind hydraulic backfilling is a commonly used technique for subsidence control of the strata over unapproachable waterlogged underground excavations. In this investigation model studies on all the three variants of this technique, namely, hydro-pneumatic or air-assisted gravity backfilling, pumped-slurry backfilling and simple gravity backfilling, have been carried out in fully transparent models of the underground excavations. On examination of the filling process, it was revealed that in all the three cases, the basic process of filling occurs by sand transport along one or more meandering channels. The relative influence of sand, water and air flow rates on the area of filling from a single inlet point and the hydraulic pressure loss per unit length were studied in details. In hydro-pneumatic backfilling process, the air bubbles while moving upward through the meandering channels provide an additional buoyant force over and above the available hydraulic head. In this way the area of filling from a single borehole may be quite large even at small flow rates of water. During actual field implementation the injected air, if not released completely from the rise side holes, may cause troubles by way of creating potholes on the surface. The pumped-slurry technique has shown its capability of filling a relatively larger area at faster rate, especially when high-volume, low-pressure method was selected. But simple gravity filling was also found to be equally effective method as slurry pumping, especially when flow rates were high. In the second and third method discussed above, examination of variations of injection pressure was also done and its relation with physical phenomenon was also attempted. Some empirical relationships were also developed using multivariate regression with a view to help the practicing engineers.

• Journal of Radiation Protection and Research
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• 제28권2호
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• pp.127-135
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• 2003

The primary contributors to the total occupational radiation exposure in operating nuclear power plants are operation and maintenance activities doting refueling outages. The Advanced Power Reactor 1400 (APR1400) includes a number of design improvements and plans to utilize advanced maintenance methods and robotics to minimize the annual collective dose. The major radiation exposure reduction features implemented in APR1400 are a permanent refueling pool seal, quick opening transfer tube blind flange, improved hydrogen peroxide injection at shutdown, improved permanent steam generator work platforms, and more effective temporary shielding. The estimated average annual occupational radiation exposure for APR1400 based on the reference plant experience and an engineering judgment is determined to be in the order of 0.4 man-Sv, which is well within the design goal of 1 man-Sv. The basis of this average annual occupational radiation exposure estimation is an eighteen (18) month fuel cycle with maintenance performed to steam generators and reactor coolant pumps during refueling outage. The outage duration is assumed to be 28 days. The outage work is to be performed on a 24 hour per day basis, seven (7) days a week with overlapping twelve (12) hour work shifts. The occupational radiation exposure for APR1400 is also determined by an alternate method which consists of estimating radiation exposures expected for the major activities during the refueling outage. The major outage activities that cause the majority of the total radiation exposure during refueling outage such as fuel handling, reactor coolant pump maintenance, steam generator inspection and maintenance, reactor vessel head area maintenance, decontamination, and ICI & instrumentation maintenance activities are evaluated at a task level. The calculated value using this method is in close agreement with the value of 0.4 man-Sv, that has been determined based on the experience aid engineering judgement. Therefore, with the As Low As Reasonably Achievable (ALARA) advanced design features incorporated in the design, APR1400 design is to meet its design goal with sufficient margin, that is, more than a factor of two (2), if operated on art eighteen (18) month fuel cycle.