• 대한화학회지
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• 제19권1호
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• pp.38-42
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• 1975

2-Acetothienone과 chloral을 축합시켜 chloral-2-acetothienone을 생성하였으며 이것을 탈수하여 trichloroethylidene-2-acetohienone을 합성하였다. Trichloroethylidene-2-acetothienone과 phenylhydrazine 또는 치환된 phenylhydrazine들과의 반응으로 2-aryl-6-(2-thienyl)-3(2H)-pyridazinone들을 얻었으며 hydrazine과의 반응에서는 3-(2-thienyl)-5-trichloromethyl-2-pyrazoline이 합성되었다.

• 대한장애인치과학회지
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• 제2권2호
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• pp.142-146
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• 2006

환아의 연령, 과다체중, 환아의 약물 거부 등으로 인하여 chloral hydrate를 이용한 수면치료가 불가능한 경우, Midazolam을 이용한 정주진정요법이 전신마취를 대신하는 대안으로 사용될 수 있다. 본 환아의 경우, 0.3mg/kg의 midazolam을 근주하고, 70% 아산화질소 가스를 이용하여 초기 수면상태를 유도하고 정맥천자를 실시한 후, 0.2mg/kg midazolam을 정주하여 50분간 별다른 부작용 없이 성공적으로 치료할 수 있었다.

• 대한소아치과학회지
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• 제47권2호
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• pp.109-119
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• 2020

이 후향적 연구는 chloral hydrate, hydroxyzine 및 N₂O/O₂ 조합을 이용한 진정 치료를 시행한 149명 환아의 188회 진정 치료의 효과와 부작용에 대해 알아보고, 효과와 부작용에 영향을 미칠 수 있는 요소를 확인하고자 하였다. 진정 치료의 효과는 Houpt 분류법을 이용하여 측정하였고, excellent와 good의 경우 효과적으로 분류하였다. 진정 치료 시간을 15분 간격으로 나누어 효과와 부작용을 분석한 결과, 치료 시간이 증가할수록 효과는 감소하고 부작용은 증가하는 것으로 나타났다. 60분 동안의 진정 치료 효과는 57.4% 이었으며, 전체 부작용 발생률은 18.1%이었다. 진정 치료의 효과는 Body mass index(BMI)가 증가할수록 증가하였으며, 술식 시작 시 진정이 되어있는 경우 진정 치료 효과가 높은 것으로 나타났다. 부작용은 나이가 증가할수록 증가하였다. 진정 치료가 2회로 나누어 시행되었을 때, 진정 치료의 횟수는 효과와 부작용에 영향을 미치지 않았다. 진정 치료 시간을 무리하게 연장하는 것은 효과 감소와 부작용 증가를 불러일으킬 수 있으므로 진정 치료를 2회에 나누어 시행하는 것이 필요할 것으로 생각된다. 또한 BMI, 술식 시작 시 진정 여부 및 나이와 같은 진정 효과를 감소시키고 부작용을 증가시키는 요소에 대한 충분한 고려가 선행된 후 진정 치료를 시행하여야 할 것으로 생각된다.

• 대한소아치과학회지
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• 제34권2호
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• pp.234-246
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• 2007

소아치과에서 진정요법은 chloral hydrate와 hydroxyzine을 함께 경구투여하는 방법이 가장 보편적이고, 진정의 심도가 술자가 원하는 정도에 미치지 못할 때에는 midazolam이나 $N_2O/O_2$를 병용투여하는 경우가 종종 있다. 본 연구는 chloral hydrate와 hydroxyzine을 이용한 진정요법의 효과와 안전성을 평가하고, 경구투여만으로 적절한 진정수준을 얻지 못하여 $N_2O/O_2$를 병용투여한 경우 $N_2O/O_2$의 치료시간과 부작용에 대한 영향 그리고, 진정요법 효과에 영향을 줄 수 있는 변수들(연령, 성별, 체중, patient compliance, waiting time 등)을 확인할 목적으로 시행하였다. 2004년 12월부터 2005년 9월까지 단국대학교 치과병원 소아치과에서 chloral hydrate와 hydroxyzine을 이용하여 진정요법하에 치료받은 평균연령 $30{\pm}8$개월(12-51개월), 체중 $13{\pm}2kg(9.5-18kg)$의 총 94명(남아-46명, 여아-48명)의 환아들을 대상으로 조사하였다. 진정요법의 효과, 체중, 연령, 병용투여 방법에 따라 군을 분류하여 성별, 연령, 체중, patient compliance, waiting time, 치료시간, 치료양(RBVU), 부작용 등을 평가하였다. 진정요법 성공률은 85%였다. 진정요법에 성공한 그룹이 실패한 그룹보다 $N_2O/O_2$로 수면을 유도하여 사용하는 경우가 많았고, 치료시간이 길었다. 36개월, 14kg미만인 환아는 경구투여만으로 수면에 이를 수 있었고, waiting time이 짧았다. 36개월 이상인 환아는 $N_2O/O_2$를 사용하여 수면을 유도하는 경우가 많았다. 연령과 $N_2O/O_2$ 사용시간, $N_2O/O_2$사용과 치료시간사이에는 상관관계가 존재한 반면, 체중과 $N_2O/O_2$사용시간사이에는 상관관계가 없었다. 치료시간 연장, $N_2O/O_2$사용여부와 부작용 발생간에서 는 통계학적으로 유의한 차이는 확인되지 않았다.

• 대한치과마취과학회지
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• 제5권2호
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• pp.101-106
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• 2005

Purpose: This retrospective study assessed the effectiveness of submucosal (SM) midazolam (M), oral chloral hydrate (CH), hydroxyzine (H), and nitrous oxide (N) 99 uncooperative pediatric dental patients over 182 sedation sessions. Methods: Selection criteria included good medical health (ASA I), from 2 to 6 years of age, uncooperative behavior, and the need for restorations and dental surgery. The children who was administerated with CH H, N was Group 1 (48 case). The children who was administerated with CH, H, N, M was Group 2 (51 case). All the patients received oral CH (50-70 mg/Kg), H (1 mg/Kg) and N (less than 50%). Additionally the Group 2 received SM midazolam (0.1-0.2 mg/kg). Behavior response was rated as quiet (Q), crying (C), movement (M), or struggling (S) every 5 minutes through operative procedures. Behavior response rating was assigned to Houpt scale of Overall behavior. Data was analyzed using Chi-Square Test. Results: The Group 2 had more effective (88.2%) than the Group 1 (68.8%)(P = 0.05). Also, vomiting response decreased in the Group 2 (94.4%) than those with oral administration of chloral hydrate alone without SM midazolam (77.1%)(P = 0.05). Conclusions: SM midazolam improved the quality of sedation and vomiting response.

• Archives of Plastic Surgery
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• 제41권1호
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• pp.40-44
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• 2014

Background Chloral hydrate (CH) is the primary agent most commonly used for pediatric sedation prior to diagnostic, therapeutic procedures. In the management of pediatric facial laceration, the initial dose of CH has to balance the need for adequate sedation against the need to minimize sedative complications. Methods A retrospective review of medical records of 834 children who visited our emergency room for facial lacerations from August 2010 to September 2012 was conducted. They were divided into six groups on the basis of the initial dose of CH administered. Further, each group was compared with the standard group (70 to ${\leq}80mg/kg$) with respect to sedation success, augmentation dose, failed sedation, time to procedure, and time of stay. Results With respect to the complication rate, only group 1 (range, 40 to ${\leq}50mg/kg$) showed a significantly lower complication rate. In the case of all the other variables considered, there were no significant differences among any of the groups. Conclusions An initial CH dose of $48{\pm}2mg/kg$ does not negatively affect the success rate of sedation or the need for additional sedative during the primary closure of facial lacerations in pediatric patients. Further, lower doses reduce the incidences of adverse effects and do not delay procedure readiness. Therefore, $48{\pm}2mg/kg$ of CH can be considered the optimal initial dose for pediatric sedation.

• 대한임상독성학회지
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• 제14권1호
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• pp.9-15
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• 2016

Purpose: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. Methods: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. Results: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. Conclusion: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.

• 대한장애인치과학회지
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• 제13권1호
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• pp.28-32
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• 2017

진정 약제에 저산소증 병력을 보였던 레녹스-가스토 증후군의 7세 4개월 여아를 전신마취 하에서 안정적으로 치과치료를 진행하였다. 레녹스-가스토 환자의 철저한 술전 평가와 의과와의 협진을 통해 전신마취 하 치과 치료가 매우 효과적으로 진행될 수 있다고 생각된다.

• 대한치과마취과학회지
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• 제10권1호
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• pp.34-44
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• 2010

The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권1호
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• pp.49-60
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• 2022

Background: Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods: This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results: The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N₂O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N₂O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion: According to our analysis, the use of N₂O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.