• Clinical Endoscopy
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• v.56 no.2
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• pp.188-193
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• 2023

Background/Aims: Data on the incidence of adverse respiratory events during recovery from gastrointestinal endoscopy are limited. The aim of this study was to investigate the incidence of these complications. Methods: In this retrospective cohort study, data were obtained from the electronic records of 657 consecutive patients, who underwent gastroenterological procedures under sedation. Results: Pulse oximetry oxygen saturation (SpO₂) <90% for <60 seconds occurred in 82 patients (12.5%), and in 11 patients (1.7%), SpO₂ of <90% for >60 seconds occurred in 79 patients (12.0%) and in 14 patients (2.1%), and SpO₂ <75% occurred in four patients (0.6%) and in no patients during the procedure and recovery period, respectively. No major complications were noted. The occurrence of desaturation during recovery was correlated with desaturation during the procedure (p<0.001). Higher American Society of Anesthesiologists score (odds ratio [OR], 1.867; 95% confidence interval [CI], 1.008-3.458), ischemic heart disease (OR, 1.815; 95% CI, 0.649-5.080), hypertension (OR, 1.289; 95% CI, 0.472-3.516), and diabetes mellitus (OR, 2.406; 95% CI, 0.950-6.095) increased the occurrence of desaturation during recovery. Conclusions: We found no major complications during recovery after balanced propofol-based sedation administered by a gastroenterologist-nurse team. Patients with the identified risk predictors must be monitored carefully.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.408-412
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• 2010

Introduction: This study examined the depth of sedation and the usefulness of the monitoring tool in determining the level of sedation in patients undergoing third molars extraction under conscious sedation with midazolam. Materials and Methods: Twenty two patients undergoing third molars extraction at the department of Oral and Maxillofacial surgery, Ewha Womans Mokdong Hospital from February 2010 to April 2010 were analyzed. All patients were classified as American Society of Anesthesiologist (ASA) class I and had no contraindications tosedation. The bispectral index was recorded continually during surgery using a bispectral monitor. The initial sedation was accomplished using a 3 mg bolus of midazolam followed by a 2 mg bolus of midazolam until the level of sedation, at which the patient’s eyes were closed or the subject was responsive only to loud or repeated calling of their name, was reached. All subjects were surveyed with a postoperative questionnaire to evaluate the level of sedation. Results: The bispectral index (BIS) decreased approximately 5 minutes after midazolam administration, but increased at the local anesthesia injection and odontomy procedure. The amnestic effect was shown effectively in the early stages of surgery. Conclusion: Conscious sedation with intravenous midazolam is effective in achieving the effect of anxiolysis, analgesia and amnesia. The BIS is an objective and useful means of assessing the depth of sedation.

• Journal of Acupuncture Research
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• v.20 no.3
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• pp.238-252
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• 2003

Objective : This study is performed for the purpose of examining the efficacy of the scolopendrid(Scolopendra morsitans L.) which has been to low back pain as a folk remedy. Methods & Results : Seventy patients with H.I.V.D. treated with the scolopendrid aquacupuncture and examined 4 tests; D.I.T.I., physical test, Oswestry disability index, and self-conscious pain rate were studied. And we follow up after discharge, we evaluated the present state and recovery period. Or we evaluated by herniated type and duration of onset. There was 58~97% of efficacy rate in each tests. Moreover, statistically valuable change in all 7 D.I.T.I. points and in disability index and in self-conscious pain rate was showed. Conclusion : The scolopendrid aquacupuncture is possible to be effective terating the H.I.V.D patients. So we suggest the possibility using this new remedy to the H.I.V.D. patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.222-238
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• 2000

The purpose of this study was to demonstrate the effect of music therapy as a nursing intervention on changes in recovery of consciousness and vital signs for postoperative patients in the recovery room. The subject for this study were fifty three of postoperative patients who were transferred from the OR to the RR at Kwangju Christian Hospital in Kwangju City. Thirty of them were assigned to the experimental group, and twenty three, to the control group. The age of the subject was between twenty and sixty years of age. The subject had a general anesthesia without any special complications, and they were not completely awake. The data were collected for six months from July 1999 to February 2000. The method used was to compare the condition of the subjects in each group at the beginning and at certain times repeatedly. The features observed were the level of consciousness, the frequency of complaints of pain, and vital signs of the subject before and 15 minutes, 30 minutes, and 60 minutes after hearing their favorite music for 30 minutes. The results are as follows 1. The recovery of consciousness was revealed through significant changes in facial expression, facial color, and grip strength in the experimental group more strongly than in the control group. No significant changes were shown in verbal order. The differences in recovery of consciousness in the pre-post music therapy between the two groups was not significant in verbal order, facial expression, or grip strength. However, significant changes were seen in facial color. 2. There were no significant differences between the two groups in changes in the frequency of pain complaints after music therapy. However, a significant difference was shown in the pre-post music therapy scres. 3. Vital signs did not show a significant difference between the two groups. However, the $SPO_2$ of the experimental group was significantly elevated after 60 minutes. The difference pre-post to the music therapy in the vital signs between two groups was significant only in body temperature. This study showed that the effect of music therapy given to postoperative patients is that it promotes changes in facial expression, facial color, and grip strength helping recovery of consciousness, stabilizing vital signs, elevating levels of $SPO_2$. and reducing complaints of pain. It is recommended that if the patient wants it music therapy be given right after surgery in the recovery room as a nursing intervention.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.71-78
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• 2018

The first clinical application of nitrous oxide ($N_2O$) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, $N_2O$ has shared a 170-year history with modern dental anesthesia. $N_2O$, an odorless and colorless gas, is very appealing as a sedative owing to its anxiolytic, analgesic, and amnestic properties, rapid onset and recovery, and, in particular, needle-free application. Numerous studies have reported that $N_2O$ can be used safely and effectively as a procedural sedation and analgesia (PSA) agent. However, $N_2O$ can lead to the irreversible inactivation of vitamin B12, which is essential for humans; although rare, this can be fatal in some patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.160-167
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• 2015

Purpose: We aimed to analyze the effectiveness and safety of low-dose midazolam and ketamine combination for upper gastrointestinal endoscopy (UGIE) in children. Methods: The study included the children (n=425, $10.78{\pm}3.81years$) who underwent UGIE for diagnostic purpose during 1 year period. All children were sedated with low dose midazolam (0.1 mg/kg) and ketamine (0.5 mg/kg) intravenously. Effectiveness of the sedation and complications during the procedure and recovery period were recorded. Results: Endoscopic procedure was successfully completed in 414 patients (97.4%; 95% confidence interval, 95.8-98.9). $Mean{\pm}standard$ deviation (SD) duration of procedure was $6.36{\pm}1.64minutes$ (median, 6.0 minutes; range, 4-12 minutes). Minor complications occurred during the procedure in 39.2% of the patients. The most common complication was increased oral secretion (33.1%). No major complications were observed in any patient. Age and Ramsay sedation scores of patients with complications during the procedure were lower than the others ($9.49{\pm}4.05years$ vs. $11.61{\pm}3.43years$, p=0.002 and $2.10{\pm}1.46$ vs. $4.37{\pm}1.16$, p=0.001). Mean recovery time was 22 minutes (range, 10-90 minutes; $mean{\pm}SD$, $25{\pm}12.32minutes$). Minor complications developed during recovery in 60.1% of the patients. The most common complication was transient double vision (n=127, 30.7%). Emergence reaction was observed in 5 patients (1.2%). Conclusion: The procedure was completed with high level of success without any major complication in our study. Combination of low-dose midazolam and ketamine is a suitable sedation protocol for pediatric endoscopists in UGIE.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.69-74
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• 2012

Background: The purpose of this study is to investigate the efficacy and safety of the sedation technique for implant surgery by combining the use of inhalation of nitrous oxide/oxygen with intravenous midazolam. Methods: Patients requiring surgery for the placement of dental implants were randomly allocated to two groups receiving intravenous midazolam or a combined technique using nitrous oxide/oxide and intravenous midazolam. Safety parameters, cooperation scores, anxiety scales, total amount of midazolam administered and recovery time were recorded and compared. Results: There were a statistically significant reduction in the amount of midazolam required to achieve optimal sedation (P<0.01), an overall significant reduction in recovery time (P<0.01), a significant reduction in anxiety scales (P<0.05), and a significant improvement in cooperation (P<0.05) and peripheral oxygen saturation (P<0.05) when a combined technique of inhalational $N_2O/O_2$ and midazolam was used. Conclusions: For implant surgery, this combining sedation technique could be safe and reliable, demonstrating reduction of total dose of midazolam and level of patient's anxiety and improvement in patient's recovery and cooperation.

• The Korean Journal of Physiology
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• v.27 no.2
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• pp.217-225
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• 1993

The role of endogenous brain angiotensin ll (Ang ll) in mediating the cardiovascular and vasopressin responses to hemorrhage was assessed in conscious spontaneously hypertensive rats (SHR), and normotensive Wistar-Kyoto (WKY) rats. Artificial cerebrospinal fluid (aCSF) with or without losartan (DuP 753), a specific Ang ll receptor subtype I $(AT_1)$ antagonist and saralasin, a combined $AT_1/AT_2$ antagonist was administered into the cerebral lateral ventricle. Hemorrhage was performed at a rate of 3 ml/kg/min far 5 min. Intracerebroventricular administration of losartan and saralasin had no effect on the basal blood pressure. However, in response to acute hemorrhage, central Ang ll antagonists produced a remarkably greater fall in blood pressure, a reduced tachycardia, and an enhanced renin release compared with the aCSF control experiment in SHR, but effected no significant change in WKY rats. Central Ang ll-blocked SHR showed significantly lower blood pressure and heart rate during the recovery period than the aCSF control rats. Vasopressin release tallowing the hemorrhage was attenuated by icv Ang ll antagonists: the effect was more pronounced in SHR than in WKY rats. Centrally administered losartan and saralasin produced remarkably similar effects on the cardiovascular function and vasopressin responses to hemorrhage. These data suggest that brain Ang ll acting primarily through AT, receptors plays an important physiological role in mediating rapid cardiovascular regulation and vasopressin release in response to hemorrhage especially in Hypertensive rats.

• Sim-seong Yeon-gu
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• v.31 no.1
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• pp.1-40
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• 2016

This thesis is a study on the symbolism of 'Yeondo', a prayer for the souls in purgatory of Korean Catholic Church as a 'psychic container' for the spiritual transformation in the psyche from a perspective of analytical psychology. Yeondo' could be the 'rites of passage' of the last judgement for the souls in purgatory which is in between the heaven and the hell. And both the bereaved and the dead go through the stages of separation, transition and incorporation which are the schema of the 'rites of passage'. In particular, they have a special sense of solidarity at the stage of transition, a middle state. The symbolic process of 'Yeondo' is a spiritual transformation of recovery of paradise which could access by the confusion of death, purification and the rebirth. A spiritual reborn process of death and rebirth takes place by contacting the collective unconscious. In 'Yeondo', the death is not the end of life but the beginning of the eternal life. The confusion and disintegration caused by death can be purified and start incorporating. The rites of a paradise recovery has the meaning of trying constantly for the recovery of a wholeness. Praying for the blessing of God and a help from saints in paradise for the sake of the dead means to require conscious cooperation for the Self-realization. Integrating and recognizing unconscious also means something beyond the conscious. The blessed souls in purgatory recovers the paradise experiencing specific purifying process heading towards Self. Going into the center, abyss of unconscious will be recognized as an absolute part of oneself. One becomes the inner man, the transformed personality who is reached by the path of self-knowledge, the kingdom of heaven within oneself and can have the transpersonal energy, which enables to access to God's world and union with God. All desire and the will become one with God. In the final analysis, praying for the blessing of God and a help from saints in paradise for the sake of the dead becomes the path for the more and more conscious expansion of the alive. Therefore, 'Yeondo' as an initiation is the individuation process of the alive and the dead to reflect on themselves.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.1 s.2
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• pp.1-6
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• 2002

The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.