• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.811-824
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• 1998

The purpose of this study was to compare the clinical sedation effect of chloral hydrate and hydroxyzine combination, midazolam, triazolam when young children were sedated for dental treatment. The uncooperative 22 children aged, 25 to 52 months of age(ASA class I) and weighting between 11 and 17kg, participated in the study. Each patient was assigned randomly to receive chloral hydrate(50mg/kg) and hydroxyzine HCl(25mg), midazolam(0.5mg/kg), and triazolam(0.25mg) oral administration : alternative regimens were administered at next appointment. According to rating scale, sleep, crying, movement, and overall behavior response were checked for evaluation of the clinical sedation effect. Pulse rate and oxygen saturation were also measured for monitoring the patients during treatment period by pulse oximeter. The results were as follows: 1. In the evaluation of sedation effect, 90.9% in chloral hydrate and hydroxyzine combination and midazolam, and 77.3% in triazolam were rated "good" or "very good". 2. Sleep was demonstrated to be statistically significant increase in chloral hydrate and hydroxyzine combination group. Despite the fact that chloral hydrate and hydroxyzine group was in a deeper state of sleep, all the children were easily aroused. 3. There were no statistically significance among the three regimens with regard to cry ing, movement, overall behavior. 4. The adverse side effect was vomiting in one patient of chloral hydrate and hydroxyzine combination. There were no clinical sign of respiratory depression.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.1 s.10
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• pp.1-5
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• 2006

Background: The aim of this study was to evaluate the preventive effect of propofol on postoperative nausea and vomiting (PONV) following general anesthesia to the patients having oral and maxillofacial surgery. Methods: In a prospective, randomized. case-controlled study. 200 patients were divided into two groups (n = 100 in each). In propofol (P) group, patients received 0.5 mg/kg of propofol intravenously at the end of anesthesia. In control (C) group, no antiemetics was given. Emetic symptoms like nausea, retching and vomiting were assessed by a blind nurse at 1 hour and at 24 hours after anesthesia respectively. Also level of sedation was checked by a blind anesthesiologist at 1 hour after anesthesia. Results: There were no significant differences in frequencies of nausea, retching and vomiting between C group and P group at 1 hour after anesthesia. However, nausea, retching and vomiting were all decreased in P group compared with C group at 24 hours after anesthesia (P < 0.05). Also there was no significant difference in level of sedation at 1 hour after anesthesia between C group and P group (P > 0.05). Conclusions: From the results, prophylactic use of subhypnotic dose of propofol could be effective for preventing PONV without change in level of sedation to the patients undergoing general anesthesia for oral and maxillofaical surgery.

• Journal of Veterinary Clinics
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• v.24 no.4
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• pp.573-576
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• 2007

The purpose of this study was to evaluate the relationship between periodontal disease and halitosis, and to develop a detail clinical protocol for assessing halitosis in animals. We measured the periodontal disease parameters, the degree of halitosis using organoleptic scale method and the concentration of volatile sulfur compounds(VSC) using portable sulfide monitor($Halimeter^{TM}$). In this study, VSC levels by $Halimeter^{TM}$ were found to be significantly associated with periodontal disease parameters(plaque index, calculus index)(P<0.05). We also found that conscious sedation did not affect the measurement of VSC levels.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.4
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• pp.937-945
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• 1996

Nitrous oxide has acquired widespread use as a tool for management of anxious and comprehensive pediatric dental patients. Clinical impressions have suggested that inhalation sedation with $N_2O/O_2$ reinforces the effect of other sedatives. Fifteen uncooperative children, mean age of 37months, who were regarded as fail in the first treatment using chloral hydrate-hydroxyzine orally, midazolam orally or intranasally, were sedated with the same sedatives in conjunction with $N_2O/O_2$. All the children were restrained in a pediwrap and were monitored with pulse oximeter for their heart rate and oxygen saturation. Degree of sleep, crying and movement were evaluated. The clinical results indicated that a satisfactory level of sedation was achieved in approximately two thirds of the cases (about 66 %) under those sedation manner. Complications were rare and those of treatments were successfully completed without difficulty.

• Korean Journal of Acupuncture
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• v.23 no.3
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• pp.81-98
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• 2006

Objectives : Acupuncture using a tonification or sedation techniques method is used as a controlling the medication for an early stroke in the Korean medicine. LR3 has indicatons of headache, vertigo, facial paralysis, apoplexy, epiepsy as the source acupoint of a liver meridian. So this study is aims to investigate the anti-apoptotic and neuroprotective effects of acupuncture on the focal ischemia induced by intraluminal filament insertion in rats. Methods : The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The animals were divided into seven groups (n=8 in each group) : Normal, intactness group; Conrol group, no therapy group after being ischemia induced; MA-l, acupuncture perpendicularly without Tonification or Sedation techniques at LR3 after being ischemia induced; MA-2, acupuncture obliquely towards the knee at LR3 after being ischemia induced; MA-3, acupuncture obliquely towards the toe at LR3 after being ischemia induced; MA-4, acupuncture obliquely towards the knee and rotate 9 times in a clockwise direction at LR3 after being ischemia induced; MA-5, acupuncture obliquely towards the toe and rotate 6 times in a counterclockwise direction at LR3 after being ischemia induced. The anti-apoptotic and neuroprotective effects of Acupuncture techniques of tonification or sedation at LR3 are observed by mGluR5, Bax, Cresyl violet, ChAT-stain and NGF. Results : The intensity of mGluR5 and the density of ChAT was increased in MA-1 group. The intensity of Bax was decreased in MA-3, MA-4 group. The density of neurons stained by Cresyl violet and ChAT was increased in MA-2, MA-3, MA-4, MA-5 group. The density of neurons stained by NGF was only increased in MA-4 group. Conclusions : Our study suggests that acupuncture perpendicularly without Tonification or Sedation techniques and obliquely towards the knee and rotate 9 times in a clockwise direction(Tonifying technique) at LR3 after being ischemia induced at LR3 shows anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.823-829
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• 1997

The patients visiting pediatric dental office have been being younger than the previous, and they were often combined with systemic disease. But, we aren't able to perform the verbal communication, because of their impediment and youthfullness. And, we can't carry out the behavior control via physical restraint, as the developed social structure and the attitude of children and their parents. So, the importance and concerning of conscious sedation using sedative medicine are increased by time and time. Among the various conscious sedation, Chloral Hydrate and Nitrous Oxide inhalation are most popularly used, and barbiturates, benzodiazepine, opioids and hydroxyzine are used often. But, these medications have some side-effects and adverse reactions, may be failed to sedate the children. And limited use of medically compromised patients, especially for ASA class III, IV or more dangerous patients. We, the Department of Pediatric Dentistry, Chosun University have met some dangerous situation due to unfavorable pharmacogenic reactions, but we can control the situation and get well healed results. The below results are common situations and their solutions during conscious sedation. 1. By the intravenous administration, thrombophlebitis is the most common side-effects, but it may be healed with time without any special treatment. 2. Under the definitive guidelines about conscious-sedation, we can perform a safe conscious sedation for ASA class III patients. 3. When adversed reaction of Benzodiazepine is occured, it could be cared effectively with benzodiazepine antagonist, named Flumazenil.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.177-182
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• 2011

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.234-246
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• 2007

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and $N_2O/O_2$ inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and $N_2O/O_2$ in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of $30{\pm}8$ months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more $N_2O/O_2$ administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by only oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and $N_2O/O_2$ using tine, but no correlation between weight and $N_2O/O_2$ using time. There was no statistically significant difference among variables of treatment duration, $N_2O/O_2$ administration and adverse event.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.91-103
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• 2017

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.114-118
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• 2017

Sedation or general anesthesia is often required to offer dental treatment to patients with special needs. However, patients with ASA classification of III or higher are not indicated for moderate sedation and might be exposed to danger when treated at outpatient dental clinic. For this reason, it is recommended to treat those patients under general anesthesia. The dental team can supervise and monitor the whole procedures during treatment with an appropriately equipped facility. This case report describes the dental treatment of a 7-year-old girl with multiple disabilities. Preoperative evaluation including medical consultation was carried out thoroughly and dental treatment was performed under general anesthesia safely.