• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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• pp.55-59
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• 2017

Digital dentistry has influenced many dental procedures, such as three-dimensional (3D) diagnosis and treatment planning, surgical splints, and prosthetic treatments. Patient-specific protective appliances (PSPAs) prevent dental injury during endotracheal intubation. However, the required laboratory work takes time, and there is the possibility of tooth extraction while obtaining the dental impression. In this technical report, we utilized new digital technology for creating PSPAs, using direct intraoral scanners and 3D printers for dental cast fabrication.

• 대한기관식도과학회지
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• 제17권1호
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• pp.65-67
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• 2011

Pyriform sinus perforation is a rare complication of endotracheal intubation. It most commonly occurs at the hands of the less experienced physician in emergency situations. It can occur after traumatic intubation and is potentially lethal. The site most commonly perforated is the pharynx, posterior to the cricopharyngeal muscle; the second most common site is the pyriform sinus. We report a case of pyriform sinus perforation after endotracheal intubation, which was successfully treated with primary closure.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.281-287
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• 2017

Background: Various techniques have been introduced to decrease complications during nasotracheal intubation. A common practice is to use nasal packing with a cotton stick and 0.01% epinephrine jelly. However, this procedure can be painful to patients and can damage the nasal mucosa. Xylometazoline spray can induce effective vasoconstriction of the nasal mucosa without direct nasal trauma. In this study, we aimed to compare the efficacy of these two methods. Methods: Patients were randomly allocated into two groups (n = 40 each): xylometazoline spray group or epinephrine packing group. After the induction of general anesthesia, patients allocated to the xylometazoline spray group were treated with xylometazoline spray to induce nasal cavity mucosa vasoconstriction, and the epinephrine packing group was treated with nasal packing with two cotton sticks and 0.01% epinephrine jelly. The number of attempts to insert the endotracheal tube into the nasopharynx, the degree of difficulty during insertion, and bleeding during bronchoscopy were recorded. An anesthesiologist, blinded to the intubation method, estimated the severity of epistaxis 5 min after intubation and postoperative complications. Results: No significant intergroup difference was observed in navigability (P = 0.465). The xylometazoline spray group showed significantly less epistaxis during intubation (P = 0.02). However, no differences were observed in epistaxis 5 min after intubation or postoperative epistaxis (P = 0.201). No inter-group differences were observed in complications related to nasal intubation and nasal pain. Conclusion: Xylometazoline spray is a good alternative to nasal packing for nasal preparation before nasotracheal intubation.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.82-82
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• 1993

기관절개술은 기도의 확보, 분비물의 제거, 환기의 유지, 흡인으로부터 기관의 보호등을 위해 시행해온 시술이다. 근래에 low pressure cuff의 개발등으로 장기간 치료를 요하는 중환자실 환자의 치료에서 기관내 삽관술과 기관절개술이 병용되며 기관내 삽관으로부터 기관절개술까지의 기간이 길어지는 추세이다. 이에 저자들은 기관내 삽관이 시행된 중환자실 환자에서 적절한 기관절개술의 시기에 대해 알아보고자 1990년 3월부터 1993년 2월까지 서울중앙병원의 중환자실에서 치료를 받은 총 8776명의 환자중 이비인후과에서 기관절개술을 시행한 97명을 대상으로 질환, 연령, 기관내 삽관의 적응증 및 기관내 삽관의 기간에 따른 기관절개술 합병증 발거유무 및 발거 실패의 원인등을 임상분석하여 문헌고찰과 함께 보고하는 바이다.

• 대한한의학회지
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• 제17권1호
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• pp.407-432
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• 1996

연구배경(硏究背景) 및 목적(目的) : 중환자실에서 기관내(氣管內) 삽관(揷管) 환자의 실태분석과 질환별 빈도, 부위 및 예후판정 등을 알아보기 위하여 본 연구를 시작하였다. 대상(對象) 및 방법(方法) : 1992년 1월 1일부터 1995년 6월 30일까지 대전대학교 부속 한방병원 중환자실에 입실(入室)하여 기관내(氣管內) 삽관(揷管)을 실시한 환자 37명을 대상(對象)으로 조사하였다. 결과(結果) 및 결론(結論) : 1. 기관내(氣管內) 삽관(揷管)을 시행한 환자수는 37명으로 전체 내실(內室)환자의 4%를 차지하였다. 2. 질환별 빈도는 허혈성 뇌졸중이 가장 많았고, 출혈성 노졸중의 순으로 나타났는데, 뇌혈전이 뇌색전보다 많았다고, 뇌실질내출혈이 지주막하출혈보다 많았다. 3. 뇌색전의 병변부위는 중대뇌동맥이 가장 많았고, 뇌혈전과 뇌실질내흡연에서는 모두 뇌교가 가장 많았다. 4. 성별로는 남녀의 비가 1:1로 같았고, 연령별로는 60대가 가장 많았다. 5. 사상체질(四象體質)분류에서는 태음인(太陰人)이 가장 많았다. 6. 입실(入室) 당시의 의식상태는 GCS 3-7점이 가장 많았다. 7. 선행질환(先行疾患)(과거력(過去歷))으로는 고혈압이 가장 많았다. 8. 중환자실(重患者室) 체류기간(滯留期間)은 2일 이내가 가장 많았고, 발병후 중환자실 퇴원까지 경과기간은 1-3인이 가장 많았다. 9. 기관내(氣管內) 삽관(揷管) 시간별(時間別) 분포(分布)는 13-15(말(末))시(時)가 가장 많았고, 지속시간(持續時間)이 2시간 이내인 경우가 가장 많았으며, 월별(月別) 분포(分布)는 2월과 5월이 가장 많았고, 계절별로는 겨울이 가장 많았다. 10. 기관내(氣管內) 삽관시(揷管時)의 결정시간(決定時間)은 심전지후가 호흡부전시보다 빈도가 높았다. 11. 중환자실에서의 합병증으로는 비뇨기감염이 가장 많았고, 폐렴의 순으로 나타났으며, 기관내(氣管內) 삽관(揷管)으로 인한 합병증은 발견되지 않았다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.7.3-7
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• 1982

기관지내의 삽관은 전신마취나 인위적인 기도확보를 위해 흔히 시행되며, 그것의 유용성은 재론의 여지가 없다. 그러나 기관내 삽관후에 후두종창 궤양 그리고 육아종이 합병증으로 가끔 생기며 또한 성대마비도 드물게 온다. 최근에 저자들은 충수절제술을 위한 기관삽관마취후에 애성을 동반한 좌측 성대마비를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.167-171
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• 2015

When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.

• Journal of Chest Surgery
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• 제32권8호
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• pp.765-767
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• 1999

기관 삽관으로 인한 기관 기관지 파열은 매우 드문 합병증이다. 저자들은 이중관 튜브의 삽관후 발생한 기관 파열을 경험하였다. 76세 여자 환자가 간헐적인 기침과 흉부 불편감을 주소로 내원하였다. 재발된 선천성 좌측주 기관지 식도 루 진단하에 수술을 시행하였다. 수술중 우연히 기관파열이 관찰되었고 기관파\ulcorner은 풍선의 과팽창에 의한 것이었으며 파열부위의 기관을 prolene과 흡수성 봉합사를 이용하여 단단 문합 하였다. 수술후 환자는 합병 증없이 퇴원하였으며 외래를 통해 추적 관찰 중이다.

• 대한기관식도과학회지
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• 제15권1호
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• pp.56-59
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• 2009

Tracheal rupture is infrequently reported, but it is considered to be fatal condition. The most common cause of tracheal rupture is neck injury, but, rarely reported after tracheal intubation. We report a 49-year old woman with dyspnea presenting tracheal rupture after endotracheal intubation. It is detected that tracheal rupture with herniation of esophagus at the level of T1 spine by computed tomography and bronchoscopy. We had a successful repair by suturing between tracheal and esophageal wall. The patient was followed up without any complication.

• The Korean Journal of Pain
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• 제10권1호
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• pp.58-63
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• 1997

Background : Endotracheal intubation is one of the methods most securely establishing airway. But accompanying hemodynamic responses are harmful to coronary or cerebral vascular disease patients. These hemodynamic responses are regarded as the results of sympathetic stimulation due to pharyngolaryngeal stimulation, and sympathetic blocking method-stellate ganglion block- may be obtundate these hemodynamic responses. Methods : 75 patients of ASA physical status I-II were selected. There were 40 patients normotensive (Group I), 35 patients hypertensive (Group II) Group I, steliate ganglion block was performed on 20 patients (Group I-S) the remainder had no procedure (Group I-O). Group II, 18 patients received SG3 (Group II-S), 17 patients had no procedure (Group II-O). SGB was performed with 1% lidocaine 8 ml on right stellate genglion after patient's consent. Blood pressure (IIP) and pulse rate(PR) were first measured in the pre-anesthesia room. Follow up BP and PR are checked immediately following SGB and every 5 minutes for subsequent 20 minutes, then after arrival at operatig room, then immediately after intubation and at 3, 5, 10, 15 and 20 minutes after incubation. Results : All group experienced significantly increased blood pressure and pulse rate upon arrival at the pre-anesthesetic and opeating rooms, as compared to when patients rates in the ward. After intubation and for subsequent 5 minutes, significant changes were measured. Patients then recovered to preblock value. In Group I, no statistical significance was recorded between subgroup I-S and I-O. However in Group II, there were significant differences between sub-group II-S and II-O. In evaluating pulse rate changes, there were no significant differences between Group I-S and I-O; nor II-S and II-O. Conclusion : The proper diagnosis of Stellate Ganglion Block had some measure of protective effect on hemodynamics following endotracheal intubation, especially in hypertensive patients.