• Title/Summary/Keyword: Inhalation anesthesia

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Analysis on the Depth of Anesthesia by Using EEG and ECG Signals

  • Ye, Soo-Young;Choi, Seok-Yoon;Kim, Dong-Hyun;Song, Seong-Hwan
    • Transactions on Electrical and Electronic Materials
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    • v.14 no.6
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    • pp.299-303
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    • 2013
  • Anesthesia, which started being used to remove pain during surgery, has become itself one of the major concerns to be considered during surgery. While actual anesthesia is being performed, patients tend to have unpleasant experiences, due to wakening that accompanies pain, or wakening that does not accompany pain. Since this awakening during anesthesia is a most unpleasant experience in a patient's life, evaluating the depth of anesthesia during surgery is essential for patients to avoid this experience. Although there has been much effort on the understanding and measurement of the depth of anesthesia, while various researches were performed on the need of anesthesia, the development of an indicator that could objectively evaluate the depth of anesthesia, other than by using the patient's vital signs, is still inadequate. Therefore, this study was to develop an objective indicator by using EEG and ECG, which are essentially measured during the surgery, to evaluate the depth of anesthesia. The experiment was performed by taking patients who require a relatively short operation time, and general inhalation anesthetics among surgical patients in obstetrics and gynecology as the subjects of experiment, to measure the EEG and ECG signals of patients under anesthetics. The result showed that SEF using EEG and LF, HF using ECG signal and correlation dimension analysis parameter were valuable parameters that could measure the depth of anesthesia, by the stage of anesthesia.

A Case of Acute Respiratory Failure After Trichloroethylene Inhalation (트리클로로에틸렌 흡입으로 인한 호흡부전 1례)

  • Park, Jae-Seok;Jeon, Young-Woo;Kim, Young-Il;Gil, Hyo-Wook;Yang, Jong-Oh;Lee, Eun-Young;Hong, Sae-Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.30-33
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    • 2011
  • Trichloroethylene (TCE, $C_2HCl_3$), which was introduced as a gas for general anesthesia and analgesia in early 1900's has been widely used in industry as an organic solvent. Occupational exposure to TCE is an important medical problem. Manifestations of acute exposure to TCE include mucocutaneous irritation, hepatotoxicity, cognitive impairment, sleep, headache, respiratory insufficiency and death. We report a 38-year-old man who was admitted to a department of emergency medicine after occupational inhalation exposure to TCE. He rapidly developed semicoma and respiratory depression. After mechanical ventilation, hypercapnea and hypoxemia disappeared and his mental state again became alert. Careful evaluation and proper respiratory support are important for respiratory failure after occupational TCE inhalation.

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Blood Gas Analysis of Respiratory Depression during Sevoflurane Inhalation Induction for General Anesthesia in the Disabled Patients (장애 환자의 전신 마취를 위한 세보플루란 흡입 유도 시 발생한 호흡 저하의 혈액 가스 분석)

  • Yoon, Taewan;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.4
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    • pp.508-513
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    • 2018
  • Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

The spinal neuronal activity induced by low power laser stimulation (저출력 레이저 자극에 의한 척수내 신경세포의 활성변화)

  • Oh, Kyung-Hwan;Choi, Young-Deog;Lim, Jong-Soo
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1005-1013
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    • 2001
  • The present study was designed to investigate the effect of low power GaAlAs laser on spinal Fos expression related to the anti-nociceptive effect of laser stimulation. Low power GaAlAs laser was applied to either acupoint or non-acupoint for 2 hour under light inhalation anesthesia. Spinal Fos expression in the dorsal horn was compared to that obtained in inhalation anesthesia control group. Furthermore, we analyzed the effect of the local treatment of lidocaine on the spinal Fos expression evoked by low power GaAlAs laser stimulation. The results were summarized as follows: 1. In the normal animals, only a few Fos like immunoreactive(Fos-IR) neurons were evident in the lumbar spinal cord dorsal horn. Similarly, following prolonged inhalation anesthesia, Fos-IR neurons were absent in the dorsal horn of the lumbar spinal cord. In animals treated with laser stimulation, Fos immunoreactive neurons were increased mainly in the medial half of ipsilateral laminae I-III at lumbar segments L3-5. These findings directly indicated that prolonged anesthesia used in this study did not affect the Fos expression in the spinal cord dorsal horn of intact animals and low power laser stimulation dramatically produced Fos expression in the spinal cord laminae that are related to the anti-nociceptive effect of laser stimulation. 2. In acupoint stimulated animals, 10mW of laser stimulation, not 3mW and 6mW intensity, significantly increased the number of Fos immunoreactive neurons in the spinal dorsal horn(p<0.05). However, laser stimulation on acupoint more dramatically increased the number of Fos immunoreactive neurons in the spinal cord rather than laser stimulatin on non acupoint. These result suggested that laser stimulatin on acupoint was more effective treatment to activate the spinal neuron than non acupoint stimulation. 3. The local treatment of lidocaine totally suppressed the activity of spinal neurons that were induced by lower power 1aser stimulation. These data indicated that the anti-nociceptive effect of laser stimulation was absolutely dependent upon the peripheral nerve activity in the stimulated location. In conclusion, these data indicate that 10mW of low power laser stimulation into acupoint is capable of inducing the spinal Fos expression in the dorsal horn related to the anti-nociceptive effect of laser stimulation, Furthermore, the induction of spinal Fos expression was totally related to the peripheral nerve activity in the laser stimulated area.

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DECREASE OF OXYGEN SATURATION DURING DENTAL TREATMENT UNDER GENERAL ANESTHESIA OF DOWN SYNDROME PATIENT WITH CONGENITAL HEART DISEASE -A CASE REPORT- (선천성 심장질환을 가진 다운증후군환자에서 치과치료를 위한 전신마취 시 산소포화도 하강 -증례보고-)

  • Seo, Kwang-Suk;Chang, Ju-Hea;Shin, Teo-Jeon;Kim, Hyun-Jeong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.18-22
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    • 2009
  • A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.

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[ $N_2O-O_2$ ] INHALATION SEDATION WITH SUCTION CATHETER IN FULL MOUTH BREATHING PATIENTS (구호흡 소아환자에서 흡인도관을 이용한 $N_2O-O_2$ 진정)

  • Yoon, Hyung-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.589-594
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    • 1999
  • There are some problems in inhalation sedation of non-cooperative pediatric patients. Usually the pediatric patients reject the nasal hood and there's no cooperation for administration of nitrous oxide gas. In mouth breathing patient, other technics of sedation such as intravenous or oral sedation or general anesthesia were recommended. Common causes of mouth breathing are common cold, allergic rhinitis, sinus problem, anatomical disorder, and habitual mouth-breathing. However in some patient not indicated the general anesthesia and high failure rate in oral and intravenous sedation. Administration of $N_2O-O_2$ with suction catheter was applied in full mouth breathing patient. Clinically effective sedation were occurred during procedure about 45 to 55 minutes. There's no any side effects by $N_2O-O_2$ inhalation sedation. The patients awoke at the end of the procedure and received 100% oxygen for 2-3 minutes. There's still some problems in use of the suction catheter such as air pollution of operation theater and elevate arterial carbon dioxide tension.

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Isoflurane Induces Transient Anterograde Amnesia through Suppression of Brain-Derived Neurotrophic Factor in Hippocampus

  • Cho, Han-Jin;Sung, Yun-Hee;Lee, Seung-Hwan;Chung, Jun-Young;Kang, Jong-Man;Yi, Jae-Woo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.139-144
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    • 2013
  • Objective : Transient anterograde amnesia is occasionally observed in a number of conditions, including migraine, focal ischemia, venous flow abnormalities, and after general anesthesia. The inhalation anesthetic, isoflurane, is known to induce transient anterograde amnesia. We examined the involvement of brain-derived neurotrophic factor (BDNF) and its receptor tyrosine kinase B (TrkB) in the underlying mechanisms of the isoflurane-induced transient anterograde amnesia. Methods : Adult male Sprague-Dawley rats were divided into three groups : the control group, the 10 minutes after recovery from isoflurane anesthesia group, and the 2 hours after recovery from isoflurane anesthesia group (n=8 in each group). The rats in the isoflurane-exposed groups were anesthetized with 1.2% isoflurane in 75% nitrous oxide and 25% oxygen for 2 hours in a Plexiglas anesthetizing chamber. Short-term memory was determined using the step-down avoidance task. BDNF and TrkB expressions in the hippocampus were evaluated by immunofluorescence staining and western blot analysis. Results : Latency in the step-down avoidance task was decreased 10 minutes after recovery from isoflurane anesthesia, whereas it recovered to the control level 2 hours after isoflurane anesthesia. The expressions of BDNF and TrkB in the hippocampus were decreased immediately after isoflurane anesthesia but were increased 2 hours after isoflurane anesthesia. Conclusion : In this study, isoflurane anesthesia induced transient anterograde amnesia, and the expressions of BDNF and TrkB in the hippocampus might be involved in the underlying mechanisms of this transient anterograde amnesia.

The study on the factors which improve skin barrier recovery (피부장벽회복에 영향을 미치는 인자에 관한 연구)

  • Cha, Jae-Hoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.21 no.2
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    • pp.39-45
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    • 2008
  • Objective : Skin barrier protects skin against harmful environment. Its function includes antimicrobial barrier as well as physical barrier. But there are few studies about the factors which improve skin barrier recovery after injury. The aim of this study is to investigate the factors which improve skin barrier recovery. Method : Nine hairless mice was anesthetized by inhalation and we tape stripped them. We used thermometer to know temperature one day ago, before anesthesia, before tape stripping, and after tape stripping. Vapometer was used to know transepidermal water loss before tape stripping, after tape stripping. And we used doppler flowmeter to measure blood flow before tape stripping, after tape stripping. Result : After analyzed data, we concluded that temperature was lower after anesthesia than before anesthesia and after tape stripping than before tape stripping. We could know that transepidermal water loss was lower after tape stripping than before tape stripping and more blood flowed after tape stripping. Conclusion : In our study, it was observed that temperature, transepidermal water loss, blood flow changed after tape stripping. But we thought lowered temperature was pathologic situation, more blood flow was to recover after injury. In traditional korean medicine, cold(寒) and imbalance of blood flow(血行) don't only make many skin diseases, but cold(寒) also obstructs blood flow. So we need to study how to warm cold(寒) and improve blood flow.

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Dental Treatment of Pediatric Patients with Mouth Opening Limitation under General Anesthesia (개구 장애가 심한 소아환자에서 전신마취 하 치과치료를 위한 기도관리)

  • Han, Hyo-Jo;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Teo-Jeon;Kwoen, Young-Sun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.172-176
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    • 2011
  • For dental treatment of children with severe dental phobia, sedation or general anesthesia is usually selected for enhancement of cooperation. But in the case of mouth opening limitation due to temporomandibular disorders, general anesthesia administration is a challenge for anesthesiologist. Because airway management failure was concerned, awake fibroscopic intubation is selected first. But, skillful fibroscopic intubation is not easy in case of uncooprative children patients. In this report, we present two cases of pediatric patients with mouth opening limitation. In the first case, the patient was 52 months old and the maximum opening distance was 1.2 cm, and in the second case the patient was 38 months old and the maximum opening distance was 1.5 cm. Both patients showed severe dental phobia. After sevoflurane inhalation without any intravenous drug, we successfully performed intubation using a fibroscope.