• 대한치과마취과학회지
• /
• 제4권1호
• /
• pp.25-29
• /
• 2004

Anaphylactic reactions to anesthetic drugs could potentially produce life-threatening immune-mediated crisis. Most published reports are associated with neuromuscular blockers and anaphylactic reactions to inhalation anesthetics are rare. A 25-year-old male patient with no significant medical history and no previous abnormal drug reaction was scheduled for orthognathic surgery under general anesthesia. After uneventful anesthetic induction and nasotracheal intubation, generalized urticaria and erythema were detected during the maintenance period with $O_2-N_2O$-enflurane. No severe changes of vital signs and no ventilation problem were accompanied. The operation was cancelled and the cutaneous lesions were faded away during the recovery with 100% $O_2$. The skin-prick and intradermal tests showed that he was hypersensitive to all halogenated inhalation anesthetics including enflurane and not to intravenous anesthetics and neuromuscular blockers. The re-operation was safely carried out under intravenous anesthesia with propofol-fentanyl-vecuronium. We report this case of intraoperative anaphylactic reaction to enflurane with literature review.

• 의료법학
• /
• 제18권1호
• /
• pp.61-99
• /
• 2017

마취는 수술 등 의료행위 시 많은 경우 필요불가결하게 동반될 수밖에 없고 마취 자체가 가진 특성 때문에 그로 인한 의료사고가 빈번하게 발생하고 있다. 마취와 관련된 의료사고가 의사의 과실로 인한 것인지를 판단하기 위해서는 마취의 전 단계를 통하여 의사 등 의료진에게 어떠한 주의의무가 요구되는지를 알아야 한다. 이 글에서는 이러한 주의의무의 기준 등을 알아보기 위하여 마취 관련된 의료사고로 판결이 선고된 1990년대부터 현재까지의 대법원 판결들과 최근의 하급심 판결사례들, 프로포폴이 사용된 사례들을 분석해보았다. 분석 결과 과거 흡입마취로 문제가 된 사례가 많았던 반면 최근에는 주로 정맥마취제나 국소마취제의 사용으로 문제가 된 사례가 많은 것을 알 수 있었고, 특히 마취제 중 프로포폴이 관련된 사고가 2007년경 이후부터 상당히 많이 발생하여 법적 분쟁이 이루어졌음을 알 수 있었다. 그런데 대법원 판례들은 대부분 과거 흡입마취로 마취한 사례여서, 흡입마취의 경우 마취 시 의료진의 주의의무의 정도와 내용에 관해 어느 정도 기준이 제시되고 있었으나, 그 외의 경우에는 그러한 기준이 제시되었다고 보기에는 미흡해 보였다. 프로포폴의 사용과 관련한 마취사고가 끊이지 않고 있는 현실 등에 비추어 볼 때 우선 의료현장에서 각각의 마취제의 사용에 관한 임상지침 등을 세우고 이를 지켜나가는 것이 중요하겠지만, 의료현실이나 의료 관행에 하나의 나침반 역할을 할 수 있도록 법원에서도 우리의 현실에 맞는 적절한 주의의무의 기준을 제시하는 것이 필요하다고 하겠다.

• 한국임상수의학회지
• /
• 제31권2호
• /
• pp.102-107
• /
• 2014

본 연구는 한국마사회 동물병원에서 시행한 전신마취 결과를 분석하고 마취 중 후에 발생한 사망률에 영향을 미치는 인자를 찾기 위하여 실시되었다. 총585두의 환마에서 전신마취가 실시되었으며, 수술의 빈도는 정형외과 수술(410)이 가장 많이 실시되었고, 산통 수술(85), 호흡기 수술(45) 순이었다. 585두 중 20두가 마취 중 후에 죽거나 안락사 되었다. 20두 중 14두는 산통 수술을 받았고, 3두는 정형외과 수술, 3두는 호흡기 수술을 받았다. 세부 사망원인으로는 산통 수술에서는 장파열, 호흡기 수술에서는 기도폐색이었다. 정형외과 수술에서는 근육병증, 재골절, 제엽염이 안락사의 원인이었다. 결과적으로 산통 수술과 호흡기 수술 후의 사망률은 정형외과 수술 후보다 높게 나타났다 (p < 0.01). 이상의 결과로부터, 산통수술을 받는 말의 사망률이 가장 높은 것을 확인하였으며, 그 원인은 예후불량에 의한 안락사이었다. 말의 마취 전후 사망률을 낮추기 위하여, 산통 수술을 받는 말은 수술 전후의 집중 관리가 필요하고, 호흡기 수술을 받는 말은 회복 중 주의 깊은 관찰이 추천된다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제21권4호
• /
• pp.321-327
• /
• 2021

Sevoflurane is familiar to anesthesiologists as an inhaled anesthetic to induce and maintain anesthesia; however, it has not been widely used for sedation. Recently, the use of sevoflurane for inhalational sedation has been increasing. Moreover, in Korea, the use of sevoflurane for conscious or deep sedation in dental care for children and the disabled is increasing, primarily by dental anesthesiologists. In this article, we reviewed a sedation method using sevoflurane.

• Journal of Yeungnam Medical Science
• /
• 제28권1호
• /
• pp.94-98
• /
• 2011

One of the most popular types of vaporizer mounting sytems is Selectatec, as it possesses a simple detachment mechanism. Detachable units can loosen between the vaporizer and anesthetic machine, which can cause vapor leakage. A locking system was subsequently developed to prevent this issue; however, we report a case of an unexpected vapor leakage from a locked vaporizer.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제17권1호
• /
• pp.13-20
• /
• 2017

Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.

• The Korean Journal of Physiology
• /
• 제8권1호
• /
• pp.39-43
• /
• 1974

정상가토(正常家兎)에 ether와 methoxyflurane으로서 흡입마취(吸入麻醉)시킨 후(後) 마취(麻醉)의 심도(深度)와 시간경과(時間經過)에 따른 각기혈당량(各其血糖量)을 측정(測定)하고 대조군(對照群)의 그것과 비교(比較)한 결과(結果) 다음의 결론(結論)을 얻었다. 1. 대조군(對照群)의 혈당량(血糖量)은 $112.04{\pm}9.88\;mg%$이었다. 2. Ether 마취군(麻醉群)에서, 경마취시(輕麻醉時) 혈당치(血糖値)는 $193.57{\pm}2.40$ mg%로서 증가(增加)하였다. 심마취즉후(深麻醉卽後)에는 혈당치(血糖値)가 $130.75{\pm}5.33mg%$로서 다시 저하(低下)되었다. 심마취시간(深麻醉時間)의 경과(經過)에 따라 혈당치(血糖値)는 계속 상승(上昇)하여 심마취(深麻醉) 120분(分)에서는 $188.61{\pm}12.33mg%$에 달(達) 하였다. 3. Methoxyflurane 마취군(麻醉群)에서는 ether 마취군(麻醉群)과 유사(類似)하게 혈당치(血糖値)의 증가양상상(增加樣狀相) 보여 주었고 methoxyflurane 경마취시(輕麻醉時)의 혈당치(血糖値)는 $186.89{\pm}10.90mg%$였다. 심마취즉후(深麻醉卽後)에는 $111.28{\pm}16.81mg%$로 저하(低下)되었다가 시간(時間)의 경과(經過)에 따라 상승(上昇)하여 120분(分)에서는 $208.98{\pm}7.52mg%$로서 상당히 상승(上昇)하였다. 4. 이상(以上)의 결과(結果)로서 ether와 methoxyflurane 마취시(麻醉時) 혈당치(血糖値)의 변동(變動)은 시간경과(時間經過)에 따라 유사(類似)한 결과(結果)를 얻었다.

• 대한치과마취과학회지
• /
• 제12권2호
• /
• pp.125-129
• /
• 2012

Dental treatment under general anesthesia is considered for behavioral control of disabled patients who have severe anxiety or involuntary movement. However, in case of simple treatment, inhalation or intravenous sedation, which has earlier onset and recovery, is preferred. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less complications. In this case report, two patients with mental retardation required simple dental treatment. Deep sedation with inhaled sevoflurane were successfully employed and patients were discharged without any complications.

• 성인간호학회지
• /
• 제21권4호
• /
• pp.379-390
• /
• 2009

Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

• 한국임상수의학회지
• /
• 제40권4호
• /
• pp.260-267
• /
• 2023

Specialized hearing tests for pets are currently in demand. A brainstem auditory evoked response (BAER) test is an objective, non-invasive, and practical electrophysiological method that records electric signals from the peripheral auditory system to the brainstem when an auditory stimulation is provided. In veterinary medicine, sedation or anesthesia is essential for a successful examination. In human medicine, research has established the indications for various sedatives, anesthetics, and drugs according to the depth of anesthesia required. However, in veterinary medicine, there are very few comparative studies on propofol or isoflurane, which are the most common anesthetics used. Therefore, the present study aimed to analyze the difference in BAER test results between sedation with medetomidine, anesthesia using propofol, and inhalation anesthesia with isoflurane after propofol administration. The test was conducted on four healthy adult dogs. There was no statistically significant difference in latency, interpeak latency, or amplitude between the various drugs. The results suggest that a sedative or anesthetic for the administration of a BAER test can be selected according to the patient's needs.