• Journal of Korean Biological Nursing Science
• /
• v.14 no.4
• /
• pp.275-281
• /
• 2012

Purpose: This study was performed to evaluate the effect of low-dose lidocaine on fentanyl-induced cough and hemodynamic changes under general anesthesia. This research was a randomized trial design and performed using a double-blind method. Methods: Data collection was performed from October 22, 2008, to May 4, 2009. One hundred and thirty two patients were randomly assigned to control group (Con G) and experimental group (Exp G) using a table of random numbers. Exp G (n=66) were administered 0.5 mg/kg lidocaine and Con G (n=66)) were administered saline. The occurrence of cough and vital sign were recorded within one minute after fentanyl bolus by an anesthesiologist. Collected data were analyzed using Repeated measures ANOVA using SPSS for Windows (Version 17.0). Results: The incidence of cough in Exp G was 13.6%, while Con G was 53%. The incidence cough in Exp G was significantly lower compared to Con G (p<.001). Lidocaine seemed not to suppress mean arterial pressure (p=.145), heart rate (p=.508), and oxygen saturation (p=.161). Conclusion: Intravenous administration of 0.5 mg/kg lidocaine seems to suppress fentanyl-induced cough without affecting mean blood pressure, heart rate and oxygen saturation. Therefore, we recommend intravenous 0.5 mg/kg lidocaine administration to suppress fentanyl-induced cough under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.15 no.4
• /
• pp.213-220
• /
• 2015

Background: Pediatric dentists face challenges when young patients require a mesiodens extraction. General anesthesia may be a burden to the child as well as the parent due to dental fears and costs. The aim of this study was to evaluate oral and intravenous sedation in the outpatient setting as a safe and effective means of managing patients who require a mesiodens extraction. Methods: Records were reviewed retrospectively to find patients who underwent a mesiodens removal procedure from January 2013 to September 2014 in the Department of Pediatric Dentistry at Ajou University Hospital (Suwon, Gyeonggi-do, Republic of Korea). A total of 81 patients (62 male and 19 female) between 4 and 11 years of age (mean [${\pm}SD$] $81.6{\pm}14.1$ months) were studied, with a mean weight of $22.9{\pm}3.3kg$ (16 kg to 30 kg). Vital signs, sedation drug dosage, and sedation time were studied. Results: Mean doses of $63.7{\pm}2.5mg/kg$ chloral hydrate and $1.36{\pm}0.22mg/kg$ hydroxyzine were used for oral sedation. Nitrous oxide/oxygen was administrated for $40.0{\pm}2.1$ min. The mean dose of midazolam administered intravenously was $0.14{\pm}0.06mg/kg$ ($2.38{\pm}0.97$ times). In all cases, the mesiodens was removed successfully. Conclusions: Intravenous sedation combined with oral sedation and nitrous oxide/oxygen inhalation can be an alternative to general anesthesia when administrated and monitored properly.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.2
• /
• pp.99-111
• /
• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.3
• /
• pp.173-185
• /
• 2024

Background: Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods: A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results: In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54±17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion: The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

• The Korean Journal of Pain
• /
• v.12 no.2
• /
• pp.250-252
• /
• 1999

A 77-year-old male patient was admitted to the hospital with acute appendicitis and underwent emergency appendectomy under inhalation anesthesia without any complications. After the operation, the patient was placed on epidural analgesia with the mixture of fentanyl-bupivacaine and scopolamine patch for nausea and vomiting. The patient experienced central anticholinergic syndrome (CAS) with hallucination, confusion, somnolence, dysarthria and delirium at 20 hours after patch placement and recovered from all symptoms of CAS in 24 hours after the removal of the patch. The CAS occurs when central cholinergic sites are occupied by specific drugs and also as a result of an insufficient release of acetylcholine. The diagnosis of CAS is often determined by a process of exclusion and not actually made until a positive therapeutic response to physostigmine, a centrally active anticholiesterase agent, has taken place. Treatment of CAS includes prompt removal of the patch, cleansing of the area, and physostigmine administration. The scopolamine patch should be used with extreme caution in elderly patient.

• Journal of Veterinary Clinics
• /
• v.35 no.5
• /
• pp.247-249
• /
• 2018

A 3-year-old black Thoroughbred colt weighing 500 kg was admitted to the Equine Hospital of Korea Racing Authority (KRA) due to the chronic gait abnormality of the hindlimbs. The history revealed that the patient had run and fallen onto the fence of the farm about at the age of 1 year old and the lameness had been worsening insidiously since the accident. The degree of lameness was 2/5 in accordance with the AAEP lameness grading system in both hindlimbs at hand walking and trot. The lameness was exacerbated at lunging clockwise and counterclockwise on both hindlimbs. The definitive diagnosis of the bilateral osteoarthritis of coxofemoral joint was established using radiography under general inhalation anesthesia. The prognosis was considered to be poor with low expectancy for racing and the colt was expelled from the racecourse eventually. The clinicians are required to consider the possibility of osteoarthritis of coxofemoral joint presented with chronic hindlimb lameness although it is rare. This is the first report on the bilateral osteoarthritis coxofemoral joint in Republic of Korea.

• Journal of Veterinary Clinics
• /
• v.20 no.4
• /
• pp.519-522
• /
• 2003

An appearance of herniated intervertebral disc into thoracolumbar vertebral canal was evaluated in two patients using computed tomography (CT). Before CT scanning, plain radiography and myelography were performed in both cases. CT images were compared to those of myelography. Dogs were positioned in sternal recumbency under inhalation anesthesia and transverse slices with 2 mm thickness were obtained around thoracolumbar region. The transverse CT images were examined using both vertebral and spiral window mode. The most common findings on CT images were loss of vertebral canal epidural fat, bulging of vertebral canal disc margins, displacement of spinal cord and flatted vertebral canal. Whereas, narrowed intervertebral disc space and simple extradural pattern were the main findings on plain and contrast radiographs. CT imges showed the extent of the herniated disc lesion, type II intervertebral disc hernation, and the displacement of spinal cord in detail in both occations. It is considered that degree and precise localization of the intervertebral disc herniation and subtle lesion of spinal cord could be identified accurately using computed tomography.

• Journal of Veterinary Clinics
• /
• v.38 no.6
• /
• pp.305-309
• /
• 2021

A 13-day-old Thoroughbred female foal weighing 59 kg was referred to the Jeju National University Equine Hospital with clinical signs including depression, labored breathing, tachycardia, anorexia, and marked distended abdomen. Uroperitoneum secondary to a rupture of the urinary bladder was diagnosed based on the history, clinical signs, and ultrasound imaging. An emergency laparotomy for cystorrhaphy under inhalation anesthesia was performed, and the patient recovered uneventfully. A course of extensive supportive therapy with systemic antibiotics after surgery was carried out. The foal fully recovered and was discharged after 14 days of hospitalization. The follow-up after seven months revealed the patient to be clinically healthy. This report describes a case of uroperitoneum secondary to the rupture of the urinary bladder in a Thoroughbred foal, along with the clinical outcomes of surgical repair and intensive treatment in detail.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.9 no.1
• /
• pp.51-55
• /
• 2013

Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. LGS seizures are often treatment resistant and the long term prognosis is poor. A 14-year-3-month old, 20.5 kg girl with LGS was scheduled for dental treatment under general anesthesia. The patient presented with multiple caries and heavy calculus. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. And caries treatment, scaling, subgingival curretage were performed. LGS patients usually have poor oral hygiene due to mental retardation and have high risk of seizure during dental treatment. In dental treatment under general anesthesia for LGS, it must be considered of seizure control during peri-operative period. Also periodic recall check, instruction of oral hygiene must be performed.

• Korean Journal of Clinical Laboratory Science
• /
• v.52 no.4
• /
• pp.317-326
• /
• 2020

Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.