• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.283-291
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• 2014

Patients with extreme anxiety who are unable to cope with dental treatment under non-pharmacological behavioral management method may require sedation, or other forms pharmacological behavioral management method. The aim of this retrospective study was to investigate the effect of concomitant administration of 0.1 mg/kg intramuscular midazolam with or without sevoflurane insufflation sedation on sedation depth and cardiopulmonary function in pediatric patients. We analysed the records of anesthesia on patients who received dental treatment under deep sedation using sevoflurane insufflation from January 2013 to March 2014. Thirty-six children, aged 3 to 6 years, undergoing dental treatment were sedated using either sevoflurane insufflation alone (Group S, n = 18) or a combination of intramuscular injection of 0.1 mg/kg midazolam plus sevoflurane insufflation (Group SM, n = 18). Upon comparison, the average entropy value of group SM was lower than that of group S, but there were no statistically significant difference between the two groups (p > 0.05). The average heart rate and mean arterial pressure of group SM were higher than those of group S (p < 0.05). Concomitant intramuscular injection of 0.1 mg/kg midazolam with sevoflurane insufflation sedation is not sufficient to enhance the quality of sedation.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.75-79
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• 2015

Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

• Clinical Endoscopy
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• v.57 no.5
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• pp.581-587
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• 2024

Although colonoscopy is a routinely performed procedure, it is not devoid of challenges, such as the potential for perforation and considerable patient discomfort, leading to patients postponing the procedure with several healthcare risks. This review delves into preprocedural and procedural solutions, and emerging technologies aimed at addressing the drawbacks of colonoscopies. Insufflation and sedation techniques, together with various other methods, have been explored to increase patient satisfaction, and thereby, the quality of endoscopy. Recent advances in this field include the prevention of loop formation, encompassing the use of variable-stiffness endoscopes, computer-guided scopes, magnetic endoscopic imaging, robotics, and capsule endoscopy. An autonomous endoscope that relies on self-propulsion to completely avoid looping is a potentially groundbreaking technology for the next generation of endoscopes. Nevertheless, critical techniques need to be refined to ensure the development of effective and efficient endoscopes.