• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.211-218
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• 2011

The aims of this study were to investigate the anesthetic effects of medetomidine-midazolam-ketamine (MMK) combination and to compare antagonistic effects of atipamezole and yohimbine in dogs anesthetized with MMK. Eighteen adult male healthy beagles were used in this study. All dogs were anesthetized with intramuscular (IM) administration of medetomidine (0.04 mg/kg), midazolam (0.2 mg/kg) and ketamine (5 mg/kg) in one syringe. Intravenous (IV) administration of atipamezole (0.24 mg/kg, MMKA), yohimbine (0.2 mg/kg, MMKY) or saline solution (0.1 ml/kg, MMK) was administered 20 minutes after MMK combination anesthesia. Induction and recovery times, scores of sedation and analgesia, heart rate, blood pressure, rectal temperature, respiratory rate and blood gases were determined and recorded for each dog. Mean anesthesia times, sternal recumbency times, standing times and walking times in the MMKA and MMKY groups were significantly shorter than those in the MMK group. But there were not significantly different between MMKA and MMKY groups. In all groups, MMK administration produced a satisfactory sedation and analgesia for all dogs. However, after administration of atipamezole or yohimbine the scores for posture and response to noxious stimuli were significantly lower in the MMKA or MMKY group than those in the MMK group. MMK produced good sedation and anesthesia effects, and atipamezole or yohimbine can be used as a safe and effective agent for antagonizing the MMK anesthesia in dogs.

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

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.429-433
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• 2017

The purpose of this study was to find anatomical variation of each small breed dog's dentition for designing more effective dental chews. Small breed dogs were volunteered for dental impressions with dental stone and alginate under tiletamine-zolazepam, tramadol, and medetomidine intravenous anesthesia. Twenty-two criteria were measured to compare dental impressions. Twenty-five dogs (9 Malteses, 8 Miniature Poodles, and 8 Shih-Tzus) were recruited. Statistically, Shih-Tzus had smaller teeth and shorter interdental spaces than those of Maltese and Miniature Poodles. Grossly, the distance between upper teeth and lower teeth was wider in Shih-Tzus. Shih-Tzu had different dental anatomy in comparative to Miniature Poodle and Maltese. It was recommended to design the dental chew considering these differences.

• Korean Journal of Veterinary Research
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• v.56 no.3
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• pp.133-137
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• 2016

Changes in the cardiovascular and bispectral index score were evaluated in dogs subjected to constant rate infusion (CRI) with alfaxalone. Fifteen dogs were assigned to three groups of 5. Groups and doses of alfaxalone were as follows: group 1, 3 mg/kg for induction and 6 mg/kg/h for CRI; group 2, 3 mg/kg for induction and 8 mg/kg/h for CRI; and group 3, 3 mg/kg for induction and 10 mg/kg/h for CRI. CRI was maintained for 1 h. Respiratory rates and blood pressures showed minimal changes; however, mild tachycardia and mild hypoxemia occurred, especially in group 3. There were some disparities between bispectral index score, electromyography and pedal withdrawal reflex test when measuring anesthetic depth. Additional premedications and/or analgesic agents would be helpful to avoid adverse effects of alfaxalone and provide improved cardiopulmonary functions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.162-165
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• 2016

We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.55-59
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• 2016

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.47-52
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• 2015

Sedation allows patients to maintain their airway independently and respond appropriately to physical stimulation and verbal command while maintaining a minimum depressed level of consciousness. Drugs commonly used for sedation of pediatric dental patients include a combination of chloral hydrate, hydroxyzine, and nitrous oxide-oxygen. Midazolam is a benzodiazepine and currently one of the most commonly used intravenous sedative agents. It can be easily titrated to provide a wide range of sedation, from conscious sedation to deep sedation, and exhibits a wide safety margin without severe respiratory and circulatory depression. At an appropriate dose, it also decreases patient anxiety and induces amnesia. We found that the submucosal administration of midazolam combined with chloral hydrate provided increased sedative effects and decreased the postoperative vomiting response compared with conventional chloral hydrate administration, with no significant difference in physiological responses. The depth of sedation can be titrated using this technique.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.125-129
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• 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.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.162-164
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• 2019

A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.81-85
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• 2021

Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.