• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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• pp.375-378
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• 2018

Endotracheal intubation is commonly associated with laryngeal injury that often resolves spontaneously without any complication. However, stenosis or granulomatous lesions are generally found on the tracheal wall or vocal process at the tube cuff level, caused by excessive cuff pressure. We present a case of fatal vocal cord granuloma leading to dyspnea following orthognathic surgery and sustained intubation for 14 hours.

• 대한장애인치과학회지
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• 제2권1호
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• pp.31-38
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• 2006

90 handicapped patients with dental problem treated under outpatient general anesthesia at one day operation room of kyungpook National University Hospital during 2000-2005 were analyzed. Following are the conclusions. 1. For those 90patients treated under general anesthesia, 62(68.9%)patients had autism or mental retardation. 2. The most difficult work for the preparation of general anesthesia was preoperative examination(53.3%). 3. The parent's satisfaction level after treatment under general anesthesia was high(75.6%). 4. 36(40%) of the patients responded to periodic recall check till now.

• 대한소아치과학회지
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• 제30권1호
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• pp.92-101
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• 2003

연세대학교 치과대학병원에서 1997년 7월부터 2000년 7월까지 외래 전신마취하에 치과치료를 시행한 235명의 치과 장애인 환자를 대상으로 연령 분포, 전신마취 선택이유, 소요시간, 마취시간, 치료내용과 합병증 등을 분석하고, 우편 설문 조사에 응답한 109명을 대상으로 보호자의 연령과 교육정도, 보호자의 전신마취 경험 유무, 환자의 연령, 치과치료 경험의 유무 등에 따른 보호자의 불안정도와 만족도를 조사하여 다음과 같은 결과를 얻었다. 1. 아동의 전신마취시 보호자가 느끼는 불안정도는 아버지보다 어머니가 더 높았으며, 보호자의 학력이 높을수록 불안정도는 감소하는 경향을 보였다.(P<0.05) 2. 보호자의 학력이 높을수록 전신마취 치료의 만족도는 높았다.(P=0.05) 필요하다면 다시 전신마취하에 치과치료를 받겠냐는 설문에 95명(87.2%)이 받겠다고 응답하였다. 이상의 결과로 볼 때 외래 전신마취하의 치과치료는 환자 보호자에게 통상의 치과치료보다 불안을 야기하지만 치료에 대한 만족도는 높았으며 행동조절의 어려움으로 인해 치과 치료받기가 어려운 환자에게 양질의 치과 서비스를 제공할 수 있는 방안임을 알 수 있었다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권1호
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• pp.5-10
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• 2015

Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.245-254
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• 2018

Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

• The Korean Journal of Pain
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• 제29권3호
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• pp.197-201
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• 2016

Because of its anatomical location and function, the costotransverse (CTRV) joint can be a source of thoracic back pain. In this retrospective observational study, we evaluated the clinical effectiveness of the CTRV joint injection in thoracic back pain patients with suspected CTRV joint problems. We enrolled 20 thoracic back pain patients with localized tenderness that was provoked by the application of pressure on the affected CTRV joints. We injected it with 0.5 ml of a ropivacaine and triamcinolone mixture at each level. The mean pre-injection pain score decreased by 37.9% ($7.2{\pm}1.5$ to $4.5{\pm}1.7$, P < 0.001) two weeks after CTRV joint injection. In addition, 70% of patients reported an excellent or good level of satisfaction. We demonstrated that an ultrasound-guided injection of the CTRV joint reduced patients' pain scores and led to a high level of satisfaction at short-term follow-ups in patients with suspected CTRV joint problems.

• Journal of Chest Surgery
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• 제25권1호
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• pp.17-22
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• 1992

The alterations in serum and urine potassium were studied in twenty two patients who underwent open heart surgery using extracorporeal circulation from June 1990 to August 1990 at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kei-myung University. There were fifteen cases congenital heart disease and seven acquired heart disease. The serum and urine potassium levels were measured pre-, intra- and postoperatively until seventh postoperative day using ionic selective electrode measuring method. After general anesthesia, the serum potassium level decreased significantly but slowly increased during.cardiopulmonary bypass and returned preoperative level after operation. The urine potassium level decreased slowly from general anesthesia to cardiopulmonary bypass weaning but returned preoperative level following operation. During cardiopulmonary bypass, serum and urine potassium levels in diuretic group were lower than that of non diuretic group. There was no remarkable difference in the serum potassium level between single RA cannulation group and bicaval cannulation group preoperatively, but the serum potassium level in single RA cannulation group was much higher than that of bicaval cannulation group. There was no significant difference in the urine potassium level between single RA can-nulation group and bicaval cannulation group postoperatively.

• The Korean Journal of Pain
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• 제7권2호
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• pp.199-204
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• 1994

The purpose of this study is to evaluate the feasibility, advantages/disadvantages of patient-controlled sedation (PCS) compared to anesthesiologist-controlled sedation (ACS) during neurolytic pain block and regional anesthesia. Forty patients were divided randomly into two groups of 20 patients each. Group 1(ACS) received 0.01 $mg{\cdot}kg^{-1}$ intravenous midazolam and 0.5 ${\mu}g{\cdot}kg^{-1}$ fentanyl intravenously by anesthesiologist just before, 30, and 60 minutes after the procedure to acheive sedation; Group 2 (PCS) patients self-administered a mixture of midazolam (0.4 mg) and fentanyl ($20{\mu}g$) using a syringe type infusion pump (Terumo, Japan) to acheive sedation. Considering the dermographics of patients, the types and durations of procedure performed, the level of average sedation the comfort level were similar in both groups. But the doses of midazolam and fentanyl administerd in group 2 were smaller than those in group 1 (p<0.01). Patients in PCS group showed their level of sedation more proper than did those in ACS group. However, patients in ACS group rated their level of comfort higher than did those in PCS group. The findings of this study indicate that PCS using a combination of midazolam and fentanyl is a fafe and effective technique. More studies are, however, needed to determinc the best choice of drug(s), doses, lock-out intervals, and possible use of continuous infusion with patient-controlled sedation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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• pp.159-165
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• 2019

Background: Dental procedures commonly involve the injection of local anesthetic agents, which causes apprehension in patients. The objective of dental practice is to provide painless treatment to the patient. The purpose of this study was to evaluate the effect of Low Level Laser Therapy (LLLT) in reducing the pain due to local anesthetic injection. Materials and Methods: A prospective, split-mouth study was conducted on 25 patients. In Condition A, LLLT was administered followed by the administration of a standard local anesthetic agent. Patients' perception of pain with use of LLLT was assessed based on a Visual Analogue Scale (VAS). In Condition B, LLLT was directed to the mucosa but not activated, followed by the administration of local anesthesia. VAS was used to assess the pain level without the use of LLLT. Results: Comparison between Condition A and Condition B was done. A P value < 0.001 was considered significant, indicating a definite statistical difference between the two conditions. Conclusion: In our study, we observed that LLLT reduced pain during injection of local anesthesia. Further multi-centric studies with a larger sample size and various modifications in the study design are required.

• Clinical and Experimental Pediatrics
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• 제60권12호
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• pp.385-389
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• 2017

Purpose: This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates. Methods: A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using general anesthesia, group 2: C/S using spinal anaesthesia, group 3: C/S using general anesthesia after failed spinal block, group 4: by NVD without anesthesia, and group 5: oxytocin-induced vaginal delivery without anesthesia. Transcutaneous total bilirubin levels (TBLs) were measured during the first 24 hours and on the fifth and eighth days of life and the levels in different groups were compared. Results: The TBLs were significantly higher in neonates delivered by C/S using general anesthesia rather than spinal anesthesia (P<0.001), and both groups had higher levels than those born by NVD without anesthesia ($P{\leq}0.001$). However, the group receiving general anesthesia after failed spinal block was found to have the highest bilirubin level. Moreover, TBLs were significantly higher with the use of oxytocin ($P{\leq}0.001$). Conclusions: C/S and general anesthesia adversely affect the bilirubin levels in neonates, and the use of oxytocin during vaginal delivery also increases TBLs in neonates.