• Archives of Plastic Surgery
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• v.40 no.3
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• pp.263-266
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• 2013

Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.235-238
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• 2019

Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of $SpO_2$ and preparations to support postoperative ventilation are necessary.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.5
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• pp.309-313
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• 2018

Oronasal fistulae (ONF) could remain after surgery in some patients with cleft palate. ONF ultimately requires intraoral surgery, which may lead to perioperative airway obstruction. Tongue flap surgery is a technique used to repair ONF. During the second surgery for performing tongue flap division, the flap transplanted from the tongue dorsum to the palate of the patient acts as an obstacle to airway management, which poses a great challenge for anesthesiologists. In particular, anesthesiologists may face difficulty in airway evaluation and patient cooperation during general anesthesia for tongue flap division surgery in pediatric patients. The authors report a case of airway management using a flexible fiberoptic bronchoscope during general anesthesia for tongue flap division surgery in a 6-year-old child.

• International Journal of Advanced Culture Technology
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• v.10 no.1
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• pp.108-115
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• 2022

The purpose of this study is to investigate the actual status of antithrombotic management before and after the procedure or surgery, the difference between the duration of medication suspension by clinical and demographic characteristics, and the patient's understanding and satisfaction after medication management by a dedicated nurse. The results were as follows. The most commonly used antithrombotic agents were aspirin and flavitol. The drug discontinuation period according to antithrombotic, procedures, and underlying diseases, there was a significant difference in duration for each variables(p<.000). In the case of antiplatelet drugs, 5-day suspension was the most frequent, and anticoagulants 2-day suspension was the most frequent. Depending on the procedure,colonoscope,nucleoplasty,rotator cuff repair,and total knee arthroplasty commonly showed more than 80% of 5-day discontinuation. The differences according to underlying diseases are as follows. 64.7% of all diseases discontinued on the 5th. The patient's understanding of the nurse's medication management performed before and after the procedure was found to be lower in Angina patients than those with other diseases. In terms of age, those in their 50s showed higher understanding than other age groups. There were no differences in understanding and satisfaction with the remaining characteristics.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.800-804
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• 2001

The authors reviewed the recent trend of surgical treatment for pediatric as well as adult onset moyamoya disease(MMD). Combined direct and indirect arterial anastomosis or multiple indirect arterial bypasss has been increasing for pediatric MMD and direct arterial bypass is recommended for adult MMD, especially in patients with hemorrhagic MMD. Besides perioperative complications related to the management of MMD and 1999 annual report by the Research Committee on Spontaneous Occlusion of the Circle of Willis(Moyamoya Disease) of the Ministry of Health and Welfare, Japan will be summarizd.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.297-310
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• 2008

Purpose: The aim of this study was to investigate the attitude of job transfer and job satisfaction in operating rooms, and to use this data towards efficient human resource management. Method: One hundred and seven nurses in operating rooms in a general hospital in Seoul, Korea were surveyed using a questionnaire. Data was collected and analyzed using SPSS/PC program. Results: The attitude toward the job transfer was generally favorable with a mean of 3.32 out of a 5 point scale in rating the need for job transfer. Among the five domains of attitudes toward job transfer, individual development scored the highest(mean, 3.75). The mean score of job satisfaction in the study participants was rated in a 5 point scale with a mean of 3.12. Among the seven domains of job satisfaction, networking(3.37) scored the highest, followed by the perspective of professional position(3.32). Therefore, it can be said that mutual interaction and professional position are the most important factors for job satisfaction. The correlation between the attitude toward job transfer and job satisfaction showed a positive relationship with a coefficient of 0.210, implying that job satisfaction was higher when the attitude toward transfer was more favorable. Conclusion: From the attitude toward job transfer, individual development and professional improvement was favorable, implying the need for such program. Therefore, it is recommended that an official policy should be provided to achieve these goals in perioperative nursing.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.40-47
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• 2020

Background: Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. Methods: In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. Results: Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. Conclusions: Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.267-277
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• 2018

Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017. Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases). Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively). Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• The Journal of the Korean dental association
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• v.48 no.1
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• pp.38-44
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• 2010

Nowadays, medically compromised patients who could not receive dental treatments in the past are able to go through minor oral surgeries with adequate preoperative measures. Thorough understanding of the systemic disease and its complications is needed as well as the management them. Frequent complications of surgical procedures are bleeding, infection, delayed healing, systemic reactions by stress and they can be aggravated due to the patients' systemic conditions. Therefore, understanding of the systemic disease of patient visiting dental office and treatment modification according to the systemic status is needed. Also consultation to the medical doctor is imperative, through which perioperative risk and complications can be reduced. Among the high frequency complications of dental treatment of medically compromised patients, bleeding, infection, delayed healing, systemic reactions by stress will be discussed with the management of each one.