• The Korean Journal of Physiology and Pharmacology
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• v.14 no.5
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• pp.291-297
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• 2010

The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$ $libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

• International Journal of Oral Biology
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• v.45 no.2
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• pp.51-57
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• 2020

Thromboelastography or rotational thromboelastometry, is being increasingly utilized in cardiac surgery of late. However, it is an indirect test and is not available in all centers. Low fibrinogen levels before and after cardiopulmonary bypass (CPB) have been described to be associated with postoperative bleeding in cardiac surgery. This study explored the usefulness of reduction ratio of the fibrinogen levels before CPB (preCPB) and after CPB (postCPB) in predicting postoperative hemorrhage. A retrospective, observational study of adult patients who underwent cardiac surgery with CPB between February 2014 and January 2016 was conducted, which included a total of 264 patients. The fibrinogen levels were measured twice, preCPB and postCPB, and the fibrinogen reduction ratio was acquired [(preCPB - postCPB)/preCPB]. Postoperative blood loss, which was defined as the blood collected from the chest drain for 12 hours following arrival at the intensive care unit, was considered severe if it was more than 1,000 mL. A multivariate analysis showed that fibrinogen reduction ratio, sex, and postCPB platelet count were significantly associated with severe postoperative bleeding. However, the pre- and postCPB fibrinogen levels were not significantly associated with severe bleeding. Furthermore, a fibrinogen reduction ratio of > 41.3% was independently associated with postoperative severe bleeding, with an odds ratio of 3.472 (1.483-8.162). These results suggest that the reduction ratio of pre- and postCPB fibrinogen levels may be utilized in predicting postoperative bleeding.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.5
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• pp.319-328
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• 2024

Background: It is vital to identify more efficient anesthesia techniques for the restorative or endodontic treatment of mandibular molars. Both articaine buccal infiltration anesthesia (ABI) and lidocaine inferior alveolar nerve block anesthesia (LIANB) may not provide profound anesthesia, necessitating supplementary anesthesia. This study aimed to investigate whether lidocaine intraosseous lidocaine intraosseous anesthesia (LIO) is more suitable than ABI as primary anesthesia for caries treatment of mandibular molars. Methods: This study retrospectively analyzed patients treated for advanced caries according to the International Caries Detection and Assessment System (ICDAS) 5 and 6. The study involved 48 patients, split evenly between those receiving ABI and LIO, and examined the anesthesia success rate, pain during anesthesia, onset time, duration, and post-anesthesia lower lip numbness using Chi-square and Independent T-tests. Results: In the ABI group, 17 patients (70.8%) did not require additional anesthesia, whereas all 24 patients (100%) in the LIO group did not require additional anesthesia (P < 0.001). ABI was associated with significantly higher pain during anesthesia, slower onset time, and longer duration of anesthesia than LIO. There was no significant difference in post-anesthesia lower lip numbness between the two methods. Conclusion: Intraosseous anesthesia using lidocaine is more effective for treating severe caries in the mandibular molars because of its higher success rate, decreased pain during anesthesia, faster onset, and shorter recovery time.

• Journal of Internet of Things and Convergence
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• v.3 no.2
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• pp.21-32
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• 2017

This study is a descriptive investigation for understanding factors influencing the length of stay in the postanesthesia care unit of elderly patients. Retrospective investigation was conducted on 300 patients aged 65 or older among those who had received an operation under general anesthesia and treated in postanesthesia care unit of hospital C located in Gyeonggi-do, from January 1 to December 31, 2014. The patients' average postanesthesia care unit stay was found to be 48.4 minutes and the 30-59 minute section accounted for the highest part with 58.0%. The postanesthesia care unit stay time according to intra-operative factors showed significant differences depending upon muscle relaxants, transfusion, ABGA, body temperature and total hours under anesthesia. Concerning the post anesthesia care unit stay length according to post-operative factors, significant differences were observed depending upon complications, PCA device, and circulatory drug use. In order to find out factors influencing the post anesthesia care unit stay length, the multiple regression analysis was conducted. As a result, the circulatory drug use and intra-operative lower body temperature were found to have an effect on the post anesthesia care unit stay length with the total explanatory power of 13%. Based on these findings above, it is deemed helpful to carefully monitor factors related to the post anesthesia care unit stay length and provide swift response accordingly for shorter post anesthesia care unit stay time of elderly general anesthesia patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.2
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• pp.101-103
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• 2020

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.73-75
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• 2019

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.1
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• pp.49-56
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• 2014

Background: Propofol (2.6-diisopropylphenol) is a widely used intravenous anesthetic agent for the induction and maintenance of anesthesia during surgeries and sedation for ICU patients. Propofol has a structural similarity to the endogenous antioxidant vitamin E and exhibits antioxidant activities.13) However, the mechanism of propofol on hypoxia/reoxygenation (H/R) injury has yet to be fully elucidated. We investigated how P-PostC influences the autophagy and cell death, a cellular damage occurring during the H/R injury. Methods: The groups were randomly divided into the following groups: Control: cells were incubated in normoxia (5% CO2, 21% O2, and 74% N2) without propofol treatment. H/R: cells were exposed to 24 h of hypoxia (5% CO2, 1% O2, and 94% N2) followed by 12 h of reoxygenation (5% CO2, 21% O2, and 74% N2). H/R + P-PostC: cells post-treated with propofol were exposed to 24 h of hypoxia followed by 12 h of reoxygenation. 3-MA + P-PostC: cells pretreated with 3-MA and post-treated propofol were exposed to 24 h of hypoxia followed by 12 h of reoxygenation Results: The results of our present study provides a new direction of research on mechanisms of propofol-mediated cytoprotection. There are three principal findings of these studies. First, the application of P-PostC at the onset of reoxygenation after hypoxia significantly increased COS-7 cell viability. Second, the cellular protective effect of P-PostC in H/R induced COS-7 cells was probably related to activation of intra-cellular autophagy. And third, the autophagy pathway inhibitor 3-MA blocked the protective effect of P-PostC on cell viability, suggesting a key role of autophagy in cellular protective effect of P-PostC. Conclusions: These data provided evidence that P-PostC reduced cell death in H/R model of COS-7 cells, which was in agreement with the protection by P-PostC demonstrated in isolated COS-7 cells exposed to H/R injury. Although the this study could not represent the protection by P-PostC in vivo, the data demonstrate another model in which endogenous mechanisms evoked by P-PostC protected the COS-7 cells exposed to H/R injury from cell death.

• Korean Journal of Adult Nursing
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• v.17 no.4
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• pp.612-621
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• 2005

Purpose: This study aims at confirming the effects of the chest meridian massage on the post-anesthetic recovery of general anesthesia appendectomy patients. Method: The research was post-test designed as a nonequivalent control group among quasi-experiments tested. The data was collected from June 20, 2003 to October 14, 2003 at a hospital in P city. In the collected data, using SPSS Win 10.0 program, these general features were analyzed by real numbers and percentages; the homogeneity among variables by $X^2-test$ and t-test and the research hypothesis by the t-test. Result: Hypothesis 1; The experimental group receiving the treatment of the chest meridian massage will have a much higher post-anesthetic recovery score than that of the control group not receiving it was supported(t=2.544, p=.014). Hypothesis 2; The experimental group receiving the treatment of the chest meridian massage will have a much shorter time of stay in the recovery room than that of the control group not receiving it was supported(t=-4.919, p=.000). Conclusion: According to these results, it may be concluded that Chest Meridian Massage is effective in producing a higher level of post-anesthetic recovery score and helps appendectomy patients reduce the time of stay in the recovery room. Therefore the chest meridian massage can be considered as an intervention therapy for directly nursing general anesthesia appendectomy patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.3
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• pp.147-154
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• 2020

Background: Single inferior alveolar nerve block is ineffective in achieving adequate pulpal anesthesia in 30-80% of patients due to anatomical variations, local tissue pH, central sensitization, and several factors. Various supplementary techniques and combination of adjuvants with lignocaine are used to overcome these failures. Magnesium sulfate (MgSO₄), one such adjuvant, acts at the N-methyl-D-aspartate glutamate receptor resulting in effective anesthesia. The aim of this prospective, randomized, double-blind, clinical controlled trial was to evaluate the onset, anesthetic efficacy, duration and post-operative analgesia of 2% lignocaine with and without the addition of MgSO₄ in patients with symptomatic irreversible pulpitis and apical periodontitis. Methods: Fourty-two patients were randomly divided into three groups: 2% lignocaine (group 1) and 2% lignocaine with MgSO₄ (75 mg) and (150 mg) in groups 2 and 3, respectively. Pre-operative vitals and Heft Parker-Visual Analogue Scale (HP-VAS) pain scores were recorded. The onset of anesthesia, anesthetic efficacy, and duration of anesthesia were evaluated post administration of the local anesthetic solution. The post-operative analgesia was examined at intervals of 2, 6, 12, 24, and 48 h. Results: Administration of 150 mg MgSO₄ hastens the onset of anesthesia (1.29 min) and produces better anesthetic efficacy (3.29 HP-VAS) compared to group 2 (2.07 min and 9.14 HP-VAS) and group 1 (3.29 min and 35.79 HP-VAS), respectively. The duration of anesthesia was significantly higher in group 3 (247.07 min) compared to that of groups 2 and 1 (190 min and 110.21 min) with P < 0.05. Conclusion: Combining 75 mg or 150 mg of MgSO₄ with lignocaine is more effective than 2% lignocaine and 75 mg of MgSO₄ is adequate for endodontic procedures.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.666-677
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• 2000

The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.