• Title/Summary/Keyword: Post anesthesia

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Percutaneous C2 Ganglionotomy in the Management of Occipital Neuralgia -A case report- (후두신경통 환자에서 시행한 경피적 제2경추신경절 절제술 -증례 보고-)

  • Lim, So-Young;Kim, Su-Gwan;Shin, Keun-Man;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.200-205
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    • 1996
  • Radiofrequency thermocoagulation(RF) techniques are safe and effective methods as compared to neurodestructive procedure. Other advantages are: ability to perform RF lesions under local or sedative anesthesia, rapid recovery period, low incidence of morbidity and mortality, ability to repeat RF lesions, and leaves no significant scarring. We performed C2 ganglionotomy by RF lesion generator on a patient, suffering post-traumatic occipital neuralgia, as the patient did not respond to conservative therapies such as: trigger point injection, TENS, cryotherapy and stretch, occipital nerve block, C2 ganglion block. Prognostic nerve block was performed usng local anesthetics. Excellent effect was conformed before C2 ganglionotomy. This procedure was performed under fluoroscopy. Type RCK-2A Rosomoff Cordotomy kit was used to stabilize the head and neck. Postoperatively, the patient was free of occipital pain and head motions no longer triggered pain. To date, the patient remains symptom free except for some cervical discomfort.

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Effect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy (Ondansetron과 Dexamethasone의 병합 투여가 복강경하 질식 전자궁 적출술 환자의 수술 후 오심 및 구토, 통증에 미치는 효과)

  • Nam, Mi-Ok;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.39 no.1
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    • pp.44-52
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    • 2009
  • Purpose: The purpose of this study was to compare the effects of ondansetron combined with dexamethasone on Post-Operative Nausea and Vomiting (PONV) and pain with ondansetron alone in patients with laparoscopy assisted vaginal hysterectomy under general anesthesia. Methods: Data were collected from April 1 through September 30, 2005 using a double blind method. Ondansetron 4 mg and dexamethasone 10 mg were administered to the experimental group (25 patients), and ondansetron 4 mg only to the control group (25 patients). The medications were administered through an intravenous line at the beginning peritoneum suture. PONV by Index of Nausea Vomiting and Retching (INVR), nausea by Visual Analogue Scale (VAS), and pain (VAS) were assessed at postoperative 1 hr, 3 hr, 6 hr, 24 hr, and 48 hr. Data were analyzed using repeated measures ANOVA, and Bonferroni methods. Results: The experimental group that received ondansetron combined with dexamethasone had less PONV (p=.048), and nausea (p=.012) than control group that received ondansetron alone. However, there was no difference in pain (p=.557) between the patients in the two groups. Conclusion: We conclude that the administration of ondansetron combined with dexamethasone is more effective than the administration of ondansetron alone to reduce PONV in patients with laparoscopic hysterectomy.

The Choice of Laryngeal Reinnervation Versus Medicalization Laryngoplasty in Unilateral Vocal Fold Paralysis (일측성 성대 마비의 치료에서 후두 신경재식법과 내측 후두 성형술의 선택)

  • Kim, Heejin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.1-6
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    • 2020
  • In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

Myositis Ossificans Traumatica in the Temporalis Muscle (측두근의 외상성 골화성 근염)

  • Oh, Seung Il;Lee, Yoon Ho
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.53-57
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    • 2013
  • Myositis ossificans is a condition characterized by ossification within a muscle. It is a rare and unusual pathologic entity that has defied medical efforts to establish a definite etiology, pathogenesis, and satisfactory treatment of the disease. The condition predominantly affects the flexor muscles of the upper limbs and thighs, but rarely the head and neck area. A 53-year-old male patient visited our medical institution complaining of trismus, defined as limited mouth opening. The patient had a history of trauma to the facial bones and the computed tomography scans revealed calcification in the left temporalis muscle. The patient underwent surgical removal of the calcified mass with bilateral coronoidectomy under general anesthesia. Mouth opening at the end of post-operative 2 months was 28 mm. His oral intake of food was satisfactory. Myositis ossificans of the temporalis muscle is a very rare case. Satisfactory outcome was obtained by combining surgical excision of the affected muscle, coronoidectomy, and detachment of the insertion site of the ossified muscle.

Generation of novel hyaluronic acid biomaterials for study of pain in third molar intervention: a review

  • Shuborna, Nadia Sultana;Chaiyasamut, Teeranut;Sakdajeyont, Watus;Vorakulpipat, Chakorn;Rojvanakarn, Manus;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.1
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    • pp.11-19
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    • 2019
  • Hyaluronic acid (HA) has long been studied in diverse applications. It is a naturally occurring linear polysaccharide in a family of unbranched glycosaminoglycans, which consists of repeating di-saccharide units of N-acetyl-D-glucosamine and D-glucuronic acid. It is almost ubiquitous in humans and other vertebrates, where it participates in many key processes, including cell signaling, tissue regeneration, wound healing, morphogenesis, matrix organization, and pathobiology. HA is biocompatible, biodegradable, muco-adhesive, hygroscopic, and viscoelastic. These unique physico-chemical properties have been exploited for several medicinal purposes, including recent uses in the adjuvant treatment for chronic inflammatory disease and to reduce pain and accelerate healing after third molar intervention. This review focuses on the post-operative effect of HA after third molar intervention along with its various physio-chemical, biochemical, and pharmaco-therapeutic uses.

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

  • Hwang, Victor;Gomez-Marroquin, Erick;Enciso, Reyes;Padilla, Mariela
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.403-408
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    • 2020
  • Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

Analysis of Media Trends and Social Perceptions on Nursing Law Legislation (간호법 제정에 대한 언론 동향 및 사회적 인식 분석)

  • Lee, Seung-Hee;Joo, Min-Ho
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.439-452
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    • 2023
  • Purpose: This study aimed to derive considerations for the enactment of nursing law by analyzing the trends and social perceptions of nursing law mentioned in major daily newspapers, cafes, and blogs. Methods: Main texts and comments that included nursing law as a keyword were collected from major daily news and online postings from January 2021 to August 2022. The data collected through web crawling were analyzed using a TousFlux program used for big data analysis. Results: During the period of study, the awareness level around nursing law enactment increased. In particular, public concern over nursing law enactment intensified due to the two political parties' policy pledges related to nursing law in January 2022 and the failure to introduce the nursing law to the national assembly judiciary committee in May 2022. Except in December 2021, public perception of nursing law enactment was generally favorable, with public opinion tilting more in favor of than against enactment. Conclusion: Public opinion should be considered when drafting and implementing the nursing law to make it easier for the people to understand what the law constitutes. In addition, it is necessary to pay attention to and continuously promote the relationship between medical care and nursing in the nursing law system of developed nations. Lastly, nursing law enactment can enhance nurses' retention intention and provide a sense of efficacy to medical services.

Guidance of Nerve Stimulator and Ultrasound for Transforaminal Epidural Steroid Injection in Lumbosacral Radicular Pain : A Single Institution Experience in Vietnam

  • Viet-Thang Le;Chi Hue Nguyen;Phuoc Trong Do;Anh Minh Nguyen;Khoi Hong Vo
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.194-201
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    • 2024
  • Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

Effect of Epidural Analgesia on the Post-thoracotomy Patient (경막외 진통법이 개흉술후 환자에게 미치는 영향)

  • Lee, Yong-Jai;Shin, Hwa-Kyun;Kim, Sun-Han;Kwon, Oh-Chun;Nam, Chung-Hee;Rho, Jung-Kee;Lee, Kihl-Rho;Kim, Young-Ah;Lee, Jang-Won;Shin, Hyung-Chul;Kim, Il-Ho;Kim, Soon-Im;Kim, Sun-Chong;Park, Wook
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.37-43
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    • 1992
  • Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxemia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine for control of postoperative pain was reported by Behar and associates. This study was carried out for twenty patients who received posterolateral thoracostomy with bleb resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes under general endotracheal anesthesia. For the relief of post-thoracotomy pain following of the general anesthesia, we selected ten patients as control group which were treated intermittently IM with injection of pethidine(50 mg) according to the conventional method and another ten patients as study group which were managed with thoracic epidural analgesia. The tip of the catheter was inserted to T4-5 epidural space through T12-L1 or L1-2 interspinous region before the induction of the general anesthesia and then the epidural analgesics(0.25% bupivacaine 15 ml+morphine 3 mg) was injected once a day via the catheter until 4 th POD in the study group. The epidural catheters were removed at postoperative 4 th day in study group. Clinical observations were done about vital signs, ABG, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; (1) The values of $V_T$ and FVC were significantly improved in study group(85% and 66%) as compared with control group(76% and 61%) during the postoperative 4 day of the epidural analgesia. (2) After the end of the epidural analgesia(7th POD), the values of FVC were improved invertly rather in control group(98%) than study group(84%). It suggested that the reduction of FVC in study group were caused by the raised pain sensitivity following the end of epidural analgesia. (3) The side effects of epidural analgesia such as transient urinary retention(2 cases), itching sensation(1) and headache(1) were noted.

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PULSE RATE AND OXYGEN SATURATION IN CHILDREN DURING ROUTINE RESTORATIVE DENTISTRY (소아 치과치료시 심박동과 동맥혈 산소포화도의 변화)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Park, Jeong-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.65-72
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    • 2008
  • Pulse oximeter to monitor oxygen saturation during pediatric dental sedations enables early detection of hypoxemia. The purpose of this study was to monitor the hemoglobin oxygen saturation level and pulse rate of nonmedicated pediatric patients during routine restorative procedures to study the effect of procedure and treated jaw. We obtained data from 53 children treated at the Department of Pediatric Dentistry, Chonbuk national university hospital. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry at each step of treatment. The results are as follows: 1. In non-anesthesia group, steep increase of pulse rate was observed during rubber dam application in the maxilla and during cavity preparation in the mandible. 2. In anesthesia group, pulse rate started to decrease after the rubber dam application in the maxilla, while its decrease observed since cavity preparation step in the mandible. 3. In non-anesthesia group, oxygen saturation level was relatively constant during all steps in the maxilla, but in mandible, it was higher during operation compared to its pre and post operation baseline. 4. In anesthesia group, oxygen saturation level was observed at 99% level through all steps in both jaw groups, and there was no statistical significance between the maxilla and the mandible groups(p>0.05). The purpose of this study was to evaluate the effect of routine dental treatment on the pulse rate and oxygen saturation level in nonmedicated pediatric patients during routine restorative procedures in the maxilla and mandible.

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