• Title/Summary/Keyword: Post anesthesia

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Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, $O_2$ Saturation and Heart Rate (Morphine과 Ketorolac의 선행진통법이 수술 후 통증, 코티졸, 산소포화도 및 심박동 수에 미치는 효과)

  • Seo, Yun-Ju;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.720-729
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    • 2008
  • Purpose: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, $O_2$ saturation and heart rate for the first 24 hr after abdominal surgery. Methods: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, $O_2$ saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, $X^2$ test, repeated measures ANOVA, and Bonferroni methods. Results: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and $O_2$ saturation between the experimental group and control group. Conclusions: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or $O_2$ saturation for 24 hr after abdominal surgery.

Comparative evaluation of the effectiveness of a mobile app (Little Lovely Dentist) and the tell-show-do technique in the management of dental anxiety and fear: a randomized controlled trial

  • Elicherla, Sainath Reddy;Bandi, Sujatha;Nuvvula, Sivakumar;Challa, Rama subbareddy;Saikiran, Kanamarlapudi Venkata;Priyanka, Vaka Jeevan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.369-378
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    • 2019
  • Background: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit. Methods: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively. Results: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group. Conclusion: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.

Voice Care for the Post-Thyroidectomy Dysphonia (갑상선 수술 후 발생하는 음성장애의 치료)

  • Chung, Eun-Jae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.14-17
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    • 2016
  • Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

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Combined Surgery of Pulmonary Resection and Coronary Artery Bypass Grafting (CABG) (폐절제와 관상동맥 우회술의 동반 수술 치험 3예)

  • Kim Jin Sun;Lee Young Tak;Kim Jhingook;Kim Kwhanmien;Choi Yong Soo;Sung Kiick;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.253-257
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    • 2005
  • The patients with primary lung cancer who have symptoms of angina pectoris commonly have underwent coronary artery bypass grafting (CABG) prior to lung resection. Recently, there are attempts to conduct simultaneous operation of CABG and lung resection to reduce disadvantages of staged operation, such as repeated general anesthesia, two wound incisions and delay of lung operation. These attempts generally report good results. Three patients underwent lung resection and CABG simultaneously, and had good post operative status without recurrence of cancer and angina pectoris. We conceive these as worthy cases to report.

A HEMATOLOGIC STUDY OF ORTHOGNATHIC SURGERY PATIENTS (악교정 수술후 혈액학적 변화에 대한 연구)

  • Lee, Jong-Seok;Ko, Seung-O;Jeong, Kil-Jung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.157-166
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    • 2007
  • Moderns have desire likely to be further good-looking concomitant with a qulitative advancement of the life. Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. It's possible to occur many complication during the operations and especially, an excessive bleeding of those may be fatal and so a tranfusion is performing for the prevention and management of that. The most notable of these for reduction of blood loss is the utilization of induced hypotensive anesthetic technique to reduce the mean arterial pressure between 55 and 60 mmHb. Another method for dealing with blood loss following orthognathic surgery is the transfusion of blood obtained as an autologous tranfusion or from banked blood. Some of the disadvantage of banked blood are overcome with the use of predeposited autologous transfusion. But currently, surgeons try so that even autologous transfusion may not transfuse the patients. We made a comparative study of hematologic change and transfusion requirement based on a series of 200 patients who had an orthognathic surgical procedure at Chonbuk National University during the period 2001-2005. This study is to make a comparative analysis of an post-operative hematologic (Hemoglobin, Hematocrit, Red blood cell) change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.

The Effects of Early First Oral Water Intake on Thirsty Feeling, Nausea, and Vomiting in Child under Ambulatory Surgery (당일수술 후 최초 경구수분섭취 시간단축이 소아에서의 갈증감소 및 오심, 구토 발생에 미치는 영향)

  • Kim, Kyung-Ja;Lee, Yoon-Young;Hyun, Dong-Su;Park, Kwang-Ok
    • Journal of Korean Biological Nursing Science
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    • v.6 no.1
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    • pp.43-52
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    • 2004
  • Purpose : The purpose of this study was to find effects of early oral water intake on thirsty feeling, nausea, and vomiting after ambulatory surgery. Method : Sixty patients who received PET(Pressure Equalizing Tube) insertion surgery under general anesthesia were conveniently sampled and divided into two groups. Experimental group was instructed to drink water after two hours and control group was directed to intake water after three hours postoperatively. Data were collected from May 1, 2002 to August 31, 2002 at ambulatory surgery center of Asan Medical Center. The thirsty feeling, nausea and vomiting score between experimental and control group were compared at the time of recovery, recovering consciousness, 2hr, 3hr, right before discharge and/or 24hr(telephone interview) postoperatively. The collected data were analyzed by SPSS 8.0 statistic program. Result : Result of this study are as follows. 1) There was a statistically significant difference(t=-10.31, p=0.00) in the occurrence of thirsty feeling at the 3hr postoperatively between experimental and control groups. 2) There was a statistically significant difference($x^2=6.66$, p=0.02) in the incidence of nausea during the 2hr postoperatively between experimental and control groups. 3) There was no difference($x^2=0.35$, p=0.55) between groups in vomiting scores. Conclusion : It was generally known that the delay of oral water intake decreases post operative complications. But, this study shows that early oral water intake decreases discomfort of thirsty and there was no adverse effects on the occurrence of postoperative nausea and vomiting.

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Correction of Post-traumatic Fingertip Pain with Dermofat Graft (진피지방이식술을 이용한 외상 후 수지첨부 동통의 교정)

  • Kim, Jung Hyun;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.485-490
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    • 2005
  • Fingertip is the end of tactile organ and the part of hand most frequently injured. Fingertip injuries should be evaluated on an individual basis considering patient's overall physical condition, medical history, etiology, time of injury, and anticipated future hand use, and accordingly one of various methods of reconstruction should be selected. Complications after the reconstruction of fingertip injuries have been reported as pain, hypersensitivity, numbness, distal paresthesia, cold intolerance, and atrophy. From January to December 2002, dermofat grafts were performed on 15 patients to correct painful fingertips after injury. The thickness of the soft tissue of fingertip was measured both preoperatively and postoperatively with simple X-ray. To evaluate the improvement of pain, visual analogue scale(VAS) was used through the direct interview with patients. The average of postoperative follow-up period was 10.9 months. The average of increased soft tissue thickness ratio was 88.4%(2.3mm to 3.8mm). The average of preoperative VAS was 7.6, and postoperative VAS was 3. Dermofat graft on fingertip needs a further long-term follow-up study for the absorption ratio of dermofat, however, this procedure is simple and could be done under local anesthesia, and would be a useful alternative procedure to correct painful fingertips with the soft tissue atrophy after injury.

Role of Dopamine upon Spontaneous Contraction of Isolated Rat Uterus in Diestrus State (Dopamine이 흰쥐 자궁의 자발적 수축에 미치는 영향)

  • Park, Hyoung-Jin;Sim, Yeo-Rim;Jo, Yang-Hyeok
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.103-107
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    • 1983
  • This experiment was undertaken to see whether dopamine has any effect on a uterine function and whether the uterus has a dopamine receptor. We used 14 female rats in the diestrus state which was identified by a vaginal smear. Under ether anesthesia, 3 pieces(1 cm length) from each side of the uterus were dissected out and mounted in 3 tissue chambers (4 cm diameter, 10 cm height) that contained Krebs-Ringer solution. The solution was continuously aerated with 95% $O_2$ containing 5% $CO_2$ and kept $37^{\circ}C$ consistantly during the whole experimental period. The spontaneous contractile activity of the isolated uterus was recorded using a force transducer. After a recovery period of 15 min in the chamber, the following experiments were carried out. In 7 rats, each piece of the uterus was received dopamine at concentrations of $10^{-4}$, $10^{-5}$ or $10^{-6}\;M$ for 10 min and then followed by domperidone at a concentration of $10^{-5}\;M$. In another 7 rats, each piece was received domperidone, a specific peripheral dopamine receptor antagonist, was administered at a concentration of $10^{-5}\;M$ for 5 min prior to dopamine at concentrations of $10^{-4}$, $10^{-5}$, or $10^{-6}\;M$. Dopamine inhibited the spontaneous uterine contraction dose-dependently (r=0.99, p<.01). The inhibited contractility by dopomine was significantly (P<.05) resumed by post-treatment of domperidone. Pre-treatment of domperidone also blocked significantly(p<.05) the inhibitory effect of dopamine. It is concluded from these results that dopamine has inhibitory role upon the spontaneous uterine contraction of the rat in the diestrus state and domperidone antagonized the inhibitory effect of dopamine. These results suggest strongly that dopamine may exert the inhibitory effect via the dopamine receptor in the rat uterus.

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Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report - (유경나사를 이용한 견갑골 관절와 골절의 관절경적 정복 및 내고정 - 증례 보고 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.127-131
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    • 2010
  • Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.