• Title/Summary/Keyword: Post anesthesia

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IMMEDIATE LIVER FUNCTION AFTER ENFLURANE OR ISOFLURANE ANESTHESIA IN ORTHOGNATHIC SURGICAL PATIENTS. (악교정수술 환자에 있어서 Enflurane, isoflurane 흡입마취제가 간기능에 단기간 미치는 영향)

  • Chang, Hyun-Ho;Kim, Jae-Seung;Kang, Jae-Hyun;Lee, Seung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.4
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    • pp.344-348
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    • 2001
  • Isoflurane and enflurane are currently used on orthognathic surgery in Korea. Since starting to use enflurane and isoflurane in orthognathic surgery, we have questioned their effect on liver function. Many studies have reported liver function after enflurane and isoflurane anesthesia. Although both enflurane and isoflurane are less hepatotoxic than halothane, some cases of liver dysfunction have been reported after enflurane and isoflurane anesthesia. And, we know that isoflurane is less hepatotoxic than its predecessors, enflurane. But, fulminant liver failure and necrosis were also reported after isoflurane anesthesia. The purpose of this study was to compare immediate liver function in healthy orthognathic surgical patients receiving enflurane or isoflurane anesthesia. To assess the effect of enflurane and isoflurane on liver function, we measured pre-and post-operative serum concentrations of aspartate aminotransferase(AST), and alanine aminotransferase(ALT), alkaline phosphatase(ALP), total bilirubin(Tbil).

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Comparison of Postoperative Pain and Nausea and Vomiting between Desflurane and Desflurane-remifentanil Anesthesia for Gynecologic Laparoscopic Surgery (부인과 복강경 수술 대상자에서 Desflurane 마취와 Desflurane-remifentanil 병용마취 시 수술 후 통증과 오심.구토의 비교)

  • Lee, In-Suk;Kim, Yun-Mi
    • Women's Health Nursing
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    • v.21 no.1
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    • pp.1-10
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    • 2015
  • Purpose: The purpose of this study was to compare desflurane anesthesia with desflurane-remifentanil anesthesia by measuring postoperative pain, nausea and vomiting after gynecologic laparoscopic surgery. Methods: Data were collected using a random double blind method. The experimental group treated with desflurane-remifentanil anesthesia had a total of 25 patients. The control group had 20 patients who were treated with desflurane anesthesia. Pain (VAS), pushing PCA button, nausea and vomiting (VAS) were assessed at PACU (Post Anesthesia Care Unit) arrival, 10 min, 20 min, 30 min in PACU and 2 hrs, 6 hrs, 24 hrs, 48 hrs in ward. INVR was assessed at 24 hrs. Extra analgesics and extra antiemetics were measured in PACU and the ward. Data were analyzed using t-test and repeated measure using ANOVA. Results: The experimental group presented with more postoperative pain (F=7.55, p<.001) than the control group. The experimental group took more extra analgesics in PACU and pressed the PCA button more often for 6 hours. The experimental group complained more postoperative nausea (F=2.11, p=.043) than the control group and took extra antiemetics during postoperative period of 24 hours. Conclusion: We conclude that desflurane-remifentanil anesthesia needs better management than desflurane anesthesia due to increased pain, nausea & vomiting after gynecologic laparoscopic surgery.

A Evaluation Parameter Development of Anesthesia Depth in Each Anesthesia Steps by the Wavelet Transform of the Heart Rate Variability Signal (HRV 신호의 웨이브렛 변환에 의한 마취단계별 마취심도 평가 파라미터 개발)

  • Jeon, Gye-Rok;Kim, Myung-Chul;Han, Bong-Hyo;Ye, Soo-Yung;Ro, Jung-Hoon;Baik, Seong-Wan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2460-2470
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    • 2009
  • In this study, the parameter extraction for evaluation of the anesthesia depth in each anesthesia stages was conducted. An object of the this experiment study has studied 5 adult patients (mean $\pm$ SD age:$42{\pm}9.13$), ASA classification I and II, undergoing surgery of obstetrics and gynecology. Anaesthesia was maintained with Enflurane. HRV signal was created by R-peak detection algorithm form ECG signal. The HRV data were preprocessing algorithm. It has tried find out the anesthesia parameter which responds the anesthesia events and shows objective anesthesia depth according to anesthesia stage including pre-anesthesia, induction, maintenance, awake and post-anesthesia. In this study, proposed algorithm to analysis the HRV(heart rate variability) signal using wavelet transform in anesthesia stage. Three sorts of wavelet functions applied to PSD. In the result, all of the results were showed similarly. But experiment results of Daubeches 10 is better. Therefore, this parameter is the best parameter in the evaluation of anesthesia stage.

Does the presence and amount of epinephrine in 2% lidocaine affect its anesthetic efficacy in the management of symptomatic maxillary molars with irreversible pulpitis?

  • Singla, Mamta;Gugnani, Megha;Grewal, Mandeep S;Kumar, Umesh;Aggarwal, Vivek
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.39-47
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    • 2022
  • Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, 𝛘2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

Management of anxiety using eye movement desensitization and reprocessing therapy in children undergoing extraction: a randomized controlled pilot study

  • Namita Kalra;Apoorva Rathore;Rishi Tyagi;Amit Khatri;Deepak Khandelwal;Padma Yangdol
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.347-355
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    • 2023
  • Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

Telephone follow-up care for disabled patients discharged after receiving dental treatment under outpatient general anesthesia

  • Chi, Seong In;Lee, Soo Eon;Seo, Kwang-Suk;Choi, Yoon-Ji;Kim, Hyun-Jeong;Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Lee, Eun-Hee;Oh, Aram;Kwon, Suk Jin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.1
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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.

Analysis of Complications of Ambulatory General Anesthesia after Discharge in Patients Who are Taking Anticonvulsant (항경련제를 복용하고 있는 지적장애 환자의 외래전신마취 하 치과치료 후 합병증 발생 조사 연구)

  • Cha, Min-Joo;Seo, Kwang-Suk;Kim, Mi-Seon;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.95-100
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    • 2014
  • Background: About 60% of patients with epilepsy showed a variety of complications after returning home. The purpose of this study is to get further information and to help in the anesthetic management of the disable patients with epilepsy. Methods: After searching the outpatient anesthesia list of Seoul National University Dental Hospital clinic of the disabled from September 2010 to March 2012, we found total 83 patient cases who were taking antiepileptic drugs. A nurse of anethesiology department called to the patient's home after general anesthesia and got surveys with questionnaires form filled with complications at home. We enrolled total of 51 patients who agreed to participate this survey. And we also reviewed pre-anesthesia evaluation sheet, anesthesia record, and recovery and discharge record. Results: 11 of 51 (21.6%) patients had seizure convulsion at home within 1 weeks. 33.4% of patients who had at least once seizure attack per week had a seizure attack within 3 days. And 50% of once a month frequency patients had a seizure attack within 1 week. 33% of 1 - 3 seizure attacks per year patient group had a convulsion within 1 week. But there was no seizure attack within 1 week in whom had no seizure attack history during more than 1 year. Conclusions: After dental treatment, patient taking anticonvulsant have so many complications-especially seizure, more than we respected. We need more research about handle these problems.

Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

  • Naveen, Naik B;Jaiswal, Manoj Kumar;Ganesh, Venkata;Singh, Ajay;Meena, Shyam Charan;Amburu, Vamsidhar;Soni, Shiv Lal
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.357-367
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    • 2022
  • Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

The Effects of Music Therapy on Anxiety, Sedation, and Stress Responses of Patients Undergoing Surgery with Spinal Anesthesia (음악요법이 척추마취 하 수술 대상자의 불안, 진정상태 및 스트레스 반응에 미치는 효과)

  • Jeong, Gye Seon;Kang, Younhee
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.525-535
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    • 2016
  • Purpose: This study was conducted to examine the effects of music therapy on anxiety, sedation, and stress responses of patients during surgery with spinal anesthesia. Methods: A quasi-experimental design with a non-equivalent control group pre-post test was used. There were 55 adults over 19 years of age scheduled for a lower leg surgery with spinal anesthesia: 27 in the treatment group and 28 in the comparison group. Each subject in the treatment group identified their music preference which was used during the period of surgery which usually lasted, 61 minutes. Data were analyzed using chi-square, Fisher's exact test, independent t-test and repeated measured ANOVA. Results: There were significant reported differences in levels of anxiety, sedation, and stress responses which were measured by plasma cortisol levels, heart rate, and respiratory rate. The findings of all the variables were effectively decreased among those in the treatment group than the comparison group. Conclusion: The preference based music therapy may be useful as a non-pharmacological intervention.

Effect of Favorite Music Therapy on Stress Response in Patients Undergoing Hysterectomy (선호음악요법이 자궁절제술 환자의 스트레스 반응에 미치는 효과)

  • Yang, Jung Lim;Yoo, Kwang Soo
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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    • pp.30-39
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    • 2017
  • Purpose: The aim of this study was to evaluate the effects of favorite music therapy on the stress response of hysterectomy patients undergoing general anesthesia. Methods: Date were collected from June 29, 2015 to January 18, 2016 and the participants were 79 hysterectomy patients (experimental group 40 and control group 39). The experimental group listened to their favorite music through earphones from the moment they entered the surgical waiting room until they exited from the post anesthesia care unit. Results: There were statistically significant differences in anxiety (F=15.92, p<.001), systolic blood pressure (F=4.23, p=.008), diastolic blood pressure (F=3.07, p=.033), and heart rate (F=19.93, p<.001) between participants in the experimental group and the control group according to measurement times. Conclusion: The study results show that favorite music therapy considering patients' preferences is effective in reducing anxiety among patients undergoing a hysterectomy under general anesthesia, thus leading to a stable change in their blood pressure and heart rate.