• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.59-67
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• 2023

General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.425-451
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• 2022

Objectives: To review trends of clinical trials on Korean medicine treatments for postoperative sleep improvement. Methods: We searched randomized controlled trials (RCTs) on Korean medicine treatments for postoperative sleep improvement from ten domestic and foreign databases. Sample sizes, diseases, types of operation, diagnosis tools, pattern identification, interventions, outcome measurements, and main results of included studies were extracted and analyzed. Results: A total of 20 RCTs were selected. Most studies were published in China. The most common target disease was cancer, followed by cardiovascular disease. Most studies lacked detailed description regarding participants such as onset, duration of sleep disturbance, and preoperative sleep issues. Herbal medicine was the most frequently used in 12 studies. The most commonly used prescription was Suanzaoren decoction. The effectiveness of Korean medicine treatment on improving postoperative sleep was found to be significant in most studies. Conclusions: Korean medicine treatments might be effective in postoperative sleep improvement. However, the quality of included studies was low. Therefore, further well-designed research studies are needed to provide high quality clinical evidence on Korean medicine treatments for postoperative sleep improvement.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.69-76
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• 2012

Purpose: Most of postoperative patients experience pain, state anxiety and sleep disturbance. These problems negatively influence the recovery of postoperative patients. So alleviating these problems has been one of the nurses' central roles. The purpose of this study was to examine the effects of back massage on pain, state anxiety and quality of sleep of postoperative gastrectomy patients. Methods: A non-synchronized non-equivalent control group pre and post-test design was used. The research instruments used in this study were the Numerical Rating Scale (NRS) for pain, the State-Anxiety Inventory (STAI) for anxiety and the Verran and Synder-Halpern scale for quality of sleep. The subjects were patients admitted to a university hospital located in D city. Twenty-nine patients in the experimental group had a 10 minute manual back massage stimulation for 5 days from the 1st day to the 5th day after their operation, and 25 patients in the control group did not. Results: The degree of pain was significantly reduced according to post operation day and quality of sleep was significantly increased. However state anxiety was not significantly reduced. Conclusion: Back massage is a partially effective nursing intervention for postoperative patients with gastrectomy who experience pain and sleep disturbance.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.203-215
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• 2023

Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R² and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R² value was 0.27 and in set II, LightGBM was the best model with the highest R² value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R² value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.

• 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 Korean Neurosurgical Society
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• v.61 no.5
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• pp.600-607
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• 2018

Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.55-59
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• 2000

Background: Intrathecal injection of morphine is widely used in the management of postoperative pain because it provides long-lasting analgesia. Intramuscular caroverine and tiaprofenate are used to produce postoperative pain relief. This study was designed to evaluate the analgesic efficacy and quality of sleep achieved with intrathecal morphine and those of intramuscular caroverine and tiaprofenate in transurethral resection of the prostate (TURP). Methods: Forty patients undergoing elective TURP were randomly allocated into 2 groups as follows: Group M (n=20); 0.25 mg of morphine hydrochloride mixed in 7.5 mg of 0.5% hyperbaric bupivacaine was administered at the time of induction of spinal anesthesia. Group S (n=20); 7.5 mg of 0.5% hyperbaric bupivacaine was administered intrathecally and caroverine and tiaprofenate intramuscularly at every 8 hr and 12hr postoperatively for management of postoperative pain. We evaluated the analgesic efficacy with visual analog scale (VAS), quality of sleep, and side effects. Results: VAS at 6, 12 and 24 hours after operation were significantly less (p<0.01) in the group M than in the group S. Group M was superior to group S with respect to quality of sleep (p<0.01). In the group M, the incidence of nausea was 30% (6/20) and that of pruritus was 35% (7/20) and clinical respiratory depression did not occur. Conclusions: Intrathecal 0.25 mg morphine provides good postoperative analgesic effect. but intramuscular caroverine and tiaprofenate does not.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.1
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• pp.114-116
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• 2008

Mania in psychiatry describes not only the state of temporary elation of the mood but also of the general mental function such as contents of a thought, thinking process, motivation, enthusiasm, interest, behavior, slumber and physical activities. The time of period when the above changes of mood, mental and behavioral disorder appear is called a manic episode. Postoperative mania is very rare and it has been reported only 5 times in english literature. It's an extremely rare case which has not yet been reported in Oral and Maxillofacial surgery. Patients normally deny the symptoms and it is easy to miss the diagnosis since the patient tends to seem content and happy. Patients show the following initial symptoms of mania - postoperative insomnia, atypical gregariousness, euphoria and unstability. Patients who are not disaffected with insomnia can also be included.

• Sleep Medicine and Psychophysiology
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• v.1 no.2
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• pp.117-124
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• 1994

Obstructive Sleep Apnea Syndrome(OSAS), that is a complex disease of neuromuscular, respiratory and cardiovascular system, can be cured by various treatment such as weight control, medical and surgical intervention. As most of OSAS may be caused by various anatomical abnormalities, preoperative evaluation for exact anatomical site of obstruction must be needed. And various diagnostic procedures such as fiberoptic nasopharyngoscopy, Mueller test, cinefluoroscopy, cephalometry, computerized tomography, polysomnography would be used for this purpose. Uvulopalotopharyngplasty is currently the most popular method for the patient with OSAS among various surgical maneuvers and is very effective for the relieving the symptoms as like snoring, daytime somnolence, and nocturnal restlessness etc. Although subjective improvement is not compatible with it's objective assessment in postoperative evaluation for it's results, uvulopalatopharyngoplasty could be a recommandable surgical procedure because of it's ample effectiveness in promoting symptom improvement without any risk of serious complications.

• Journal of Rhinology
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• v.25 no.2
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• pp.99-102
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• 2018

Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a 40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presented with swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computed tomography. The patient was carefully monitored under conservative care and discharged without complications. Although subcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management, in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incision along the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase in intrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed with meticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complications and, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.