• Journal of Korean Academy of Dental Administration
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• v.9 no.1
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• pp.32-37
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• 2021

Many approaches to local anesthesia have been studied in dentistry. In this study, we introduce a new local anesthetic method, "Point-Inject Technique (PIT)", and compare it with traditional injection techniques. The PIT method utilizes both the vasoconstrictive and antinociceptive properties of local anesthetics as well as the application of controlled pressure during injection, reducing the time to complete anesthesia. Fifty patients were selected as the experimental group who were anesthetized using PIT, and the other 50 patients were selected as the control group using the direct injection method with a carpool syringe. The PIT group received 0.25 cartridges of 2% lidocaine with 1:100,000 epinephrine. The control group received 1.5~2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Both groups were asked to mark the intensity of the pain caused by anesthesia using the Numeric Pain Rating Scale. The average time to recover from anesthesia was 40 minutes in the experimental group and 90 minutes in the control group. Additionally, 96% of the experimental group reported feeling no pain, while 78% of the control group reported having some form of pain during injection. The PIT method reduced both the reported pain scores of patients as well as time to recover from local anesthesia than the widely-used syringe injection method.

• Journal of Chest Surgery
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• v.54 no.3
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• pp.200-205
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• 2021

Background: Various methods have been used to reduce postoperative pain after thoracic surgery. However, these methods may affect the patient's respiratory response and delay recovery from anesthesia. We aimed to evaluate the effects of fentanyl and remifentanil during extubation after video-assisted thoracic surgery (VATS). Methods: This study included 45 randomly-selected male patients who underwent VATS for pneumothorax between July 2011 and August 2012. We divided the participants into 3 groups: the F group, which received a bolus injection of 1.0 ㎍/kg of fentanyl; the R1 group, which received a 0.04 ㎍/kg/min remifentanil infusion; and the R2 group, which received a 0.08 ㎍/kg/min remifentanil infusion. Hemodynamics, pain, cough, consciousness level, and nausea were assessed for each group. Results: The number and severity of coughs were lower in the R1 and R2 groups than in the F group, and there were no differences between the R1 and R2 groups. Respiratory depression and loss of consciousness were not observed in any of the patients, and there were no differences in hemodynamics. Conclusion: In comparison with fentanyl, remifentanil did not result in a wide fluctuation of blood pressure and heart rate upon emergence from general anesthesia. Moreover, remifentanil contributed to cough suppression and postoperative pain control. Remifentanil seems to be a safe and effective analgesic after VATS.

• Clinical Endoscopy
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• v.51 no.6
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• pp.552-557
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• 2018

Although colonoscopy was originally a diagnostic imaging procedure, it has now expanded to include an increasing range of therapeutic interventions. These procedures require precise maneuvers of instruments, execution of force, efficient transmission of force from the operator to the point of application, and sufficient dexterity in the mobilization of endoscopic surgical instruments. The conventional endoscope is not designed to support technically demanding endoscopic procedures. In case of colonoscopy, the tortuous anatomy of the colon makes inserting, moving, and orientating the endoscope difficult. Exerting excessive pressure can cause looping of the endoscope, pain to the patient, and even perforation of the colon. To mitigate the technical constraints, numerous technically enhanced systems have been developed to enable better control of instruments and precise delivery of force in the execution of surgical tasks such as apposing, grasping, traction, counter-traction, and cutting of tissues. Among the recent developments are highly dexterous robotic master and slave systems, computer-assisted or robotically enhanced conventional endoscopes, and autonomously driven locomotion devices that can effortlessly traverse the colon. Developments in endoscopic instrumentations have overcome technical barriers and opened new horizons for further advancements in therapeutic interventions. This review describes examples of some of these systems in the context of their applications to advanced therapeutic colonoscopy.