• Title/Summary/Keyword: Regional Anesthesia

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A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic

  • Shin, Bisol;Yoo, Seunghoon;Kim, Jongsoo;Kim, Seungoh;Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.203-208
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    • 2016
  • Background: In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods: This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results: Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was $132.7{\pm}77.6min$, and the mean duration of treatment was $101.9{\pm}71.2min$. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions: Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

Nursing Needs for Elderly Patients with Regional Anesthesia during Operation (부위마취 수술 노인환자의 수술 중 간호요구)

  • Eom, Hea-Kyoung;Ko, Sung-Hee;Lee, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.16 no.5
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    • pp.351-360
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    • 2016
  • Purpose: The purpose of this study was to identify the nursing needs of elderly patients who got a surgical operation under regional anesthesia(spinal, epidural, nerve block). Methods: The participants were 126 elderly patients who completed a questionnaire. The data were collected October 1 and October 31, 2012, and analyzed using descriptive statistics, t-test and ANOVA, $Scheff{\acute{e}}$ test. Results: The mean score for the nursing needs of elderly patients administered regional anesthesia during surgery was $3.08{\pm}0.38$, The scores for specific nursing needs were as follows: educational needs ($3.47{\pm}0.50$), spiritual needs ($3.37{\pm}0.78$), physical needs ($3.31{\pm}0.46$), emotional needs ($2.72{\pm}0.50$), and environmental needs ($2.51{\pm}0.47$). There were significant differences in nursing needs relative to gender, religion, and spouse status. Additionally, there were significant differences in nursing needs according to surgery department, the length of time the surgery, and the ASA(American Society of Anesthesiologists) physical classification. of the operation-related characteristics. Conclusion: When caring for elderly patients during the surgery, nurses must provide adequate information about the surgery and anesthesia. Further studies are needed to develop and evaluate nursing interventions to provide quality surgical care for the elderly patients.

Dobutamine-Induced Perioperative Anaphylaxis in a Dog

  • Jeong, Youngeun;Jang, Yunseol;Moon, Changhwan;Jeong, Jaemin;Roh, Yoonho;Lee, Haebeom;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.37 no.3
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    • pp.145-148
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    • 2020
  • A 9-years old spayed female Maltese was referred for the treatment of mass on the right 1st mammary gland and acute weight bearing lameness of right hindlimb. It was diagnosed as malignant mammary tumor and cranial cruciate ligament rupture of right stifle joint. Right upper regional mastectomy followed by cranial closing wedge osteotomy (CCWO) of the right tibia were planned for the present problems. Preanesthetic work-up did not show any remarkable abnormalities. Forty-five minutes after induction of anesthesia dobutamine was administered at a rate of 5 ㎍/kg/min by constant rate infusion due to gradual decrease of blood pressure below MAP 60 mmHg during surgical procedure. Despite of the increase of dobutamine infusion rate up to 20 ㎍/kg/min, blood pressure didn't recover. At the end of regional mastectomy generalized skin redness and eyelid edema were identified. Anesthesia was stopped and CCWO procedure was cancelled. To recover from the anaphylactic reactions dexamethasone and diphenhydramine were administered. After about one hour, the patient completely recovered from hypotension and anaphylactic reactions. After 4 weeks, intradermal skin test (IDST) was performed for all the drugs used during anesthesia. Only dobutamine showed positive reaction in IDST. Therefore, dobutamine was considered as the causative agent of anaphylaxis in this patient during the anesthesia. In case of perioperative anaphylactic reaction, postoperative investigation should be performed to identify causative agent and to provide safe recommendations for future anesthetic procedure.

Physical Therapy and Rehabilitation of Complex Regional Pain Syndrome in Shoulder Prosthesis

  • Celik, Derya;Demirhan, Mehmet
    • The Korean Journal of Pain
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    • v.23 no.4
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    • pp.258-261
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    • 2010
  • We report a 66-year-old woman with complex regional pain syndrome (CRPS) 1 treated with combined medical and active physical therapy. She was diagnosed with CRPS 1 following partial shoulder prosthesis due to proximal humerus fracture. Despite continuous medication and physical therapy, there was no improvement in her pain and functional outcome. Her overall pain was decreased by stellate ganglion block 3 times in two weeks conducted during the second month of the follow-up period. Following the ganglion blockades, pain and the other symptoms were decreased intermittently but range of motion (ROM) and functional status were not satisfied as much as expected. After the third month of follow-up, her passive and active ROM of the shoulder joint was increased after application of manipulation under general anesthesia. In conclusion, because CRPS 1 remains one of the most difficult pain syndromes, early diagnosis and treatment are important to have adequate functional results from physical therapy. Manipulation under general anesthesia may be an additional effective treatment tool to obtain functional improvement in some patients diagnosed with CRPS 1.

Effects of Early Oral Feeding versus Delayed Oral Feeding on Bowel Function, Gastrointestinal Complications and Surgical Recovery after Cesarean Section under Regional Anesthesia: Systematic Review and Meta-Analysis (부위마취로 제왕절개 수술을 받은 산모의 조기 경구섭취가 장 기능, 위장관 합병증 및 수술 후 회복에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, HyoJin;Jeon, YeongKyung;Yoon, SoYoung;Lee, GeumMoon
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.732-745
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    • 2021
  • Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

Unilateral Paraparesis after Cesarean Section under Epidural Anesthesia -A case report- (경막외 마취하 제왕절개술 후에 발견한 일측 부전마비 -증례 보고-)

  • Lee, Jeong-Min;Lee, Gwan-Woo;Kang, Bong-Jin;Kim, Dong-Hee
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.253-256
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    • 2001
  • One of the most serious complications of regional anesthesia is a neurological deficit. Although such a problem is very rare, obstetric patients may develop paresthesia and motor dysfuntion during the postoperative period in association with number of other factors, including direct nerve trauma, equipment problems, adhesive arachnoiditis, anterior spinal artery syndrome, epidural hematoma or abscess and adverse drug effect. We experienced a case of unilateral paraparesis following epidural anesthesia with 20 ml of 0.75% ropivacaine and $25{\mu}g$ of fentanyl in an obstetric patient.

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Study on application of surgical therapeutic method of foot diseases and foot anesthesia technique in cattle (소 발굽병의 외과적 치료법 및 발굽마취법 확립에 관한 연구)

  • Jeong, Soon-wuk;Yun, Suk-jung
    • Korean Journal of Veterinary Research
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    • v.39 no.1
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    • pp.240-246
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    • 1999
  • forty-five claw lamed cows with pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa were treated surgically through resection of necrotic tissues, currettage, antibiotics application, and compressive bandage, under retrograde intravenous regional anesthesia of claw. At 7 days postoperation were showed lameness score 0, absense of swelling of extremitis, without fistulation and purulent exudate in wound. Mean duration time of action of local anesthetic drug was 75 minutes and mean operation time for treatment of pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa was 35 minutes, 20 minutes, and 21 minutes, respectively.

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Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

  • Tae-Yeong Kim;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.339-346
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    • 2022
  • Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

Development of Local Drug Delivery System: Prolonged Sciatic Nerve Blockade From Biodegradable Microspheres

  • Lim, Jeong-Ok
    • Journal of Pharmaceutical Investigation
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    • v.25 no.3
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    • pp.33-35
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    • 1995
  • Microspheres containing tetracaine or bupivacaine with poly-lactic-glycolic acid were prepared with a range of compositions. Using the rat scicatic nerve model in vivo it was found that prolonged blockade for periods of 2-7 days. depending on composition variables. Polymer-local anesthetics microspheres are feasible delivery vehicle for prolonged regional nerve blockade.

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The Effect of Stellate Ganglion Block for Controlling Postoperative Pain after the Shoulder Joint Surgery (견관절 수술 시 성상신경절 차단이 술 후 통증에 미치는 영향)

  • Park, Chai Geun;Kim, Jong Sun;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.197-201
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    • 2006
  • Background: There are cases in which shoulder pain persists long after shoulder joint surgery and this pain can not be reduced by intravenous patient controlled analgesia (IVPCA). Our purpose was to evaluate the effect of stellate ganglion block (SGB) on postoperative shoulder pain and also to investigate the effect of preventive SBG on complex regional pain syndrome (CRPS). Methods: Forty patients, who were evaluated to ASA class 1 and 2 and who were scheduled for shoulder joint surgery under general anesthesia, were randomly divided into 2 groups. The experimental group of patients (n = 20) received SGB with 0.5% mepivacaine 8 ml after induction of general anesthesia. The control group of patients (n = 20) received only general anesthesia. Their postoperative pain was assessed using the visual analog scale (VAS) at 30 min, 1, 2, 6, 12, 24 and 48 hours postoperatively. Whenever patients wanted supplemental analgesia, diclofenac sodium 75 mg was injected intramuscularly and the need for supplemental analgesia was recorded. Results: The experimental group of patients had significantly lower pain scores at 30 min, 1, 2 and 6 hours and also significantly lower analgesic requirement at 1, 2 and 6 hours. Conclusions: We found SGB was effective for controlling postoperative pain after shoulder joint surgery. Also, we could expect that SGB reduced the incidence of CRPS.