• 대한치과마취과학회지
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• 제4권1호
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• pp.17-20
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• 2004

Chronic periodontitis is one of the most common disease in clinical dentistry, which needs various surgical interventions to treat the moderate to severe destruction of supporting periodontium. Most patients have fear and anxiety to these surgical procedures and some dentists also have problems to deal with these patients. Applying the conscious sedation technique in outpatient units, periodontists have become to manage their patients successfully without any fear and anxiety and increased the level of patients' satisfaction. Particularly, periodontal treatments require relative long chair-time and patients are usually reluctant to the periodontal instruments used in the oral cavity. This study is focused on the sedation procedure with intravenous midazolam infusioon performed in Department of Periodontology, Ewha Womans University Hospital. The whole procedure of intravenous midazolam sedation is briefly reviewed from patient selection to patient discharge.

• Clinical Endoscopy
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• 제55권5호
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• pp.581-587
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• 2022

Procedural sedation has become increasingly common in endoscopy. Sedatives and analgesics induce anxiolysis and amnesia. In addition, an appropriate level of sedation is necessary for safe procedures including therapeutic endoscopy. Midazolam and propofol are the most commonly used drugs in sedative endoscopy. In recent years, the need to ascertain the safety and effectiveness of sedation has increased in practice. Therefore, new sedatives and analgesic drugs for optimal sedative endoscopy, have recently emerged. This article reviews the characteristics of sedatives and analgesics, and describes their clinical use in gastrointestinal endoscopy.

• 대한치과의사협회지
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• 제56권1호
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• pp.49-57
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• 2018

The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.

• 대한치과마취과학회지
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• 제6권2호
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• pp.65-81
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• 2006

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.251-255
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• 2015

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.

• 대한치과마취과학회지
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• 제5권1호
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• pp.6-14
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• 2005

Chronic periodontitis is one of the most common diseases in clinical dentistry, which requires various surgical interventions to treat the moderately to severely destructed supporting periodontium. Most patients have anxiety and fear to these surgical procedures and dentists often have problems dealing with these patients. By applying the conscious sedation technique in outpatient units, periodontists have become able to manage their patients successfully with less anxiety or fear. Also, we have experienced the increased level of patients' satisfaction. Generally, periodontal treatments are time consuming procedures and patients are usually reluctant to the periodontal instruments. This study is focused on the sedation procedure with intravenous midazolam infusion performed in Department of Periodontology of Ewha Womans University Hospital. Using questionnaires, we evaluated 80 randomly selected patients for the anxiolytic effect of intravenous midazolam. Anxiety control using IV sedation was very helpful in performing various periodontal reconstructive and advanced surgical procedures in implant dentistry.

• 대한소아치과학회지
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• 제45권1호
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• pp.75-81
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• 2018

최근 진정법은 소아치과의 영역에서 협조도가 부족한 어린이를 대상으로 흔히 사용되고 있다. 본 연구의 목적은 5년간 단국대학교 치과병원 소아 치과에서 시행된 진정법에 대한 정보를 다각도로 분석하는 것이다. 종합의료정보시스템(Order Communication System)을 사용하여 2011년 1 월부터 2015년 12월까지 단국대학교 치과병원 소아치과에서 시행된 치과 치료에 대한 정보를 수집하였다. 수집된 정보는 환자의 성별, 연령, 진정법 시행여부 및 약물 종류, 시술 날짜 및 유형이었다. 전체 증례에 대한 의식하진정법 사용 증례의 비율은 2011년에서 2014년까지 지속적으로 감소하였다. 반면 전신마취 증례의 빈도는 점진적으로 증가하였다. 의식하진정 유도를 위한 방법 중 midazolam 근육주사와 아산화질소 흡입진정의 사용빈도는 최근 증가하였다. 의식하진정법의 사용은 환아의 나이가 만3세 이상인 경우 그 빈도가 크게 감소하였으나, 전신마취는 전 연령대에서 사용 빈도가 비슷하였다. 환아가 여아인 경우보다 남아인 경우에, 그리고 수복치료만을 시행하는 경우보다 신경치료를 함께 시행하는 경우에 더 깊은 진정 상태에서 치료를 시행하려는 경향이 관찰되었다. 또한 진정의 심도가 깊을수록 수복치료 이후 90일 이내에 재치료를 시행하는 빈도는 감소하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권6호
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• pp.527-545
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• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• Korean Journal of Acupuncture
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• 제39권3호
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• pp.91-96
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• 2022

Objectives : The purpose of this study was to characterize the stimulation intensity in acupuncture manipulation techniques for tonification and sedation therapy. Methods : To describe the level of stimulation used in acupuncture manipulation techniques for tonification and sedation therapy, we reviewed the acupuncture manipulation techniques described in classical medical textbooks. Results : Based on the patients' conditions and pattern identification, acupuncture manipulation strategies for tonification and sedation therapy were chosen. For example, the excess condition was treated with sedative therapy, and the deficiency condition was treated with tonification therapy. For tonification therapy, weak to modest stimulation was applied in acupuncture manipulation techniques, whereas intense stimulation was applied for sedative therapy. Even though the intensity of acupuncture stimulation was chosen based on the clinical examination, deqi sensation is a crucial component of acupuncture treatment, and during acupuncture practice, the practitioner should choose the right intensity of acupuncture stimulation based on deqi response in each patient. Conclusions : We concluded that the tonifying and sedative effects of acupuncture treatment are related to the stimulation intensity of acupuncture manipulation techniques. For individualized medicine, the right amount of acupuncture stimulation should be administered based on the patients' conditions and responses, such as deqi responses.

• 대한소아치과학회지
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• 제32권3호
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• pp.444-453
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• 2005

진정요법은 소아치과에서 사용하는 보상, 속박, 체계적 탈감작법(말-시범-시행), 친밀감 같은 통상의 방법으로는 환자의 반응이 개선되지 않아 일반적인 치과치료가 불가능할 때 사용하는 행동조절법이다. 최근 국내에서도 진정요법을 이용하는 사례가 증가하는 추세이나 그 기준이나 방법들에 대한 연구는 매우 부족한 상태이다. 미국소아치과학회의 진정요법에 관한 기준이 있기는 하지만 국내의 상황이 미국과 다르므로 한국에서의 연구가 필요하다. 이에 저자는 국내에 거주하고 있는 소아치과의사들을 대상으로 국내 소아치과에서의 진정요법 현황에 대한 실태를 조사, 그 결과를 정리하여 향후 소아치과 임상에서의 진정요법에 대한 임상 기준을 정하는데 기여하고자 국내에 거주하고 있는 대한소아치과학회 회원 573명을 대상으로 진정요법 사용 실태에 관한 설문지를 발송하여 이 중 회신을 한 220명의 설문을 분석하여 다음의 결과를 얻었다. 1. 응답자의 약 66%가 진정요법을 사용하고 있다고 답했다. 진정요법에 관한 이전 연구 결과와 비교해 볼 때, 국내 소아치과에서 진정요법의 사용빈도가 증가하였다. 2. 진정요법으로 치료를 결정하게 된 요인은 행동조절, 치료내용과 양, 보호자의 요구, 내원횟수, 전신질환의 순서이었다. 3. 진정요법으로 치료받는 환자의 연령은 만 3세가 가장 많았고, 만 4-5세, 만 2세 미만, 만 6-10세, 만 10세 이상의 순서로 조사되었다. 4. 진정요법 시 chloral hydrate는 60-70mg/kg, hydroxyzine은 10-40mg/kg(25mg/kg)을 사용하고 있었고, 경구 투여가 가장 선호하는 약물투여 경로였다. 5. 진정요법 시 사용하는 환자감시 방법은 피부나 손톱색 등의 관찰을 포함한 환자 평가와 맥박 산소측정기(pulse oximeter)를 통한 환자감시를 선호하는 것으로 조사되었다. 6. 진정요법을 사용하고 있다고 응답한 사람의 약 56%에서 심폐소생술 교육을 받은 것으로 조사되었다.