• Journal of Chest Surgery
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• v.47 no.3
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• pp.249-254
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• 2014

Background: Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Methods: One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to $0.8\;{\mu}g/kg/hr$; n=67) or remifentanil (range, 1,000 to $2,500\;{\mu}g/hr$, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care. Results: When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects. Conclusion: This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.

• Korean Journal of Acupuncture
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• v.39 no.3
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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.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.1
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• pp.8-14
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• 2022

Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.348-355
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• 2022

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

• Korean Journal of Health Education and Promotion
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• v.4 no.2
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• pp.46-70
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• 1987

The survey with questionnaire were conducted to grasp the actual condition of four cautious drugs-antibiotics, sedative hypnctics, mincr tranquilizer, analeptics-self -medication behavior through drugstore use and to analyze the primary factors connected with it. The following six objectives were established. 1) To catch the reason why the man who medicate himself buy four cautious drugs at a drugstore, and to know the choice motive of each drug purchased. 2) To grasp the distribution of four cautious drug taken by the man who medicate himself and to analyse the reason of taking the drug. 3) To find out whether the buyer has taken the same drug past and to know the duration and the frequency. 4) To grasp the degree of recognition about four cautious drugs and the attitude toward continuous taking them. 5) To analyze the degree of recognition about the influence on human body and the attitude of medication behavior. 6) To know "the experience of side-effects" and to grasp the kind of the side-effects. The data were collected from 15 drugstores with 677 respondents in seoul from August 17 to september 21, 1987. The following results were obtained. 1) The reasons for drugstore use were first, "for easy access and convenience" (53.7%) second, "for the slightness of illness" (19.9%) third "for the cheap price" (13.2%). According to that result, the factor of "the easy access of drugstore" was most influential. In case of the poor, the factor "for the cheap price "was revealed second (37.3%). And "for the slightness of illness" was second reason in the medically insured (22. 9%), "for the cheap price" was second reason in the others (29%). 2) The kind of drugs purchased were antibiotics (62.8%), analeptics(17.2%), minor tranquilizer(13.3%) and sedative hypnotics (6.7%) on the whole. In teenagers, besides antibiotics the percentage of taking analepits came second (42.4%) and it was revealed that the percentage of sedative hypnotics, minor tranquilizer increase with age. But in proportion to the increase of age, the taking of analeptis decreased. 3) The choice motives of each drug purchased were all different. In case of antibiotics "recommendation of pharmacist" was 39.6%, sedative hypnotics "recommendation of pharmacist" and "my own judgement", 28.9%, respectively, minor tranquilizer "my own judgement", 35.2%. and in case of analeptics "my oun judgement" was most common with 53.5%. 4) The reasons for taking drugs were as follows. antibiotics was taken for the inflammation mitigation of a wound and a swelling (38.5%), sedative hypnotics for the removal of insomnia (97.5%), minor tranquilizer because of restlessness and qloominess(39.3%), and analeptics for the shortening of sleeping hours (35.1%). 5) Those experienced in taking four cautious drugs were 78.2% on the average. It was revealed that antibiotics use duration was "from one week to one month" (38.9%), the frequency was "rarely" (62.1%), sedative hypnotics and minor tranquilizer; "More than three years", (35.7%, 30.4%), respectively, "Somtimes", (43.8%, 35%), respectively. analeptics ; "from one year to three years", (27.6%), "Sometimes", (42.7%). 6) In regard to the source of information in taking drugs, 35.3 percent of male were relied on "recommendation of pharmacist", 32.6 percent of female "my own judgement", There was a difference between below the middle school graduates and over the high school graduates Thease were relied on "recommendation of pharmacist" first, those "my own judgement" first. And "my own judgement" was the first source of specialist(40%), labours(41.4%), salesman(43.5%), and jobless men(36.8%), "recommendation of ralatives on friends" was the first source of students (30.4%), "recommendation of pharmacist" was the first soure of teachers, administrative office workers (39%) and housewives (40.7%). 7) The degree of recognition about four cautious drugs was as follows. "know a little" was (43.0%), "don't know" (30.2%), "know" (26.8%), respectively. In regard to the attitude toward continuous taking them, it was revealed that "I will take it according to circumstamces" was first (56.2%), " I will not take it as possible" was first(56.2%), "I dont know well" (12.9%), "I will take it continuously" (8.3%). 8) About the influence on human body, "if proper, it is effect" was common attitude toward antibiotics (43.6%), "Probably bad influence on the health" was first toward the other drugs (46.2%), In terms of the degree of observance to taking-time and dose of drugs, "suitably" was first (37.3%), "relatively correctly" second (27%), "correctly" (17%). 9) The percentage of four cautious drugs side-effects was 27.5 on the average. The kind of side-effects were eruption and urticaria (28.5%), heart acceleration and so forth. (25.4%), headache and Giddiness, dyspepsia (23%), respectively.

• Korean Journal of Pharmacognosy
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• v.16 no.4
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• pp.233-238
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• 1985

A number of sedative alkaloids were isolated from Sanjoin(酸棗仁), the seeds of Zizyphus vulgaris Lamark var. spinosus Bunge (Rhamnaceae) which is an important Chinese medicinal material used to treat insomnia and sometimes to treat sleepiness. Those compounds were designated as Sanjoinine-A, B, C, D, etc. depending on the order of increasing polarity. Sanjoinine-A, $C_{31}H_{42}N_4O_4$, $mp\;249^{\circ}$, $[{\alpha}]^{27}_D-316$, Sanjoinine-B, $C_{30}H_{40}N_4O_4$, $mp\;212{\sim}4^{\circ}$, Sanjoinene, $C_{29}H_{35}N_3O_4$, $mp\;281{\sim}2^{\circ}$, $[{\alpha}]^{22}_D-272$, Sanjoinine-D, $C_{32}H_{46}N_4O_5$, $mp\;256{\sim}8^{\circ}$, $[{\alpha}]^{22}_D-53.6$, Sanjoinine-F, $C_{31}H_{42}N_4O_5$, $mp\;228{\sim}9^{\circ}$, $[{\alpha}]^{22}_D-215$, and $Sanjoinine-G_1,\;C_{31}H_{44}N_4O_5,\;mp\;236{\sim}8^{\circ},\;[{\alpha}]^{22}_D-68.6$, were found as 14-membered cyclic peptide alkaloids, $Sanjoinine-G_2,\;C_{30}H_{42}N_4O_4,\;mp\;182^{\circ},\;[{\alpha}]^{22}_D-79.2$, as being open chain peptide alkaloid, and Sanjoinine-E, $C_{19}H_{21}NO_2$, $mp\;166^{\circ}$, $[{\alpha}]^{20}_D-146.2$, N-Methylasimilobine, $C_{18}H_{19}NO_2$, $mp\;193{\sim}5^{\circ}$, $[{\alpha}]^{20}_D-204$, Sanjoinine-Ia, $C_{18}H_{19}NO_2$, $mp\;155{\sim}7^{\circ}$, $[{\alpha}]^{20}_D-140$, Sanjoinine-Ib, $C_{19}H_{21}NO_4$, $mp\;184^{\circ}$, Sanjoinine-K, $C_{16}H_{19}NO_3$, $mp\;159{\sim}61^{\circ}$, $[{\alpha}]^{20}_D+35$, Caaverine, $C_{17}H_{17}NO_2$, $mp\;204^{\circ}$, $[{\alpha}]^{20}_D-80$, and Zizyphusine, $C_{20}H_{24}NO_4$, $mp\;214{\sim}6^{\circ}$, $[{\alpha}]^{20}_D+317$ as being aporphine alkaloids. The heat treatment of the cyclic peptide alkaloids produced their isomeric products which showed enhanced sedative activity. The chemical structure of the isomeric products will be discussed.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.579-588
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• 1999

Monitoring of patients is essential in assuring the safety of sedation in the dental office. The purpose of this study was to explore the utilization and preferences of sedation, utilization of monitoring methods, and the preparation for emergencies during sedation. Members of the Korean Academy of Pediatric Dentistry were surveyed(n=245) from 1998. 10. 1 to 1998. 12. 20 to establish current trends in the use of sedation practices and monitoring methods in Korea. Findings of the survey include: 1. Twenty nine percent of pediatric dentists use sedative agents in their practices. Seventy one percent of pediatric dentists do not use any sedative agents in their practices 2. Thirty nine percent of pediatric dentists who use sedative agents do so without monitoring devices 3. Nitrous oxide inhalation sedation was the most frequently utilized sedation method by pediatric dentists and chloral hydrate was the most frequently utilized sedative by pediatric dentists. Pulse oximeter was the most frequently utilized monitoring method during sedation in dental office. 4. Only twenty eight percent of pediatric dentists obtain the informed consent of the child's legal guardian. 5. Only sixty percent of pediatric dentists prepare for emergencies during sedation.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.355-361
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• 2011

Sedative method and its effect are affected by diverse variables: dosage and intake method of drug, weight, gender, patient compliance, sleeping hours prior to procedure, treatment hours, health status, type of used drugs are the factors. This study is conducted with empirical observation that shorter the sleeping hours before the day of chloral hydrate sedation, the effectiveness is larger; and therefore to actually recognize the correlation between chloral hydrate/hydroxyzine sedation and sleeping hours of child patient prior to sedation. The subjects were those children whose sleeping hours were similar to each other at the ages ranging from 2 to 5 years old totaling 37 children. Total 11 of them received pulp treatment. Sedative effect was evaluated by the same assessor with Houpt's rating scale. Sedative effect in relation with prior day's sleeping hours evaluated with simple regression analysis. Sedative effect in relation with pulp treatment was analyzed with independent t-test. Sleeping hours prior to sedation and sedation effect have negative correlation. No significant correlation is found between pulp treatment and sedation effect(p>0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.53-61
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• 2006

When routine behavior control is impossible, midazolam is often used for sedation, because it has wide margin of safety, relatively few side-effects and multiple route of administration. Although intramuscular administration of all administration route is frequently used, it is a major source of anxiety, discomfort, and trauma in children. To the contrary, oral administration of midazolam is easily administered and accepted by children. But, it's therapeutic drug concentration has not been established. The purpose of this study was to compare sedation effect and physiologic parameter of oral midazolam which palliate demerits of intramuscular administration in sedating young pediatric patients with intramuscular midazolam Twelve negative children, mean age 62.5 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study On every visit, one of the following 2 different sedative regimen was given : (1) 0.30mg/kg midazolam by intramuscular administration (2) 0.75mg/kg by oral administration. Physiologic parameter(oxygen saturation, heart rate) was recorded by ten procedure and behavior was videotaped and rated using Ohio State University Behavior Rating Scale and Automated Counting System by one investigator, blind to administration route The analyzed sedative effect of oral midazolam resulted in good sedative effect, comparing to intramuscular route, And there is no statistically difference between oral and intramuscular administration of midazolam (p>0.05).

• Korean Journal of Acupuncture
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• v.27 no.2
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• pp.203-216
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• 2010

Objectives : The purpose of this study is to identify the effect of tonifying or sedative manipulation on LI4 and KI7 for sweet deficiency under cold environment. Methods : The participants were divided into 4 groups; intact group without acupuncture(Intact), acupuncture group inserting straightly with LI4 & KI7 method((LI4-straight KI7-straight), acupuncture group inserting twisting with LI4 tonificaton & KI7 tonificaton method(LI4-tonify KI7-tonify) and acupuncture group inserting twisting with LI4 sedation & KI7 sedation method(LI4-purge KI7-purge). We obtained the baseline data under cold condition with the temperature $14{\pm}1^{\circ}C$. After making the participant staying under cold condition for 10 minute, we measured sweating rate on skin surface and biological responses such as body temperature, oxygen saturation, pulse rate, systolic blood pressure, diastolic blood pressure, deoxy-Hb and oxy-Hb in subcutaneous. Results : The sweating rate on skin surface was not different in all treatment groups compared to the intact group. The body temperature was significantly increased in LI4-straight KI7-straight group compared to the intact group. The oxygen saturation significantly increased in LI4-purge KI7-purge group compared to the intact group. The systolic blood pressure was significantly increased in LI4-purge KI7-purge group compared to the intact group. The deoxy-Hb was significantly decreased in LI4-purge KI7-purge group compared to the intact group. Conclusions : The above results, the effect of LI4, KI7 acupuncture due to the tonifying or sedative manipulation on sweating control could be observed. However, other biological responses with the acupuncture of tonifying or sedative manipulation were giving different expressions. We suggest that continued research of tonifying or sedative manipulation is of importance order to find these expressions.