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Dexmedetomidine during suprazygomatic maxillary nerve block for pediatric cleft palate repair, randomized double-blind controlled study

  • Mostafa, Mohamed F.;Aal, Fatma A. Abdel;Ali, Ibrahim Hassan;Ibrahim, Ahmed K.;Herdan, Ragaa
    • The Korean Journal of Pain
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    • v.33 no.1
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    • pp.81-89
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    • 2020
  • Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

Inferior alveolar nerve block by intraosseous injection with Quicksleeper at the retromolar area in mandibular third molar surgery

  • Sovatdy, Sam;Vorakulpipat, Chakorn;Kiattavorncharoen, Sirichai;Saengsirinavin, Chavengkiat;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.6
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    • pp.339-347
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    • 2018
  • Background: There are many techniques of inferior alveolar nerve block injection (IANBI); one among them is the computer-assisted intraosseous injection (CAIOI). Here we aim to evaluate the effectiveness of CAIOI with $Quicksleeper^{(R)}$ in mandibular third molar surgery. Methods: This study is a clinical, single-blind, randomized, split-mouth, controlled trial including 25 patients (10 males and 15 females, mean age 21 years). The patients underwent surgical removal of bilateral mandibular third molars with two different IANBI techniques. One side was injected using $Quicksleeper^{(R)}$, and the other side was injected using a conventional IANBI. Both techniques used one cartridge (1.7 ml) of 1:100,000 epinephrine 4% articaine. A supplementary injection was used if necessary. All volumes of anesthetic agent used were recorded. Statistical analysis was performed using paired t-test and Wilcoxon test. Results: This research showed that CAIOI has faster onset and shorter duration of action than IANBI (P < 0.05). The pain was similar in both techniques. In the CAIOI group, one-third of the cases could be completed without additional anesthesia. The remaining two-thirds required minimal supplementary volume of anesthesia. The success rates were 68% for CAIOI and 72% for IANBI, respectively. Conclusion: CAIOI is an advantageous anesthetic technique. It can be used as an alternative to conventional IANBI for mandibular third molar surgery.

The analgesic efficacy of the continuous adductor canal block compared to continuous intravenous fentanyl infusion with a single-shot adductor canal block in total knee arthroplasty: a randomized controlled trial

  • Kim, Min Kyoung;Moon, Hyoung Yong;Ryu, Choon Gun;Kang, Hyun;Lee, Han Jun;Shin, Hwa Yong
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.30-38
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    • 2019
  • Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

A High-speed Masking Method to protect ARIA against Side Channel Analysis (부채널 분석에 안전한 고속 ARIA 마스킹 기법)

  • Kim, Hee-Seok;Kim, Tae-Hyun;Ryoo, Jeong-Choon;Han, Dong-Guk;Hong, Seok-Hie
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.18 no.3
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    • pp.69-77
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    • 2008
  • In the recent years, power attacks were widely investigated, and so various countermeasures have been proposed. In the case of block ciphers, masking methods that blind the intermediate results in the algorithm computations(encryption, decryption, and key-schedule) are well-known. Applications of masking methods are able to vary in different block ciphers, therefore suitable masking methods about each ciphers have been researched. Existed methods of ARIA have many revisions of mask value. And because existed masking methods pay no regard for key schedule, secret information can be exposed. In the case of ARIA, this problem is more serious than different block ciphers. Therefore we proposes an efficient masking scheme of ARIA including the key-schedule. Our method reduces time-complexity of ARIA encryption, and solve table-size problem of the general ARIA masking scheme from 256*8 byte to 256*6 byte.

SITM Attacks on Skinny-128-384 and Romulus-N (Skinny-128-384와 Romulus-N의 SITM 공격)

  • Park, Jonghyun;Kim, Jongsung
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.32 no.5
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    • pp.807-816
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    • 2022
  • See-In-The-Middle (SITM) is an analysis technique that uses Side-Channel information for differential cryptanalysis. This attack collects unmasked middle-round power traces when implementing block ciphers to select plaintext pairs that satisfy the attacker's differential pattern and utilize them for differential cryptanalysis to recover the key. Romulus, one of the final candidates for the NIST Lightweight Cryptography standardization competition, is based on Tweakable block cipher Skinny-128-384+. In this paper, the SITM attack is applied to Skinny-128-384 implemented with 14-round partial masking. This attack not only increased depth by one round, but also significantly reduced the time/data complexity to 214.93/214.93. Depth refers to the round position of the block cipher that collects the power trace, and it is possible to measure the appropriate number of masking rounds required when applying the masking technique to counter this attack. Furthermore, we extend the attack to Romulus's Nonce-based AE mode Romulus-N, and Tweakey's structural features show that it can attack with less complexity than Skinny-128-384.

A Block based 3D Map for Recognizing Three Dimensional Spaces (3차원 공간의 인식을 위한 블록기반 3D맵)

  • Yi, Jong-Su;Kim, Jun-Seong
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.49 no.4
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    • pp.89-96
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    • 2012
  • A 3D map provides useful information for intelligent services. Traditional 3D maps, however, consist of a raw image data and are not suitable for real-time applications. In this paper, we propose the Block-based 3D map, that represents three dimensional spaces in a collection of square blocks. The Block_based 3D map has two major variables: an object ratio and a block size. The object ratio is defined as the proportion of object pixels to space pixels in a block and determines the type of the block. The block size is defined as the number of pixels of the side of a block and determines the size of the block. Experiments show the advantage of the Block-based 3D map in reducing noise, and in saving the amount of processing data. With the block size of $40{\times}40$ and the object ratio of 30% to 50% we can get the most matched Block-based 3D map for the $320{\times}240$ depthmap. The Block-based 3D map provides useful information, that can produce a variety of new services with high added value in intelligent environments.

Fault-Tolerant Adaptive Routing : Improved RIFP by using SCP in Mesh Multicomputers (적응적 오류 허용 라우팅 : SCP를 이용한 메쉬 구조에서의 RIFP 기법 개선)

  • 정성우;김성천
    • Journal of KIISE:Computer Systems and Theory
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    • v.30 no.11
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    • pp.603-609
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    • 2003
  • Adaptive routing methods are studied for effective routing in many topologies where occurrence of the faulty nodes are inevitable. Mesh topology provides simplicity in implementing these methods. Many routing methods for mesh are able to tolerate a large number of faults enclosed by a rectangular faulty block. But they consider even good nodes in the faulty block as faulty nodes. Hence, it results the degradation of node utilization. This problem is solved by a method which transmits messages to destinations within faulty blocks via multiple “intermediate nodes”. It also divides faulty block into multiple expanded meshes. With these expanded meshes, DAG(Directed Acyclic Graph) is formed and a message is able to be routed by the shortest path according to the DAG. Therefore, the additional number of hops can be resulted. We propose a method that reduces the number of hops by searching direct paths from the destination node to the border of the faulty block. This path is called SCP(Short-Cut Path). If the path and the traversing message is on the same side of outside border of the faulty block, the message will cut into the path found by our method. It also reduces the message traverse latency between the source and the destination node.

An Area-Efficient Design of Merged TEA Block Cipher for Mobile Security (모바일 보안용 병합 TEA 블록 암호의 면적 효율적인 설계)

  • Sonh, Seungil;Kang, Min-Goo
    • Journal of Internet Computing and Services
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    • v.21 no.3
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    • pp.11-19
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    • 2020
  • In this paper, a merged TEA block cipher processor which unifies Tiny Encryption Algorithm(TEA), extended Tiny Encryption Algorithm(XTEA) and corrected block TEA(XXTEA) is designed. After TEA cipher algorithm was first designed, XTEA and XXTEA cipher algorithms were designed to correct security weakness. Three types of cipher algorithm uses a 128-bit master key. The designed cipher processor can encrypt or decrypt 64-bit message block for TEA/XTEA and variable-length message blocks up to 256-bit for XXTEA. The maximum throughput for 64-bit message blocks is 137Mbps and that of 256-bit message blocks is 369Mbps. The merged TEA block cipher designed in this paper has a 16% gain on the area side compared to a lightweight LEA cipher. The cryptographic IP of this paper is applicable in security module of the mobile areas such as smart card, internet banking, and e-commerce.

Determination of Adequate Entry Angle of Lumbar Sympathetic Ganglion Block in Korean

  • Kim, Won-Ho;Kim, Sang-Kwon;Lee, Chul-Joong;Kim, Tae-Hyeong;Sim, Woo-Seok
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.11-17
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    • 2010
  • Background: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. Methods: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. Results: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was $30.5{\pm}0.4^{\circ}$ and entry point was $7.7{\pm}0.2\;cm$ and $6.7{\pm}0.1\;cm$ lateral from midline in males and females respectively. Conclusions: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.

The Standardization of Developing Method of 3-D Upper Front Shell of Men in Twenties (20대 성인 남성 상반신앞판현상의 평면 전개를 위한 표준화 연구)

  • Cui, Ming-Hai;Choi, Young-Lim;Nam, Yun-Ja;Choi, Kueng-Mi
    • Fashion & Textile Research Journal
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    • v.9 no.4
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    • pp.418-424
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    • 2007
  • The purpose of this study is to propose a standard of converting 3D shape of men in twenties to 2D patterns. This can be a basis for scientific and automatic pattern making for high quality custom clothes. Firstly, representative 3D body shape of men was modeled. Then the 3D model was divided into 3 shells, front, side and back. Among them, the front shell was divided into 4 blocks by bust line and princess line. Secondly, curves are generated on each block according to matrix combination by grid method. Then triangles were developed into 2D pieces by reflecting the 3D curve length. The grid was arranged to maintain outer curve length. Next, the area of developed pieces and block were calculated and difference ratio between the block area and the developed pieces' area is calculated. Also, area difference ratio by the number of triangles is calculated. The difference ratio was represented as graphs and optimal section is selected by the shape of graphs. The optimal matrix was set considering connection with other blocks. Curves of torso upper front shell were regenerated by the optimal matrix and developed into pieces. We validated it's suitability by comparing difference ratio between the block area and the developed pieces' area of optimal section. The results showed that there was no significant difference between block area and the pieces' area developed by optimal matrix. The optimal matrix for 2D developing could be characterized as two types according to block's shape characteristics, one is affected by triangle number, the other is affected by number of raws more than columns. Through this study, both the 2D pattern developing from 3D body shape and 3D modeling from 2D pattern is possible, so it's standardization also possible.