• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.1
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• pp.19-22
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• 2013

Certain oral surgery can be performed safely under monitored anesthesia care (MAC) with local anesthesia. Several drugs, such as propofol, benzodiazepine, and opioids have been used for MAC either alone or in combination. Benzodiazepine may cause excessive sedation and confusion, and propofol can also result in disorientation and excessive sedation. Low dose propofol anesthesia with the concomitant use of dexmedetomidine is an effective technique for MAC in patients who are scheduled for intraoral surgery.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.407-414
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• 2003

Purpose: The purpose of this study was to discern the effects of music therapy on the patients' level of anxiety and operative satisfaction during cataract surgery under local anesthesia. Method: The subjects for this study were fifty patients. Half of the subjects were categorized as an experimental group and the other half as a control group. All of the subjects were admitted to one hospital in Seoul for cataract surgery. This study was conducted from September 7 to October 2, 2002. The level of anxiety determined by self-reporting anxiety, pulse rate, systolic blood pressure, and diastolic blood pressure, was measured before and after the music therapy. The satisfaction degree was measured after the surgery. The tools for this study were Spilberger's state anxiety inventory and Patient Care Management System. Each patient in the experimental group chose the music used in his/her surgery and it was played through an audio system in the operating room. The data analysis was performed using the SAS/pc+(version 8.0). Results: 1. The anxiety of the experimental group decreased significantly compared to the control group. 2. The pulse rate of the experimental group decreased more than the control group. 3. The blood pressure of the experimental group decreased more than the control group. 4. The operative satisfaction of the experimental group was higher than the control group. Conclusion: According to the previous results, music therapy turned out to be a very efficient way to increase the satisfaction of a cataract patient after surgery by reducing the anxiety and the pulse rate of the patient during an operation with local anesthesia.

• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.97-106
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• 1999

This study was designed to investigate the effect of a hand massage program on anxiety and immune function in patients during cataract surgery. The hand massage program, in this study, consisted of hand massage and hand-holding. The subjects were sixty-three patients, thirty for the experimental and thirty-three for the control group, who were admitted at Kang Nam St. Mary's Hospital for cataract surgery. This study was carried out from December 10, 1997 to February 26, 1998. The level of anxiety as measured by the Visual Analogue Scale, systolic blood pressure, diastolic blood pressure, and pulse rate were measured before, after hand massage, and after hand-holding. Epinephrine, norepinephrine, cortisol, blood sugar levels, neutrophil, lymphocyte, and natural killer cell percentages also were measured before hand massage and five minutes before the end of the operation. Data were analyzed by t-tests, ANCOVA, repeated measures ANOVA, and Bonferroni multiple comparisons. The results were as follows : 1) After hand massage, psychological anxiety levels decreased significantly compared with before hand massage in the experimental group, not in the control group. After hand holding, there were significant decrease in both groups. 2) There were not significant differences on systolic blood pressure, diastolic blood pressure, and pulse rates in both groups. 3) The hand massage program decreased epinephrine, norepinephrine, and cortisol significantly in the experimental group, and increased epinephrine, norepinephrine, and cortisol in the control group. 4) There were no differences in blood sugar levels, neutrophil and lymphocyte percentages in white blood cells after the hand massage program. However, natural killer cells in lymphocytes were significantly increased in the experimental group. These findings indicate that a hand massage program could be a effective nursing intervention in decreasing the psychological and physiological anxiety levels and improving immune function in clients having cataract surgery under local anesthesia.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.84-88
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• 2000

Background: An increase in the maximum level of sensory blockade (MLSB) following an epidural top-up in combined spinal epidural anesthesia (CSE) may be achieved by a volume effect as the volume of local anesthetic compresses the dural sac, by a local anesthetic effect, or by a combination of both effects. This study was conducted to investigate the contribution of each of these effects. Methods: Sixty patients scheduled for lower limb surgery under CSE were randomly allocated to one of three groups of twenty patients each. Using the needle-through needle technique, all patients received a subarachnoid dose of 10 mg hyperbaric 0.5% bupivacaine. At 30 min after subarachnoid injection, an epidural top-up with saline 10 ml (group II) or 0.5% bupivacaine 10 ml (group III) was administered; patients in group I received no epidural top-up. The level of sensory blockade was assessed at 5, 10, 15, 20, 25, 30 min after subarachnoid injection and at 5, 10, 15, 20, 25, 30 min after epidural top-up. Results: There was no significant difference in the MLSB and the onset time of MLSB among group I-III. Conclusions: We concluded that the epidural top-up with saline 10 ml or 0.5% bupivacaine 10 ml which injected at 30 min after subarachnoid injection did not significantly increase the level of subarachnoid block in lower extremity surgical patients.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.276-282
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• 2017

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.236-244
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• 1996

The maxillary sinus elevation for simultaneous placement of dental implants and combination grafts of autogenous bone harvested from the maxillary tuberosity and demineralized freeze dried bone and HA is relatively easy and safely done under local anesthesia in out patients clinic. This article is to introduce the sinus floor elevation method which has been performed to 5 patients in the department of Dentistry/Oral & Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University, from 1993.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.44-50
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• 2008

Background: The use of regional local anesthetics or opioids during laparoscopic cholecystectomy (LC), in combination with general anesthesia, has been investigated in several interventional studies. Methods: We studied a total of 240 (n = 60, each) patients who were undergoing LC, and they received local infiltration and intraperitoneal instillation with normal saline or 0.25% levobupivacaine 60 ml. Group R (S) received infiltration of normal saline 20 ml before incision and at the end of surgery and then 40 ml intraperitoneal instillation after removal of the gall bladder under remifentanil-based anesthesia. Group R (L) received 0.25% levobupivacaine instead of normal saline in the same method like group R (S). Group S (S) received the same method as group R (S) under sevoflurane based anesthesia in place of remifentanil. Group S (L) received 0.25% levobupivacaine instead of normal saline with the same method as group S (S). Pain was assessed on a visual analog scale at 1, 6, 12 and 24 hours after operation. Results: The pain intensity of Group R (L) was significantly lower than that of group R (S), and the the incisional pain of group S (L) was significantly lower than that of group S (S) in the first six hours. The time delay to first operative analgesics in group R (S) and group S (S) was significantly shorter than that of group R (L) and group S (L). Conclusions: Infiltration and instillation of levobupivacaine reduced the postoperative pain and remifentanil did not increase the pain severity and opioid requirement when performing the LC.

• The Journal of the Korean dental association
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• v.44 no.2 s.441
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• pp.139-144
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• 2006

Local anesthesia is routine procedure in dental practices and has several complication. One of them, needle fracture is not uncommon in past, but rare in recent. The number of cases reported in the literature of broken needle in local anesthetic procedure has shown a marked decrease since the use of disposable spiral-constructed dental needle began. This complication results from lack of patient cooperation, inaccurate anesthetic technique, sudden movement of patient, error in the manufacturing procedure, use of short needle, and bending before use. Most common site is pterygomandibular space during inf. alveolar nerve block. In two patients, we removed broken needles under general anesthesia without complication. So we report cases with review of literatures.

• Journal of Periodontal and Implant Science
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• v.39 no.sup2
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• pp.239-251
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• 2009

Purpose: Full-mouth disinfection enables to reduce the probability of cross contamination from untreated pockets to treated ones, for completing the entire SRP under local anesthesia with chlorhexidine as a mouth wash in two visits within 24 hours. This study aimed to compare the clinical effects of modified full-mouth disinfection (Fdis) after 6 months with those of conventional SRP (cSRP). Methods: Thirty non-smoking chronic periodontitis subjects were randomly allocated two groups. The Fdis group underwent the entire SRP under local anesthesia in two visits within 24 hours, a week after receiving supragingival scaling. A chlorhexidine (0.1%) solution was used for rinsing and subgingival irrigation for Fdis. The cSRP group received SRP per quadrant under local anesthesia at one-week intervals, one week after they had received scaling. Clinical parameters were recorded at baseline, after 1, 3 and 6 months. Results: There are significant (P<0.05) decreases in the sulcus bleeding index, and plaque index, and the increases in gingival recession were significantly smaller with Fdis after six months compared with cSRP. There was significant improvement in the probing depth and clinical attachment level for initially medium-deep pockets (4-6mm) after Fdis compared with cSRP. Multi-rooted teeth showed significantly larger attachment gain up to six months after Fdis. Single-rooted teeth showed significantly more attachment gain, 1 and 6 months after Fdis. Conclusions: Fdis has more beneficial effects on reducing gingival inflammation, plaque level, probing depth, gingival recession and improving clinical attachment level over cSRP.