• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.513-521
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• 2018

Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.170-175
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• 2008

The present study was performed to investigate the anesthetic or analgesic effect of tiletamine-zolazepam (TZ) and electro acupuncture analgesia (EAA) in cats. Twelve healthy cats were randomly assigned to receive either TZ or EA. TZ group cats with weight of $3.65{\pm}0.48kg$ received 10.0 mg/kg of TZ intramuscularly. EA group cats with weight of $3.62{\pm}0.52kg$ received 5V, 30Hz and 60 minutes of EA. The acupoints used were Tian-ping (GV-5, +), Bai-hui (GV-20, -). Therefore, after and before experiment, some serum chemistry profiles (alkaline phospatase, aspartate aminotransferase, alanine aminotransferase, glucose and total protein) and change of vital signs (rectal temperature, heart rate, respiratory rate) were examined. All cats were examined pre, and 5, 25, 65 and 105 minutes after administration of TZ or operation of EA. The cats in EA group showed a smaller change in rectal temperature, heart rate and respiratory rate than in the TZ group (p<0.05). In both groups, total protein concentration was constant throughout the period of anesthesia, and the serum glucose increased gradually throughout the period of anesthesia. However, the cats in EA group showed a smaller change in alkaline phospatase, aspartate aminotransferase and alanine aminotransferase within the limit of safety than in the TZ group (p<0.05). While coming to induction, the TZ group took a mean $2.4{\pm}0.7$ minutes to achieve sternal recumbency, compared with $10.5{\pm}2.1$ minutes by the EA group, and $3.2{\pm}0.6$ minutes to achieve lateral recumbency, compared with $18.8{\pm}1.9$ minutes by the EA group (p<0.05). When recovering from anesthesia, the TZ group took $164.3{\pm}17.9$ minutes to achieve sternal position time, compared with $67.7{\pm}4.6$ minutes by the EA group, and $202.0{\pm}15.7$ minutes to stand, compared with $73.0{\pm}6.1$ minutes for the EA group (p<0.05). In this study, the cats anesthetized with EA showed a more rapid recovery rather than the cats under TZ anesthesia. Also, there do not appear to be any negative physiologic effects associated with acupuncture-induced surgical analgesia. So, it was considered that EAA may be used effectively in shock, debilitated cats, as compared to TZ.

• Journal of Pharmaceutical Investigation
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• v.35 no.6
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• pp.417-422
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• 2005

This study was aimed to design and formulate the moisture-activated patches containing ofloxacin and lidocaine for antibacterial and local anesthetic action. The solubility of lidocaine at $32^{\circ}C$ in various vehicles decreased in the rank order of PG $759.5{\pm}44.5\;mg/mL$ > PGL > IPM > PEG 300 > PEG 400 > Ethanol > PGMC > DGME > PGML > OA > $Captex^{\circledR}\;300$ > $Captex^{\circledR}\;200$ > water $(4.0{\pm}0.1\;mg/mL)$. Ofloxacin revealed very low solubility, which the highest solubility was obtained from PEG 400 $(18.7{\pm}6.3\;mg/mL)$ among the vehicles used. The addition of lactic acid increased the solubility of ofloxacin dramatically; the solubility at 5% lactic acid was $133.7{\pm}9.7\;mg/mL$. As $2-hydroxypropyl-{\beta}-cyclodextrin$ was added at the concentrations of 40, 80, 120, 160 and 200 mM, the solubilities of lidocaine and ofloxacin were enhanced up to three and two times, respectively, with concentration-dependent pattern. Gel intermediates for filmtype patches were prepared with mucoadhesive polymer, viscosity builders, lidocaine or ofloxacin at pH values from 5 to 7. Gels were cast onto a release liner and dried at room temperature. Dried patch was attached onto an adhesive backing layer, thus forming a patch system. Patches containing a single drug component were characterized by in vitro measurement of drug release rates through a cellulose barrier membrane. The release study was carried out at $37^{\circ}C$ using a Franz-type cell. Receptor solutions were isotonic phosphate buffers (pH 7.4). Samples $(100\;{\mu}L)$ were taken over 24 hours and quantitated by a verified HPLC method. The releases from all tested were proportional to the square root of time. The release rates were 0.9, 157.3 and $281.7\;{\mu}g/cm^{2}/min^{1/2}$ for the lidocaine patches and 19.8,37.2 and $50.7\;{\mu}g/cm^{2}/min^{1/2}$ for the ofloxacin patches at the concentrations of 0.3, 0.5 and 1 %, respectively. The release rates were dose dependent in both drug patches $(R^{2}\;=\;0.9077\;for\;lidocaine;\;R^{2}\;=\;0.9949\;for\;ofloxacin)$ and those were also thickness-dependent $(R^{2}\;=\;0.9246\;for\;lidocaine;\;R^{2}\;=\;0.9512\;for\;ofloxacin)$.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.1
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• pp.1-7
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• 2013

Background: Intravenous sedation is effective for dental patients who are anxious. Recently, target-controlled infusion (TCI) has begun to be used widely to administer and titrate propofol and remifentanil during sedation. To investigate the effect and safety of the pharmacologic agents used in anesthetic department, we performed a retrospective study. Methods: Retrospective study of a series of dental procedure under intravenous sedation performed in department of anesthesiology in Dental Hospital of Dankook University was carried out with propofol or propofol/remifentanil between January and August 2011 and January and April 2012. All patients received oxygen by nasal cannula. The average propofol and remifentanil target was 0.5 ${\mu}g/ml$ and 1.0 ng/ml, respectively using a TCI pump. The average peripheral oxygen saturation ($SpO_2$), heart rate, blood pressure, respiratory rate, nasal end-tidal $CO_2$ were recorded at 5-10 minute intervals. The age, gender, weight, procedure and sedation time, type of procedure were also recorded. Results: We included 22 cases of 19 adults (group A) and 6 cases of children (group B). In group A, 4 patients received propofol (group A-P), and 15 patients received propofol with remifentanil (group A-PR). In group B, 6 patients received propofol only. The mean age of group A was 41.1 years old and that of group B was 9.5 years old. No clinically significant complications were noted. There were no case of de-saturation <90%. The median respiratory rate was 13.1 (range 6 to 36) in group A and 19 (range 13 to 25) in group B. The median end tidal $CO_2$ was 36.7 mmHg(range 8 mmHg to 56 mmHg) in group A and 41.7 mmHg (range 30 mmHg to 53 mmHg) in group B. Conclusions: Based on our results, dental sedation using propofol/remifentanil in adult and propofol in children with TCI pump seems to appear as a safe and effective procedure while performing dental procedure.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.131-135
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• 2008

Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.468-478
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• 2009

This research was performed to provide basic data for the development of infection related dental hygiene studies by surveying the current condition of recognition among students in the department of dental hygiene toward hospital infection management while receiving the following results by using a personal self-administered survey method targeting 303 students in the department of dental hygiene from certain areas. 1. With the current condition of recognition on the sanitization and sterilization of instruments among students in the department of dental hygiene(study), the rate at which surgical instruments are to be sterilized with autoclaves was 79.9% which was relatively higher than other instruments while it was shown that prosthetic instruments for treatment was 56.4%, conservative instruments for treatment was 51.8%, and ultrasonic scaler tip was 51.1% while the way syringe tips(36.1%) and the dental anesthetic apparatus(27.9%) were revealed to require sanitization by alcohol. 2. The 'hand wash' area was the highest with 4.71 while the 'materials and environment management' area and 'equipment management' area appeared high respectively with 4.43 and 4.41. 3. With the current condition of recognition on equipment management, 'equipments used for contagious patients are separately washed after a one-time use and must be sterilized or separated-and-discarded' was the highest with 4.82 while 'sterilization equipments with humidity or water on it are considered contaminated and are not used' showed the lowest recognition level with 3.90. 4. Regarding the current condition of materials and environment management, 'contagious and general trash are separated and discarded' was the highest with 4.70 while 'the refrigerator for medicine storage is cleaned on a regular basis once a month' was revealed as the lowest with 4.11. 5. With the current condition of recognition on hand washing, 'one must wash their hands after coming in contact with contagious patients, was the highest with 4.90 while washing hands after taking off gloves' appeared as the lowest with 4.51 point. To conclude department of dental hygiene there is to infection management and necessary about organization disinfecting and pasteurization to strengthen an education in order raising a stamp helping practical ratio about the infection management which whole, is from presence at a sickbed and connection does and about the infection management which is substantial and educational program development leads feed with the fact that deepening studying which is continuous must become accomplished becomes.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.336-342
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• 2010

The purpose of this study was to determine the antagonistic effects of flumazenil on anesthesia induced with tiletamine/zolazepam in dogs. The anesthetic effects (sedation, analgesic, muscle relaxation, posture and auditory response score), vital signs (heart rate, respiratory rate and rectal temperature) and blood biochemistry (glucose (GLU), total protein (TP), alanine aminotransferase (ALT), aspartate aminotransferase (AST)) were examined as indicators of the antagonistic effects. A total of 6 clinically healthy mongrel dogs were used in this study. The dogs in TZ group received administration of tiletamine/zolazepam 10 mg/kg IV. The dogs in TZF group received administration dose of TZ 10 mg/ kg IV followed by the administration of flumazenil 0.1 mg/kg 20 minutes after administering a TZ 10 mg/kg dose. There were significant differences in the recovery of anesthesia between the groups. The GLU level in the TZF group after the administration of flumazenil was significantly higher than that of the TZ group. There was a larger change in the HR in the TZF group than in the TZ group until 30 minutes after flumazenil administration. The sternal recumbency, standing and walking times of the TZF group were faster than those of the TZ group. In conclusion, flumazenil showed antagonistic effect against tiletamine/zolazepam in dogs. When recovering from anesthesia, flumazenil reduced sternal recumbency, standing and walking times.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.485-493
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• 2007

Purpose: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats(RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern(0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. Methods: These phases include before, during and after tooth extraction or anesthesia or something.36 patients' stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system(ANS) which represents the level of stress. Results: All HRV parameters including HF(high frequency), LF(low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. Conclusion: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest?after the?anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.

• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.283-289
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• 2002

The effects of electroacupuncture (EA) at SP-6 with different durations on the minimum alveolar concentration (MAC) and on the cardiovascular system were evaluated in dogs under isoflurane anesthesia. Eight healthy male beagles were randomly assigned to four study groups (n = 5/group) with washout period of 7 days for recovery and anesthetic withdrawal between experiments. Four study groups were control, nonacupoint electrical stimulation (NA), EA for 30 minutes (SP-6) and continuous EA for 70 or 90 minutes (SP-6C). For the nonacupoint electrical stimulation group, needles were inserted into the nonacupoint at the muscle bellies of left triceps brachii and right quadriceps femoris. MAC and cardiovascular parameters were determined after EA at SP-6 acupoint and at nonacupoint. Thirty minutes of EA and continuous EA until re-determination of MAC at SP-6 acupoint lowered the MAC of isoflurane by 21.3$\pm$8.0% and 16.1$\pm$4.6%, respectively (p<0.05). The decrements in MAC values were not significantly different between two EA groups. However, electrical stimulation of nonacupoint did not induce a significant change in MAC. In SP-6 and SP-6C groups, significant changes in cardiovascular parameters were not observed. These results indicate that EA at SP-6 have an advantage in isoflurane anesthesia in terms of reducing the requirement for anesthetics and minimizing cardiovascular side effects. EA for 30 minutes at maximum might be the sufficient time to produce acupuncture analgesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.229-236
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• 2023

Background: Local anesthesia has been reliably used to control pain during dental procedures and is important in pediatric dentistry. However, children occasionally complain of prolonged numbness after dental treatment, leading to several problems. Studies conducted to reverse the effect of local anesthesia using phentolamine mesylate and photobiomodulation therapy (PBM) are encouraging but limited. PBM is a type of light therapy that utilizes visible and near-infrared non-ionizing electromagnetic spectral light sources. Hence, this study used this modality to compare the reversal of local anesthesia at two different wavelengths. This study compared the effect of PBM at 660 and 810 nm wavelengths on the reversal of soft tissue local anesthesia using a diode LASER in pediatric dentistry. Method: Informed consent and assent were obtained, and the participants were then divided randomly into three groups of 20 children each: control group-without LASER irradiation, LASER irradiation at 660 nm, and LASER irradiation at 810 nm. Sixty children aged 4-8 years with deciduous mandibular molars indicated for pulp therapy were administered an inferior alveolar nerve block. After 45 min of injection, a duration that was similar to the approximate duration of treatment, they were exposed to 660- and 810-nm LASER irradiation according to their groups until reversal of local anesthesia was achieved. The control group did not undergo LASER irradiation. The reversal of the soft tissue local anesthetic effect was evaluated using palpation and pin prick tests every 15 min, and the LASER irradiation cycle continued until reversal of the soft tissue local anesthesia was achieved. Results: A significant reduction of 55.5 min (27.6%) in the mean soft tissue local anesthesia reversal time was observed after the application of 810 nm wavelength PBM and 69 min (34.7%) after 660 nm wavelength LASER irradiation. Conclusion: PBM with a 660 nm wavelength was more effective in reducing the mean soft tissue local anesthesia reversal duration, and thus can be used as a reversal agent for soft tissue local anesthesia in pediatric dentistry.