• 제목/요약/키워드: depth of anesthesia

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전신 마취 중 전력스펙트럼 분석을 이용한 마취심도 파라미터 개발 (Development of Parameters on Depth of Anesthesia using Power Spectrum Density Analysis during General Anesthesia)

  • 백승완;예수영;박준모;전계록
    • 한국전기전자재료학회논문지
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    • 제22권6호
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    • pp.537-545
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    • 2009
  • In this paper, new parameters were developed to estimate the depth of anesthesia during a general anesthesia using EEG. Power spectral density(PSD) analysis was used for these parameters because EEG became slow wave during anesthesia. The new parameters were DTR, ATR, TDR, ADR, BTR and BDR applied to PSD. These parameters were compared with SEF which is conventionally used at clinic and confirmed clinical value. As the results, DTR, ATR, TDR, ADR among parameters were not useful compared with SEF but BTR and BDR is valuable for clinic. 15 patents, at pre-operation BDR the value is $265.36{\pm}25.29$, at induction the value is $129.23{\pm}34.92$, at operation the value is $154.99{\pm}38.34$, at awaked the value is $283.83{\pm}39.80$ and at post-operation the value is $234.80{\pm}23.46$. Also at pre-operation BTR value is $183.38{\pm}13.59$, at induction the value is $104.09{\pm}25.11$, at operation the value is $115.38{\pm}23.42$, at awaked the value is $190.33{\pm}23.31$ and at post-operation the value is $172.38{\pm}19.08$. Trend of BDR and BTR is similar to change of SEF, so two parameters are useful. to estimate the depth of anesthesia.

산모의 요추부 경막외강 깊이에 대한 고찰 (A Study on the Depth of the Lumbar Epidural Space from the Skin in Parturients)

  • 박찬흠;송필오;신명근;김인규;이성호
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.73-76
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    • 1997
  • Background : Epidural anesthesia is now accepted as a popular technique for pain relief and anesthesia. However, accidental dural puncture may occur during placement of the epidural needle. This study was undertaken to evaluate difference of the epidural depth between parturients and non-parturients. Method : Eighty non-parturients receiving epidural anesthesia were assigned to group I, and eighty parturients whose body weight had not yet increased over 15 kg from pregnancy were assigned to group II. With patients in lateral decubitus position, 18 guage Tuohy needle was punctured by approaching at $L_{3-4}$ interspace. Epidural space was identified using loss-of-resistance to air technique. Result : Epidural depth was 4.18 cm and 4.25 cm in group I and group II respectively. There was no significant statistical difference in body mass index(BMI) and ponderal index(PI) (p<0.05), nor in epidural depth between the two groups. Conclusion : Epidural needle need not be placed deeper in parturients than in nonparturients.

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Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

  • Swathi Tummalapalli;Ravi Sekhar M;Naga Malleswara Rao Inturi;Venkata Ramana Murthy V;Rama Krishna Suvvari;Lakshmi Prasanna Polamarasetty
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권4호
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    • pp.213-220
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    • 2023
  • Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

HRV 신호의 선형 및 비선형 분석을 이용한 마취심도 평가 (Estimation on the Depth of Anesthesia using Linear and Nonlinear Analysis of HRV)

  • 예수영;백승완;김혜진;김태균;전계록
    • 한국전기전자재료학회논문지
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    • 제23권1호
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    • pp.76-85
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    • 2010
  • In general, anesthetic depth is evaluated by experience of anesthesiologist based on the changes of blood pressure and pulse rate. So it is difficult to guarantee the accuracy in evaluation of anesthetic depth. The efforts to develop the objective index for evaluation of anesthetic depth were continued but there was few progression in this area. Heart rate variability provides much information of autonomic activity of cardiovascular system and almost all anesthetics depress the autonomic activity. Novel monitoring system which can simply and exactly analyze the autonomic activity of cardiovascular system will provide important information for evaluation of anesthetic depth. We investigated the anesthetic depth as following 7 stages. These are pre-anesthesia, induction, skin incision, before extubation, after extubation, Post-anesthesia. In this study, temporal, frequency and chaos analysis method were used to analyze the HRV time series from electrocardiogram signal. There were NN10-NN50, mean, SDNN and RMS parameter in the temporal method. In the frequency method, there are LF and HF and LF/HF ratio, 1/f noise, alphal and alpha2 of DFA analysis parameter. In the chaos analysis, there are CD, entropy and LPE. Chaos analysis method was valuable to estimate the anesthetic depth compared with temporal and frequency method. Because human body was involved the choastic character.

Effects of Isoflurane Anesthesia on Post-Anesthetic Sleep-Wake Architectures in Rats

  • Jang, Hwan-Soo;Jung, Ji-Young;Jang, Kwang-Ho;Lee, Maan-Gee
    • The Korean Journal of Physiology and Pharmacology
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    • 제14권5호
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    • pp.291-297
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    • 2010
  • The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$ $libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

개에서 Propofol 점적투여율 변화에 따른 마취효과 (Comparative Anesthetic Effect as Propofol Infusion Rate During Maintenance of Anesthesia in Dog)

  • 장광호;임재현;장인호
    • 한국임상수의학회지
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    • 제17권1호
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    • pp.109-120
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    • 2000
  • To evaluate anesthetic effecto of propofol infusion after premedication with xylazine, 20 days were randomly assigned 4 groups. Propofol was infused (group 1: 0.2 mg/kg/min, group 2 : 0.4 mg/kg/min, group 3 : 0.6 mg/kg/min, group 4 : 0.8 mg/kg/min) for a period of 90 minute immediately after premedication with xylazine(1 mg/kg) and atropine(0.05mg/kg) under oxygen supplementation. Induction of anesthesia was rapid and smooth providing satisfactory conditions for intubation in all the dogs. No vomiting and cyanosis were observed after induction and during propofol infustion. There was pain reflex in group 1 but not in group 3 and 4. Mean arousal times (mins) were $6.18{\pm}3.65(group 1), 13.07{\pm}5.05(group 2), 22.06{\pm}6.48(group 3) and 23.33{\pm}9.28 (group 4) and Mean walking times were 16.20{\pm}6.15(group 1), 15.80{\pm}4.73(group 2), 28.27{\pm}7.55 (group 3), 39.10{\pm}13.75$ (group 4) respectively. In group 4, body temperature during total infusion period in group 3, 4. Hematologic values (WBC, RBC, PCV) and serum chemistry values(ALT, AST, BUN, creatinite) were monitored before anesthesia, 1 hour and 1 day after termination of infusion postanestesia. No significant changes were monitored in all experimental group. Although propofol infusions of 0.2 mg/kg/min and 0.4mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min proper to provide a light planes for minor surgical procedure during 90 minutes with xylazine premedication.

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완전정맥마취와 휘발성유도/유지마취에서 정량적 뇌파를 이용한 마취심도의 감시 (Monitoring of anesthetic depth with q-EEG (quantitative EEG) in TIVA (total intravenous anesthesia) and VIMA (volatile induction/maintenance anesthesia))

  • 이수한;노규정;정병현
    • 대한수의학회지
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    • 제46권1호
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    • pp.47-55
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    • 2006
  • To evaluate method for monitoring anesthetic depth with quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) and pain score till 100 minutes in beagle dogs anesthetized for 60 minutes with propofol (n = 5, PRO group), isoflurane (n = 5, ISO group) and propofol-ketaminefentanyl (n = 5, PFK group). Raw EEG was converted into 95% spectral edge frequency (SEF) by fast Fourier transformation (FFT) method. We investigated anesthetic depth by comparing relationship (Pearson's correlation) between q-EEG (95% SEF) and pain score. Pearson's correlation coefficients are +0.2372 (p = 0.0494, PRO group), +0.79506 (p < 0.001, ISO group) and +0.49903 (p = 0.0039, PFK group).

뇌파의 바이스펙트럼과 DFA 분석을 이용한 마취심도 측정 (Measuring depth of anesthesia with Bispectrum and DFA analysis of the EEG)

  • 예수영;엄상희
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2015년도 춘계학술대회
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    • pp.397-400
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    • 2015
  • 수술시 시행되는 마취과정에서 마취가 깊지 못해서 깨어나는 각성으로 인하여 환자가 정신적 육체적으로 극심한 고통을 경험할 수 있다. 이러한 상태를 미연에 방지하기 위하여 수술중 마취심도를 측정하여 환자상태를 모니터링하는 것이 필요하다. 본 연구에서는 실제 수술 시 사용 가능한 정량적인 지표 개발의 가능성을 보고자하였다. 이러한 지표로는 뇌파의 DFA에 의한 멱함수 지수와 바이스펙트럼지수들로 수술 중 이들 지표를 관찰하여 마취심도 측정 가능성을 검증하고자 하였다. 실험결과 수술 전단계에서는 바이스펙트럼이 전영역에 나타나고, DFA값은 감소하는 경향을 나타내었다. 수술 중 단계에서는 바이스펙트럼값이 저주파 대역으로 집중되어 나타나고, DFA값은 증가하는 경향을 나타내었다. 수술후 단계에서는 바이스펙트럼과 DFA값 모두 수술전 수준으로 돌아가는 현상을 관찰하였다. 따라서 바이스펙트럼의 피크 분포와 DFA값의 변화 경향은 마취 심도와 상관성이 밀접한 것으로 나타났다.

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A Comparative Study of the Brainstem Auditory-Evoked Response during Medetomidine, Propofol and Propofol-Isoflurane Anesthesia in Dogs

  • Sorin Choi;Myeong-Yeon Lee;Young Joo Kim;Dong-In Jung
    • 한국임상수의학회지
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    • 제40권4호
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    • pp.260-267
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    • 2023
  • Specialized hearing tests for pets are currently in demand. A brainstem auditory evoked response (BAER) test is an objective, non-invasive, and practical electrophysiological method that records electric signals from the peripheral auditory system to the brainstem when an auditory stimulation is provided. In veterinary medicine, sedation or anesthesia is essential for a successful examination. In human medicine, research has established the indications for various sedatives, anesthetics, and drugs according to the depth of anesthesia required. However, in veterinary medicine, there are very few comparative studies on propofol or isoflurane, which are the most common anesthetics used. Therefore, the present study aimed to analyze the difference in BAER test results between sedation with medetomidine, anesthesia using propofol, and inhalation anesthesia with isoflurane after propofol administration. The test was conducted on four healthy adult dogs. There was no statistically significant difference in latency, interpeak latency, or amplitude between the various drugs. The results suggest that a sedative or anesthetic for the administration of a BAER test can be selected according to the patient's needs.

Clinical evaluation of efficacy of transcortical anesthesia for the extraction of impacted mandibular third molars: a randomized controlled trial

  • Demir, Esin;Ataoglu, Hanife
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권1호
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    • pp.9-17
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    • 2020
  • Background: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery. Methods: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer. Results: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013). Conclusion: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.