• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.278-290
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• 1997

The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.

• 대한의용생체공학회:의공학회지
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• 제28권6호
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• pp.750-755
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• 2007

The linear SEF (Spectral Edge Frequency) parameter and spectrum analysis method can not reflect the non-linear of EEG. This method can not contribute to acquire real time analysis and obtain a high confidence in the clinic due to low discrimination. To solve the problems, the development of a new index is carried out using the bispectrum analyzing the EEG including the non-linear characteristic. At the bispectrum analysis of the 2 dimension, the most significant's power spectrum density peaks appeared much at the specific area in awake and anesthesia state. Because many peaks are showed at the specific area in the frequency coordinate, these points are used to create the new index. Range of the index is 0-100. At the anesthesia, the index is 20-50 and at the awake, the index is 90-60. New index can discriminate the awake and anesthesia state.

• 한국임상수의학회지
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• 제39권5호
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• pp.226-234
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• 2022

To evaluate butorphanol and tramadol as adjuvants to lidocaine in dogs undergoing mandibular nerve block. Fifteen beagles were allocated to groups based on the following treatments: lidocaine alone (L group), lidocaine + butorphanol (LB group), or lidocaine + tramadol (LT group). After mandibular nerve block with opioids as an adjunct to local anesthetics, the onset time, duration of action, and depth of anesthesia were evaluated using a quantitative method through neuromuscular blockades (NMBs) monitoring. The onset time of nerve block was 4.60 ± 2.06 min, 2.00 ± 0.00 min, and 2.60 ± 1.62 min in the L, LB, and LT groups, respectively; however, there was no statistically significant difference. The duration of nerve block was 111.88 ± 34.78 min, 302.00 ± 76.72 min, and 260.40 ± 49.88 min in the L, LB, and LT groups, respectively, with a significant difference between L and LB groups. The LB group demonstrated a more profound depth of anesthesia compared to the L and LT groups. In this study, using a quantitative method through NMBs monitoring, it was demonstrated that lidocaine and butorphanol in combination can increase the duration of nerve block and more profound the depth of anesthesia rather than lidocaine alone. Additionally, the combined use of lidocaine and opioids presented an objective indicator that could provide a more clinically stable nerve block.

• 한국정보통신학회논문지
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• 제19권6호
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• pp.1471-1476
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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 모니터링 하는 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.

• Korean Journal of Anesthesiology
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• 제71권6호
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• pp.447-452
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• 2018

Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%. Results: BIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: -0.847, CSI: -0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 ($R^2=0.905$, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% ($R^2=0.559$, 0.540). However, the linearity and slope were decreased in 6% and 8% ($R^2=0.163$, 0.014). Conclusions: CSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.

• 한국임상수의학회지
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• 제8권1호
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• pp.81-91
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• 1991

This study was carried out to investigate the effects of intravenous drip with ketamine hydrochloride and its application for control depth and maintenance of anesthesia in dogs. Changes of blood pressure, vital signs, blood gas and anesthetic state were observed in this study. The obtained were summerized as follows ; 1. Changes of blood pressure and heart rate after intravenous drip anesthesia with ketamine hydrochloride were observed with significant increase in all group ; group II (0.135m81k9/min), group III (0.269mg/kg/min) and group IV(0.538mg/kg/min). These conditions were maintained unchangeably until 160 minutes after administration in all group. This may be indicated that there were no side effects on account of ketamine accumulation. 2. There were irregular respiration, pain reflex, Jaw tone reflex and vomition probability in the anesthetic conditions of group II The anesthetic conditions of group III were rarely shown as mentioned above. Awakening time and recovery time of group H were more prolonged 21 minutes and 27 minutes respectively than those of group III. These experimental data suggested that the optimal dosage of intravenous drip anesthesia of ketamine Hcl was 0.269mg/kg/min.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2002년도 하계종합학술대회 논문집(5)
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• pp.289-292
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• 2002

In this study, we measure and analyzed variation of EEG signal by anesthesiologist progress step. In an experiment, the EEG signal was acquired and analyzed as 5 steps(prior surgical operation, during induction, surgical operation, awakening, posterior surgical operation). As a result, we confirm the anesthesiologist progress phase, concluded the possibility of anesthesia depth because using SEF and MF, and Delta ratio confirmed that can presume operating patient's consciousness state.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.540-545
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• 2012

Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. Methods This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 ${\mu}g/mL$ remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 ${\mu}g/mL$ and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Results Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Conclusions Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.307-312
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• 2017

Background: The aim of this study was to estimate the optimal depth of nasotracheal tube placement. Methods: We enrolled 110 patients scheduled to undergo oral and maxillofacial surgery, requiring nasotracheal intubation. After intubation, the depth of tube insertion was measured. The neck circumference and distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch were measured. To estimate optimal tube depth, correlation and regression analyses were performed using clinical and anthropometric parameters. Results: The mean tube depth was $28.9{\pm}1.3cm$ in men (n = 62), and $26.6{\pm}1.5cm$ in women (n = 48). Tube depth significantly correlated with height (r = 0.735, P < 0.001). Distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch correlated with depth of the endotracheal tube (r = 0.363, r = 0.362, and r = 0.546, P < 0.05). The tube depth also correlated with the sum of these distances (r = 0.646, P < 0.001). We devised the following formula for estimating tube depth: $19.856+0.267{\times}sum$ of the three distances ($R^2=0.432$, P < 0.001). Conclusions: The optimal tube depth for nasotracheally intubated adult patients correlated with height and sum of the distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch. The proposed equation would be a useful guide to determine optimal nasotracheal tube placement.

• Journal of Oral Medicine and Pain
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• 제31권1호
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• pp.59-67
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• 2006

발치 등 치과치료 후에 발생한 하악신경의 감각이상(이감각증)으로 인해 발음문제를 호소하는 환자들이 있지만, 감각신경의 이상과 운동구어능력 사이의 직접적인 관련성에 대해서는 논란이 존재한다. 본 연구의 목적은 편측 하악 신경의 마취로 인한 일시적인 감각손상이 운동구어능력에 미치는 영향을 평가하여 감각이상과 운동구어능력과의 관련성을 밝히고자 하였다. 본 연구는 단국대학교 치과대학에 재학중인 학생들 중 표준어를 구사하는 건강한 지원자 10명 (남:녀=7:3)을 대상으로 통법에 따라 우측 하치조신경, 설신경, 장협신경의 마취를 시행하였다. 주관적인 평가를 위해 대상자들은 마취전, 마취 후 30초, 30분, 60분, 90분, 120분, 150분, 180분에 마취 심도와 주관적으로 느끼는 발음불편감의 정도를 VAS로 기록하게 하였고, 운동 구어능력을 객관적으로 평가하기 위해 선택된 문장과 단어를 각각의 경과시간 마다 피검자에게 읽도록 하여 녹음하고 채취된 녹음샘플을 Computerized Speech $Lab^{(R)}$, Model 4500을 사용하여 발화속도, 교호운동력, 억양, 음성진전, 발음을 평가하였다. 실험 결과, 마취에 의한 주관적인 발음불편감 정도는 마취 후 60분에서 최고조에 이르고 이후 점점 감소하는데, 이는 주관적 마취 심도의 증감과 상당한 상관관계가 있었다. 주관적 마취 심도와 마취에 대한 발음불편감 정도에 따르는 다중선형회귀 분석결과, 연속발화기본 주파수에서만 통계학적으로 유의한 차이를 보였고 발화속도, 교호운동력, 음성진전 등 나머지 항목에서는 통계학적으로 유의한 차이를 보이지 않았다. 또한, 마취 전후 발음상의 변화도 관찰되지 않았다. 즉, 편측 하악 전달마취는 마취의 증감에 따라 주관적인 발음불편은 변화하지만, 객관적 항목에서 운동구어능력에는 뚜렷한 영향을 미친다고 볼 수는 없었다. 그러므로 편측 하악의 감각손상이 운동구어능력에 뚜렷한 영향을 미친다고 볼 수는 없는 것으로 사료된다.