• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.1
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• pp.75-80
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• 2024

Dental sedation plays a pivotal role in alleviating patient anxiety during various procedures. Remimazolam, a benzodiazepine derivative, stands out for its distinctive attributes, particularly its rapid onset of sedation coupled with a brief duration, making it an invaluable option for dental applications. The patient was admitted for the extraction of impacted third molars via patient-controlled sedation and not only demonstrated stable vital signs but also expressed a high level of satisfaction with the procedure. An in-depth analysis of plasma remimazolam concentrations and changes in the Patient State Index revealed negative correlation patterns, highlighting the inherent potential of remimazolam in achieving effective sedation. This expanded research scope aims to provide a more nuanced understanding of the pharmacological responses to remimazolam in dental sedation scenarios. This case report offers valuable insights into the evolving landscape of dental sedation methodologies and paves the way for a more informed and evidence-based approach to the use of remimazolam in patient-controlled sedation.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.49 no.6
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• pp.334-338
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• 2000

Even though it is not practical, yet there is a trend of the researches related to the anesthesia on the determination of depth of anesthesia and level of consciousness in the view point of neurophysiological aspects. That is, quantification of physiological signals which represent human brain function and pharmacological response could be used to find the level of consciousness based on the changes in physiological signals. This research was performed to analyze the relationship between parameters extracted from LAEP(long latency auditory evoked potential) and the amount of sedatives injected to the patients. Seventeen patients were participated for the experiment. Two different sedatives, midazolam and diazepam, were injected intramuscularly, and LAEPs caused by 1KHz and 2KHz auditory tone bust were obtained. It was found that amplitude of extracted parameters from LAEP, N100 and P300, were reduced as dose of sedatives were increased. Results of this study could be used for extracting more meaningful index and establishing algorithm for predicting changes of level of consciousness induced by sedatives.

• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.2
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• pp.118-121
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• 2008

Background: This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery. Methods: The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured. Results: In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was $4.2{\pm}3.2\;cm$. The ML of difficult intubation cases was $10.1{\pm}3.8\;cm$. The TMD of difficult intubation cases was $5.9{\pm}4.3\;cm$. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation. Conclusions: The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.77-84
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• 1999

Anesthetic agents are useful in inducing the anesthesia for surgical operations and various biological experiments, but they can disturb the body homeostasis and cause the stress in animals. Much efforts have been directed on reducing such side effects of anesthesia. In this work, we measured the serum ACTH, corticosterone and glucose concentration in rabbits to compare the degree of stress induced by two commonly-used anesthetics, ketamine, xylazine, and the combination of xylazine and ketamine. 1. The anesthesia was induced in about 10 min in the rabbits treated with xyalzine, ketamine and xylazine-ketamine. The duration of complete loss of righting reflex were 12, 13 and 115 min in the groups treated with xylazine, ketamine and xylazine-ketamine, respectively. 2. Serum ACTH concentrations in all treatment groups were higher than those in control group. At 30 min after the administration of the drugs, serum ACTH levels in ketamine-treated group were significantly higher than those in control, xylazine- and xylazine-ketamine-treated groups. However, at 1, 2, 5 and 9 hours after the drug administration, serum ACTH levels in xylazine-treated-group were higher than those in control. 3. Serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were lower than those in control or ketamine-treated groups at 0.5 and 1 hour after the administration. However, at 5 and 9 hours after the administration, serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were significantly higher than those in ketamine-treated group or control. 4. Serum glucose levels transiently increased to 3 times of the pre-injection levels at 0.5 and 1 hours after the administration in xylazine or xylazine-ketamine-treated groin, but were not changed in control and ketamine-treated group. These results indicate that xylazine-induced stress lasts longer than ketamine-induced, suggesting that the difference in stress-related hormone levels during anesthesia could be due to the differences in modes of actions of individual drugs used and the depth of anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.2
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• pp.81-90
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• 2024

Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

• Journal of the Institute of Convergence Signal Processing
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• v.21 no.1
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• pp.7-12
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• 2020

Various parameters are used to measure anesthetic depth during surgery using brain waves, and in actual clinical use, the linear analysis SEF is widely used. However, with recent studies showing that biological signals including EEG, contain nonlinear properties interest in nonlinear analysis of brain signals is increasing and parameters based on these are being developed. In this study, we are going to develop a parameter that can measure EEG using the nonlinear analysis method and extract noise that can be mixed with external electronic equipment and EEG instrumentation by comparing it with the data from the bispectrum analysis of static waves.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.47-52
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• 2015

Sedation allows patients to maintain their airway independently and respond appropriately to physical stimulation and verbal command while maintaining a minimum depressed level of consciousness. Drugs commonly used for sedation of pediatric dental patients include a combination of chloral hydrate, hydroxyzine, and nitrous oxide-oxygen. Midazolam is a benzodiazepine and currently one of the most commonly used intravenous sedative agents. It can be easily titrated to provide a wide range of sedation, from conscious sedation to deep sedation, and exhibits a wide safety margin without severe respiratory and circulatory depression. At an appropriate dose, it also decreases patient anxiety and induces amnesia. We found that the submucosal administration of midazolam combined with chloral hydrate provided increased sedative effects and decreased the postoperative vomiting response compared with conventional chloral hydrate administration, with no significant difference in physiological responses. The depth of sedation can be titrated using this technique.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.369-376
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• 2021

In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.55-59
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• 2016

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

• The Journal of the Korean dental association
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• v.11 no.12
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• pp.783-786
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• 1973

The healing response may very with the tissue, the site and the degree of wound. the author observed histochemically the epithelial regeneration in the har palate wound of healthy male albino rats, varying in age from 120 to 150 days, and weighing about 100 gm. The deep wounds were made antero-posterior linealy by surgical knife to the depth of bone level. They were sacrified by ether anesthesia on 1, 2, 4, 7, 10 and 14 days after wounding. the staining methods used were Mcmanus' PAS reaction, Mowry's modification of the Hale reaction employing Muller's colloidal iron reagent, alloxan-Schiff reaction and hematoxylin-eosin stain. The results were as follows : 1. In the wound healing of hard palate, the epithelium had marked PAS positive reaction in the granular and the prickle cell layers on the from 2nd to 7th day. 2. Alloxan-Schiff reactions of regenerated epithelium were slightly increased on 7th day.