Objective : This study was conducted to compare the effect of etomidate with that of thiopental on brain protection during temporary vessel occlusion, which was measured by burst suppression rate (BSR) with the Bispectral Index (BIS) monitor. Methods : Temporary parent artery occlusion was performed in forty one patients during cerebral aneurysm surgery. They were randomly assigned to one of two groups. General anesthesia was induced and maintained with 1.5-2.5 vol% sevoflurane and 50% $N_2O$. The pharmacological burst suppression (BS) was induced by a bolus injection of thiopental (5 mg/kg, group T) or etomidate (0.3 mg/kg, group E) according to randomization prior to surgery. After administration of drugs, the hemodynamic variables, the onset time of BS, the numerical values of BIS and BSR were recorded at every minutes. Results : There were no significant differences of the demographics, the BIS numbers and the hemodynamic variables prior to injection of drugs. The durations of burst suppression in group E ($11.1{\pm}6.8$ min) were not statistically different from that of group T ($11.1{\pm}5.6$ min) and nearly same pattern of burst suppression were shown in both groups. More phenylephrine was required to maintain normal blood pressure in the group T. Conclusion : Thiopental and etomidate have same duration and a similar magnitude of burst suppression with conventional doses during temporary arterial occlusion. These findings suggest that additional administration of either drug is needed to ensure the BS when the temporary occlusion time exceed more than 11 minutes. Etomidate can be a safer substitute for thiopental in aneurysm surgery.
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 Korea Assosiation for Disability and Oral Health
/
v.14
no.1
/
pp.1-6
/
2018
General anesthesia is an effective behavior management method for disabled patients or uncooperative children who have difficulty in cooperation. The objective of this study was to assess and analyze dental treatment under general anesthesia in department of pediatric dentistry at Pusan National University Dental Hospital for 5 years. One hundred and nine cases of general anesthesia from June 2013 to May 2018 were surveyed for this study. Patients' distribution, reasons for general anesthesia, treatment pattern, agents for general anesthesia, duration of treatment, and visiting route were assessed. The proportion of male was higher than female and age group of 5 to 9 was highest. Reasons for general anesthesia were handicapped situations with or without systemic disease(52%), operative treatment needs(13.2%), uncooperative(15%) and others(29.8%). Most used agents for general anesthesia were thiopental sodium and sevoflurane. Dental treatment under general anesthesia for handicapped and uncooperative children has been increasing. Therefore, it is important to improve the system and efficiency of general anesthesia to provide satisfactory treatment.
Journal of The Korean Dental Society of Anesthesiology
/
v.14
no.4
/
pp.205-211
/
2014
Background: General anesthesia is a necessary method for successful dental treatment for children, compromised patients and the disabled who have difficulty in cooperation. The aim of this study was to assess dental treatment under general anesthesia at the department of pediatric dentistry, Ajou university hospital on children and the disabled. Methods: 217 general anesthesia from June 2010 to June 2014 were assessed for this study. Patient's distribution, treatment pattern, reasons for general anesthesia, distribution of combined operation, duration of anesthesia, treatment, frequency of general anesthesia and agents for general anesthesia were examined. Results: The proportion of male, the disabled were higher and above 19 years age group was the highest. Combined operation with otolaryngology was highest. Main reasons for general anesthesia were mental retardation for the disabled and uncooperative behavior for the non-disabled. Percentage of restorative treatment was the highest. Average anesthesia duration was 186 minutes and average treatment time was 143 minutes. Most of the airway was maintained by nasotracheal intubation and induction was done by sevoflurane. Conclusions: General anesthesia for dental treatment has been increasing for children, the disabled who have a difficulty of cooperation. The demand for dental treatment under general anesthesia is expected to continuously increase. Therefore, continuous research and studies should be done to establish efficiency and safety of general anesthesia and provide an enhanced environment for treatment.
Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong;Han, Hyo-Jo;Shin, Teo-Jeon;Chang, Ju-Hea
Journal of The Korean Dental Society of Anesthesiology
/
v.11
no.2
/
pp.146-152
/
2011
Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.
Jung, Ki Tae;Yoon, Myung Ha;Lee, Hyun Young;Yu, Bo Yeon;Kim, Dong Kyu;Lim, Kyung Joon
The Korean Journal of Pain
/
v.26
no.2
/
pp.125-129
/
2013
Background: 5-hydroxytryptamine 3 (5-HT3) receptors have been known to be associated with the modulation of nociceptive transmission. However, it is uncertain whether 5-HT3 plays a role in the antinociceptive or pronociceptive pathway for incisional pain. In this study, we evaluated the effects of palonosetron, a 5-HT3 receptor antagonist, on incisional pain in rats when administered intrathecally or intraplantarly. Methods: An intrathecal catheter was implanted through the cisterna magna and placed in the intrathecal space of rats. An incision in the plantaris muscle of the right hind paw was done under anesthesia with sevoflurane. Withdrawal thresholds were evaluated with the von Frey filament after 2 hours. Palonosetron (0.5 and 0.1 ${\mu}g$ intrathecally; 0.5 ${\mu}g$ intraplantarly) was administered and the thresholds were observed for 4 hours. Results: Mechanical hypersensitivity developed after the incision. Intrathecal palonosetron (0.5 ${\mu}g$ and 0.1 ${\mu}g$) did not alter the paw withdrawal threshold. Intraplantar palonosetron (0.5 ${\mu}g$) also did not change the paw withdrawal threshold. Conclusions: Intrathecal and intraplantar palonosetron (0.5 ${\mu}g$) had no effect on modulating the mechanical hypersensitivity in the incisional pain model of rats.
Park, Chan-Hee;Lee, Jong-Hyung;Lee, Han-Gil;Kim, Ji-Hun
The Journal of Korea Assosiation for Disability and Oral Health
/
v.14
no.2
/
pp.71-77
/
2018
This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.
Lee, Jae Ho;Huh, In Young;Lee, Jae Min;Lee, Hyung Kwan;Han, Il Sang;Kang, Ho Jun
Kosin Medical Journal
/
v.33
no.3
/
pp.369-379
/
2018
Objectives: Analysis of heart rate variability (HRV) has been used as a measure of cardiac autonomic function. According to the pNN50 statistic, the percentage of differences between successive normal RR intervals (RRI) that exceed 50 ms, has been known to reflect cardiac vagal modulation. Relatively little is known about the validity of pNN50 during general anesthesia (GA). Therefore, we evaluated the correlation of pNN50 with other variables such as HF, RMSSD, SD1 of HRV reflecting the vagal tone, and examined the validity of pNN50 in anesthetized patients. Methods: We assessed changes in RRI, pNN50, root mean square of successive differences of RRI (RMSSD), high frequency (HF) and standard deviation 1 (SD1) of $Poincar{\acute{e}}$ plots after GA using sevoflurane anesthesia. We also calculated the probability distributions for the family of pNNx statistics (x: 2-50 ms). Results: All HRV variables were significantly decreased during GA. HF power was not correlated with pNN50 during GA (r = 0.096, P = 0.392). Less than pNN47 was shown to have a correlation with other variables. Conclusions: These data suggest that pNN50 can not reflect the level of vagal tone during GA.
Cho, Sang-Hyeon;Kim, Sung-Su;Hyun, Dong-Min;Yoon, Hyeong-Suk;Han, Jung-Woo;Kim, Jin Sun
Korean Journal of Anesthesiology
/
v.71
no.6
/
pp.447-452
/
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.
Amit Sharma;GD Puri;Rajeev Chauhan;Ankur Luthra;Gauri Khurana;Amarjyoti Hazarika;Shyam Charan Meena
Journal of Dental Anesthesia and Pain Medicine
/
v.24
no.1
/
pp.67-73
/
2024
Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m3 (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO2 equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.