• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• The Korean Journal of Pain
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• 제14권2호
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• pp.181-185
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• 2001

Background: Bradycardia frequently occurs in intravenous anesthesia with propofol. Additionally, the thoracic sympathetic nerves influence the heart so that the heart rate (HR) and blood pressure are expected to decrease due to this procedure. Therefore, we measured changes in HR, mean arterial pressure (MAP) and both thumb temperatures before and after thoracic sympathicotomy under total intravenous anesthesia with propofol. Methods: The subjects included 21 outpatients of ASA class I who received thoracoscopic thoracic sympathicotomy under total intravenous anesthesia. Anesthesia was induced with propofol (2 mg/kg) and vecuronium (0.1 mg/kg) and maintained with propofol-fentanyl-oxygen (100%). The surgical procedure was performed at the T3 level in the order of left sympathicotomy (LST) and right sympathicotomy (RST). Measurements of HR, MAP and both thumb temperatures were taken before induction of anesthesia, before and after LST and RST, and 1 hour after the completion of anesthesia. Additionally, the time to the beginning of a rise in temperature in both thumbs after sympathicotomy was recorded. Results: HR did not show any significant difference before or after sympathicotomy, however it decreased at 1 hour after the completion of anesthesia. MAP decreased after LST and decreased further after RST. Left thumb temperature began to increase at $45.8{\pm}10.7$ seconds after LST. Right thumb temperature initially decreased after LST and increased from $45.2{\pm}11.8$ seconds after RST. Subsequently, both increased temperatures were maintained at 1 hour after the completion of anesthesia. Conclusions: Although HR and MAP decreased, there were no severe hemodynamic changes. An increase in the thumb temperature was confirmed within 1 minute after sympathicotomy on the same side.

• Journal of Chest Surgery
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• 제55권1호
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• pp.30-36
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• 2022

Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

• 한국임상수의학회지
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• 제22권3호
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• pp.259-263
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• 2005

To compare cardiopulmonary effects and recovery between total intravenous anesthesia (TIVA) with propofol (PRO group, n=5) and volatile induction/maintenance anesthesia (VIMA) with isoflurane (ISO group, n=5), we investigated changes of heart rate, $SpO_2$, arterial pressure, rectal temperature and respiratory rate during 60 minute anesthesia and 40 minute recovery period in beagle dogs, and investigated recovery (extubation, head lift, sternal position and righting) after 60 minute anesthesia. Rectal temperature was significantly low in ISO group (p<0.05) from 10 to 100 minute. Heart rate was significantly low in ISO group (p<0.05) at 40, 50, 60 minute. Respiratory rate was significantly low in PRO group (p<0.05) at induction and 70 minute. $SpO_2$ tendency was similar. Systolic arterial pressure (SAP) was significantly low in ISO group (p<0.05) at induction and during anesthesia. Recovery was similar in two groups. We concluded that TIVA with propofol is useful in stabilizing rectal temperature and arterial pressure during anesthesia and provide fast and stable recovery.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 춘계학술대회
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• pp.144-144
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• 2006

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.101-103
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• 2020

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 춘계학술대회
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• pp.148-149
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• 2006

• 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.

• 기본간호학회지
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• 제22권4호
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• pp.379-386
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• 2015

Purpose: The trend of body temperature change during laparoscopic surgery and the most adequate site for monitoring temperature measurements have not been investigated thoroughly. In this study body temperature change during laparoscopic surgery was measured and measurements of the tympanic, esophageal, and nasopharyngeal core temperatures in surgical patients with total intravenous anesthesia were compared. Methods: From February to October 2013, 28 laparoscopic surgical patients were recruited from a tertiary hospital in Seoul. The patients' core temperature was measured 12 times at ten minute intervals from ten minutes after the beginning of endotracheal intubation. Results: Repeated measure of core temperatures indicated a significant difference according to body part (p=.033), time of measure (p<.001) and the reciprocal interaction between body part and time of measure (p<.027). The core temperatures were highest at tympany location, lowest at nasopharynx. The amount of temperature change was least for the esophagus ($36.10{\sim}36.33^{\circ}C$), followed by nasopharynx and tympany. Conclusion: The esophageal core temperature showed the highest stability followed by nasopharyngeal and tympanic temperature. Therefore, close observations are required between 10~20minutes after the beginning of the operation.

• The Korean Journal of Pain
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• 제8권2호
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• pp.257-265
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• 1995

Patient-Controlled Analgesia (PCA) has been widely used for postoperative pain relief. Meperidine is useful for PCA and has efficient analgesia, rapid onset, and low incidence of adverse effect. To compare the analgesic effect, total dose and hourly dose, side effect and neonatal status of breast feeding with meperidine via intravenous or epidural PCA for 48 hours after Cesarean Section, 40 parturient women undergoing elective Cesarean Section were randomly divided into two groups. Each respective group of 20 parturient women received meperidine via one of the intravenous PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after epidural block with 2% lidocaine 20ml combined with general anesthesia with only $N_2O$ and $O_2$ (EpiPCA group) when they first complained of pain in recovery room. Following the administration of analgesic initial dose, parturient women of IVPCA group were allowed intravenous meperidine 10 mg every 8 minutes when they felt pain. The EpiPCA group received additional bolus dose of meperidine 2 mg and bupivacaine 0.7 mg were administered every 8 minutes as requested the patients with hourly continuous infusion of meperidine 4 mg and bupivacaine 1.4 mg. Data was collected during the 48 hours observation period including visual analog scale (VAS) pain scores, total meperidine dose, hourly dose during 48 hours and each time interval, incidence of adverse effect, satisfaction, and neonatal status with breast feeding. VAS pain scores of analgesic effect in EpiPCA group was significantly lower than in IVPCA group at 2 hours after the initial pain after Cesarean Section. Total dose and hourly dose of meperidine significantly reduced in EpiPCA group. Hourly dose of meperidine at each time interval significantly reduced during first 6 hours and from 12 hours to 24 hours in EpiPCA group. The side effects in IVPCA group were mainly sedation, nausea, and local irritation of skin. And EpiPCA group experienced numbness and itching. The degree of satisfaction of parturient women was 88.2 % in IVPCA group and 85.7 % in EpiPCA group. We did not observe any sedation, abnormal behavior, or seizure like activity in any neonates of breast feeding. From the above results we conclude that epidural PCA was more efficiently analgesic, less sedative, and consumptional, and safer for neonate than intravenous PCA, and could be an alternative method to intravenous PCA.