• 한국임상수의학회지
• /
• 제34권2호
• /
• pp.135-139
• /
• 2017

This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.

• 한국수학교육학회지시리즈A:수학교육
• /
• 제48권3호
• /
• pp.287-302
• /
• 2009

This study investigated how 5th grade students found and understood triangle congruence conditions (SSS, SAS, ASA). In particular, this study focused on children's processes of discovering triangle congruence conditions and the obstacles which they encountered in the process of making sense of these conditions. Our data indicates that inquiring the cases in which less than three factors of triangle are given is helpful for children to guess triangle congruence conditions and understand the minimal characteristic of these conditions. And the degree of difficulty of discovering each congruence condition is different. Children discovered SAS condition and ASA condition easily, but it was hard for them to discover and understand that SSS was also a triangle congruence condition because they connected the length of a given side with the use of a scaled ruler not a compass.

• Journal of Gastric Cancer
• /
• 제11권4호
• /
• pp.200-205
• /
• 2011

Purpose: Gastric cancer has a high incidence and mortality rate in Korea. Despite a growing older population and an increase in the number of older patients with gastric cancer, the older patients are not willing to undergo surgery due to their operative risks. Hence, to determine the clinical characteristics and outcomes of gastric cancer surgery for them, we investigate factors influencing the treatment decision. Materials and Methods: Between January 1996 and December 2005, a total of 1,519 patients were classified into two groups; the younger age group between 41 and 69 years of age, and the older age group of 70 years or older. The analysis conducted included patient characteristics, accompanying disorders, related American Society of Anesthesiologists (ASA) grade, pathological characteristics and survival rate for each age group. Results: Significant differences were found in the ASA grade (P<0.001) and the number of accompanying disorders (P<0.001) between the two groups. The average length of hospital stay after surgery was 14.5 days in the younger age group, and 13.3 days in the older age group (P=0.065). The average survival time was 47.5 months in the younger age group, and 43.2 months in the older age group (P<0.001). Conclusions: This study demonstrated that there was more number of accompanying disorders with a high surgical risk in the older age group. However, there was no significant difference between the older and younger age groups in terms of the incidence of complications, under the given disease conditions and if proper management was provided.

• Journal of Yeungnam Medical Science
• /
• 제24권2호
• /
• pp.154-161
• /
• 2007

직접 후두경하에 기관내 삽관의 난이도를 Cormack & Lehane 등급에 따라 분류하여 등급 3 또는 4에 해당하는 환자 40명을 대상으로 하였다. 모든 환자들이 적절한 마취 심도에 도달한 후 직접 후두경으로 성대와 후두개의 노출 여부를 판단하여 Cormack & Lehane 등급 3 또는 4에 해당되면 직접 후두경을 제거하고 대신 Bonfils intubation fibrescope으로 기관내 삽관을 시도하였다. 기관내 삽관의 성공 여부, 삽관 시도 횟수, 삽관에 소요되는 시간, 턱에서 갑상연골의 상부 방패패임까지의 길이(thyromental distance), 턱에서 흉골 상부까지 의 길이(sternomental distance) 그리고 $SpO_2$가 90%이하로 감소하는 지의 여부를 기록하였다. 이 외에 기관내 삽관동안 폐내흡인, 역류, 기관지경련, 기도 폐쇄, 경추 손상 그리고 치아 손상 여부 등이 발생하는지를 관찰하였다. Cormack & Lehane 등급 3에서는 96.9%의 기관내 삽관 성공률을 보였으며 등급 4에서는 50%의 성공률을 나타내어 등급 간 통계적으로 유의한 차이가 있었다(P<0.01). 기관내 삽관에 소요된 시간은 등급 3에서 20 (10-49[7-300]) 초였고 등급 4에서 180 (31-300[10-300])초로 통계적으로 유의하였다(P=0.01). 기관내 삽관시 $SpO_2$가 90% 이하로 감소된 경우는 등급 3에서 3.1%, 등급 4에서 50%로 통계적으로 유의한 차이를 나타내었다(P<0.01). 기관내 삽관성공률과 삽관에 소요된 시간으로 보아 Bonfils intubation fibrescope은 Cormack & Lehane 등급 3인 환자에서 유용한 기도 관리 장비로 보이나 등급 4인 환자에서는 항상 선택적으로 사용할 수 있는 기도 관리 장비라고는 할 수 없으며, 기관내 삽관 시 다른 대체 장비가 필요할 가능성도 있음을 알아야 하겠다.

• 대한치과마취과학회지
• /
• 제11권2호
• /
• pp.153-158
• /
• 2011

Midazolam is known to produce sedation as well as amnesia. Many articles reported about anterograde amnesia, but it is rare that articles about retrograde amnesia. The 61-year-old female patient (64 kg, 154 cm, ASA physical status I) was administered 3.02 mg (0.047 mg/kg) of midazolam during 2 hours. The patient's Modified Observer's Assesment of Alertness/Sedation Scale was 4. The patient who had been consciously sedated with midazolam, exhibited profound amnesia, both anterograde and retrograde after implantation. The patient's memory restoration was begun after 6 hours.

• The Korean Journal of Pain
• /
• 제31권1호
• /
• pp.39-42
• /
• 2018

Background: Venipuncture pain is an uncomfortable suffering to the patient. It creates anxiety, fear and dissatisfaction. The ketoprofen transdermal patch is a proven treatment for musculoskeletal and arthritic pain. We planned this study to evaluate the efficacy of the ketoprofen patch to reduce venipuncture pain. Methods: Two hundred adult patients, aged 18-60 years, of either sex, ASA grade I or II, were enrolled. Presuming that therapy would decrease venipuncture pain by 30%, a power calculation with ${\alpha}=0.05$ and ${\beta}=0.80$ required enrollment of at least 24 patients into each group. However, 100 patients in each group were recruited. Group I (Control) received a placebo patch; Group II (Ketoprofen) received a 20 mg ketoprofen patch. A selected vein on the dorsum of the patient's non-dominant hand was cannulated with 18 g intravenous cannula 1 h after the application of the respective patch. Assessment of pain was done by a 10 cm visual analogue scale (VAS) of 0-10, where 0 depicts "no pain" and 10 is "the worst imaginable pain". The venipuncture site was assessed for the presence of skin erythema, swelling and rashes at 12 h, 24 h and at the time of decannulation. Results: Incidence of pain was 100% (94/94) in the control group as compared to 93% (85/91) in the ketoprofen group. The severity of the venipuncture pain was 6 (2) and 2 (2) for control and ketoprofen groups respectively (P < 0.05). Conclusions: Application of a ketoprofen patch at the proposed site of venipuncture one hour before the attempt is effective and safe for attenuating venipuncture pain.

• The Korean Journal of Pain
• /
• 제29권4호
• /
• pp.239-248
• /
• 2016

Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.