• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.1-6
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• 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 Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.245-254
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• 2018

Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.271-279
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• 2020

Background: The present study aimed to evaluate and compare the efficacy of buffered and unbuffered local anesthesia solutions during inferior alveolar nerve block (IANB) administration in children. Methods: PubMed, Ovid SP, and Cochrane databases were searched separately by two independent reviewers for potential papers published between 1980 and April 2020 using relevant MeSH terms and pre-specified inclusion and exclusion criteria. T Studies of IANB administration in children comparing buffered and unbuffered local anesthesia solutions were evaluated. The primary outcome evaluated was pain (perception and reaction), while the secondary outcome was the onset of anesthesia. Results: A total of five articles were included in a qualitative analysis; among them, four qualified for quantitative analysis of the primary outcome and three for quantitative analysis of the secondary outcome. A fixed-effects model was used to perform the meta-analysis. Pain perception (child-reported pain): Significantly lower pain scores were reported with buffered local anesthesia solution than with unbuffered solution (P = 0.006, MD: -0.32, 95% CI: -0.55 to -0.09). Pain reaction (observer-reported pain reaction in child): No significant difference was found between buffered and unbuffered solution in terms of observer-reported pain behavior in the child (P = 0.09, MD: -0.21, 95% CI: -0.46 to 0.04). Onset of anesthesia: A significantly lower duration of anesthesia onset was reported with buffered local anesthesia solution than with unbuffered solution (P = 0.00001, MD: -12.38, 95% CI: -17.64 to -7.13]. Conclusion: Buffering local anesthesia solution may reduce discomfort due to IANB injection administration and lower the initial onset time of anesthesia. More randomized control trials with adequate sample sizes should be carried out to validate the accuracy of these results.

• Korean Journal of Veterinary Research
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• v.42 no.1
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• pp.123-130
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• 2002

To investigate the cardiopulmonary and anesthetic effects of propofol in dogs, experimental dogs were randomly divided into 4 groups (propofol infusion anesthesia, P/INF, propofol intermittent anesthesia, P/INTER, propofol induction anesthesia, P/ISO, thiopental Na induction anesthesia, T/ISO) and monitored analgesic and anesthetic effects, recovery time, body temperature, heart rate, mean arterial pressure, respiratory rate, systolic and diastolic pressure. In all groups, apnea was not observed. In the P/INF group, the respiratory rate(RR) was slightly decreased, but in the P/INTER group, RR was increased and shallowing. In the groups of P/ISO and T/ISO, the respiratory rate was decreased. Heart rate(HR) was increased after induction anesthesia in all groups, but gradually decreased. Mean arterial pressure(MAP) was decreased after injection anesthesia in the groups of P/INF and P/INTER. In the groups of P/ISO and T/ISO, however, MAP was slightly increased. Systolic and diastolic arterial pressure were gradually decreased after induction anesthesia, but not significantly. In the groups of P/INF and P/ISO, recovery time was shorter than the groups of P/INTER and T/ISO. In all groups, body temperature of animals was decreased gradually according to time but no significant changes were observed. Propofol injection doesn't make the complete loss of responses of animals, especially, in the P/INTER group. In the P/INF group, deep pain was present until the end of anesthetic period. During recovery period, any other side effects except incoordination were not monitored. The present study suggested that infusion anesthesia was superior to intermittent anesthesia as injection anesthetic agent, and propofol was better than thiopental Na as induction anesthetic agent.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.203-208
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• 2016

Background: In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods: This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results: Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was $132.7{\pm}77.6min$, and the mean duration of treatment was $101.9{\pm}71.2min$. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions: Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.24-30
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• 2019

Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

• Journal of the Korean Society for Nondestructive Testing
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• v.25 no.4
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• pp.262-267
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• 2005

Epidural block under general anesthesia has been widely used to control postoperative pain. In this anesthetic state many hemodynamic parameters are changed. Moreover pulse transit time is influenced by this memodynamic change. m change in the finger and the toe due to relaxation of arterial wall muscle after general anesthesia and epidural block under general anesthesia. This study, in the both general anesthesia and epidural block under general anesthesia, ${\Delta}PTT$ of the toe and of the finger are measured. In addition, ${\Delta}PTT$(toe-finger) of the epidural block under general anesthesia and of the general anesthesia were compared.

• Journal of Biomedical Engineering Research
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• v.30 no.4
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• pp.327-332
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• 2009

In this paper, new index was developed to estimate the depth of anesthesia during general anesthesia using EEG. Analysis of the power spectral density(PSD) of EEG was used to develop new parameters because EEG signal tends to have slow wave during anesthesia. Classifier for index creator was developed by using SEF, BDR and BTR parameters, which are calculated by power spectral density. EEG data were obtained from 7 patients (ASA I, II) during general anesthesia with Sevoflurane. The anesthetic depth evaluation indexes ranged from 0 to 100. The average were $86.05{\pm}10.1$, $36.98{\pm}20.2$, $15.33{\pm}13.6$, $50.87{\pm}16.5$ and $87.72{\pm}11.7$ for the states of pre-operation, induction of anesthesia, operation, awaked and post-operation, respectively. The results show that while the depth of anesthesia was evaluated, more accurate information can be provided for anesthetician.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.409-412
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• 1999

To establish the electroacupuncture anesthesia for pigs, 6 piglets (Landrace mixed, 1 month old, 3.7~5.3 kg, female: 3 heads and male: 3 heads) were examined. The acupoints used for porcine electroacupuncture anesthesia were An-shen, and Tian-ping and Bai-hui. After horizontal insertion of needle to left and right An-shen, and perpendicular insertion to Tian-ping and Bai-hui, respectively, positive electrode was connected at right An-shen and Tian-ping, and negative electrode was connected at left An-shen and Bai-hui using veterinary electroacupuncture anesthesia apparatus, respectively. Electric condition was 3 V and 30 Hz. To examine the effect of electroacupuncture anesthesia, laparotomy (4 heads) and castration (2 heads)were applied. The induction time of electroacupuncture anesthesia was very rapid and about 1 minute, and pain of the body surface including the extremities was not detected. As for the reactions with electroacupuncture anesthesia, the head was directed to backward, nasal part was curved to one side, and blepharum was closed in part of changed nasal part. In addition, consciousness was vivid, and muscle tension and lift of the tail were observed in early stage but was relaxated afterwards. The pain was not found during incision and suture, bleeding was comparatively small volume and the class of anesthesia effect was excellent.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.417-421
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• 1999

To establish the electroacupuncture anesthesia for experimental animal, 5 adult rabbits (Newzealand-white species) and 6 rats (Spraque-dawley) were examined. The acupoints used for electroacupuncture anesthesia were Tian-ping and Bai-hui. After perpendicular insertion of needle to the acupoints, positive electrode was connected at Tian-ping and negative electrode was connected at Bai-hui using veterinary electroacupuncture anesthesia apparatus, respectively. Electric conditions were 2~3 V and 30 Hz in rabbits, and 1.5~2 V and 30 Hz in rats, respectively. To examine the effect of electroacupuncture anesthesia, laparotomy (2 heads), castration (2 heads) and ovariohysterectomy (1 head) were applied in rabbits, and laparotomy (5 heads) and castration (1 head) were peformed in rats, respectively. The induction time of electroacupuncture anesthesia was very rapid and approximately 1 minute, and pain of body surface including the extremities was not detected in rabbits and rats. As for the reactions with electroacupuncture anesthesia, consciousness was vivid, blepharoreaction was not observed and the tail was up at early stage but was down afterwards in rabbits. The same findings except cotinuous lifting of the tail were observed in rats. The pain was not observed during incision and suture, bleeding was comparatively small volume and the class of anesthesia effect was excellent.