• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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• pp.143-149
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• 2019

Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.229-236
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• 2023

Background: Local anesthesia has been reliably used to control pain during dental procedures and is important in pediatric dentistry. However, children occasionally complain of prolonged numbness after dental treatment, leading to several problems. Studies conducted to reverse the effect of local anesthesia using phentolamine mesylate and photobiomodulation therapy (PBM) are encouraging but limited. PBM is a type of light therapy that utilizes visible and near-infrared non-ionizing electromagnetic spectral light sources. Hence, this study used this modality to compare the reversal of local anesthesia at two different wavelengths. This study compared the effect of PBM at 660 and 810 nm wavelengths on the reversal of soft tissue local anesthesia using a diode LASER in pediatric dentistry. Method: Informed consent and assent were obtained, and the participants were then divided randomly into three groups of 20 children each: control group-without LASER irradiation, LASER irradiation at 660 nm, and LASER irradiation at 810 nm. Sixty children aged 4-8 years with deciduous mandibular molars indicated for pulp therapy were administered an inferior alveolar nerve block. After 45 min of injection, a duration that was similar to the approximate duration of treatment, they were exposed to 660- and 810-nm LASER irradiation according to their groups until reversal of local anesthesia was achieved. The control group did not undergo LASER irradiation. The reversal of the soft tissue local anesthetic effect was evaluated using palpation and pin prick tests every 15 min, and the LASER irradiation cycle continued until reversal of the soft tissue local anesthesia was achieved. Results: A significant reduction of 55.5 min (27.6%) in the mean soft tissue local anesthesia reversal time was observed after the application of 810 nm wavelength PBM and 69 min (34.7%) after 660 nm wavelength LASER irradiation. Conclusion: PBM with a 660 nm wavelength was more effective in reducing the mean soft tissue local anesthesia reversal duration, and thus can be used as a reversal agent for soft tissue local anesthesia in pediatric dentistry.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.187-194
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• 2020

Background: The aim of the present systematic review was to evaluate and compare the efficacy of warmed and unwarmed local anesthesia solutions in reduction of pain during intraoral injection administration. Methods: PubMed, Ovid SP, and Cochrane Central Register of Controlled Trials were searched from publication years 1990 to 2020 with relevant MeSH terms. Studies were screened by titles and abstracts, followed by full-texts evaluation of the included studies. Results: A total of four studies were included in the systematic review. Outcomes evaluated were subjective and objective pain during administration of the warmed local anesthesia solution in comparison with the unwarmed local anesthesia solution. Among the four studies that evaluated the self-reported pain score, three studies showed significantly lower pain scores associated with warmed local anesthesia. Only two studies evaluated the observed pain score, and both of them reported a significantly lower pain reaction with the warmed local anesthesia solution. Conclusion: Within the limits of this systematic review, warming the local anesthesia solution to body temperature (37℃) before administration seemed to reduce the discomfort during intraoral local anaesthesia administration, and more high-quality studies should be carried out to validate the same.

• The Korean Journal of Physiology and Pharmacology
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• 제14권5호
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• pp.291-297
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• 2010

The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$ $libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

• 대한전기학회논문지:시스템및제어부문D
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• 제55권1호
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• pp.35-41
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• 2006

Although reachers have studied for a long time, they don't make criteria for anesthesia depth. anesthetists can't make a prediction about patient's reaction. Therefor, patients have potential risk such as poisonous side effect late-awake, early-awake and strain reaction. EEG are received from twenty-five patients who agreed to investigate themselves during operation with Enflurane-anesthesis in progress of anesthesia. EEG are divided pre-anesthesia, before incision of skin, operation 1, operation 2, awaking, post-anesthesia by anesthesia progress step. EEG is applied pre-processing, base line correct, linear detrend to get more reliable data. EEG data are handled by electronic processing and the EEG data are calculated by bicoherence. During pre-anesthesia and post anesthesia, appearance rate of bicoherence value is observed strong appearance rate in high frequency range($15\~30Hz$). During the anesthesia of patient, a strong appearance rate is revealed the low frequency area(0~10Hz). After bicoherence is calculated by percentage of a appearance rate, that is, Bicpara$\#$1, Bicpara$\#$2, Bicpara$\#$3 and Bicpara$\#$4 parameter are extracted. In result of bicoherence analysis, Bicpara$\#$2 and Bicpara#4 are considered that the best parameter showed progress of anesthesia effectively. And each separated bicoherence are calculated by average bicoherence's numerical value, divide by 2 area, appear by each BicHz$\#$1, BicHz$\#$2, and observed BicHz$\#$1/BicHz$\#$2's change. In result of bicoherence analysis, BicHz$\#$1, BicHz$\#$2 and BicHz$\#$1/BicHz$\#$2 are considered that the best parameter showed progress of anesthesia effectively. In conclusion, I confirmed the anesthesia progress phase, concluded to usefulness of parameter on bispectrum and bicoherence analysis and evaluated the depth of anesthesia. In the future, it is going to use for doctor's diagnosis and apply to protect an medical accident owing to anesthesia.

• 비파괴검사학회지
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• 제25권4호
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• pp.262-267
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• 2005

전신마취시 경막외차단술은 수술 후 통증을 조절하는데 널리 이용되고 있다. 마취상태에서는 여러 가지 혈류역학적 파라미터의 변화가 있으며, 맥파전달시간은 이러한 혈류역학적 파라미터들에 의해 많은 영향을 받고 있다. 맥파전달시간은 경막외차단술을 병행한 전신마취와 일반적인 전신마취 후에 동맥혈관벽의 이완으로 인해 손가락과 발가락에서의 PTT가 변화한다. 본 연구에서는 경막외차단술을 병행한 전신마취와 일반적인 전신마취에서 손가락과 발가락 PTT의 변화를 각각 측정하였다. 더불어, 일반적인 전신마취와 경막외 차단술을 병행한 전신마취에서의 손가락과 발가락사이의 pTT변화를 비교하였다.

• 한국임상수의학회지
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• 제11권1호
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• pp.407-417
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• 1994

Present experiments were undertaken for the purpose of clarifying the effect of repeated halothane anesthesia on the liver and kidney function. Nine mongrel dogs were divided into three groups. The group one dogs were anesthesized once(control group) and the other two groups twice and trice respectively on 10th day of previous anesthesia experimental groups. Hematological examinations and blood chemical assays were undertaken during the period from one hour to 10 days after the anesthesia. From these experiments fellowing results were obtained; 1. No significant changes of erythrocyte count were recognized in both the control and experimental groups after the halothane anesthesia. 2. The total leukocyte counts of experimental groups showed significant decrease on one hour and subsequent increases after the anesthesia. 3. No significant changes were observed in SGOT, SGPT, ALP, BUN and serum glucose values in both the control and experimental groups. 4. The total serum protein values showed a tendency to decrease on the first hour of halothane anesthesia in both the control and experimental groups. From these results it may be concluded that the repeated halothane anesthesia done 10th day of previous anesthesia do not affect the liver and kidney function in dogs.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.9-17
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• 2018

Background: The structure and function of bone tissue is maintained through a constant remodeling process, which is maintained by the balance between osteoblasts and osteoclasts. The failure of bone remodeling can lead to pathological conditions of bone structure and function. Remifentanil is currently used as a narcotic analgesic agent in general anesthesia and sedation. However, the effect of remifentanil on osteoclasts has not been studied. Therefore, we investigated the effect of remifentanil on pre-osteoclast (pre-OCs) differentiation and the mechanism of osteoclast differentiation in the absence of specific stimulus. Methods: Pre-OCs were obtained by culturing bone marrow-derived macrophages (BMMs) in osteoclastogenic medium for 2 days and then treated with various concentration of remifentanil. The mRNA expression of NFATc1 and c-fos was examined by using real-time PCR. We also examined the effect of remifentanil on the osteoclast-specific genes TRAP, cathepsin K, calcitonin receptor, and DC-STAMP. Finally, we examined the influence of remifentanil on the migration of pre-OCs by using the Boyden chamber assay. Results: Remifentanil increased pre-OC differentiation and osteoclast size, but did not affect the mRNA expression of NFATc1 and c-fos or significantly affect the expression of TRAP, cathepsin K, calcitonin receptor, and DC-STAMP. However, remifentanil increased the migration of pre-OCs. Conclusions: This study suggested that remifentanil promotes the differentiation of pre-OCs and induces maturation, such as increasing osteoclast size. In addition, the increase in osteoclast size was mediated by the enhancement of pre-OC migration and cell fusion.

• 대한치과의사협회지
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• 제56권1호
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• pp.49-57
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• 2018

The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.

• 대한치과마취과학회지
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• 제6권1호
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• pp.1-5
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• 2006

Background: The aim of this study was to evaluate the preventive effect of propofol on postoperative nausea and vomiting (PONV) following general anesthesia to the patients having oral and maxillofacial surgery. Methods: In a prospective, randomized. case-controlled study. 200 patients were divided into two groups (n = 100 in each). In propofol (P) group, patients received 0.5 mg/kg of propofol intravenously at the end of anesthesia. In control (C) group, no antiemetics was given. Emetic symptoms like nausea, retching and vomiting were assessed by a blind nurse at 1 hour and at 24 hours after anesthesia respectively. Also level of sedation was checked by a blind anesthesiologist at 1 hour after anesthesia. Results: There were no significant differences in frequencies of nausea, retching and vomiting between C group and P group at 1 hour after anesthesia. However, nausea, retching and vomiting were all decreased in P group compared with C group at 24 hours after anesthesia (P < 0.05). Also there was no significant difference in level of sedation at 1 hour after anesthesia between C group and P group (P > 0.05). Conclusions: From the results, prophylactic use of subhypnotic dose of propofol could be effective for preventing PONV without change in level of sedation to the patients undergoing general anesthesia for oral and maxillofaical surgery.