• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.4
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• pp.229-233
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• 2012

Hemophilia, the most common of the inherited bleeding disorder, is the result of a deficiency of clotting factor. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. We report on the diagnosis and treatment of a 9-year-old boy having severe hemophilia visited our department with the chief complaints of pus discharge on the left lower molar region. In the clinical and radiographic examination, periapical abscess and dental caries were diagnosed. Considering complexity of the treatment and complication in the coagulation, it was decided to carry on the treatment under general anesthesia. Clotting factor IX concentrates were intended to provide 50-70% plasma level. Pulpectomy, resin restoration and Stainless steel crown were given under general anesthesia. Several teeth were extracted and the sockets were packed with Surgicel$^{(R)}$ (Oxidized Regenerated Cellulose, Johnson and Johnson Co. Neuchatel, Switzerland) under general anesthesia. Transpalatal arch and lingual arch were given for maintaining the extracted space before discharged. For people with severe hemophilia, factor replacement is necessary before scaling, surgery or regional block injections. Therefore, if several extractions are needed, dental care under general anesthesia would be effective and efficient management.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.226-234
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• 2014

Purpose: This prospective study was designed to investigate the incidence of acute postoperative pain (APP) ${\geq}4$ and the risk factors of APP${\geq}$ for the first 48 hours after surgery. Methods: Data from 531 surgical patients were collected from November, 2009 to May, 2010. APP was assessed from the time of arrival at the Post Anesthetic Care Unit (PACU) to the end of the post-operative 48 hours. Risk factors of APP${\geq}$ were analyzed by logistic regression analysis. Results: The incidence of APP ${\geq}4$ was 58.8% for the first postoperative 4 hours; 33.5%, 24 hours; 11.1%, 48 hours. The score of pain was 5.55, the highest on arriving at PACU; 5.03 at postoperative 30 minutes; 4.03 at 1 hour; 3.96 at 4 hours; 2.76 at 24 hours; 1.44 at 48 hours Risk factors for APP ${\geq}4$ were females (Odds ratio [OR], 1.94; p=.013), general anesthesia (OR, 4.29; p<.001) and patient controlled analgesia (PCA) (OR, 2.83; p<.001) at 4 hours after operation; body mass index (BMI) ${\geq}25$ (OR, 1.80; p=.009), duration of surgery ${\geq}1$ hour (OR, 2.87; p=.037), general anesthesia (OR, 3.99; p<.001) and PCA (OR, 6.23; p<.001) at 24 hours; general anesthesia (OR, 3.53; p=.003) and PCA (OR, 3.01; p=.013) at 48 hours. Conclusion: Surgical patients with BMI ${\geq}25$, PCA and general anesthesia seem to have a higher incidence of pain ${\geq}4$ through the first postoperative 48 hours.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1209-1214
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• 2000

Objectives : The measurement of resistance to cerebrospinal fluid outflow($R_o$) can clearly delineate cerebrospinal fluid dynamics in patients with ventricular dilatation and can help in selecting patients to undergo shunt placement. With regards to type of infusion method, bolus injection is known to be more practical and safer than continuous infusion. The purpose of this study was to obtain $R_o$ of normal adults using lumbar bolus injection method. Material and Methods : Twenty adults aged 25 to 52 years were studied using lumbar bolus injection method. Fifteen patients with hemifacial spasm and five with cerebral concussion underwent $R_o$ measurement under propofol general anesthesia and local anesthesia, respectively. Results : The mean values of $R_o$ determined 1 minute and 2 minutes after bolus injection were $4.8{\pm}1.7$ and $4.4{\pm}1.6mmHg/ml/min$, respectively. There was no significant difference of $R_o$ between propofol general anesthesia group and local anesthesia group. Two patients showed $R_o$ greater than 6mmHg/ml/min. One patient revealed unexpectedly high level of $R_o$ due to severe spinal stenosis. Conclusion : Mean Ro in this study was higher than that of Shapiro's study. Borderline Ro near 6mmHg/ml/min should be regarded with caution and compared with clinical symptoms and results of other studies. Patients with severe spinal stenosis should be evaluated with caution.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.54-59
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• 2007

Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.2
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• pp.1189-1199
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• 2015

This study examined the effects of favorite music therapy on the anxiety and vital signs at each point in gynecologic surgery using the general anesthesia. The research design was a non-equivalent control group non-synchronized design. The data were collected from May 1 to July 30, 2013 and the participants were 44 patients (experimental group, 21, control group, 23) received music therapy while waiting for anesthetic induction and PACU (Post Anesthesia Care Unit). Repeated measures ANOVA was performed to analyze the data by SPSS 18.0. Music therapy reduced the anxiety level at inducing the anesthetic time, and awakening time (p=.003; p=.011). The systolic blood pressure maintained stability at discharge from the PACU (p=.023), and pulse rate was stable at the awakening time (p=.016). This findings support the use of music as a nursing intervention to reduce anxiety and maintain the vital signs for gynecologic surgery patients under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.1
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• pp.67-73
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• 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.

• Journal of Acupuncture Research
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• v.21 no.6
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• pp.167-176
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• 2004

Objective : This study was designed to investigate the effects of electro-acupuncture(EA) and moxibustion at CV13, CV12, CV10 and ST36 serum gastin level in rats. Methods : The present study was conducted to see the effects produced by combined electro-acupuncture(EA) and moxibustion using four different acupoints on serum gastrin level in rats. Electro-acupuncture (2 Hz, intensity ; 10 times muscle twitch threshold) was applied for 30 minutes to ST36 under halothane anesthesia. Moxibustion ($1.6{\pm}0.3mg$, 5 times of a day) was applied during 3 days to CV13, CV12, CV10 under halothane anesthesia. Results : Both of EA applied to the ST 36 and Moxibustion applied to the CV10, CV12 decreased serum gastrin level significantly. And the effect of combined EA at ST36 and moxibustion at CV10 was shown stronger effect than each singular stimulus of EA at ST36 and moxibustion at CV10. These data suggest that both of EA and moxibustion at specific acupoints produce change of serum gastrin level in rats and combined EA and moxibustion was shown quite effect than each singular stimulus.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.65-69
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• 2017

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.389-394
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• 1988

The patient was 22-year old male who had been suffered from labored breathing. Computerized tomography, tracheoscopy, tracheogram disclosed tracheal obstruction by external mass compression on Tl level, which ranged 4.Oem in the length and approximately 4mm in diameter on tracheogram. Under the local anesthesia, tracheostomy was done to prevent intraoperative airway obstruction. And general anesthesia, low collar incision 8z extended median sternotomy was made and nearly total thyroidectomy was performed. After the circumferential resection of the obstructed segment approximately 4cm in length[7 tracheal rings], direct end-to-end anastomosis of trachea was performed. Postoperatively, the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Postoperatively. medical therapy[Comthyroid k Calcium lactate] and radiotherapy were done. At present, 2-months after operation, he lives well.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.37-46
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• 2017

Background: In oxidative stress, reactive oxygen species (ROS) production contributes to cellular dysfunction and initiates the apoptotic cascade. Autophagy is considered the mechanism that decreases ROS concentration and oxidative damage. Propofol shows antioxidant properties, but the mechanisms underlying the effect of propofol preconditioning (PPC) on oxidative injury remain unclear. Therefore, we investigated whether PPC protects against cell damage from hydrogen peroxide ($H_2O_2$)-induced oxidative stress and influences cellular autophagy. Method: COS-7 cells were randomly divided into the following groups: control, cells were incubated in normoxia (5% $CO_2$, 21% $O_2$, and 74% $N_2$) for 24 h without propofol; $H_2O_2$, cells were exposed to $H_2O_2$ ($400{\mu}M$) for 2 h; $PPC+H_2O_2$, cells pretreated with propofol were exposed to $H_2O_2$; and 3-methyladenine $(3-MA)+PPC+H_2O_2$, cells pretreated with 3-MA (1 mM) for 1 h and propofol were exposed to $H_2O_2$. Cell viability was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide thiazolyl blue (MTT) reduction. Apoptosis was determined using Hoechst 33342 staining and fluorescence microscopy. The relationship between PPC and autophagy was detected using western blot analysis. Results: Cell viability decreased more significantly in the $H_2O_2$ group than in the control group, but it was improved by PPC ($100{\mu}M$). Pretreatment with propofol effectively decreased $H_2O_2$-induced COS-7 cell apoptosis. However, pretreatment with 3-MA inhibited the protective effect of propofol during apoptosis. Western blot analysis showed that the level of autophagy-related proteins was higher in the $PPC+H_2O_2$ group than that in the $H_2O_2$ group. Conclusion: PPC has a protective effect on $H_2O_2$-induced COS-7 cell apoptosis, which is mediated by autophagy activation.