• Journal of East-West Nursing Research
• /
• v.30 no.1
• /
• pp.51-59
• /
• 2024

Purpose: The purpose of this study was to determine the effect of preoperative guidance and operating room environment experience using virtual reality on increasing satisfaction with information and reducing anxiety in preoperative patients undergoing general anesthesia and local anesthesia. Methods: A non-equivalent control group quasi-experimental design was employed. The participants were 80 surgical patients from 4 wards (40 experimental group and 40 control group) of the general hospital located in Gyeonggi-do. Data collection was conducted from June to November 2023 after completing the control group survey in January 2023. Data were analyzed using Chi-square, t-test, and Mann-Whitney U test using SPSS 23.0 program. Results: Satisfaction with preoperative information was higher in the experimental group than that of the control group. Additionally, anxiety related to surgery in the experimental group was significantly lower than that of the control group. The preoperative state anxiety score in the experimental group was not significantly lower than that of the control group. Conclusions: These results suggest that providing patient education and information using virtual reality technology can not only alleviate patients' anxiety related to surgery, but also have the potential to be used as an effective intervention to improve positive patient experiences.

• The Korean Journal of Pain
• /
• v.8 no.2
• /
• pp.257-265
• /
• 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.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.19.2-19
• /
• 1983

A Clinical and bacteriologcal observation was performed 128 cases of chronic otitis media who had taken middle ear surgery at Dept. of otolaryngology of St. Benedict Hospital during the period of Feb. 1981 to Feb. 1983. The following results were obtained. 1) Among total 128 cases, male were 60 cases (46.9%) and female were 68 cases (53.1 %) and age distribution showed 48 cases (37.5 %) in 3rd decade, 37 cases (28.9 %) in 2nd decade and 27 cases (21.1 %) in 4th decade. 2) Site distribution were 71 cases (55.5%) in right, 57 cases (44.5 %) in left. 3) Degree of preoperative hearing loss were 64 cases (50%) in moderate, 32 cases (25% ) in mild, 27 cases (21.1 %) in severe and 5 cases (3.9%) were normal. 4) Central perforation were observed in 65 cases (50.8 %), total perforation in 44 cases (34.4 %), attic perforation in 12 cases (9.4 %) and marginal perforation in 7 cases (5.4 %). 5) Pathologic changes of middle ear and mastoid antrum showed granulation in 81 cases (63.3 %), cholesteatoma in 47 cases (36.7%). 6) The route of approach were 123 cases (96.1%) in postauricular, 3 cases (2.3%) in transmeatal and 2 cases (1.6 %) in endaural. 7) Type of operation were 53 cases (41.4 %) in intact canal wall tympanoplasty with mastoidectomy, 42 cases (32.8 %) in tympanoplasty without mastoidectomy, 23 cases (18%) in modified radical mastoidectomy and 10 cases (7.8%) in radical mastoidectomy. 8) Type of anesthesia were 95 cases (74.2 %) by local anesthesia, 33 cases (25.8 %) were by general anesthesia. 9) Among 93 specimens of culture, proteus (31.2%), staphylococcus (28.7%), pseudomonas (23.7 %), streptococcus (7.5 %) and etc. (8.7%) in order of frequency.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.4
• /
• pp.283-309
• /
• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.109-117
• /
• 2024

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.2
• /
• pp.213-217
• /
• 2010

The use of chloral hydrate and hydroxyzine for oral sedation is most effective in children aged less than 36 months and weighing less than 15 kg. Children who do not belong to this category may show frequent movements due to shallow sedation level, and it can lead to sedation failures. One of the solutions to such sedation failure is conversion to deeper sedation. But, it is not so much of an option, since inhalation anesthetics and devices are required. In this case, conversion from oral sedation to intravenous sedation was successfully achieved without causing injection pain while searching for an intravenous route, by using EMLA cream (Eutectic Mixture of Local Anesthesia). A patient aged 46 months and weighing 15 kg visited the Pediatric Department of Dankook University Dental Hospital. Treatment under TSD(Tell Show Do) was offered, but due to the parent's request, oral sedative measures were taken. Considering prompt converting from oral sedation to iv sedation in case the oral sedation fails, EMLA cream was apllied preemptively. Adequate sedation level could not be achieved after 90 minutes of oral administration, therefore, under the parent's consent, intravenous route was prepared after conscious sedation by $N_2O-O_2$. During treatment, $ETCO_2$, $SPO_2$ and heart rate was monitored every 5 minutes. The patient showed stable vital signs and did not show any movements. The whole procedure took two and a half hours in total, and the treatment was completed without any adverse effects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.3
• /
• pp.142-147
• /
• 2023

Objectives: As medical history before surgery is often based on patient reporting, there is the possibility that patients intentionally hide underlying diseases or that dentists cannot recognize abnormal health states. Therefore, more professional and reliable treatment processes are needed under the Korean dental specialist system. The purpose of this study was to elucidate the necessity of a preoperative blood testing routine prior to office-based surgery under local anesthesia. Patients and Methods: Preoperative blood lab data for 5,022 patients from January 2018 to December 2019 were assembled. Study participants were those who underwent extraction or implant surgery under local anesthesia at Seoul National University Dental Hospital. Preoperative blood tests included complete blood count (CBC), blood chemistry, serum electrolyte, serology, and blood coagulation data. Values outside of the normal range were considered an "abnormality," and the percentage of abnormalities among the total number of patients was calculated. Patients were divided into two groups based on the presence of underlying disease. The rates of abnormalities in the blood tests were compared between groups. Chi-square tests were performed to compare data from the two groups, and P<0.05 was considered statistically significant. Results: The percentages of males and females in the study were 48.0% and 52.0%, respectively. Of all patients, 17.0% (Group B) reported known systemic disease, while 83.0% (Group A) reported no specific medical history. There were significant differences between Groups A and B in CBC, coagulation panel, electrolytes, and chemistry panel (P<0.05). In Group A, the results of blood tests that required a change in procedure were identified even though the proportion was very small. Conclusion: Preoperative blood tests for office-based surgery can detect underlying medical conditions that are difficult to identify from patient history alone and can prevent unexpected sequelae. In addition, such tests can result in a more professional treatment process and build patient confidence in the dentist.

• Korean Journal of Radiology
• /
• v.21 no.4
• /
• pp.422-430
• /
• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.3
• /
• pp.276-282
• /
• 2005

Inferior alveolar nerve block using lidocaine is the most frequent local anesthetic method in the dental treatment, but clinically it is not always successful. The 2% lidocaine cartridge has been used commonly in dental anesthesia. It contains vasoconstrictor and antioxidant, which presents low pH which provides chemical stability and longer shelf life. But alkalinized local anesthetics has less tissue trauma, easier dissociation of the non-ionized base which penetrates nerve sheath, rapid onset and more intensity. In this study, in inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate (experimental group) is compared with plain lidocaine (control group) about injection pain, anesthetic onset, duration and postinjection discomfort. In inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate showed lower injection pain. There was significant difference statistically from plain lidocaine(p=0.019). Comparing with plain lidocaine, alkalinized lidocaine produced more rapid onset (lip & pulp anesthetic onset), there was no significant difference(p>0.05). but there was boundary significance (0.050.05). These results suggest that addition of sodium bicarbonate to 2% lidocaine(1:100,000 epinephrine) for inferior alveolar nerve block is more effective for reduction of injection pain and onset time.

• Archives of Craniofacial Surgery
• /
• v.11 no.2
• /
• pp.107-110
• /
• 2010

Purpose: Chondroid syringoma is a rare mixed tumor of the skin that was first described by Hirsch and Helwig (1961). Characteristically, it is composed of the proliferation of epithelial cells in a myxoid and chondroid matrix. Most lesions occur on the head and neck region, and their size may range from 0.5~3 cm. Since a chondroid syringoma presents similar characteristics to other masses on the head and neck region, it is significantly important to distinguish with other masses by a surgical biopsy. Methods: A 51-year old woman presented with a painless nodular mass ($0.5{\times}0.5{\times}0.5cm$) on the philtrum, which appeared during the previous year. The mass was treated with a laser without a surgical biopsy. However, the size of the mass showed no changes. Surgical excision under local anesthesia was performed and sent for histopathology. Results: Gross examination showed a mass surrounded by a well developed capsule within the dermal layer. After complete excision without injury to the orbicularis oris muscle, the wound was covered with a local flap. The histology examination revealed numerous cuboid epithelial cells with tuboalveolar structures and keratinous cysts within a chondroid stroma. No recurrence or metastasis was observed at the follow-up visits. Conclusion: Chondroid syringoma is a rare mass on the face. An accurate diagnosis is essential for optimal treatment. This paper reports a case of a chondroid syringoma on the philtrum with a brief review of the relevant literature.