• 대한수의학회지
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• 제46권1호
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• pp.47-55
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• 2006

To evaluate method for monitoring anesthetic depth with quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) and pain score till 100 minutes in beagle dogs anesthetized for 60 minutes with propofol (n = 5, PRO group), isoflurane (n = 5, ISO group) and propofol-ketaminefentanyl (n = 5, PFK group). Raw EEG was converted into 95% spectral edge frequency (SEF) by fast Fourier transformation (FFT) method. We investigated anesthetic depth by comparing relationship (Pearson's correlation) between q-EEG (95% SEF) and pain score. Pearson's correlation coefficients are +0.2372 (p = 0.0494, PRO group), +0.79506 (p < 0.001, ISO group) and +0.49903 (p = 0.0039, PFK group).

• 대한치과마취과학회지
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• 제9권1호
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• pp.9-16
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• 2009

Background: This study aimed to evaluate the cooperative levels of dental patients requiring general anesthesia during dental treatments. Anesthetic induction methods for patients were also recorded and analyzed using descriptive statistics. Methods: Total 566 patients who visited Seoul National University Dental Hospital Clinic for Persons with Disabilities were reviewed on pre-anesthetic review and anesthesia records. The cooperative levels of patients were graded by 4 levels and induction methods used for the patients during general anesthesia application were analyzed. Results: More than half of patients(55.8%) were willing to receive the anesthetic induction(cooperative level 1), 18.6% were minimally cooperative(level 2), 20.8% needed physical restraint prior to induction(level 3), and 4.8% was poorly cooperative and induction procedure was performed under an unconscious condition after ketamine intramuscular injection(level 4). There was no gender difference in cooperative levels(P=0.11). Patients over 30 years revealed better cooperation levels compared to other age groups(P<0.05). For patients of level 1, 53.5% were anesthetized in a way of intravenous induction, while 77.1% out of patients of level 3 were anesthetically induced through inhalation method. Conclusion: Many dental patients with special needs were not cooperative to receive anesthetic induction. Additional behavioral support may be applied to poorly cooperative patients for the safe and successful clinical outcome.

• The Korean Journal of Pain
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• 제28권1호
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• pp.11-21
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• 2015

Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.7-14
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• 2011

Purpose: Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. Methods: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods. Results: The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia. Conclusion: The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.

• 임상간호연구
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• 제14권3호
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.81-88
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• 2016

Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.

• 융합신호처리학회논문지
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• 제20권2호
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• pp.63-69
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• 2019

본 연구에서는 뇌파의 스펙트럼 분석에 의해 추출되는 마취심도 지표인 SEF(spectral edge freqency), MF(median frequency)의 가변성 감소를 위하여 뇌파의 비선형성에 근거하여 바이스펙트럼 분석기법을 도입하고자 한다. 수술환경에서 뇌파의 계측과 분석은 다양한 외부 아티팩트 요소를 감안하여야 한다. 바이스펙트럼 분석은 비선형적 신호의 특성을 추출하는 분석법으로 외부 유입 아티팩트의 유무를 확인 할 수 있어 뇌파에 인입되어 분석에 영향을 끼치는 아티팩트를 효과적으로 제거하는데 기여한다. 이러한 과정을 통해 SEF, MF와 같은 마취심도 파라미터의 실시간 가변성을 감소시킬 수 있었다. 이러한 가변성 감소는 수술현장에서 실시간 활용 가능한 임상 지표서 SEF, MF의 유용성을 제고시켜 줄 수 있을 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.377-386
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• 2020

Background: To compare pain perception during palatal injection administration in children aged 7-9 years while using pre-cooling of the injection site versus application of topical anesthesia as a pre-injection anesthetic during the six months. Method: A prospective randomized split-mouth crossover trial was conducted among 30 children aged 7-9 years, who received topical application of either a pencil of ice (test group) or 5% lignocaine gel (control group) for 2 min before injection. The primary and secondary outcome measures were pain perception and child satisfaction, measured by the composite pain score and the faces rating scale, respectively. Unpaired t-test was performed to determine significant differences between groups. Results: The test group had significantly lower pain scores for self-report and behavioral measures (P < 0.0001). The changes in physiological parameters at the baseline (P = 0.74) during (P = 0.37) and after (P = 0.88) the injection prick were not statistically significant. Children felt better by the pre-cooling method (P < 0.0001). Conclusion: Ice application using a pencil of ice for 2 min reduced pain perception significantly compared to the use of a topical anesthetic. Moreover, ice application was preferred by children.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.276-282
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• 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.