• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.203-212
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• 2020

Background: This research evaluated the numbness produced by lignocaine at an equal or higher concentration than that of 4% articaine through a single point of injection for maxillary third molar surgery. This randomized double-blind study was conducted to compare the anesthetic efficiency of 4% lignocaine with that of 4% articaine in impacted maxillary third molar surgery using a single buccal infiltration alone. Methods: The study participants were 30 healthy patients requiring the bilateral surgical removal of symmetrically-positioned maxillary third molars. Using a split-mouth design, each patient randomly received buccal infiltration of 1.7 ml of 4% lignocaine and 1.7 ml of 4% articaine during two separate appointments. After 15 minutes of anesthetic injection, surgery was performed by the same surgeon using a consistent technique on both sides. Pinprick test pain scores of the buccal and palatal gingiva of the maxillary third molar after 10 minutes and 15 minutes latencies, pain scores during the surgery, the need for supplemental anesthesia, and patients' satisfaction with anesthetic efficiency were recorded. Surgery performed without supplemental anesthesia was categorized as successful. Results: The success rates of 4% lignocaine and 4% articaine (83.34% vs. 86.67%, P = 1.00) were not significantly different. Only 5 cases (4 cases in the articaine group and 1 case in the lignocaine group) reported mild pain and pressure sensation (NRS ≤ 1) on probing at the palatal side after 15 minutes of latency (P = 0.25). The pain scores of maxillary third molar surgery in the two groups were not significantly different (P > 0.05). Moreover, the statistical analysis confirmed the comparable patient satisfaction of two study groups (P = 0.284). Conclusion: This study provides evidence that single buccal infiltrations of 4% lignocaine and 4% articaine have comparable anesthetic efficacy and success rates for impacted maxillary third molar surgery. Both 4% lignocaine and 4% articaine can produce effective palatal anesthesia and pain control using buccal infiltration alone after 15 minutes of latency.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.87-90
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• 2015

Purpose: We evaluated the efficacy of ultrasound-guided lower extremity nerve block in trauma patients. Methods: From July 2013 to April 2014, 17 patients with multiple trauma had lower extremity nerve block for immediate management of open wound in the lower extremity. We evaluated the patient satisfaction of the anesthesia and any complications related to the block. Results: During the lower extremity nerve block, incomplete nerve block occurred in one patient. This is the second case, the reason for this was the lack of technique. There was no anesthetic complications. Conclusion: Ultrasound-guided lower extremity nerve block in trauma patients is an effective anesthesia technique in the immediate management of open wound in lower extremities.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.1021-1026
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• 1990

The patients with tracheal stenosis have become more increasing in recent due to the increased use of tracheostomy and assisted ventilation Anesthetic management during tracheal reconstruction is a concern to the anesthetist and the surgeon, who must share the airway as a operation field and at the same time provide good gas exchange. Multiple technique such as the tube ventilation system or C \ulcornerP bypass method have been recommended to achieve this goals. However, these methods have disadvantages of poor surgical exposure and hemorrhagic complication from using C \ulcornerP bypass The technique for HFJV was first described for bronchoscopy, and it involves positive-pressure breathing with high flow[40 \ulcorner60L/min] of oxygen This flow is directed to a semirigid catheter inserted in the endotracheal tube and the tracheal reconstruction can be done without interruption. From Dec. 1986 to July 1990 we have experienced 6 patients of tracheal stenosis necessitating circumferential resection and end to end anastomosis; 5 patients with tracheal stenosis following cuffed tracheostomy or intubation, a patient with tracheal stenosis due to invasive thyroid cancer. The specific advantages during tracheal reconstruction are unobstructed field during surgical reconstruction and good gas exchange through the procedure.

• The Korean Journal of Pain
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• v.4 no.1
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• pp.37-41
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• 1991

Celiac Plexus neurolysis (C. P. N) has been commonly used to treat malignant pain of the abdominal area that is intractable. It relieves the pain effectively instead of using massive systemic narcotic analgesics. C. P. N. with modified transaortic technique was performed under C-T guidance, in which a single needle was advanced from a left posterior paramedian approach through the aorta in order to inject anesthetic agents directly into the celiac plexus. There was marked pain relief without any hemorrhagic and neurological or other complications. We found this modified transaortic method of C. P. N. to be very effective, safe and easy to perform compared with the classic two needle technique.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.217-226
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• 2022

Background: Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Methods: Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). Results: The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. Conclusion: The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.317-320
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• 1998

Since Reiestad and Str$\ddot{o}$mskag reported interpleural installation of local anesthetic solutions as a technique for the management of postoperative pain in the patients undergoing cholecystectomy, renal surgery and breast surgery, many physician applied this technique for upper abdominal pain from various reasons such as technically simple, effective pain relief, less respiratory depression. So we tried interpleural analgesia in two patients who suffered from severe upper abdominal pain. One had upper abdominal pain due to chronic pancreatitis and the other had right upper abdominal pain after PTBD (percutaneous transhepatic bile drainage) for biliary cirrhosis and systemic jaundice. Both were injected 10 ml of 1% lidocaine and infused continuously with 1% lidocaine (2 ml/hr) using 2-Day Baxter$^{(R)}$ infusor. After bolus injection of lidocaine, pain scores (VAS 0~100) were recorded below 25mm and had not exceed that level during continuous infusion. After removing the catheters, two patients were all satisfied with this therapy. Our experiences with this technique showed that continuous infusion of local anesthetics through an interpleural catheter is effective in the control of refractory upper abdominal pain without any complication.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.254-257
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• 1997

Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

• Journal of Korean Academy of Dental Administration
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• v.9 no.1
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• pp.32-37
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• 2021

Many approaches to local anesthesia have been studied in dentistry. In this study, we introduce a new local anesthetic method, "Point-Inject Technique (PIT)", and compare it with traditional injection techniques. The PIT method utilizes both the vasoconstrictive and antinociceptive properties of local anesthetics as well as the application of controlled pressure during injection, reducing the time to complete anesthesia. Fifty patients were selected as the experimental group who were anesthetized using PIT, and the other 50 patients were selected as the control group using the direct injection method with a carpool syringe. The PIT group received 0.25 cartridges of 2% lidocaine with 1:100,000 epinephrine. The control group received 1.5~2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Both groups were asked to mark the intensity of the pain caused by anesthesia using the Numeric Pain Rating Scale. The average time to recover from anesthesia was 40 minutes in the experimental group and 90 minutes in the control group. Additionally, 96% of the experimental group reported feeling no pain, while 78% of the control group reported having some form of pain during injection. The PIT method reduced both the reported pain scores of patients as well as time to recover from local anesthesia than the widely-used syringe injection method.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.73-76
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• 1997

Background : Epidural anesthesia is now accepted as a popular technique for pain relief and anesthesia. However, accidental dural puncture may occur during placement of the epidural needle. This study was undertaken to evaluate difference of the epidural depth between parturients and non-parturients. Method : Eighty non-parturients receiving epidural anesthesia were assigned to group I, and eighty parturients whose body weight had not yet increased over 15 kg from pregnancy were assigned to group II. With patients in lateral decubitus position, 18 guage Tuohy needle was punctured by approaching at $L_{3-4}$ interspace. Epidural space was identified using loss-of-resistance to air technique. Result : Epidural depth was 4.18 cm and 4.25 cm in group I and group II respectively. There was no significant statistical difference in body mass index(BMI) and ponderal index(PI) (p<0.05), nor in epidural depth between the two groups. Conclusion : Epidural needle need not be placed deeper in parturients than in nonparturients.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.127-131
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• 1990

Pediatric caudal anesthesia was done in 50 infants and children under 10 years of age, who were to undergo surgery of inguinal region. All cases were given 10mg/kg body weight of 1% lidocaine solution with epinephrine 1:200,000. The results were as follows : 1) Pediatric caudal anesthesia was simple, easy and reliable in technique. 2) Additional intravenous administration of Ketamine or pentothal sodium was needed. ie, to provide a more cooperative state. 3) Anesthetic effect was judged very Excellent. 4) Cardiovascular and respiratory changes were minimal. Author's came to conclusion that caudal anesthesia for pediatric inguinal region surgery is reliable, simple in technique, favorable to surgeon, and is considered to be a good technique for pediatric anesthesia.