• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.456-466
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• 2017

Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.22 no.6
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• pp.537-545
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• 2009

In this paper, new parameters were developed to estimate the depth of anesthesia during a general anesthesia using EEG. Power spectral density(PSD) analysis was used for these parameters because EEG became slow wave during anesthesia. The new parameters were DTR, ATR, TDR, ADR, BTR and BDR applied to PSD. These parameters were compared with SEF which is conventionally used at clinic and confirmed clinical value. As the results, DTR, ATR, TDR, ADR among parameters were not useful compared with SEF but BTR and BDR is valuable for clinic. 15 patents, at pre-operation BDR the value is $265.36{\pm}25.29$, at induction the value is $129.23{\pm}34.92$, at operation the value is $154.99{\pm}38.34$, at awaked the value is $283.83{\pm}39.80$ and at post-operation the value is $234.80{\pm}23.46$. Also at pre-operation BTR value is $183.38{\pm}13.59$, at induction the value is $104.09{\pm}25.11$, at operation the value is $115.38{\pm}23.42$, at awaked the value is $190.33{\pm}23.31$ and at post-operation the value is $172.38{\pm}19.08$. Trend of BDR and BTR is similar to change of SEF, so two parameters are useful. to estimate the depth of anesthesia.

• Journal of Biomedical Engineering Research
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• v.30 no.4
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• pp.327-332
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• 2009

In this paper, new index was developed to estimate the depth of anesthesia during general anesthesia using EEG. Analysis of the power spectral density(PSD) of EEG was used to develop new parameters because EEG signal tends to have slow wave during anesthesia. Classifier for index creator was developed by using SEF, BDR and BTR parameters, which are calculated by power spectral density. EEG data were obtained from 7 patients (ASA I, II) during general anesthesia with Sevoflurane. The anesthetic depth evaluation indexes ranged from 0 to 100. The average were $86.05{\pm}10.1$, $36.98{\pm}20.2$, $15.33{\pm}13.6$, $50.87{\pm}16.5$ and $87.72{\pm}11.7$ for the states of pre-operation, induction of anesthesia, operation, awaked and post-operation, respectively. The results show that while the depth of anesthesia was evaluated, more accurate information can be provided for anesthetician.

• Journal of Korean Academy of Nursing
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• v.42 no.3
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• pp.333-341
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• 2012

Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2491-2496
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• 2010

The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia. We studied ASA I or II adult patients supported by the society of anesthesiologists. Patients with history of dementia and neurological disorder are excluded. Average age is $48.9{\pm}10.9$ old, average weight is $57.1{\pm}8.2$ kg and average hight is $158{\pm}6.6$cm of the patients under the operation. Anesthesia medicine is Sevoflurane and the stages of anesthesia are 6 stages, that is pre-operation, induction, right after induction, stop the medicine and post-operation. Among the scaling exponent ${\alpha}1$, ${\alpha}2$, ${\alpha}3$ we know that ${\alpha}1$, ${\alpha}3$, were well appeared to discriminate pre-operation, induction, right after induction, stop the medicine and post-operation. So we confirmed that the parameters is useful to the depth of anesthesia.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.503-506
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.155-165
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• 2021

Background: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. Methods: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. Results: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. Conclusions: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.50-53
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• 2019

Awareness during general anesthesia occurs in approximately 0.1-0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0-5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7-1.3 MAC, awareness during anesthesia occurred.