• Kosin Medical Journal
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• v.33 no.2
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• pp.245-251
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• 2018

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.2
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• pp.95-99
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• 2020

Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.57-57
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• 2023

• The Journal of Korean Physical Therapy
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• v.18 no.4
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• pp.41-50
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• 2006

Purpose: The purpose of this study was to determined that the efficacy and comfort of iontophoretic transdermal delivery of lidocaine by comparison of local anesthetic duration, sensory threshold, pain threshold and pain tolerance levels according to four different cleansing regimes. Methods: Forty healthy volunteers were randomly assigned to four groups; oil cleansing group, lotion cleansing group, solution cleansing group and alcohol cleansing group. All subjects were received lidocaine iontophoresis on the forearm using direct current with 4 mA for 10 minutes. All subjects were measured the duration of local anesthesia after lidocaine iontophoresis, also evaluated the sensory threshold, pain threshold and pain tolerance level during iontophoresis. For comparisons of the efficacy and the sensory characteristics of iontophoresis within the groups, an one-way ANOVA was used. Results: The duration of local anesthesia were found significant difference between groups (p<0.001). The anesthetic duration in solution and alcohol cleansing groups were significantly longer than oil and lotion cleansing group by post hoc (p<0.05). Statistically significant difference were noted in respect to all sensory characteristics such as sensory threshold, pain threshold and pain tolerance between groups (p<0.001). The sensory threshold in solution and alcohol cleansing group were significantly lower than oil and lotion cleansing group by post hoc using Duncan multiple range test (p<0.05). The pain threshold and pain tolerance in solution and alcohol cleansing group were significantly higher than oil and lotion cleansing group by post hoc (p<0.05). Conclusion: These results demonstrated that cleansing regimes have affected the efficacy and discomfort of iontophoretic transdermal delivery of lidocaine. These findings indicate that cleansing agents without oil ingredient contributed to more comfort, and more successful achievement of the iontophoretic transdermal delivery.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.271-287
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• 2021

Background: Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. Methods: We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Conclusions: Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.66-71
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• 1989

It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.19 no.6
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• pp.1471-1476
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• 2015

Due to the anesthesia process is inappropriate on the operation, awakening state was appeared. To prevent the state, it is necessary to monitor the patients by measuring the depth of anesthesia. In this study, we investigate the possibility of the development of actual surgery available quantitative indicators. The DFA which is included the correlation property of the EEG is used to analysis the depth of anesthesia and bispctrum index. In the results, at the pre-operation, the peak of bispectrum was widely distributed, DFA value was decreased. At the during operation, bispectrum was concentrically appeared in the low frequency area. At the post operation, bispectrum and DFA was both returned to the pre-operation state. We confirmed to be close correlation between the peaks of the bispectrum and DFA value.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2015.05a
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• pp.397-400
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• 2015

Due to the anesthesia process is inappropriate on the operation, awakening state was appeared. Because of that patients suffered from severe mental and physical pain. To prevent the state, it is necessary to monitor the patients by measuring the depth of anesthesia. In this study, we investigate the possibility of the development of actual surgery available quantitative indicators. The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia and bispctrum index. In the results, at the pre-operation, the peak of bispectrum was widely distributed, DFA value was decreased. At the during operation, bispectrum was concentrically appeared in the low frequency area. At the post operation, bispectrum and DFA was both returned to the pre-operation state. As a result, we confirmed to be close correlation between the peaks of the bispectrum and DFA value.

• 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 The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.