Purpose: This study aims at confirming the effects of the chest meridian massage on the post-anesthetic recovery of general anesthesia appendectomy patients. Method: The research was post-test designed as a nonequivalent control group among quasi-experiments tested. The data was collected from June 20, 2003 to October 14, 2003 at a hospital in P city. In the collected data, using SPSS Win 10.0 program, these general features were analyzed by real numbers and percentages; the homogeneity among variables by $X^2-test$ and t-test and the research hypothesis by the t-test. Result: Hypothesis 1; The experimental group receiving the treatment of the chest meridian massage will have a much higher post-anesthetic recovery score than that of the control group not receiving it was supported(t=2.544, p=.014). Hypothesis 2; The experimental group receiving the treatment of the chest meridian massage will have a much shorter time of stay in the recovery room than that of the control group not receiving it was supported(t=-4.919, p=.000). Conclusion: According to these results, it may be concluded that Chest Meridian Massage is effective in producing a higher level of post-anesthetic recovery score and helps appendectomy patients reduce the time of stay in the recovery room. Therefore the chest meridian massage can be considered as an intervention therapy for directly nursing general anesthesia appendectomy patients.
Purpose: This research was conducted to evaluate, analyze, and determine the limitation of the anesthesia that is used in there covery room in order to provide the foundation for developing the effectiveness of it. Method: There covery records of this study were collected from 41 hospitals in Seoul, Kyung Kii-Do, and Inchon province. The post anesthetic recovery records consisted of the evaluation of type, evaluative items, frequency, time, score and $SaO_2$. These records were collected from September to December of 2005. Results: The most commonly used post anesthetic evaluation tool was Alderete Score, which was used in 73% of hospitals. The second was Aldrete Score with $SaO_2$(17%). Also, 5% of the hospitals used the modified AS form. There were 2.5% of the hospitals applying the adult and child in the evaluation separately. Also, the last 2.5% of the hospitals did not use AS but measured BP, pulse, respiration, temperature, and $SaO_2$ with observing nausea, vomiting, urinary retention, backache, laryngitis, shock, and neurologic assessment. Conclusion: It is necessary to develop a post-anesthetic recovery evaluation tool including the application of $SaO_2$, so that the early-diagnosis of hypoxia can be possible. In addition, it is necessary to develop a post- anesthetic recovery evaluating method that can distinguish a difference between adults and children.
The purpose of this study was to evaluate and compare the effectiveness of ilioinguinal-hypogastric nerve blocks(IHNB) and caudal block in producing post-orchiopexy and post-heniorrhaphy analgesia in children. Forty consenting healthy children, ages 3~10yr, were randomly assigned to receive caudal bupitvacaine (0.125%, 0.5ml/kg), or IHNB bupivacaine (0.25%, 0.3 ml/kg). Blocks were performed following the induction of general anesthesia, be fore the operation. Pre-anesthetic medication in form of atropine 0.01 mg/kg, droperidol 0.05 mg/kg were given intramuscularly one hour before induction to 40 children. Children were induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously. Anesthesia was maintained with oxygen-nitrous oxide ($FiO_2$ 0.3) and ethrane. When the patients stabilized after induction. IHNB was done in the supine position and caudal block was done in the lateral position. The local anaesthetic was injected after negative aspiration. Postoperative pain was assessed with face pain rating scale (RPRS) at rest on discharge of recovery room, and 5 hours after discharge of recovery room, and the "red and white" visual analogue scale (VAS) at rest and mobilization from supine to sitting position on discharge of recovery room, and 5 hours after discharge of recovery room. Post-operative recovery was quiet and comfortable, without side effect. Relief of ain was complete in both IHNB group and caudal group. Surgeons, parents and recovery room personnel were satisfied. There were no surgical or anesthetic complications. In our study, the postpoerative pain scores were similar in both IHNB group and caudal group. IN conclusion, we found that both IHNB and caudal blocks before the start of surgery for orchiopexy & herniorrhaphy are safe and effective in controlling the postoperative pain of children.
Journal of Korean Academy of Nursing Administration
/
v.14
no.4
/
pp.432-439
/
2008
Purpose: The purpose of this study was to examine nursing workload associated with patient and anesthetic factors in the post-anesthesia care unit(PACU). Method: The data used in this study were collected from February 26th, 2008 to May 16th, 2008. The subjects were 828patients and collected data were analyzed by using SPSS program. Results: It was found that there were statistical differences in gender, age, past history, type of anesthesia, duration of anesthesia, type of surgery. The mean PRN for nursing workload was 25 for below 17 years, and 27.5 for above 61 years. The mean PRN for nursing workload was 27 for general anesthesia, and 16 for regional anesthesia. The mean PRN for nursing workload was 29 for orthopedic surgery and neurosurgery, and 23 for ophthalmology. The mean PRN for nursing workload was 24.6 for below 1hour in duration of anesthesia, and 27.5 for above 2hours in duration of anesthesia. Conclusion: This study was carried out to examine nursing workload in the PACU. The results from this study will be help to improve nursing in PACU through efficient distribution of nursing workload in PACU.
The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$$libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.
So, Eunsun;Kim, Hyun Jeong;Karm, Myong-Hwan;Seo, Kwang-Suk;Chang, Juhea;Lee, Joo Hyung
Journal of Dental Anesthesia and Pain Medicine
/
v.17
no.4
/
pp.271-280
/
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.
Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.
Kim, Jae-Jun;Jo, Min-Seop;Cho, Kyu-Do;Park, Yeon-Jin;Kim, Yong-Shin;Cho, Deog-Gon
Journal of Chest Surgery
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v.40
no.4
s.273
/
pp.313-316
/
2007
Negative pressure pulmonary edema (NPPE) during anesthetic recovery is a rare, but potentially serious complication for patients who are undergoing different surgical procedures. The proposed mechanism is the generation of high negative pressure during markedly respiratory effort and upper airway obstruction from glottis closure and laryngospasm, and this all leads to pulmonary edema. We report here on a case of a healthy 26-year-old male who immediately developed NPPE and hemoptysis following extubation after partial rib resection due to benign rib tumor; the patient was treated conservatively. We also include a review of the review literatures.
Journal of The Korean Dental Society of Anesthesiology
/
v.14
no.2
/
pp.95-100
/
2014
Background: About 60% of patients with epilepsy showed a variety of complications after returning home. The purpose of this study is to get further information and to help in the anesthetic management of the disable patients with epilepsy. Methods: After searching the outpatient anesthesia list of Seoul National University Dental Hospital clinic of the disabled from September 2010 to March 2012, we found total 83 patient cases who were taking antiepileptic drugs. A nurse of anethesiology department called to the patient's home after general anesthesia and got surveys with questionnaires form filled with complications at home. We enrolled total of 51 patients who agreed to participate this survey. And we also reviewed pre-anesthesia evaluation sheet, anesthesia record, and recovery and discharge record. Results: 11 of 51 (21.6%) patients had seizure convulsion at home within 1 weeks. 33.4% of patients who had at least once seizure attack per week had a seizure attack within 3 days. And 50% of once a month frequency patients had a seizure attack within 1 week. 33% of 1 - 3 seizure attacks per year patient group had a convulsion within 1 week. But there was no seizure attack within 1 week in whom had no seizure attack history during more than 1 year. Conclusions: After dental treatment, patient taking anticonvulsant have so many complications-especially seizure, more than we respected. We need more research about handle these problems.
Purpose: To identify the apoptosis caused by Proparacaine hydrochloride (PPC), a topical anesthesia, applied to conjunctival cell lines and determine whether pigallocatechin-gallate (EGCG), has protective effects on. Methods: The conjunctival cell lines were treated with 0.5% of Alcaine$^{(R)}$, 0.5% of PPC and 0.01% of Benzalkonium chloride (BAC) for 15 minutes, respectively in order to investigate the effects of topical anesthesia on cells, and followed by cultured for 12 and 24 hours. The recovery effects were investigated by measuring level of cellular proliferation inhibiting using MTT assay and LDH assay. The conjunctival cell lines were pre-treated with EGCG $10{\mu}M$ for 3 hrs and post-treated with 0.5% PPC for 15 mins in order to investigate whether EGCG has protective effects, flow cytometry were performed in order to observe apoptosis. Results: A result of the additional culture of 12 and 24 hours and again immediately after the treatment for 15 minutes 0.5% of Alcaine$^{(R)}$, 0.5% of PPC, the 0.01% of BAC, cell viability was not increased in all groups (p<0.05). The cell viabilities were higher than in cells 3 hours post-treated with $10{\mu}M$ of EGCG and pre-treated PPC 0.5% (68.2%), compared to cells ($32.2{\pm}2.0%$) treated only with 0.5% of PPC. PPC 0.5% also induced apoptosis in the treated group was reduced by the addition of EGCG. Conclusions: It is considered that the EGCG has cell protective effects when it is added to PPC, a topical anesthesia, by improving cell viability and inhibiting apoptosis.
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