• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.397-411
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• 2021

This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = -1.00; 95% confidence interval [CI] = -1.33 to -0.66), 12 hours (SMD = -0.80; 95% CI = -1.05 to -0.56), and 24 hours (SMD = -0.72; 95% CI = -1.02 to -0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.25-29
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• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.369-374
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• 2010

Purpose: Most of the patients who underwent surgery feels variable kinds of fear or anxiety; an uncomfortable mood state that happens without specific object affects patient's satisfaction before and after the surgery. As music therapy is rather noninvasive method generally used in reducing patient's anxiety, the authors researched about the extent of anxiety with the change of vital sign before the operation while comparing with the cases of patients who took the music therapy at closed reduction under general anesthesia. Method: We divided the patients in 4 groups; A with the premedication (Midazolam, Dormicum$^{(R)}$) before the operation, B with the premedication and music therapy, C with only music therapy, D with no premedication or therapy. And we measured the vital signs after the arrival at the operation room, after induction and 20 minutes after the operation. Also we observed the changes of anxiety index with the STAI (State Trait Anxiety Inventory)-K (Korea)YZ 1 hour before and 8 hours after the surgery. Result: The group B showed the least changes in blood pressure as the group D showed the highest change. Both group C and A showed increase in blood pressure but the upswing in group A was lower than group C. At the change of pulse rate group B showed the lowest upswing also group D showing the highest. Group B showed quite a few upswing but lower than group D, but, at the same time, group A showed lower upswing when comparing two cases. After analysis of STAI-KYZ score, the anxiety relatively decreased in group B and C in comparison with group D. And the index of anxiety state of group A showed just as much to group D. Conclusion: The music therapy is better healthcare method compared to other therapies in reducing anxiety also with satisfying effect who underwent operation. The authors recommend music therapy assisted with use of premedication for better relief of anxiety.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.9
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• pp.4061-4067
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• 2011

This study was conducted to verify the effects of preparatory information, the anxiety level of premedication as well as physiologic variable of patients undergoing bronchoscopy. Data collection was performed from June 4 from December 28 2007 with 102 patients. The degree of anxiety of the subjects was measured by the Spielberger State Trait Anxiety Inventory (Korea version). A booklet constructed by researcher as a research tool was used or patients education. Data were analyzed by using SPSS 14.0 program. As a result of the effect that preparatory information and premedication to the subjects undergoing bronchoscopy was statistically effective in reducing the degree of anxiety(p=.005) and controlling pulse rate(p=.033), respiratory rate(p=.006) on the specific threatening procedure but show no significant effectiveness on stabilizing systolic pressure(p=.062) and diastolic pressure(p=.189). Therefore it is thought that it can be actively applied to clinical practice.

• Proceedings of the KSLP Conference
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• 2009.03a
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• pp.33-35
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• 2009

• The Journal of the Korean dental association
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• v.10 no.8
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• pp.495-497
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• 1972

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.2
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• pp.100-103
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• 2009

Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.323-341
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• 2019

Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.109-120
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• 2000

To evaluate anesthetic effecto of propofol infusion after premedication with xylazine, 20 days were randomly assigned 4 groups. Propofol was infused (group 1: 0.2 mg/kg/min, group 2 : 0.4 mg/kg/min, group 3 : 0.6 mg/kg/min, group 4 : 0.8 mg/kg/min) for a period of 90 minute immediately after premedication with xylazine(1 mg/kg) and atropine(0.05mg/kg) under oxygen supplementation. Induction of anesthesia was rapid and smooth providing satisfactory conditions for intubation in all the dogs. No vomiting and cyanosis were observed after induction and during propofol infustion. There was pain reflex in group 1 but not in group 3 and 4. Mean arousal times (mins) were $6.18{\pm}3.65(group 1), 13.07{\pm}5.05(group 2), 22.06{\pm}6.48(group 3) and 23.33{\pm}9.28 (group 4) and Mean walking times were 16.20{\pm}6.15(group 1), 15.80{\pm}4.73(group 2), 28.27{\pm}7.55 (group 3), 39.10{\pm}13.75$ (group 4) respectively. In group 4, body temperature during total infusion period in group 3, 4. Hematologic values (WBC, RBC, PCV) and serum chemistry values(ALT, AST, BUN, creatinite) were monitored before anesthesia, 1 hour and 1 day after termination of infusion postanestesia. No significant changes were monitored in all experimental group. Although propofol infusions of 0.2 mg/kg/min and 0.4mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min proper to provide a light planes for minor surgical procedure during 90 minutes with xylazine premedication.

• Journal of Veterinary Clinics
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• v.16 no.1
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• pp.86-94
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• 1999

To invstigate the available dosage and effects of xylazine as preanesthetics on the propofol anesthesia in the dog, the experimental animals were randomly divided into 3 groups (xylazine 0.55 mg/kg (group 1), 1 mg/kg (group 2) and 2 mg/kg (group 3) were premedicated) and, monitored analgesic and anesthetic effect, body temperature, respiratory rate (breaths/minute), heart rate (beats/minutes). Also, hematological and serum chemical changes were monitored. In all experimental groups, the animals were recumbent just after propofol injection and time difference was not detected. Except vomitting after xylazine injection and insignificant ataxia during recovery, no significant side effects were observed. In group 2, loss of toe-web needle prick response time was slightly longer than group 1 but the response in group 2 and group 3 were similar, In group 2 and 3, the duration of anesthesia was longer than group 1 (2 folds) but there was no difference between group 2 and 3. Recovery time was prolonged in proportion to administration dosage of xylazine. In all experimental groups, the body temperature of animals was decresed gradually according to experimental time but no significant changes were monitored. The heart rate and respiratory rate were significantly (p<0.01, p<0.05) decreased after propofol injection Hematologically, no significant changes were monitored in total leukocye numbers, total erythrocye numbers, MCV, MCH, MCHC, serum GOT and GPT values Significant changes in all groups were not observed except significant increase in BUN, total-protein and abumin values of group 3. On the basis of these result, premedication of xylazine can be helpful in decresing some side effects and the dosage of propofol. 1 mg/kg of xylazine as preanesthetics on the propofol anesthesia in the dog is considered to be available.