• Biomolecules & Therapeutics
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• v.14 no.2
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• pp.83-89
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• 2006

The main aim of this study was to characterize the pharmacological profile of flavonoids utilizing behavioral tests and to investigate how the psychopharmacological activities of wogonin, baicalein and oroxylin A are different. Wogonin, baicalein and oroxylin A were intraperitoneally injected as dosages of 2.5, 5, 10 and 20 mg/kg. In the locomotor activity, Rota-rod test, and elevated plus-maze tests, the behavioral parameters were analyzed by automatic systems. Thiopental induced sleeping time was measured. Water extract of S. baicalensis didn't exhibit sedative effect. Wogonin and bacalein exhibited anxiolytic activity although it was less potent than buspirone. Wogonin and baicalein decreased locomotor activity at a dose of 10 mg/kg. Wogonin also shortened significantly running time on the rota-rod at doses of 5 and 10 mg/kg. Wogonin and baicalein enhanced sleeping at doses of 5 and 10 mg/kg. These results indicate that wogonin produce anxiolysis with sedation and so did bacalein with mild sedation. On the contrary, oroxylin A enhanced running activity on the rotarod and did't depress locomotor activity. Oroxylin A significantly hindered sleeping rather than helped it at doses of 5 and 10 mg/kg. Oroxylin A didn't produce anxiolysis and instead, produce awakening effect. This study demonstrates that wogonin and bacalein exhibited anxiolytic activity with mild sedation, but oroxylin A didn't produce anxiolysis and instead, produce awakening effect. This result indicates that anxiolytic effect without sedation induced by Scutellaria baicalensis is produced by combination of flavonoids.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.241-244
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• 2011

Introduction: Intravenous sedation is performed to ensure smooth and safe surgery. Dental anxiety is a reaction to an unknown danger. The Spielberger's state-trait anxiety inventory (STAI) can be used to simultaneously evaluate the levels of state and trait anxiety. State anxiety is defined as subjective feelings of nervousness. This study assessed the presurgical anxiety using STAI and performed intravenous sedation for patients whose level of state anxiety was > stage IV. Based on our clinical experience, it is believed that higher doses of sedatives are needed to induce the desired levels of sedation in patients with a high level of state anxiety. Objectives: This study examined whether the sedative consumption of the patient with a high anxiety level increased. Patients and Methods: Patients with state anxiety scores of ${\geq}$51 were included in Group V, and those with state anxiety scores ranging from 42 to 50 were placed in Group IV. To induce sedation, intravenous access was established, and a bolus dose of 3.0 mg midazolam was administered intravenously. Sedation was maintained by administering a continuous infusion of propofol, which was aimed at achieving an Observer's Assessment of Alertness/Sedation scale of 10-12/20. In this study, midazolam was initially administered when the body movements appeared to occur or the blood pressure increased. This was followed by the administration of higher doses of propofol if low sedation was observed. Results: There were no significant differences in the patient demographics, duration of sedation, and doses of local anaesthetic agents between Groups IV and V. The midazolam dose and mean propofol dose needed to maintain comparable levels of sedation were significantly higher in Group V than in Group IV. Conclusion: In female patients, whose level of preoperative state anxiety is more than Stage V of STAI, a large quantity of sedatives is needed for intravenous sedation.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.263-271
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• 2005

To compare the sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam (n = 5, TZ group), xylazine-ketamine (n = 5, XK group) and propofol (n = 5, PI group), we investigated the changes of hemodynamic (heart rate, arterial pressure), $SpO_2$, rectal temperature, respiratory rate and pain score during 60 minute sedation and 40 minute recovery period in beagle dogs. The value of rectal temperature was significantly higher in PI groups (p<0.05) during recovery period. The value of heart rate was significantly lower in XK group (p<0.05) during sedation. The changes of respiratory rate were similar tendency in all groups. The change of $SpO_2$ was stable during sedation and value was significantly higher in PI group (p<0.05) during recovery period. The value of systolic arterial pressure (SAP) was significantly lower in XK group (p<0.05) than PI group during sedation and recovery period. Low analgesic effect occurred in PI group. We concluded that intravenous anesthesia by intermittent bolus injection with propofol is useful in stabilizing rectal temperature, $SpO_2$ and hemodynamic during sedation and provide fast recovery, but have low analgesic effect.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.461-469
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• 2021

Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• YAKHAK HOEJI
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• v.31 no.1
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• pp.19-24
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• 1987

In order to find out the pharmacologically active but less toxic compounds than piperine, the actions of several amide derivatives of 5-phenyl-2, 4-pentadienoic acid on the CNS depressant activities were examined. The nine amide derivatives were investigated by using ICR mice as an experimental amimals on acute toxicities, anticonvulsant, sedative, analgesic and antipyretic effects. In the case of acute toxicities, all derivatives were weaker than piperine except compound III. Compound I showed strong anticonvulsant activity. On the other hand, compound I, III and IV significantly prolonged the sleeping time induced by hexobarbital in mice. Compound I, III and IV exhibited better analgesic effect than aspirin while compound II, V, VII and IX showed similar antipyretic activity to aspirin.

• YAKHAK HOEJI
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• v.43 no.2
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• pp.251-262
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• 1999

In order to investigate pharmacological properties of New Wonbang Woohwangchungsimwon Pill (NSCH) and Wonbang Woohwangchungsimwon Pill (SCH), the effects of NSCH and SCH on cerebral ischemia and central nervous system were compared. Cerebral ischemia insult was performed using unilateral carotid artery occlusion in mongolian gerbils. The histological observations showed preventive effects of NSCH and SCH treatments with ischemia-induced brain damage. The ATP in brain tissue was decreased in vehicle-treated ischemic gerbils. This decrease was prevented by SCH treatment. In contrast to what was inhibited by NSCH and SCH treatments. While NSCH and SCH had no effects on the hexobarbital-induced sleeping time, they prevented the seizures induced by electric shock and strychnine. NSCH and SCH showed sedative effect in rotarod and spontaneous activity test. Furthermore, NSCH and SCH showed anti-stress effect. Our findings suggest that the pharmacological profiles of NSCH on cerebral ischemia and central nervous system are similar to those of SCH.

• YAKHAK HOEJI
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• v.17 no.1
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• pp.1-8
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• 1973

The pharmacological activities of paeoniflorin abtained from paeony roots, F$_M$100 from glycyrrhiza roots, crude saikosides from bupleurum roots, crude platycodin from platycodon roots, and bothj of ginsenoside Rb and ginsenoside Rg series from ginseng roots were investigated. Paeoniflorin, F$_M$ 100, crude saikosides, and crude platycodin exhibited sedative antipyretic, anlagesic and anti-ulcerative actions. In addition, crude saidosides and crude platycodin showed antitusaive and the potent anti-inflammatory action. An expectorant action was also observed with crude platycodin. These results coincided with the clinical applications of the aforementioned oriental medicinals. It also should be noted that crude saikosides nad crude platycodin are preferable to the other steroidal nad nonsteroidal drugs as an anti-inflammatory agent, because the drugs aggravate the digestive ulcer. In ginseng, G No3. and GNS frctions out of ginsenoside Rb series hsowed stimulant and antifatigue actions. The synergistic effects identified between paeoniflorin and F$_M$ 100 on the various pharmacological activities, have verified the reasonability of combined uses of two oriental drugs as Jakyak Gaqmcho-Tang.

• YAKHAK HOEJI
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• v.29 no.1
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• pp.1-10
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• 1985

The ether fraction obtained from dry fruit of Cornus officinalis was investigated for the anti-inflammatory action, acute toxicity and central nervous system activities. From several pharmacological examinations, it was found that the ether fraction suppressed considerably carrageenin edema at the dose of 600mg/kg p.o. in rats, inhibited the granuloma formation in rats as given 100mg/kg p.o. for 7 days and decreased the swelling of both of complete adjuvant injected and noninjected (contralateral) paws of the rats at the dose of 100mg/kg p.o. given for 14 days. The $LD_{50}$ of the fraction are estimated to be more than 2,000mg/kg p. o. and 642mg/kg i. p. in mice. And the fraction did not show any sedative, stimulative, analgesic and anticonvulsant action but exhibited hypothermic action. These results might be concluded that the ether fraction of Corni fructus showed anti-inflammatory action in both of acute and chronic type models without any considerable central nervous depressant activity and exhibited very weak acute toxicity in mice.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.117-123
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• 2012

Optimal level of sedation and analgesia is important for the comfort and safety of critically ill patients. However, suboptimal sedation is relatively common in the intensive care unit (ICU) and it could cause prolonged mechanical ventilation and ICU stay, also increase delirium and ICU acquired weakness and resultant decreased survival. Therefore, accurate assessment of the level of sedation and analgesia, maintaining adequate level of sedation, and daily evaluation of each patient and following adjustment could be important treatment strategy in critically ill patients. Recently, the strategy for sedation in the ICU is changing toward the direction of lowering sedation level or even "no sedation" with concurrent use of analgesics and the use of ultra short acting analgesics could be helpful in some patients. Clinicians should be aware of the importance of algorithmic approach including daily interruption of sedative and assessment of sedation level and especially in the patients under mechanical ventilation, organizational approaches such as the 'ABCDE' bundle could improve the management of critically ill patients.