• Title/Summary/Keyword: Sedatives

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Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study (중환자실 환자의 집중치료 경험 및 관련 요인: 이차분석 연구)

  • Jiyeon Kang;Hyojeong Woo
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.11-23
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    • 2023
  • Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

Pharmacological Behavioral Management for children and adolescence (소아청소년의 약물적 행동유도)

  • Shin, Teo Jeon
    • The Journal of the Korean dental association
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    • v.54 no.11
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    • pp.923-931
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    • 2016
  • Managing uncooperative behaviors related to dental treatment is necessary for guiding children and adolescence to more favorable behaviors. The first approach should be controlling their behaviors using non-phamarcologic behavior management techniques. However, if this approach fails, it is helpful to control negative behaviors pharmacologically. Accordingly, sedation is frequently used to relieve anxiety related to dental treatment. Also, general anesthesia has been applied to the situations in which sedation is either ineffective or impossible to gain cooperation during treatment. This article discusses the pharmacology of widely used sedatives for children and adolescence and clinical considerations of managing uncooperative children and adolescence with the use of sedation. Furthermore, we recommend clinical indication of selecting general anesthesia rather sedation for the purpose of behavior management.

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DENTAL TREATMENT OF PSYCHIATRIC PATIENTS (정신장애 환자의 치과치료)

  • Moon, Sung-Yong;Kim, Su-Gwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.1
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    • pp.1-9
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    • 2006
  • Patients with severe mental problems have difficulty maintaining good oral hygiene, so that the incidence of dental disease is greater, the disease is more severe, and the progression is much faster in these patients. Generally, they require physical restraint, drug-induced sedation, and general anesthesia since they are not cooperative. In many cases, these patients have systemic disease, so that the prognosis after dental treatment depends highly on the management of existing diseases. The problems related to treating these patients are examined and methods of using general anesthesia and sedatives are further examined to propose better ways of treating these patients.

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Phthalide Content of Cnidium Rhizome (토천궁과 일천궁의 Phthalide류 성분비교)

  • Lee, Sook-Youn;Kim, Myung-Jin;Yim, Dong-Sool;Chi, Hyung-Joon;Kim, Hyun-Soo
    • Korean Journal of Pharmacognosy
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    • v.21 no.1
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    • pp.69-73
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    • 1990
  • Cnidium Rhizome(Chuan-Xing) used as sedatives, the treatment of anemia, woman's disease and ozena etc. has been one of the important oriental medicines. This paper deals with a comparison of butylidene phthalide and ligustilide as main components between rhizome of Conioselinum sp. and rhizome of Cnidium officinale by HPLC. The contents of butylidene phthalide in rhizome of Conioselinum sp. and rhizome of Cnidium officinale were found to be 0.083%, 0.067% and that of ligustilide to be 0.304%, 0.272% respectively.

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Sleep-Related Eating Disorder (수면 관련 식이 장애)

  • Park, Young-Min
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.5-9
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    • 2011
  • Sleep-related eating disorder (SRED) is a newly recognized parasomnia that describes a clinical condition of compulsive eating under an altered level of consciousness during sleep. Recently, it is increasingly recognized in clinical practice. The exact etiology of SRED is unclear, but it is assumed that SRED might share features of both sleepwalking and eating disorder. There have been also accumulating reports of SRED related to the administration of various psychotropic drugs, such as zolpidem, triazolam, olanzapine, and combinations of psychotropics. Especially, zolpidem in patients with underlying sleep disorders that cause frequent arousals, may cause or augment sleep related eating behavior. A thorough sleep history is essential to recognition and diagnosis of SRED. The timing, frequency, and description of food ingested during eating episodes should be elicited, and a history of concurrent psychiatric, medical, sleep disorders must also be sought and evaluated. Interestingly, dopaminergic agents as monotherapy were effective in some trials. Success with combinations of dopaminergic and opioid drugs, with the addition of sedatives, has also been reported in some case reports.

Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging

  • Jung, Sung Mee
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.159-168
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    • 2020
  • The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. The traditional drugs, such as chloral hydrate, pentobarbital, midazolam, and ketamine, are still used due to the ease of administration despite low sedation success rate, prolonged recovery, and significant adverse events. Currently, dexmedetomidine, with respiratory drive preservation, and propofol, with high effectiveness and rapid recovery, are preferred for children undergoing ambulatory MRI. General anesthesia using propofol or sevoflurane can also provide predictable rapid time to readiness and scan times in infants or children with comorbidities. The selection of appropriate drugs as well as sufficient monitoring equipment are vital for effective and safe sedation and anesthesia for ambulatory pediatric MRI.

How can neurological outcomes be predicted in comatose pediatric patients after out-of-hospital cardiac arrest?

  • Kim, Hyo Jeong
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.164-170
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    • 2020
  • The prognosis of patients who are comatose after resuscitation remains uncertain. The accurate prediction of neurological outcome is important for management decisions and counseling. A neurological examination is an important factor for prognostication, but widely used sedatives alter the neurological examination and delay the response recovery. Additional studies including electroencephalography, somatosensory-evoked potentials, brain imaging, and blood biomarkers are useful for evaluating the extent of brain injury. This review aimed to assess the usefulness of and provide practical prognostic strategy for pediatric postresuscitation patients. The principles of prognostication are that the assessment should be delayed until at least 72 hours after cardiac arrest and the assessment should be multimodal. Furthermore, multiple factors including unmeasured confounders in individual patients should be considered when applying the prognostication strategy.

The Causes and Treatment of Complicated Chronic Insomnia (까다로운 만성불면증의 원인과 치료)

  • Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.2 no.2
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    • pp.138-145
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    • 1995
  • The causes of complicated chronic insomnia are very various and interact with vicious circle. Patient with this insomnia has generally a strong fear and frustration about failing to control of sleep and a deep mistrust toward doctor. To solve this complicated problems detailed history taking and sleep questionnaires are needed with objective polysomnography. Through these procedures, doctor should clarify causes of insomnia and explain them to patient in details and kindly. This process would be very helpful to restore the mistrustful relationship between patient and doctor and reduce patient's vague fear for insomnia. In treatment of complicated chronic insomnia, it is most important for patient to understand his problems and participate in the treatment schedule actively with assurance. Also doctor should encourage patient persistently not to be drop out. Most important factor for prognosis is patient's personality. Causes of complicated chronic insomnia are like these, overdose of hypnotics and sedatives, daily drinking alcohol with hypnotics, insomnia associated depression, delayed sleep phase syndrome, sleep state misperception, marked fear for insomnia, hyperarousal at bed, insomnia associated periodic leg movement and sleep apnea, chronic hypnotic insomnia, and immature personality. And possible treatments of these insomnias were discussed.

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Sleep and Alcohol (수면과 알코올)

  • Lee, Jin-Seong;Kim, Sung-Gon;Jung, Woo-Young;Yang, Young-Hui
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.59-62
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    • 2013
  • Alcohol has been used as sedatives historically. The effect of alcohol on sleep is different according to its dose, timing of ingestion, and drinking frequency. Sleep problems may play a role in the development and course of alcohol-related disorders. Insomnia in alcohol-dependent patients is common and early treatment of insomnia may reduce the rate of relapse. Sleep apnea, restless legs syndrome, periodic limbs movement disorder, and altered circadian rhythm may be more frequent in this patients. Management of sleep and alcohol problems is important in treating alcohol-related disorder and sleep disorders, respectively.

THE EFFECT OF SEDATIVES ON AUDITORY BRAINSTEM RESPONSE (Sedative가 정상청력 성인의 ABR에 미치는 영향)

  • 손진호;장원삼;손수준;조태환;성창섭
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.7.3-8
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    • 1987
  • 청성뇌간 유발반응이 Juwett 및 Sohmer와 Feinmesser에 의하여 보고된 이래 타각적 청력검사로서 임상적응용에까지 이르렀다. 타각적 청력검사는 반응역치와 청각역치의 오차가 적어야 하며 주파수별로 역치측정이 가능하여야 하며 개인차가 적고 반응의 재현성이 높아야 되며 반응의 판정이 용이해야 함이 필요조건으로서 이러한 조건이 피검자의 수면상태하에서도 충족되어야 한다. 저자들은 정상 성인 청력자를 대상으로 sedation전후의 ABR에 대한 latency 및 amplitude를 중심으로 관찰하여 다음과 같은 결과를 얻었다. 1) Sedative의 사용에 있어서 amplitude및 latency의 차이는 없었다. 2) Sedative의 사용에는 무관하게 low frequency filter에서 high frequency filter보다 voltage의 유의한 차가 있었다.

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