• 대한치과마취과학회지
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• 제13권3호
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• pp.81-87
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• 2013

This article discusses the issues of benefit and possibility of application of patient-controlled sedation (PCS) for the dental treatment. The purpose of administering PCS for patients is to diminish anxiety and to provide cooperative and effective dental treatment. But there are a lot of barriers to application of PCS such as knowledge about pharmacokinetics of sedatives, expensive high speed and patient-controllable syringe pump, and well educated sedationist. And there could be risk of deep sedation, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, appropriate drug selection, selection of right bolus dose, lock-out time is much important.

• 한국환경보건학회지
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• 제33권3호
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• pp.202-206
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• 2007

Petasites japonicus (Compositae) is a perennial herb which has been used as treatment of antitussive, expectorant, sedatives, paralysis, diurectics in folk remedies. The pharmacological studies of this natural drug have not yet estabilished. So, we examined anti-lipid peroxidative effects and liver protective effect on $CCl_4$ induced lipid peroxidation and hepatotoxicity in rats. In vivo liver lipid, MeOH Ex. revealed significant increase of anti-lipid peroxidative effects according to concentration dependently. In chemical parameters obtained from serum analysis, MeOH Ex. as a increase of medicine concentration (0.25 g/kg, 0.5 g/kg, 1.0 g/kg), GOT, GPT, AlP decreased. In 0.5 g/kg GPT administered group, there was relative in GOT, AlP. Cholesterol decreased in 1.0 g/kg and 1.0 g/kg administered group, BUN decreased relatively in 1.0 g/kg administered group.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.123-133
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• 2023

Sedation methods for dental treatment are increasingly explored. Recently, ketofol, which is a combination of ketamine and propofol, has been increasingly used because the advantages and disadvantages of propofol and ketamine complement each other and increase their effectiveness. In this review, we discuss the pharmacology of ketamine and propofol, use of ketofol in various clinical situations, and differences in efficacy between ketofol and other sedatives.

• Journal of Hospice and Palliative Care
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• 제19권2호
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• pp.119-126
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• 2016

목적: 본 연구의 목적은 섬망이 있는 말기암환자에 있어 진정제의 투약 투약 관련 특성을 파악하고, 진정제 투약군과 비투약군 간의 생존기간의 차이를 확인하기 위함이다. 방법: 본 연구는 2012년 1월부터 2013년 12월까지 B 광역시 소재 P대학교병원에서 응급실과 수술실, 중환자실을 제외한 병동에서 임종한 암환자 900명 중 경과기록지, 간호기록지를 통해 섬망선별 도구인 Nu-DESC를 이용하여 섬망이 있었던 말기암환자 240명을 대상자로 선정하였다. 투약기록지를 통해 진정제인 haloperidol, diazepam, lorazepam을 정맥 또는 근육주사로 규칙적이거나 필요 시 투여한 횟수를 조사하였다. 결과: 연구 대상자의 섬망기간은 최소 1일에서 최대 61일까지 나타났고, 중앙값은 5일이었다. 연구 대상자에게서 나타난 섬망 특성은 부적절한 행동이 35.0%로 가장 많았다. 연구 대상자의 연령(F=3.96, P=0.021), 원발암의 종류(F=3.31, P=0.010), 항암치료 여부(t=-3.44, P=0.001)에 따른 섬망기간이 유의한 차이가 있었다. 연구 대상자가 진정제를 복용한 경우는 72.1%이었고, 투약된 진정제의 종류는 haloperidol이 59.6%로 가장 많았다. 진정제 투약군의 생존기간은 평균 16.85일, 비투약군은 9.37일로 나타났으나 이는 통계적으로 유의하지는 않아(t=1.766, P=0.079) 진정제 투약이 생존기간에 영향을 미치지는 않았다. 결론: 말기암환자의 섬망 발생 시 진정제 투약이 생존기간에 미치지 않았다. 이러한 결과를 바탕으로 생명단축의 윤리적 문제로 인해 진정제 사용을 꺼려하기 보다는 증상완화를 위한 진정제 치료를 적극적으로 권유할 수 있다. 또한 섬망은 가족이나 의료진과의 의사소통 장애를 유발할 뿐 아니라 환자나 가족들에게 스트레스로 작용하며 돌봄에 대한 부담감을 가중시키므로, 적절한 진정제의 투여는 말기암환자와 가족의 안위를 위해 적극적으로 추천하는 바이다.

• 대한간호학회지
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• 제3권1호
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• pp.85-95
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• 1972

For the purpose to clarify the effects of nursing, intervention with comfort measures which promote rest, exercise and sleep on the patient′s rehabilitation, this study was carried out on 119 postoperative patients at St. Mary′s Hospital, the National Medical Center and Seoul Red Cross Hospital during the 9 months period from March 1971 to November 1971. In this study one experimental nursing approach was utilized; an emphasis on interpersonal techniques along with physical care-comfort measures. A daily evening care including support and instruction was given to facilitate interaction of nursing to the experimental group by the investigator. For the control group, routine hospital nursing care was performed. The nursing observation was followed for 4 days postoperatively and recorded in check list. The results of the findings were as follows. 1. 3.5% of control group and 32.3% of experimental group got out of bed within 24 hours postoperatively. 38.6% of control group got out of bed within 72 hours postoperatively where only 16.1% of the experimental group did (x$^2$= 19.865, p<0.005). Interaction in nursing is, in turn, significantly more effective than the usual routine care in improving rate of healing. 2. The irritations and tension that may interfere patient′s sleep and rest at night can be reduced to a minimum if nursing environment is better controlled with planned nursing care for individual patient. Various treatments which tend to give patient discomfort may preferably be performed before 6 p.m. if not absolutely indicated. 3. During 4 days of observation the patients without administration of sedatives and analgesics postoperatively were 25.9% in the experimental group where as 10.5% in the control group. The frequency of administration of sedatives and analgesics in average was 1.4 in the experimental group, and 2.0 in the control group. This indicates that not all postoperative discomforts expressed by the patients should be regarded as incision pain, and those discomforts could be relieved to a certain extent by nursing interventions effectively. 4. There were significant differences between the responses to nursing care given in the experimental group and 33% of the control group in average through 4 days of observation responded "good". 3.6% of the experimental group and 17. 1% of the control group responded "poor" in this study. It was recommended that the study be replicated in a more defined and controlled manner. Some alternative areas for investigation were suggested.

• 한국보건간호학회지
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• 제9권2호
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• pp.17-32
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• 1995

The purpose of this study is to promote health for young female workers. It is based on questionnaires collected from 215 female workers in Incheon area. This study includes health condition (fatigue scores), occupational disease, knowledge of abused drugs and the actual condition of drug use. The results are summerized as follows: - $47.4\%$ visited their health center and were treated with diseases like cold and headache $(34.9\%)$, gastroenteric disease $(6.5\%)$, trauma $(7.9\%)$ and chronic disease such as diabetes and hypertension $(3.3\%)$ - $44.7\%$ received regular health education and $4.7\%$ among them received education on abused drugs. - $20.5\%$ were suffering from work related diseases such as gastroenteric disease, headache, trauma, repiratory disease, skin problem, arthritis, low back pain, shortsightness and tuberculosis. - Total mean fatigue score as an indication of health status was $9.0\pm5.4$ points out of 30 points. Physical mean score (group I) was $3.92\pm2.2$ points and psychological mean score was $2.5\pm2.3$ points and neurosensory mean score was $2.6\pm2.1$ points out of each 10 points. - They recognized analgesics $(55.0\%)$ and the next are laxatives $(49.8\%)$, inhalants $(40.0\%)$, narcotics $(24.2\%)$, stimulants $(24.0\%)$, antihistamines$(5.9\%)$, diuretics $(3.0\%)$, tranquilizer $(2.4\%)$ and sedatives $(1.4\%)$ - They used analgesics $(37.2\%)$ the most and then laxatives $(6.0\%)$, stimulants$(5.6\%)$, diuretics $(1.9\%)$, antihistamines$(0.5\%)$, And nobody used tranquilizer, sedatives, narcotics and inhalant. - The relationship between career, drug abuse education, health center utilization and and the actual condition of drug using was examined. The longer the career and the more educated with drug abuse, the less drug used. And those who utilized health center rarely used more drugs. - The relationship between career, health center utilization, the score of fatigue and use of analgesics was also examined. Those group who have a longer career above 3 years and the group who have never used health center used more analgesics. And the group of fatigue score above 11.0 points used a little more analgesics than the other group. These results indicate that analgesics are the most frequent used drugs among female workers. Those analgesics such as geborin, penzal, saridon, aspirin, tyrenol should be used properly. These basic data is submitted for the education and consultation which are carried out by industrial nurses for promoting health of industrial workers.

• Tuberculosis and Respiratory Diseases
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• 제73권3호
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• pp.151-161
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• 2012

Background: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation. Methods: A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG. Results: In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, $1.3{\pm}0.5{\mu}g/kg/min$; day 2, $0.9{\pm}0.4{\mu}g/kg/min$; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; $r_s$=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; $r_s$=0.77), and RASS and BIS ($r_s$=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS. Conclusion: Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.

• The Korean Journal of Pain
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• 제27권4호
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• pp.313-320
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• 2014

Dexmedetomidine, an imidazoline compound, is a highly selective ${\alpha}_2$-adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties. In order to minimize the patients' pain and anxiety during minimally invasive spine surgery (MISS) when compared to conventional surgery under general anesthesia, an adequate conscious sedation (CS) or monitored anesthetic care (MAC) should be provided. Commonly used intravenous sedatives and hypnotics, such as midazolam and propofol, are not suitable for operations in a prone position due to undesired respiratory depression. Dexmedetomidine converges on an endogenous non-rapid eye movement (NREM) sleep-promoting pathway to exert its sedative effects. The great merit of dexmedetomidine for CS or MAC is the ability of the operator to recognize nerve damage during percutaneous endoscopic lumbar discectomy, a representative MISS. However, there are 2 shortcomings for dexmedetomidine in MISS: hypotension/bradycardia and delayed emergence. Its hypotension/bradycardiac effects can be prevented by ketamine intraoperatively. Using atipamezole (an ${\alpha}_2$-adrenoceptor antagonist) might allow doctors to control the rate of recovery from procedural sedation in the future. MAC, with other analgesics such as ketorolac and opioids, creates ideal conditions for MISS. In conclusion, dexmedetomidine provides a favorable surgical condition in patients receiving MISS in a prone position due to its unique properties of conscious sedation followed by unconscious hypnosis with analgesia. However, no respiratory depression occurs based on the dexmedetomidine-related endogenous sleep pathways involves the inhibition of the locus coeruleus in the pons, which facilitates VLPO firing in the anterior hypothalamus.

• 대한수의학회지
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• 제38권4호
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• pp.737-744
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• 1998

The rhizomes of the Acorus gramineus Soland have been used as sedatives, analgesics, stomachics and anthelmintics in chinese medicine. It is known that the rhizomes of the Acorus gramineus Soland contains the essential oil about 0.5~0.8% and this essential oil contains asarone about 86%. The asarone possess many pharmacological properties similar to those of reserpine and chlorpromazine. Sedative and analgesic effects of essential oil of Acorus gramineus Solaad in mouse was observed. The essential oil of Acorus gramineus Soland decreased the frequency of ambulation on mouse in proportion of concentration. ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride) were markedly decreased in frequency of ambulation. The essential oil of Acorus gramineus Soland decreased writhing syndrome in mouse and ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride), opioids receptor antagonist(naloxone hydrochloride) were not increased above effects. In conclusion, these experimental results show that the essential oil of Acorus gramineus Soland have sedative and analgesic effects, but it did not antagonized ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride).

• 대한간호학회지
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• 제43권5호
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.