• 대한치과의사협회지
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• 제51권7호
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• pp.382-388
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• 2013

Inhalation sedation has may advantageous properties that make it a suitable choice for sedation in pediatric, disabled and many patients, either alone or in conjunction with other agents. We need review of Guideline on use of nitrous oxide for dental patients that make minimizing complication of sedation for safe and effective sedation. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less failure of sedation. Recently sevoflurane can be used to provide sedation as a sole agent in air or oxygen or in combination with nitrous oxide in dentistry.

• 대한치과마취과학회지
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• 제12권2호
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• pp.125-129
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• 2012

Dental treatment under general anesthesia is considered for behavioral control of disabled patients who have severe anxiety or involuntary movement. However, in case of simple treatment, inhalation or intravenous sedation, which has earlier onset and recovery, is preferred. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less complications. In this case report, two patients with mental retardation required simple dental treatment. Deep sedation with inhaled sevoflurane were successfully employed and patients were discharged without any complications.

• 대한소아치과학회지
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• 제41권1호
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• pp.18-26
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• 2014

심한 불안이나 불수의적인 움직임으로 행동조절이 어려운 소아와 장애인의 치과치료를 위해 깊은 진정법이 고려된다. 응급 치과진료에 있어 세보플루란 흡입을 이용한 깊은 진정이 빠른 유도와 회복으로 인해 선호된다. 2013년 1월부터 2013년 10월까지 세보플루란을 이용한 깊은 진정을 받은 소아와 장애인 121명을 대상으로 조사분석하였다. 깊은 진정법을 사전 계획한 환자군과 소아외상이나 장애인의 특성 등으로 응급으로 시행한 환자군을 비응급 세보플루란진정군과 응급 세보플루란진정군으로 나누었다. 비응급 세보플루란진정을 받은 환자는 95명이었고 응급 세보플루란진정을 받은 환자는 26명이다. 두 군간에 성별, 나이, 진정법을 시행한 이유, 유도방법, 진정시간 및 치료시간, 치료내용, 진료과를 비교분석하였다. 비응급 세보플루란진정은 소아와 장애인의 행동조절에 안전하고 효과적으로 사용되었고 응급 세보플루란진정은 외상을 입은 어린 소아환자의 짧고 간단한 치료에 유용하게 사용되었다. 세보플루란을 이용한 깊은 진정은 점차적으로 전신마취의 사용을 줄이고 소아와 장애인 환자의 응급 치과진료에 유용한 방법이었다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.321-327
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• 2021

Sevoflurane is familiar to anesthesiologists as an inhaled anesthetic to induce and maintain anesthesia; however, it has not been widely used for sedation. Recently, the use of sevoflurane for inhalational sedation has been increasing. Moreover, in Korea, the use of sevoflurane for conscious or deep sedation in dental care for children and the disabled is increasing, primarily by dental anesthesiologists. In this article, we reviewed a sedation method using sevoflurane.

• 대한치과마취과학회지
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• 제12권4호
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• pp.235-241
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• 2012

Although sevoflurane sedation have the advantage of the reduction of anxiety and pain relief, difficult airway is attributed to increased agitation, tachycardia, desaturation, ventilation difficulty, sedation failure. In the sedation for dental treatment, we should pay more attention to the airway management because dental procedures take place in the mouth of airway unlike any other area. The layngeal mask airway (LMA) has become commonly used device for airway management during anesthesia for relatively short procedures, such as minor oral surgery and dental procedures. It can be inserted without use of a larygoscope and muscle relexants, and insertion is easy to achieve and generally takes less time than endotracheal intubation. The LMA is an excellent barrier against aspiration of saliva, blood within the surgical field but should not be used in patients at risk of aspiration In this study, we reported that after a failure of airway management in inhalation sedation, we performed the short-emergency dental treatment successfully, using a laryngeal mask.

• 대한소아치과학회지
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• 제45권4호
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• pp.508-513
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• 2018

세보플루란에 의한 일회 환기량은 낮은 용량에서는 호흡수의 증가로 안정적이다. 그러나 진정 깊이가 증가하면 폐포 환기는 세보플루란에 의해 감소되어 결과적으로는 $PaCO_2$가 증가한다. 호흡 억제의 발생은 깊이 진정된 장애 환자에서 심한 저산소증과 고탄산혈증의 위험을 증가시킨다. 세보플루란 흡입 마취는 여러 위험성이 내제되어 있으며 체내 산 염기 상태에 따라 혈역학적 변화가 발생하기에 예기치 못한 문제 상황이 발생할 수 있다. 세보플루란으로 장애인의 마취 유도 시 발생하는 호흡 억제로 인한 체내 산 염기 상태가 안정한지 알아보고자 이 연구를 진행하였다. 마취 유도는 4 vol% 세보플루란, 4 L/min 아산화질소, 4 L/min 산소를 자발 호흡 하에서 환자 안면부에 마스크를 거치하여 유도하였다. 그 뒤 환자의 의식소실 및 근육 긴장 완화 후 즉시 전문가에 의해 IV line을 거치한 뒤 정맥 채혈을 하여 정맥 내 혈액가스 분석을 하였다. 깊은 진정 상태에서 전체 환자의 평균 pH는 $7.36{\pm}0.06$으로 측정되었다. $PvCO_2$는 전체 환자에서는 평균 $48.8{\pm}8.50mmHg$로 측정되었다. $HCO_3{^-}$는 전체 환자에서 평균 $27.2{\pm}3.0mmol/L$로 측정되었다. 결론적으로 장애인을 대상으로 한 치과 진료시 세보플루란을 이용한 흡입 진정에 대한 체내 산 염기 반응은 비교적 안정적이었다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.161-163
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• 2020

Myringotomy and ventilation tube insertion are widely performed in pediatric patients with chronic otitis media. This procedure is performed under general anesthesia or sedation with local anesthesia infiltration in pediatric patients. In this case report, we report a case of transient facial paralysis in a pediatric patient who underwent myringotomy and ventilation tube insertion using sevoflurane inhalation and four-quadrant blocks with lidocaine.

• 대한소아치과학회지
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• 제40권3호
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• pp.194-200
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• 2013

본 연구는 단국대학교 치과병원 소아치과에 2012년 1월부터 2012년 5월까지 내원한 환자 중 세보플루란을 이용한 깊은 진정으로 치과치료를 받은 환자 총 14명의 마취기록지를 분석하여 적정 수준의 진정을 얻기 위한 유효한 세보플루란의 농도를 측정하고 진정 과정 중의 호흡 및 심혈관계 평가를 통해 안정성을 평가해 보고자 함에 있다. 심박수(Heart rate)는 평균 101.4회/분(76.4~135.4회/분)을 보였다. 혈압(Blood pressure)은 수축기혈압은 평균 96.9 mmHg(84.2~109.2 mmHg), 이완기혈압은 평균 50.5 mmHg(34.0~62.0 mmHg)를 보였다. 호흡수(Respiration rate)는 평균 24.4회/분(15.0~36.7회/분)을 보였다. 산소포화도($SpO_2$)는 평균 99.4%(97.5~100.0%)를 보였다. 호기말 이산화탄소 농도(end tidal $CO_2$ volume; $ETCO_2$)는 평균 27.8 mmHg(16.4~38.0 mmHg)를 보였다. 호기말 세보플루란 농도(end tidal sevoflurane volume)는 평균 1.9 vol%(1.0~3.4 vol%)를 보였다.

• 대한치과마취과학회지
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• 제7권2호
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• pp.114-119
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• 2007

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

• 대한치과마취과학회지
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• 제11권2호
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• pp.172-176
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• 2011

For dental treatment of children with severe dental phobia, sedation or general anesthesia is usually selected for enhancement of cooperation. But in the case of mouth opening limitation due to temporomandibular disorders, general anesthesia administration is a challenge for anesthesiologist. Because airway management failure was concerned, awake fibroscopic intubation is selected first. But, skillful fibroscopic intubation is not easy in case of uncooprative children patients. In this report, we present two cases of pediatric patients with mouth opening limitation. In the first case, the patient was 52 months old and the maximum opening distance was 1.2 cm, and in the second case the patient was 38 months old and the maximum opening distance was 1.5 cm. Both patients showed severe dental phobia. After sevoflurane inhalation without any intravenous drug, we successfully performed intubation using a fibroscope.