• Title/Summary/Keyword: anesthetic cases

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A Comparison of Pain Reducing Effects of Topical EMLA Cream and Subcutaneous Lidocaine in Hemodialysis Patients (혈액투석시 EMLA크림 처치와 Lidocaine 피내주사에 따른 통증정도의 비교)

  • Shin Mee-Ok;Park Hye-Ja;Chang Eun-Jeung;Suh Youn-Hee;Heo Mi-Yeon;Kim Mi-Kyoung;Choi Mi-Lee;Lee Myoung-Ja;Kim Young-Ju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.37-43
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    • 1995
  • This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as $4.56{\pm}1.38$ and $2.05{\pm}1.36$ points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%)and pallor (5 cases, 6.3%)were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27cases, 16.9%)and fear for needle insertion(6 cases, 3.8%). The most frequent problems with EMLA cream application were an inconvenience in use (11 cases, 6.9%)and tedious long pretreatment time(11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.

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Case Reports of Periodontal Treatment Under Hypnoanesthesia (최면마취하의 치주처치 증례보고)

  • Kim, Jong-Eun;Kim, Young-Chul;Lee, Chung-Ho
    • The Journal of the Korean dental association
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    • v.11 no.10
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    • pp.667-670
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    • 1973
  • It has been studied over 500 cases of hypnotic susceptibility test and among them performed 15 cases of periodontal treatment under hypnoanesthesia. Conclusions were obtaines as following ; 1) The patients with chronic periodontal disease were surrendered more easily to the operator than those with acute periodontal disease. 2) bleeding was occurred much more than in drug anesthetic state and less in waking state. 3) The different depth of hypnotic state was needed to the different individual. 4) The post-operative pain did not occurred by the operators suggestion. 5. Those operation brought more rapid healing of wounds.

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Three Cases of Spontaneous Intracranial Hypotension(SIH) Treated with Epidural Blood Patch (자발성 두개내 저압환자에서 경막외 혈액봉합술로 치험한 3예)

  • Shin, Jin-Woo;Yun, Chang-Seob;Lee, Cheong
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.104-108
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    • 1997
  • Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most characteristic symptom is an occipital or frontal headache which is aggrevated in the erect position and relieved in the supine position. This syndrome usually resolves spontaneously or with strict bed rest. When the headach persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. Epidural blood produces an organized clot which effectively tamponade any dural CSF leak. The rapid relief of headache immediately after the infusion of blood occur by some other mechanism, such as an increase in subarachnoid pressure that is known to occur with infusion of fluid into the lumbar epidural space. We report three cases of spontaneous intracranial hypotension successfully treated with epidural blood patch.

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Stellate Ganglion Block for the Treatment of Primary Dysmenorrhea -Two cases- (월경곤란증에서의 성상신경절 차단 효과 -증례 보고-)

  • Lim, Hyun-Kyoung;Chung, Chong-Kweon;Kim, Tae-Jung
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.113-115
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    • 1998
  • Dysmenorrhea(cyclic pain associated with menses) is a frequent disorder, with as many as 50% of young women experiencing the symptom, and up to 10% being unable to function normally for some time each month. The most recent theory of the cause of the pain of dysmenorrhea incriminates uterine ischemia and sensitization of uterine pain fibers resulting from excessive myometrial contractility after prostaglandin stimulation. We administered stellate ganglion block for the treatment of dysmenorrhea and had good results in two cases. From our experience, we recommend the stellate ganglion block may be an effective treatment for a dysmenorrhea.

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Flexible laryngeal mask airway management for dental treatment cases associated with difficult intubation

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.1
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    • pp.61-64
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    • 2017
  • Nasotracheal intubation is generally a useful maxillofacial surgery that provides good surgical access for intraoral procedures. When nasotracheal intubation is difficult, laryngeal mask airway (LMA) insertion can be performed, and the flexible $LMA^{TM}$ (FLMA) is also useful for anesthetic management. However, the FLMA provides limited access to the mouth, which restricts the insertion of instrumentation and confines the surgical field available. Here, we present our experience using the FLMA airway management for dental treatment cases involving difficulty with intubation.

Lower Extremity Paralysis Developed during Pain Therapy -A case report- (통증 치료시 발생된 하지 마비 -증례 보고-)

  • Kwang, Min-Jeon;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.283-287
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    • 1996
  • Recently, continuous epidural catheter insertion is usually employed in operation and chronic pain control. Delayed migration of an extradural catheter into subdural space or subarachnoid space is a rare but life threatening complication of continuous epidural catheter insertion, especially with out patients. The symptoms may include lower extremity weakness, hypotension, drowsy and respiratory depression. We experienced two cases of lower extremity paralysis due to delayed migration into subdural or subarachnoid spaces at our pain clinic. The tecnical procedures for continuous epidural catheterization went smoothly without any complications. However, clinical signs of lower extremity paralysis and sensory loss developed gradually, about 2 hours and 30 minutes after the continuous epidural injection. Two cases were confirmed by subdurogram and myelogram.

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Application of Monitored Anesthesia Care Using Dexmedetomidine to Common Oral and Maxillofacial Trauma Cases

  • Lee, Deok-Won;Shin, Min Cheol;Hong, Sung ok
    • Journal of Korean Dental Science
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    • v.10 no.2
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    • pp.82-86
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    • 2017
  • Oral and maxillofacial surgery (OMFS) trauma cases are commonly treated under general anesthesia. The purpose of this case report is to introduce an alternative method of anesthesia in patients who refuse general anesthesia. A combination of dexmedetomidine and ketamine for sedation anesthesia in 3 frequent fracture types in the field of OMFS-Le Fort I fracture, mandibular fracture, and alveolar bone fracture-was used. Dexmedetomidine as the single agent has not shown stable success rates for invasive procedures. To overcome some of the pitfalls with dexmedetomidine, combination sedation using ketamine was performed. Visual analogue scale scores were recorded postoperatively. Dexmedetomidine combined with ketamine administration provided safe and effective sedation and anxiolysis for surgical reduction and internal fixation of OMFS fractures. It showed advantages of decreased admission time, reduced expenses, minimal pain, and reduced anesthetic burden for the patient thus ultimately increasing overall satisfaction.

Balance impairment caused by diazepam in 2 dogs with vestibular disease: case reports

  • Kim, Hyunseok;Son, Won-gyun;Lee, Inhyung;Jang, Min
    • Korean Journal of Veterinary Research
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    • v.61 no.4
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    • pp.35.1-35.4
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    • 2021
  • Following intravenous (IV) administration of diazepam as a preanesthetic agent, sudden balance impairment, such as falling, leaning, and rolling, was identified in 2 canine cases. The 2 dogs were anesthetized for brain magnetic resonance scan to diagnose about a history of head tilt. After end of the diagnostic procedures, during the anesthetic recovery period, balance impairment was also observed. However, the symptoms gradually ceased by IV administration of flumazenil. These 2 canine cases indicated that diazepam premedication was responsible for the acute balance impairment.

Anesthetic management for emergency tracheostomy in patients with head and neck cancer: a case series

  • Ci Young, Kim;Seongji, Cho;Seung-Hwa, Ryoo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.457-464
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    • 2022
  • Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

  • Chung, Kyu-Jin;Cha, Kyu-Ho;Lee, Jun-Ho;Kim, Yong-Ha;Kim, Tae-Gon;Kim, Il-Guk
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.540-545
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    • 2012
  • Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. Methods This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 ${\mu}g/mL$ remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 ${\mu}g/mL$ and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Results Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Conclusions Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.