• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.65-69
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• 2018

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.97-102
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• 1990

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62(83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents(65 cases). Of 57 smaller calculi than 1Cm(radiographic largest diameter) 50(88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications durinf or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.3
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• pp.341-345
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• 1997

The management of varicoceles was performed on 24 patients with testicular dragging pain and/or left lower abdominal pain under local anesthesia. The surgery was completed within 20 to 45 minites, postoperative complications were severe cord edema 3 cases, wound infection 1 case, epididymitis 1 case, and postoperative anesthetic duration was 90 to 150 minites. Therefore, these procedures is cost effective and safe surgical method.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.121-127
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• 1983

To identify the changes in professional services pattern after introducing the deligated system of claims review started in 1982, a university hospital under this system was examined. For comparison, claims of the hospital to Federation of Korean Medical Insurance Societies, where this system is not accepted, were reviewed. A total of 600 cases each were studied operated at the Departments of General Surgery & Orthopedic Surgery in 1981 and 1983. The results are summarized as follow: 1. Percentages of hospital charges for basic care was decreased by 10.2% and that for medical service increased by 8.4% in 1983. 2. After the introduction of the deligated review system, percentages of cutting off the claims was decreased by 12.4% for basic care and increased by 3.8% for medical services. 3. Percentage of testing liver function, and the frequency of administering high cost intravenous fluid injection, applicating Robinul as anesthetic premedication were decreased respectively after introducting the deligated services system.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.125-134
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• 2019

Successful local anesthesia in dental treatment is the most important prerequisite for pain control of patients. However, unlike that in the maxilla, it is difficult to administer local anesthesia in the mandible, and the success rate of conventional inferior alveolar nerve block (IANB) is only 80-85%. It is attributed to various causes such as anatomical variations, extreme anxiety, and technical errors; thus, various alternatives have been devised to improve this. We will analyze the causes of failure in conventional IANB and examine various alternatives that can be applied in these cases.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.583-587
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• 2021

Lidocaine is the most commonly used local anesthetic (LA) agent in various dental as well as oral and maxillofacial procedures. Although rare, adverse effects and allergic reactions to lidocaine have been reported. In patients with suspected allergy to LA or a history of such reaction, careful history-taking and allergy testing should be performed to choose an alternative LA agent to avoid any adverse effects. Here, we present two cases of delayed hypersensitivity reaction to lidocaine, wherein the patients presented with erythema, edema, and itching. Intradermal testing confirmed allergic reaction to lidocaine, and the patients underwent successful dental treatment using an alternative LA agent. This report highlights the importance of allergy testing prior to LA use considering the serious consequences of allergy to these agents and describes the management of such patients using an alternative LA agent.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.172-177
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• 2010

Background: Damages of trigeminal nerve, particularly inferior alveolar nerve and lingual nerve, could occur following dental procedures. In some cases, nerve damage may happen as a complication of the local anesthetic injection itself and not of the surgical procedure. Methods: From September 2006 to August 2010, 5 cases of inferior alveolar nerve and lingual nerve damages, which were assumed to happen solely due to local anesthesia, were reviewed. All cases were referred to Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University Medical Center for legal authentication in the process of criminal procedure. Results: In all five cases, patients complained of altered sensation occurred in the distribution of the inferior alveolar or lingual nerve following block anesthesia. The local anesthetics were 2% lidocaine with 1 : 100,000 epinephrine and the amount of local anesthetics, which were used during injection, were varied. Most of patients experienced the electric stimulation during injection. Recovery was poor and professional supportive care was mostly absent. Conclusions: Dental practitioners should consider that the surgical procedure caused the trigeminal nerve damage, however, dental local anesthesia for inferior alveolar nerve and lingual nerve could be one of the causes for damages. The various mechanisms for nerve damages by local anesthesia are thoroughly discussed.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.279-285
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• 1995

Extradural block is a form of treatment described as early as the beginning of the present centuries. It has since had positive criticism from a number of authors in different countries. Epidural injections of steroids with or without local anesthetic have become an occasional method of conservative treatment in sciatica & lumbago, especially in acute case. We assess the results of continuous epidural block with steroids and local anesthetics in sciatica & lumbago. From July 1994 to June 1995, we treated 46 case of lumbago and sciatica using continuous epidural block with steroids and local anesthetics. After placement of 17-Gauge Tuohy needle in the epidural space by the technique of loss of resistance, 0.25% bupivacaine 5 cc and triamcinolone 40 mg was administered and then epidural catheter was placed and connected to multiday infusor(Paragon) using 1% lidocaine with continuous infusion rate of 1 ml/hour. Usually, the catheter was removed after 1~2 weeks and then treated with the physical therapy. At the time of patient's discharge, 69.5% of all cases showed excellent or good results. Of particular note, 26 of the 46 cases were followed up by telephone. At present, in using Of particular note, 26 of the 46 cases were followed up by telephone. At present, in using continuous epidural block procedure, a relief in symptoms showed in 65.5% of these 26 cases. Continuous epidural block provides shortening of the recovery time from pain, avoidance of long period bed rest and early physical therapy and exercise. Therefore, continuous epidural block is simple and safe in the treatment of lumbago and sciatica, especially in acute phase.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.131-135
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• 2008

Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6703-6707
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• 2014

Objective: To observe the influence of propofol, isoflurane and enflurance on interleukin-8 (IL-8) and IL-10 levels in cancer patients. Methods: Ninety cancer patients with selective operation from March 2011 to May 2014 were randomly divided into group A (34 cases), group B (28 cases) and group C (28 cases). Intramuscular injections of scopine hydrochloride and phenobarbital sodium were routinely conducted to 3 groups. After general anesthesia was induced, tracheal intubations were given. During the maintenance of anesthesia, 0.5~1.0 mg/kg propofol was intravenously injected to group A discontinuously, while continuous suctions of isoflurane and enflurance were subsequently performed to group B and C correspondingly. Clinical outcomes, postoperative complications as well as serum IL-8 and IL-10 levels before operation (T0), at the time of skin incision (T1), 3 h after the beginning of the operation (T2) and 24 h (T3) and 72 h (T4) after the operation were observed among 3 groups. Results: Operations in all groups were successfully completed. The rates of surgery associated complications were 8.82% (3/34), 7.14% (2/28) and 7.14% (2/28) in group A, B and C, respectively, and there were no significant differences (P>0.05). Serum IL-8 and IL-10 levels increased gradually from the beginning of the operation and reached the peak at T3, and were evidently higher at each time point than at T0 (P<0.01). At T1, serum IL-8 and IL-10 levels had no significant differences among 3 groups (P>0.05), but the differences were significant at T2, T3 and T4 (P<0.05). Moreover, correlation analysis suggested that serum IL-8 level was in positive relation with IL-10 level (r=0.952, P<0.01). Conclusions: Propofol, which is better in inhibiting serum IL-8 secretion and improving IL-10 secretion than isoflurane and enflurance, can be regarded as a preferable anesthetic agent in inhibiting traumatic inflammatory responses.