• Title/Summary/Keyword: induction anesthesia

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USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT- (기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료)

  • Yi, Young-Eun;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Teo-Jeon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.88-91
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    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

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Anesthetic Management of the Dental Treatment in a Child with Liver Failure Scheduled for Liver Transplantation - A case report - (간이식 예정인 간부전 환아의 치과치료 시 마취관리 -증례 보고-)

  • Park, Chang-Joo;Jang, Ki-Taeg;Yum, Kwang-Won;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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    • pp.114-117
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    • 2002
  • Special anesthetic considerations were required for children with acute or chronic liver disease. We experienced a case of dental treatment to control infection under general anesthesia in the 2-year-old girl with liver failure. She was also scheduled for liver tansplantation. Her preanesthetic results of liver function test, electrolytes, and coagulation panel were unstable and out of normal ranges. Uneventful anesthetic induction using isoflurane and atracurium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 2 hours. Oozing from multiple extraction sites was sustained, so the transfusion of platelet concentration 1 units, fresh frozen plasma 1 unit, and packed red blood cell 1 unit was done. She was recovered without complication but was transferred to pediatric intensive care unit for wound care with her endotracheal tube kept. She was transferred to a ward without noticeable complications next day. So we report this successful case of anesthetic management for dental treatment in a child with liver failure.

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Intraoperative Anaphylatic Reaction to Enflurane -A Case Report - (Enflurane으로 인하여 발생한 마취 중 급성과민증)

  • Park, Chang-Joo;Seo, Kwang-Suk;Kim, Hyun-Jeong;Choi, Jin-Young;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.4 no.1 s.6
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    • pp.25-29
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    • 2004
  • Anaphylactic reactions to anesthetic drugs could potentially produce life-threatening immune-mediated crisis. Most published reports are associated with neuromuscular blockers and anaphylactic reactions to inhalation anesthetics are rare. A 25-year-old male patient with no significant medical history and no previous abnormal drug reaction was scheduled for orthognathic surgery under general anesthesia. After uneventful anesthetic induction and nasotracheal intubation, generalized urticaria and erythema were detected during the maintenance period with $O_2-N_2O$-enflurane. No severe changes of vital signs and no ventilation problem were accompanied. The operation was cancelled and the cutaneous lesions were faded away during the recovery with 100% $O_2$. The skin-prick and intradermal tests showed that he was hypersensitive to all halogenated inhalation anesthetics including enflurane and not to intravenous anesthetics and neuromuscular blockers. The re-operation was safely carried out under intravenous anesthesia with propofol-fentanyl-vecuronium. We report this case of intraoperative anaphylactic reaction to enflurane with literature review.

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Circunferential resection and direct end to end anastomosis of mediastinal trachea on a post tracheostomy stenosis (기관절개술후 종격동기관 협착증에 대한 기관절제 단단 문합술)

  • Kim, Se Wha;Park, Hee Chul;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.496-496
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    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

Cervicomediastinal cystic hygroma: report of a case (경부 및 상부종격동에 발생한 낭상임파관종 1례)

  • 서충헌
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.503-506
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    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

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Bronchial Rupture by Blunt Chest Trauma -a case- (외상성 기관지 단절의 수술 치험 -1례-)

  • 정종화
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.547-552
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    • 1988
  • Rupture of the main bronchus followed by blunt chest trauma is comparatively very rare. Early recognition of bronchial rupture and emergency thoracostomy and management is essential for reducing of morbidity and mortality and late complications. This case was 11 years old female who was a primary school student. The patient was sustained a crushing injury to her right hemithorax by traffic accident and had been taken emergency closed thoracostomy at her second intercostal space, midclavicular line at emergency room. In the course of the next 2 hours, the girl`s condition remained critical with tension pneumothorax and abnormal arterial blood gas analysis. Induction of anesthesia started 3 hours after the accident. During the general anesthesia, cardiac arrest was occurred and cardiac resuscitation was performed. Right upper lobectomy and end-to-end anastomosis of ruptured right main bronchus was performed. Postoperative course was satisfactory.

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Study on Clinical Utility of the Laryngeal Mask Airway in Dogs (개에서 Laryngeal Mask Airway의 임상적 효용성에 관한 연구)

  • Kim Yong-hoon;Lee Joo-myoung;Cheong Jongtae
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.214-219
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    • 2005
  • This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

Monitoring of anesthetic depth with q-EEG (quantitative EEG) in TIVA (total intravenous anesthesia) and VIMA (volatile induction/maintenance anesthesia) (완전정맥마취와 휘발성유도/유지마취에서 정량적 뇌파를 이용한 마취심도의 감시)

  • Lee, Soo-Han;Noh, Gyu-Jeong;Chung, Byung-Hyun
    • Korean Journal of Veterinary Research
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    • v.46 no.1
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    • pp.47-55
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    • 2006
  • To evaluate method for monitoring anesthetic depth with quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) and pain score till 100 minutes in beagle dogs anesthetized for 60 minutes with propofol (n = 5, PRO group), isoflurane (n = 5, ISO group) and propofol-ketaminefentanyl (n = 5, PFK group). Raw EEG was converted into 95% spectral edge frequency (SEF) by fast Fourier transformation (FFT) method. We investigated anesthetic depth by comparing relationship (Pearson's correlation) between q-EEG (95% SEF) and pain score. Pearson's correlation coefficients are +0.2372 (p = 0.0494, PRO group), +0.79506 (p < 0.001, ISO group) and +0.49903 (p = 0.0039, PFK group).

Anaphylaxis occurred immediately after prophylactic antibiotics injection with negative intradermal skin test during laparoscopic cholecystectomy

  • Jeong, Hyung Joo;Kung, Hsi Chiang;Park, Tae Woo;Kang, Dong Hee;Shin, Yu Som;Kim, Ju Deok
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.245-251
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    • 2018
  • Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

Use of laryngeal mask after repeated endotracheal intubation failure in a patient with tracheobronchopathia osteochondroplastica: case report

  • Kim, Sang Gyun;Kim, Hyun;Son, Jong Chul;Lee, Ji-Hyang;An, Jihyun;Kim, Eunju
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.252-256
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    • 2018
  • We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.