• Title, Summary, Keyword: regional anesthesia

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Regional anesthesia for maxillofacial surgery in developing countries

  • Kim, Soung Min;Seo, Mi Hyun;Myoung, Hoon;Lee, Jong Ho
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.245-252
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    • 2016
  • Regional anesthesia in the maxillofacial region is safer and more efficient than general anesthesia when its indications are carefully considered. In addition, the majority of medical institutions in developing countries are not well equipped for proper anesthesia and elective surgery. In this review, we describe regional anesthesia and cutaneous nerve divisions in the maxillofacial region. In addition, we summarize detailed regional anesthetic techniques adapted for representative cleft lip cases in developing countries.

Study on the Application of Retrograde Intravenous Regional Anesthesia in Claw Lamed Cows (발굽 천행우에서 회귀성 국부 정맥무취위 활용에 관한 연구)

  • 정순욱
    • Journal of Veterinary Clinics
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    • v.15 no.1
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    • pp.56-61
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    • 1998
  • A retrograde intravenous regional anesthesia was applied to the extremities of 30 cows, which was showed that mean value of induction time was 13.5 seconds, duration time 74.4 minutes, frequency of injection until to keep needle into the vein 1.27, and didn't observed local and systemic complications. Under the retrograde intravenous regional anesthesia, it was possible for surgical treatment of 20 cows with various foot disorders, to resect soft tissues of extremities and claw horns, to sexarticulate 2nd phalanx without pain reactions.

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Development of an Instrument to Measure Intra-Operative Caring Behaviors Perceived by Regional Anesthesia Patients (부위마취 환자가 지각한 간호사의 수술 중 돌봄행위 측정도구 개발)

  • Kim, Mi-Jung;Lee, Eun-Nam
    • Journal of Korean Academy of Nursing
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    • v.42 no.5
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    • pp.749-758
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    • 2012
  • Purpose: The purpose of this study was to develop a tool for measuring the intra-operative caring as perceived by regional anesthesia patients. Methods: A preliminary instrument with 54 questions, based on a literature review and semi-structured interviews with 11 regional anesthesia patients, was developed. A group of experts revised individual questions, and 34 questions were finally selected. This tool was tested with 137 regional anesthesia patients admitted to D university hospital in B city from August to October 2008. Results: The validity and reliability of the tool were tested using factor analysis. After item analysis, one question with a correlation coefficient under .30 was discarded After performing factor analysis on the final 33 questions, 7 factors were identified; holistic needs fulfillment, consideration, protective environment, cautiousness, concern, information, physical comfort. The total variance shown in the test was 73.5%. A Cronbach alpha of 0.96 showed the reliability of the instrument. Conclusion: Results of this study indicate that the tool is statistically reliable and valid to measure the intra-operative caring perceived by regional anesthesia patients. This tool can be utilized usefully in assessing the effects of nursing interventions for regional anesthesia patients.

Pectoral nerve block (Pecs block) with sedation for breast conserving surgery without general anesthesia

  • Moon, Eun-Jin;Kim, Seung-Beom;Chung, Jun-Young;Song, Jeong-Yoon;Yi, Jae-Woo
    • Annals of Surgical Treatment and Research
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    • v.93 no.3
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    • pp.166-169
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    • 2017
  • Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma. Block was uneventful and showed no complications. Thus, Pecs block with sedation could be an alternative to general anesthesia for breast surgeries.

Computed tomography-guided 3D printed patient-specific regional anesthesia

  • Jundt, Jonathon S.;Chow, Christopher C.;Couey, Marcus
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.325-329
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    • 2020
  • Classic anesthetic techniques for the inferior alveolar nerve, lingual nerve, and long buccal nerve blockade are achieved by estimating the intended location for anesthetic deposition based on palpation, inspection, and subsequent correlation for oral anatomical structures. The present article utilizes computed tomography (CT) data to 3D print a guide for repeatable and accurate deposition of a local anesthetic at the ideal location. This technical report aims to anatomically define the ideal location for local anesthetic deposition. This process has the potential to reduce patient discomfort, risk of nerve damage, and failed mandibular anesthesia, as well as to reduce the total anesthetic dose. Lastly, as robotic-based interventions improve, this provides the initial framework for robot-guided regional anesthesia administration in the oral cavity.

Treatment of severe pain in a patient with complex regional pain syndrome undergoing dental treatment under general anesthesia: A case report

  • Rhee, Seung-Hyun;Park, Sang-Hun;Ha, Sung-Ho;Ryoo, Seung-Hwa;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.5
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    • pp.295-300
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    • 2019
  • Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.

Regional anesthetic management of elderly patients (노인 수술환자의 부위마취관리)

  • Kwak, Kyung-Hwa;Park, Sung Sik
    • Journal of the Korean Medical Association
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    • v.60 no.5
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    • pp.377-383
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    • 2017
  • In general, elderly patients are less able to respond to perioperative stress and are more likely to suffer from postoperative complications and even death because of the decline in their functional organ reserve. Although no definitive evidence indicates that regional anesthesia is superior to general anesthesia in terms of the long-term prognosis in the elderly, regional anesthesia appears to be beneficial in many ways because it reduces bleeding during surgery, the stress response, and the incidence of thromboembolic complications, as well as facilitating excellent postoperative pain control. However, some issues specific to the elderly should also be considered. Age-related anatomical changes in elderly patients may make it difficult to perform epidural and spinal anesthesia, and physiologic and pharmacodynamic responses to local anesthetics may change with age. Elderly patients also show a greater extent of sensory and motor block, and are at a greater risk of hypotension after epidural and spinal block. In order to provide optimal anesthetic care and to facilitate a rapid recovery and improved outcomes in elderly patients, clinicians must have a better understanding of age-related changes when regional anesthesia is administered. Additionally, tailored anesthetic techniques should be used, as well as good perioperative care, in accordance with the type of surgery and the individual physical status of elderly patients.

A working paradigm for managing mandibular fractures under regional anesthesia

  • Chellappa, Natarajan;Meshram, Vikas;Kende, Prajwalit;Landge, Jayant;Aggarwal, Neha;Tiwari, Manish
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.6
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    • pp.275-281
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    • 2018
  • Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

The Effects of Music Therapy on State Anxiety and Vital Sign (음악요법이 상태불안과 활력징후에 미치는 효과)

  • Lee, Jung-Hee;Jung, Hyun-Teak;Kim, Eun-Mi;Hwang, Ok-Nam
    • The Korean Journal of Rehabilitation Nursing
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    • v.9 no.1
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    • pp.64-71
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    • 2006
  • Purpose: This study has tried to find out the effects of music therapy on anxiety of surgery patients during operation under regional anesthesia. In order to find out the effects, this research design was used nonequivalent control group non-synchronized design. Method: The subjects were the sixty inpatients under regional anesthesia in K hospital. They were assigned to two groups, thirty to the experimental group and thirty to control group. The data were collected using the Visual Analogue Scale(VAS) for State Anxiety and vital sign. The Experimental group received favorite music of the 4 different genre. The control group were inserted ear plug during operation. Data were analyzed by $X^2$-test, T-test, ANOVA and Repeated Measured ANOVA of the SPSS WIN (12.0) version program. Results: 1) Hypothesis 1: The hypothesis "that the figure for state anxiety of the experimental group provided with music therapy would be lower than that of the control group" was confirmed(F=0.27, P=0.01). 2) Hypothesis 2 : Three subordinating hypotheses were established in order to verify the hypothesis "that the figures for vital sings of the experimental group provided with such as music therapy would be lower than those of the control group." were rejected. Conclusion: Music therapy can be regarded as an effective nursing intervention that relieves operative anxiety of surgical patients under regional anesthesia.

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Serratus anterior plane block combined with monitored anesthesia care for surgery of lateral side of breast -a case report-

  • Yoon, Hyeong-Seok;Yu, Byoung-Woo;Kim, Young-Mu;Lee, Jae-Ho;Koh, Won-Uk;Yang, Hong-Seuk
    • Korean Journal of Anesthesiology
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    • v.72 no.5
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    • pp.500-503
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    • 2019
  • Background: In breast surgery, regional anesthesia rather than primary anesthesia has been mainly used for postoperative analgesia. Serratus anterior plane block is a new method for ultrasound-guided thoracic wall block. It is less invasive and relatively safer than conventional regional anesthetic techniques. Case: We report a case of breast surgery under serratus anterior plane block as primary anesthesia with monitored anesthesia for a 78-year-old patient with a medical history of cardiopulmonary resuscitation due to stress-induced cardiomyopathy caused by pneumonia. Conclusions: Serratus anterior plane block might be simple and effective technique for breast surgery when a lesion is located on lateral side.