• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.4
• /
• pp.187-194
• /
• 2020

Background: The aim of the present systematic review was to evaluate and compare the efficacy of warmed and unwarmed local anesthesia solutions in reduction of pain during intraoral injection administration. Methods: PubMed, Ovid SP, and Cochrane Central Register of Controlled Trials were searched from publication years 1990 to 2020 with relevant MeSH terms. Studies were screened by titles and abstracts, followed by full-texts evaluation of the included studies. Results: A total of four studies were included in the systematic review. Outcomes evaluated were subjective and objective pain during administration of the warmed local anesthesia solution in comparison with the unwarmed local anesthesia solution. Among the four studies that evaluated the self-reported pain score, three studies showed significantly lower pain scores associated with warmed local anesthesia. Only two studies evaluated the observed pain score, and both of them reported a significantly lower pain reaction with the warmed local anesthesia solution. Conclusion: Within the limits of this systematic review, warming the local anesthesia solution to body temperature (37℃) before administration seemed to reduce the discomfort during intraoral local anaesthesia administration, and more high-quality studies should be carried out to validate the same.

• Journal of Korean Biological Nursing Science
• /
• v.17 no.2
• /
• pp.114-122
• /
• 2015

Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.4
• /
• pp.191-199
• /
• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• Journal of Digestive Cancer Research
• /
• v.11 no.3
• /
• pp.125-129
• /
• 2023

Appropriate sedation and analgesia are crucial for successful endoscopic procedures, patient safety, and satisfaction. Endoscopic resection for upper gastrointestinal tumors requires a deep sedation level because the procedure is lengthy and induces moderate to severe pain. Continuous patient consciousness assessment and vigilant vital signs monitoring are required for deep sedation. General anesthesia may unintentionally occur even during deep sedation for endoscopic tumor resection, which may cause unexpected complications, especially in high-risk patients. Previous studies have revealed that general anesthesia increases the en bloc resection rate and decreases the procedure time. Complications, such as perforation, aspiration pneumonia, and cardiopulmonary instability, including hypoxemia, hypotension, and arrhythmia, occurred more frequently in patients with sedation compared to those with general anesthesia. Therefore, general anesthesia demonstrated potential benefits in endoscopic treatment results and patient safety. General anesthesia should be considered a useful alternative for sedation in patients undergoing endoscopic gastrointestinal tumor resection. However, more high-quality prospective studies are required to determine the safety and effectiveness of general anesthesia in endoscopic upper gastrointestinal tumor resection because most studies comparing general anesthesia and sedation in these procedures have been retrospectively conducted and the results were inconsistent.

• The Journal of the Korean dental association
• /
• v.56 no.1
• /
• pp.58-65
• /
• 2018

Dental local anesthesia is important procedure for the elimination of pain during dental treatment. However, the pain during local anesthesia is one of the main source of fear to the patients. The cause of pain during dental local anesthesia includes soft tissue damage during penetration of the oral mucosa, pressure from the spread of the anesthetic solution, temperature of anesthetic solution, low pH of anesthetic solution, and the characteristics of the drug. Several concepts and devices introduced to date to reduce the pain during local anesthesia for dental treatment. In this report, devices that can reduce the pain during local anesthesia will be discussed.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.17 no.2
• /
• pp.91-103
• /
• 2017

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.

• Journal of Veterinary Clinics
• /
• v.16 no.2
• /
• pp.413-416
• /
• 1999

To establish feline electroacupuncture anesthesia, 5 cats (mixed, 1 month old, 0.4~0.5 kg, female) were examined in the present study. The acupoints used for feline electroacupuncture anesthesia were Tian-ping and Bai-hui. After perpendicular insertion of needle to Tian-ping and Bai-hui, respectively, positive electrode was connected at Tian-ping and negative electrode was connected at Bai-hui, respectively, Electric condition was 3 V and 30 Hz. To examine the effect of electroacupuncture anesthesia, laparotomy (5 heads)was applied. The pain of the body surface and the extremities excluding the tail was not found, and the induction time of electroacupuncture anesthesia was approximately 1 minute. As for the reactions with electroacupuncture anesthesia, the head part was directed to backward, blepharoreaction was mild and the consciousness was vivid. The class of anesthesia effect was excellent in 4 heads and was poor in 1 head. The pain was not observed and bleeding was comparatively small volume during surgery in excellent group.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.3
• /
• pp.173-178
• /
• 2020

We experienced a case of induction of general anesthesia without using neuromuscular blocking agents (NMBAs) in a 40-year-old woman with a history of anaphylaxis immediately after the administration of anesthetics lidocaine, propofol, and rocuronium to perform endoscopic sinus surgery 2 years before. The skin test showed a positive reaction to rocuronium and cis-atracurium. We induced general anesthesia without using NMBAs after inducing airway anesthesia with lidocaine (transtracheal injection and superior laryngeal nerve block). Deep general anesthesia was maintained with end-tidal 4 vol% sevoflurane. Hypotension was treated with phenylephrine infusion. The operation condition was excellent, and patient recovered without complications after surgery. Airway anesthesia with local anesthetics may be helpful when we cannot use NMBAs for any reason, including hypersensitivity to NMBA and surgery that needs neuromuscular monitoring.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.1
• /
• pp.73-75
• /
• 2019

• Transactions on Electrical and Electronic Materials
• /
• v.14 no.6
• /
• pp.299-303
• /
• 2013

Anesthesia, which started being used to remove pain during surgery, has become itself one of the major concerns to be considered during surgery. While actual anesthesia is being performed, patients tend to have unpleasant experiences, due to wakening that accompanies pain, or wakening that does not accompany pain. Since this awakening during anesthesia is a most unpleasant experience in a patient's life, evaluating the depth of anesthesia during surgery is essential for patients to avoid this experience. Although there has been much effort on the understanding and measurement of the depth of anesthesia, while various researches were performed on the need of anesthesia, the development of an indicator that could objectively evaluate the depth of anesthesia, other than by using the patient's vital signs, is still inadequate. Therefore, this study was to develop an objective indicator by using EEG and ECG, which are essentially measured during the surgery, to evaluate the depth of anesthesia. The experiment was performed by taking patients who require a relatively short operation time, and general inhalation anesthetics among surgical patients in obstetrics and gynecology as the subjects of experiment, to measure the EEG and ECG signals of patients under anesthetics. The result showed that SEF using EEG and LF, HF using ECG signal and correlation dimension analysis parameter were valuable parameters that could measure the depth of anesthesia, by the stage of anesthesia.