소아치과 외래에서 Chloral Hydrate를 사용한 Sediation

윤형배 치과연구사 1989 치과연구 Vol.25 No.1

소아치과 환자에서의 외래마취

윤형배 치과연구사 1989 치과연구 Vol.25 No.1

Nitrous Oxide를 이용한 흡입진정

윤형배,Yoon, Byung-Bae 대한치과마취과학회 2002 Journal of Dental Anesthesia and Pain Medicine Vol.2 No.1

The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.

행동조절이 어려운 소아치과 환자 치료시 Halothane과 Midazolam을 사용한 Modified Deep Sedation

윤형배 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.1

Manangement of children who show negative response to treatment was difficult. Usually the dentist used the restraintor sedatives for these children. Especially it is very difficult to management of definitely negativebehavior patients who resist to ordinary sedative technics including psychosedation and various sedatives. These patients were managed with general anesthesia. Midazolam was used for sedation of non-cooperative pediatric patients and halothane for induce initial sleepness. If the patient shows negative response to management after 15 minutes of midazolam administration, used the halothane in 30 to 120 seconds for calm down the patient. After induce sleepness, cut off the halothane administration and maintain the sedation with N₂O in 50-70 vol.% concentration. This technic reduce the toxity and untoward effects of major anesthetics. To compare the difference of sedation effect by dosage, dose of 0.2㎎/㎏ and 0.3㎎/㎏ were injected respectively. Though there's no statistical difference in duration and results between two dosage but show the increment of score with age. If the patients show positive response to management after midazolam administered, try to conscious sedation with nitrous oxide in 30 to 70 vo.% concentration. Nitrous oxide concentration was administered slowly according to their consciousness and response to treatment by incerment or decrement. The success rate of conscious sedation were 21.2% in 0.2㎎/㎏ and 30.3% in 0.3㎎/㎏. There's many factors in proceed of conscious sedation. The most inportant factors are age of patient and experience of children for dental care.

비동기 혼류 생산라인의 유연 영역에 대한 공정할당, 생산순서, 재공버퍼 최적화

윤형배,고정한 대한산업공학회 2023 대한산업공학회 춘계학술대회논문집 Vol.2023 No.5

비동기 혼류 생산라인의 유연 영역에 대한 공정할당, 생산순서, 재공버퍼 최적화

윤형배,고정한 한국경영과학회 2023 한국경영과학회 학술대회논문집 Vol.2023 No.5

구호흡 소아환자에서 흡인도관을 이용한 $N_2O-O_2$ 진정

윤형배,Yoon, Hyung-Bae 대한소아치과학회 1999 大韓小兒齒科學會誌 Vol.26 No.4

소아치과 환자에서 협조가 안 되는 환자의 진료시 여러 가지 방법의 진정요법이나 다른 방법이 이용된다. 이 중에서도 최근의 경향은 약물을 이용하여 진정을 시행하는 방법이 주로 이용된다. 약물 투여방법 중에서도 흡입가스를 이용하여 진정을 유발하는 경우가 장점이 많아 최근 사용이 증가하는 추세이다. 흡입가스를 이용한 경우 폐를 통해 약물이 흡수되므로 적절한 진정수준에 도달하기 위해서는 환자의 호흡양상이 주 영향을 끼친다. 가스를 이용한 흡입진정 시에는 환자가 반드시 비호흡을 하여야 폐를 통해 흡수가 되므로 구호흡을 하는 경우는 정맥로를 이용한 진정이나 기관내삽관을 필요로 한다. 저자는 $N_2O-O_2$를 이용한 진정요법을 시행하는 중에 완전한 구호흡을 하는 환자를 기관내삽관을 하지 않고 끝 부분이 둥글고 유연한 흡인도관을 사용하여 아산화질소를 투여함으로서 만족할 만한 결과를 얻었기에 이에 보고 한다. There are some problems in inhalation sedation of non-cooperative pediatric patients. Usually the pediatric patients reject the nasal hood and there's no cooperation for administration of nitrous oxide gas. In mouth breathing patient, other technics of sedation such as intravenous or oral sedation or general anesthesia were recommended. Common causes of mouth breathing are common cold, allergic rhinitis, sinus problem, anatomical disorder, and habitual mouth-breathing. However in some patient not indicated the general anesthesia and high failure rate in oral and intravenous sedation. Administration of $N_2O-O_2$ with suction catheter was applied in full mouth breathing patient. Clinically effective sedation were occurred during procedure about 45 to 55 minutes. There's no any side effects by $N_2O-O_2$ inhalation sedation. The patients awoke at the end of the procedure and received 100% oxygen for 2-3 minutes. There's still some problems in use of the suction catheter such as air pollution of operation theater and elevate arterial carbon dioxide tension.

균형마취의 문제점

尹馨培 단국대학교 1988 論文集 Vol.22 No.-

The balanced anesthesia, which introduced by Lundy in 1926, be used to produce the different component of anesthesia. Nowadays, balanced anesthesia which opium used as major anesthetic agent, has been widely used in anesthesia for cardiac surgery. The main advantages of opium-induced anesthesia in maintains of stable cardiovascular hemodynamics during surgery. But, occasionally in some patients reveals following dissadvantages: hypertension, hypotension, bradycardia, tachycardia, muscle rigidity, and awareness during operation. The hypotensive disorder was prominent in morphine and demerol which significant release of histamine. The hypotensive disorder was common in fentanyl anesthesia and high incidence after sterneotomy. The bradycardia was common problems in all opoid except meperidine which structural similarity with atropine. The muscle rigidity revealed in all opioid. The muscle rigidity and awareness are appeared in all opioid anesthesia. For the prevefnt or treatment of above side effects, following items being recommanded: 1. slow injection of narcotics 2. premedication with atropine, neuromuscular blocker and antihistamines 3. adequate fluid replacement 4. cautious use of supplements which induces of significant depression of cardiovascular hemodynamics

행동조절이 어려운 소아환자의 Deep sedation을 이용한 치과치료

엄혜숙,윤형배 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.4

It is one of difficulties to control children who show defintely negative behavior in dental clinic. In such a case, the pharmacologic management has been used to provide quality care, minimize the extremes of disruptive behavior, promote a positive psychologic response to treatment and patient welfare and safety. Deep sedation can be defined as a controlled, pharmacologically-induced state of depressed consciousness from which the patient is not easily aroused which may be accompanied by a partial loss of protective reflexes. In this retrospective report, the sedation records of 200 pediatric dental patients of ASA Class Ⅰ&Ⅱ Who were not successfully treated under conscious sedation were used for analysis. Most frequently used regimen of deep sedation was the co-medication of midazolam(0.3mg/kg), enflurane(1.0-2.0 vol%) and 50-70% N₂O-O₂. The average age and weight of the patients was 4.6 yr (S,D:2.72) and 18.7kg(S.D:6.35)respectively. The average operative time was 52 minutes and midazolam (0.1-0.2㏄) was additionally administered intranasally to prolong the operative time as needed. The episodes of untoward side effects were reported during and/or after the procedure in 58 patients. Serious adverse reactions such as cyanisis or laryngospasm were even reported in 7 patients but without mortality. deep sedation is a very effective way of completing the dental treatments for those who failed to respond well to the conscious sedation. This technique has many practical advantages over general anesthesia case but the demands for the rigid monitoring criteria limit its use in general practice setting. The continuous efforts to improve the safety of the medication and the technique are required for the benefits of the patients and parent.

植物凝集素 Sophola japonica와 赤血球에 의한 사람 尿의 型分類에 關한 硏究

尹馨培,黃迪駿 고려대학교 의과대학 1991 고려대 의대 잡지 Vol.28 No.1

In order to classify the type of the urine by using of the inhibition effect of Sophola japonica which acts as pan-phytagglutinin, to human red blood cells. Compared the relationship between the type of urine classified in this study and the types of other specimens which are already proven by other methods. There are two types of human urine : one with sub-stances that inhibit the agglutination of Sophola Japonica extract to human red blood cells and the other without those substances. Among 300 human urine specimens involved In the present study, 12% (36 specimens )were shown to have those inhibition substances in their urine. The types of urine classified in this study showed no relationship with those classified by the Agastache rugosa extract. Neither the known type of saliva nor the type of experimented by the Sophola japonica extract had any relationship with the type of urine determined in this study. No significant relationship could be found between the various type of blood and Serum types such as ABO, MN, H, Cl, IPO, NPO, ICO, NCO and the urine type.