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어려운 기관 내 삽관이 예상되는 환자의 기도관리 -증례 보고-
오세리,이진한,O, Se-Ri,Lee, Jin-Han 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.2
Difficult airway management including difficult intubation, difficult ventilation and difficult mask ventilation is a life threatening issue during anesthesia care. A 23-year-old woman with Treacher Collins syndrome was scheduled for distraction osteogenesis. She had hypoplasia of mandible and malar bone, bilateral deformities of auricles with partial deafness and antimongoloid slant of the palpebral fissures. A 56-year-old woman with mandibular hypoplasia due to childhood trauma was scheduled for distraction osteogenesis. She had a history of difficult intubation. We anticipated a difficult intubation and ventilation. Fiberoptic bronchoscopic guided awake intubation was selected for anesthesia induction. After intravenous injection of midazolam and remifentanil, 10% lidocaine pump spray on the pharyngolarynx with a direct laryngoscope and on the nasal canal. However fiberoptic bronchoscopic guided awake intubation was failed due to severe gag reflex. After intravenous injection of propofol and remifentanil using the target controlled infusion (TCI), mask ventilation was easily performed and, after intravenous injection of vecuronium, fiberoptic bronchoscopic guided intubation was easily performed using a wire reinforced endotracheal tube. The operation was completed successfully without any adverse events.
의료진의 실수로 인한 미다졸람의 근육 내 과다 투여 -증례보고-
오세리,김윤희,O, Se-Ri,Kim, Yun-Hee 대한치과마취과학회 2011 Journal of Dental Anesthesia and Pain Medicine Vol.11 No.1
We report two cases of accidental overdoses of intramuscular midazolam used for a conscious sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The pedodontist prescribed midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 2 ml (2 mg) by verbal order to hygienist. The hygienist instead of the pedodontist wrote a prescription for midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 2 ml (10 mg). The inexperienced nurse gave an injection to his buttock as prescription. The child fell into a deep sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The inexperienced pedodontist gave an injection to his buttock midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 3 ml (15 mg) instead of midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 3 ml (3 mg). The child fell into a deep sedation. Both cases had no complications, but the accidents happened as a result of the inexperienced dental staffs. The five times midazoalm instead of the intended doses was inadvertently given intramuscularly, fortunately caused no harm in our cases. However, the situations suggest that we should carefully check the dosage and review the correct procedures, even when using a drug that is considered to be familiar with most practitioners.
치과 치료에 대한 심한 공포가 있는 환자들에서 미다졸람 정주 후 나타난 기이반응 -증례보고-
오세리,O, Se-Ri 대한치과마취과학회 2009 Journal of Dental Anesthesia and Pain Medicine Vol.9 No.1
Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.
구역반사가 심한 환자의 임플란트 치료에서 프로포폴과 미다졸람을 이용한 정주진정법 -증례 보고-
오세리,이준,O, Se-Ri,Lee, Jun 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1
The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.
직장인의 정서표현신념이 전문적도움추구태도에 미치는 영향: 정서표현양가성과 심리적유연성의 이중매개효과
하세리나(Serena Ha),이수림(Su-Lim Lee) 한국콘텐츠학회 2021 한국콘텐츠학회논문지 Vol.21 No.11
본 연구는 직장인의 정서표현신념이 전문적 도움추구 태도에 미치는 영향에서 정서표현 양가성과 심리적 유연성의 이중매개효과를 검증하고자 하였다. 이를 위하여, 19세 이상의 직장인 346명(남 176명, 여 170명)을 대상으로 연구를 진행하였다. 연구참여자들에게 정서표현신념, 정서표현 양가성, 심리적 유연성, 전문적 도움추구 태도를 측정하는 설문을 실시한 뒤 SPSS와 Macro를 활용하여 분석을 실시하였다. 주요 결과를 요약하면, 첫째, 정서표현신념, 정서표현 양가성, 심리적 유연성, 전문적 도움추구 태도 간에 유의미한 상관이 나타났다. 둘째, 정서표현신념과 전문적 도움추구 태도의 관계에서 심리적 유연성의 매개역할은 유의미하였고, 정서표현 양가성의 매개효과는 유의미하지 않았다, 셋째, 정서표현신념이 정서표현 양가성과 심리적 유연성을 거쳐 전문적 도움추구 태도로 이어지는 이중매개효과가 유의하였다. 이를 통해 직장인의 전문적 도움추구 태도 형성 과정을 이해하고 이들의 도움추구를 도울 수 있는 개입방안을 모색하고자 한다. The purpose of the study is to examine the mediating effects of ambivalence over emotional expression and psychological flexibility on the relationship between employees’ beliefs about emotional expression and attitudes toward seeking professional psychological help. The subjects of this study were 346 employees(male: 176, female:170) over the age of 19. Questionnaires including beliefs about emotional expression, ambivalence over emotional expression, psychological flexibility, attitude toward seeking professional psychological help were conducted and the collected data were analyzed by using SPSS and Macro. A summary of the results as follows. First, in the results of the correlation analysis on the primary factors had a significant correlation. Second, psychological flexibility had a mediating effect in the relationship between beliefs about emotional expression and attitude toward seeking psychological help while mediating effect of ambivalence over emotional expression was not significant. Lastly, the sequential mediating effect of ambivalence over emotional expression and psychological flexibility between beliefs about emotional expression and attitudes toward seeking professional psychological help was significant.