The behavioral disturbances such as agitation, aggression and wandering oc-curred in the geriatric patients have imposed much burdens on the caregivers. The origin of the behavioral disorders in the geriatric patients were identified to be based on the multidimensional interaction of the biological, psychological and social factors. There are no satisfactory instrum-ents for assessment of behavioral disorders in the geriatric patients. Furthermore, the functional assessments are also required to evaluate the environmental events to influence the problem beh-aviors in the geriatric patients.
Aggression ; Caregivers ; Dihydroergotamine ; Humans

No abstract available.
Anesthesia ; Dihydroergotamine ; Methyl Ethers

BACKGROUND: We designed this study to find the appropriate dose of fentanyl for the prevention of emergence agitation in pediatric tonsillectomy patients under sevoflurane anesthesia. METHODS: Sixty pediatric patients receiving sevoflurane anesthesia for tonsillectomy was assigned to 3 groups. Fentanyl 0.5microgram/kg (group 1), 1.0microgram /kg (group 2), or 1.5microgram/kg (group 3) was administered intravenously 10 min before the end of surgery. Agitation score was checked at the postanesthesia care unit. RESULTS: The results showed a lower incidence of severe agitation in groups 2 and 3 than in group 1. There was no difference between groups 2 and 3. CONCLUSIONS: For preventing emergence agitation after sevoflurane anesthesia, we recommend using fentanyl in a dose of more than 1.0micrgram/kg.
Anesthesia* ; Dihydroergotamine* ; Fentanyl* ; Humans ; Incidence ; Tonsillectomy*

< 0.05). The incidence of emergence agitation was 17% in the subtenons lidocaine injection group, which was significantly lower than in the control group (36%) (P < 0.05). CONCLUSIONS: A lidocaine injection into the subtenons space reduces emergence agitation after sevoflurane anesthesia in pediatric strabismus surgery.
Anesthesia* ; Anxiety* ; Dihydroergotamine* ; Incidence ; Lidocaine* ; Strabismus*

Behavior disturbances in dementia have many causes, and it is difficult to judge the effectiveness of any method as well as to classify and choose the right agents or methods of treatment. Because agitated behavior disturbances are intermittent phenomena, it is not certain that the change of symptom is response of treatment or incidental. We should help elderly people with risk of dementia, including the preventive intervention and various treatment strategies for the last stages of life. To the comprehensive treatment of behavioral disturbance of patients with dementia, adequate medical resources are essential through organized medical delivery system as well as environmental modification, family management and pharmacotherapy.
Aged ; Dementia ; Dihydroergotamine ; Drug Therapy ; Humans

BACKGROUND: The present study tested the effect of midazolam administration after sevoflurane anesthesia against emergence agitation in children in the recovery phase. METHODS: A total of 60 children presenting for ophthalmic surgery under sevoflurane anesthesia were randomly placed in four groups from Group I to Group IV. Before the end of the surgery, we injected normal saline 2 ml in Group I and Group IV. We administered a 2-ml mixture of midazolam 0.025 mg/kg and midazolam 0.050 mg/kg to Group II and Group III respectively. Among the patients with agitation scores 4 or 5 in the peostanesthesia care unit (PACU), Group IV patients were intravenously given a 1-ml mixture of midazolam 0.025 mg/kg and normal saline up to 3 times. Agitation parameters, anesthesia recovery times, and the total administration amounts of midazolam were measured. RESULTS: Extubation time was significantly longer and maximum agitation scores higher in Group III than in Group I. The rate of the length of the period when the agitation score was 4 or 5 out of the length of stay in the PACU was significantly lower in Group II, Group III, and Group IV than in Group I. The length of stay in the PACU was significantly longer in Group III, and Group IV than in Group I. CONCLUSIONS: For pediatric patients under sevoflurane anesthesia, postoperative midazolam administration slightly prolonged the length of stay in the PACU. But it effectively reduced emergence agitation without any side effects.
Anesthesia ; Child ; Dihydroergotamine ; Humans ; Length of Stay ; Methyl Ethers ; Midazolam ; Strabismus

BACKGROUND: Behavioral and psychological symptoms (BPS) following acute middle cerebral artery (MCA) infarcts are not uncommon, but these have been considered to be less important than physical disability. The purpose of this study is to evaluate the characteristics of BPS following acute MCA infarcts by using the Korean version of neuropsychiatric inventory (K-NPI). METHODS: Fifty-one patients with acute MCA infarcts were studied using the K-NPI scale. We investigated newly developed BPS after the onset of MCA infarcts by interviewing the primary caregiver of each patient. We then evaluated factors related to the BPS such as lesion laterality and various characteristics of the subjects. RESULTS: The most common BPS following acute MCA infarcts was depression. It was present in 69% of the patients, followed by anxiety (61%), agitation (39%), apathy (29%) and irritability (25%). Depression and anxiety were associated with left MCA lesion, whereas apathy was associated with right lesion. Patients with recurrent MCA infarcts more often had depression and anxiety than those without (p=0.03, p=0.04, respectively). Patients with MCA infarcts caused by cardioembolism more often had irritability and disinhibition than those with other subtypes (p=0.01, p=0.02, respectively). CONCLUSIONS: BPS is frequently observed following acute MCA infarcts. Therefore, early and adequate assessment of post stroke BPS and appropriate therapy may be important in patients with MCA infarcts.
Anxiety ; Apathy ; Caregivers ; Depression ; Dihydroergotamine ; Humans ; Middle Cerebral Artery* ; Stroke

BACKGROUND: The effectiveness of preemptive analgesia is still controversial. This study was designed to compare the effects of nalbuphine used in the pre-anesthesia period and after surgery for pain control when performing adenoidectomy or tonsillectomy in children. METHODS: Two hundreds four patients (aged 3 to 12 years) were randomly allocated into two groups: the preemptive group (group P, n = 98) and the intraoperative group (group I, n = 106). Nalbuphine 0.1 mg/kg was administered into the patients before induction of anesthesia in group P and it was injected at least 10 minutes after the beginning of surgery in group I. The anesthesia was performed in the conventional fashion. The pain score, the sedation score and the agitation score were checked and recorded in the postanesthetic room (PAR) at arrival (0), at 15 minutes and at 30 minutes. RESULTS: The pain scores for PAR 0, 15 and 30 minutes were significantly lower in group I than those in group P. The other sedation scores or agitation scores were similar in both groups. CONCLUSIONS: Nalbuphine used during the pre-anesthetic period was less effective than that used in the intraoperative period for pain control when performing adenoidectomy or tonsillectomy in children.
Adenoidectomy ; Analgesia ; Anesthesia ; Child ; Dihydroergotamine ; Humans ; Intraoperative Period ; Nalbuphine ; Tonsillectomy

OBJECTIVE: Dementia symptoms (cognitive function, daily-living function, and neuropsychiatric symptoms) become more serious over time, which is likely to increase caregiver burden. The aim of this study is to investigate which dementia-related symptoms, and how the progression of these symptoms, have influenced caregiver burden during a 1-year follow-up assessment. METHODS: A total of 110 patients with dementia were assessed for their cognitive function, daily-living function, and neuropsychiatric symptoms. Caregivers were assessed for their caregiver burden. Bivariate analyses were conducted between caregiver burden and dementia patients' symptoms, in order to examine which particular symptoms were significantly associated with caregiver burden at the baseline. A multiple regression analysis was then conducted with each significantly associated variable with a view to identifying determinants, influencing caregiver burden. Additionally, bivariate analyses were conducted between the changes in caregiver burden and the changes in patients' symptoms, to investigate which patient variable could best describe caregiver burden from baseline to the 1-year follow-up. A multiple regression analysis was conducted with each significantly-associated change in symptom, in order to identify determinants that influence a change in caregiver burden. RESULTS: Neuropsychiatric symptoms, such as irritability, aberrant motor-behavior, delusions and disinhibition were found to be significant predictors of caregiver burden at baseline, according to multiple regression analysis. In addition, changes in neuropsychiatric symptoms, such as delusions, agitation and memory-related functioning in daily-living significantly predict a change in caregiver burden. CONCLUSION: Our results demonstrate that neuropsychiatric symptoms and memory impairment in daily-living functions are significant predictors of an increase in caregiver burden.
Caregivers* ; Delusions ; Dementia* ; Dihydroergotamine ; Follow-Up Studies* ; Humans ; Memory

OBJECTIVE: Delirium is defined as an alteration in mental status characterized by brief disturbances in consciousness and attention, cognition, and perception that tend to fluctuate during the course of the day. Traditionally, haloperidol has been used to treat agitation as it may occur in delirium. However, atypical antipsychotics are increasingly used to treat delirium itself. A comparative study was undertaken to compare the clinical efficacy of haloperidol and aripiprazole for the treatment of delirium. METHODS: Forty patients (20 patients assigned to haloperidol and 20 to aripiprazole) diagnosed with delirium by DSM IV-TR were recruited and randomly assigned to receive a flexible-dose regimen of haloperidol or aripiprazole over 7 days. The severity of delirium was assessed by using the Delirium Rating Scale-Revised-98 scores (DRS-R-98). RESULTS: DRS-R-98 severity scores for each group decreased significantly over the study period (p<0.01), but no statistically significant difference was detected between the two groups (p=0.607). CONCLUSION: These data show no statistically significant difference in efficacy between haloperidol and aripiprazole in the treatment of delirium. Since haloperidol has great potential for causing extrapyramidal symptoms(EPS), aripiprazole, a medication with known low side effects, may be an effective alternative agent in the treatment of delirium.
Antipsychotic Agents ; Cognition ; Consciousness ; Delirium* ; Dihydroergotamine ; Haloperidol* ; Humans ; Aripiprazole