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*

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

< 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*

PURPOSE: This aim of this phenomenological study was to describe and understand the experience of spiritual conflict in hospice nurses by identifying the meanings and structures of the experience. METHODS: Participants were 12 nurses working for one year or more at hospice units of general hospitals in a metropolitan city and experiencing of spiritual conflict as hospice nurses. Over six months data were collected using individual in-depth interviews and analyzed with the method suggested by Colaizzi. RESULTS: The experience of spiritual conflict in participants was organized into three categories, six theme-clusters, and 13 themes. The participants felt existential anxiety on death and a fear of death which is out of human control and skepticism for real facts of human beings facing death. They also experienced agitation of fundamental beliefs about life with agitation of the philosophy of life guiding themselves and mental distress due to fundamental questions that are difficult to answer. Also they had distress about poor spiritual care with guilty feelings from neglecting patients' spiritual needs and difficulties in spiritual care due to lack of practical competencies. CONCLUSION: Findings indicate the experience of spiritual conflict in hospice nurses is mainly associated with frequent experience of death in hospice patients. The experience of spiritual conflict consisted of existential anxiety, agitation of fundamental beliefs and distress over poor spiritual care. So, programs to help relieve anxiety, agitation and distress are necessary to prevent spiritual conflict and then spiritual burnout in hospice nurses.
Anxiety ; Dihydroergotamine ; Hospices* ; Hospitals, General ; Humans ; Methods ; Philosophy ; Qualitative Research

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

BACKGROUND: Anesthesiologist must be aware of the common problems that occur in pediatric anesthesia. The purpose of this survey was to collect information to help improve the quality of pediatric anesthesia by comparing the opinions of anesthesiologists that treat children and those that do not treat children. METHODS: A questionnaire surveying the attitudes of 103 anesthesiologists with regard to pediatric problems was analyzed. The questionnaire inquired about the number of years worked in field, the form of work and the responsibilities with regard to the pediatric anesthesia. Each question was rated from 1 (very infrequent) to 5 (very common) for the frequency of problems and from 1 (not importance) to 5 (very important) for the importance of the problem. Then we calculated the average of each item and combined the scores to obtain an average frequency and an average importance. RESULTS: The list of problems had high combined scores for preoperative anxiety (10.62), incision pain (9.59), postoperative agitation (9.53), hypothermia (9.40), and vomiting (9.30) for the pediatric anesthesiologist group. In addition, the problem list had high combined scores for propofol injection pain (11.25), preoperative anxiety (10.92), vomiting (10.17), hypothermia (9.44), and postoperative agitation (9.42) for the non-pediatric anesthesiologist group. CONCLUSIONS: The results of this study showed a difference in the pediatric and non pediatric anesthesiologist groups for propofol injection pain. Differences were noted for the average importance (2.34 : 2.80) compared to the average frequency (3.93 : 4.01). The pediatric anesthesiologists regarded propofol injection pain to be less of a problem than did the anesthesiologists who did not care for pediatric patients.
Anesthesia ; Anxiety ; Child ; Dihydroergotamine ; Humans ; Hypothermia ; Propofol ; Vomiting ; Surveys and Questionnaires

Subaortic left brachiocephalic vein is a rare congenital anomaly that is sometimes found in the normal population. We report here on a case of subaortic left brachiocephalic vein that was detected incidentally by performing contrast transesophageal echocardiography (TEE) with using agitated saline and computed tomography (CT).
Brachiocephalic Veins* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dihydroergotamine ; Echocardiography, Transesophageal

BACKGROUNDs: It is widely known that desflurane provides fast emergence but with a high incidence of emergence agitation. This study was designed to investigate the emergence agitation resulting from thiopental or ketamine induction with desflurane anesthesia for pediatric patients. METHODS: Forty patients, aged 3-8 years, scheduled for a tonsillectomy or a tonsillectomy and adenoidectomy were randomly allocated into two groups. Anesthesia was induced using 5 mg/kg thiopental sodium (Group T patients) or 2 mg/kg ketamine (Group K patients), and was maintained using O2-N2O-desflurane. The recovery time and incidence of emergence agitation were assessed. RESULTS: The incidence of emergence agitation was less in patients in the ketamine induction group. There were no differences in the recovery time and reported side effects. CONCLUSIONS: We conclude that ketamine induction provides less emergence agitation when compared to thiopental induction for desflurane anesthesia for a pediatric tonsillectomy or a tonsillectomy and adenoidectomy without delayed recovery.
Adenoidectomy ; Anesthesia* ; Child* ; Dihydroergotamine* ; Humans ; Incidence ; Ketamine* ; Thiopental* ; Tonsillectomy*