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

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*

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

PURPOSE: The purpose of this study was to determine the relationship between assessed pain, functional status, and emotional status in elderly women with dementia. METHODS: The method was a descriptive correlational design. Subjects were sampled from 75 elderly women with dementia who were resident in nursing home. and their pain, functional status(physical function, cognitive function), emotional status(depression, agitation) were measured. The collected data were analyzed for correlations between pain and functional status and for emotional status using the SPSS 11.0 statistical program. RESULTS: The pain degree of the aged women in dementia were as follows; between 0 and 27 points, average 4.04 points, which was a possible point extent. Looking at the grades in detail items, the wry face expression was shown highest, an average of 0.84 points. The relation with cognitive function was(r=-.259, p<.025) a minus relation. And the relation with physical function was (r=.406, p<.001) a plus one. The relation with depression was (r=.462, p<.001), plus one. And (r=.592, p<.001) a plus relation was found with agitation. CONCLUSION: Pain is associated with impaired functional and emotional status. Major efforts are needed to improve nursing assessment and management of pain in this cognitive impaired population.
Aged* ; Dementia* ; Depression* ; Dihydroergotamine* ; Female ; Humans ; Nursing Assessment ; Nursing Homes

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