Journal of Yeungnam Medical Science

Review articles

Anesthesiology and Pain Medicine
Acute postoperative pain control in pediatric patients: a scoping review: Eun Kyung Choi, Sang-Jin Park, Seong Wook Hong; J Yeungnam Med Sci. 2026;43:1. Published online December 10, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.1

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Abstract PDF: Acute postoperative pain results from tissue injury during surgery and subsequent inflammatory responses. The incidence of chronic postsurgical pain ranges from 10% to 30%, and its development is influenced by various clinical factors, including psychological, biological, and social determinants. Optimal management of acute postoperative pain is crucial for enhancing patient satisfaction, preventing adverse outcomes in the immediate postoperative period, and minimizing progression to chronic postoperative pain. In particular, postoperative pain in pediatric patients is often underestimated and inadequately managed because of developmental differences in pain perception, expression, and challenges in assessment. Therefore, age-appropriate and validated assessment tools that consider cognitive development and situational factors are required. Given age-related variability in pharmacokinetics and pharmacodynamics, individualized multimodal analgesic strategies with careful dose adjustments should be utilized. These approaches have demonstrated improved analgesic efficacy and enhanced recovery outcomes in pediatric surgical patients. A comprehensive understanding of pediatric pain pathophysiology, combined with appropriate methods of pain assessment and management strategies, should be selected to promote postoperative recovery and reduce morbidity.

Anesthesiology and Pain Medicine
Regional analgesia for postoperative pain control after thoracic surgery: a narrative review: Sang-Jin Park, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:80. Published online December 4, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.80

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Abstract PDF: Effective management of post-thoracotomy pain is essential to prevent pulmonary complications and reduce the risk of developing chronic pain syndrome. Although systemic opioids remain a common option, their use is limited by significant adverse effects, making regional analgesia the cornerstone of postoperative pain management. Thoracic epidural analgesia, historically regarded as the gold standard, provides potent postoperative pain relief but carries risks of hypotension and, in rare cases, severe neurological events. Thoracic paravertebral block (PVB) has emerged as the primary alternative, offering comparable analgesic efficacy and an improved safety profile, particularly in maintaining hemodynamic stability. However, PVB is technically demanding and associated with a higher failure rate and localized procedural complications such as pneumothorax. Fascial plane blocks have recently been developed to prioritize safety. The erector spinae plane block is technically simpler, using the transverse process as a “bony backstop” to minimize the risk of pleural injury; however, its analgesic potency may be lower than that of PVB. The intertransverse process block seeks to combine the efficacy of PVB with enhanced safety; however, supporting evidence remains limited. Alternative regional techniques, such as serratus anterior plane block, intercostal nerve block, and continuous wound instillation, typically provide insufficient analgesia for the comprehensive pain associated with open thoracotomy. No regional analgesic technique has demonstrated universal superiority. The optimal approach should be individualized, balancing the distinct risk–benefit profile of each block with patient comorbidities, surgical factors, and institutional expertise.

Anesthesiology and Pain Medicine
Anesthetic implications of psychotropic medications: a narrative review: Sung Mee Jung, Sang-Jin Park; J Yeungnam Med Sci. 2025;42:70. Published online November 5, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.70

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Abstract PDF: Psychotropic medications are widely used in the treatment of mental and nonmental disorders such as chronic pain and other off-label indications. With the increase in comorbidities of mental and physical illnesses, anesthesiologists more frequently encounter patients taking psychotropic medications who require surgical procedures. Commonly prescribed psychiatric medications include antidepressants, mood stabilizers, anxiolytics, and antipsychotics. These medications can interact with anesthetic agents or other drugs commonly used during anesthesia at both pharmacokinetic and pharmacodynamic levels, potentially precipitating life-threatening syndromes such as serotonin syndrome, neuroleptic malignant syndrome, and lithium toxicity. This review summarizes the current knowledge on the pharmacology of commonly prescribed psychiatric medications, including their adverse effects and interactions with anesthetic agents routinely used in the perioperative period. Additionally, considering the risk of withdrawal symptoms and psychiatric relapse or recurrence, current recommendations for the discontinuation or continuation of these medications during the perioperative period are discussed.

Case Report

Anesthesiology and Pain Medicine
Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome: Sang-Jin Park, Eun Kyung Choi, Suyong Park, Kunjin Bae, Deokhee Lee; Yeungnam Univ J Med. 2018;35(2):219-221. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.219

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Abstract PDF: Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Original Article

Anesthesiology and Pain Medicine
Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery: Hyuckgoo Kim, Jisoo Han, Sung Mee Jung, Sang-Jin Park, Nyeong Keon Kwon; Yeungnam Univ J Med. 2018;35(1):54-62. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.54

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7 Crossref

Abstract PDF

Background
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Methods
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
Results
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
Conclusion
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

Citations

Citations to this article as recorded by

Effects of Intravenous or Inhalation Anesthesia on Blood Glucose in Patients with Type 2 Diabetes Mellitus: A PRISMA-Compliant Systematic Review and Meta-Analysis
Sang Min Yoon, Hyun Kang, Yoon Ji Choi, Sang Hun Kim, Seongtae Jeong, Sejong Jin
Medicina.2026; 62(1): 128. CrossRef
Propofol-Induced Hyperglycemia in the Critically Ill: An Unfamiliar Side Effect of a Common Anesthetic
Muhammad A Qureshi, Greeshma A Thomas, Tijin Mathew, FNU Anshul
Cureus.2024;[Epub] CrossRef
The Maternal and Neonatal Glycemic Stress Response in Normal Vaginal Delivery: A Comparative Study Between Epidural and Parenteral Opioids Analgesia
Ala”a Alhowary, Omar Altal, Diab Bani Hani, Anas Alrusan, Yaser Ba Jusair, Rania Al-Bataineh, Ahmed Al Sharie, Abdelwahab Aleshawi
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Strategies for intraoperative glucose management: a scoping review
Nathaniel Morin, Sarah Taylor, Danae Krahn, Leyla Baghirzada, Michael Chong, Tyrone G. Harrison, Anne Cameron, Shannon M. Ruzycki
Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(2): 253. CrossRef
Impact of total intravenous anesthesia and total inhalation anesthesia as the anesthesia maintenance approaches on blood glucose level and postoperative complications in patients with type 2 diabetes mellitus: a double-blind, randomized controlled trial
Xinghui Xiong, Yong He, Cheng Zhou, Qin Zheng, Chan Chen, Peng Liang
BMC Anesthesiology.2023;[Epub] CrossRef
Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review
Vladimir N. Kuklin, J. Matri, N. P. Barlow, S. H. Tveit, J. E. Kvernberg, E. -M. Ringvold, V. Dahl
Annals of Critical Care.2022; (4): 33. CrossRef
Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
Yiyong Wei, Donghang Zhang, Jin Liu, Mengchan Ou, Peng Liang, Yunxia Zuo, Cheng Zhou
BMC Anesthesiology.2021;[Epub] CrossRef

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