{"title":"Sudden unconsciousness during local anesthesia.","authors":"R Peter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case demonstrates the necessity of adequate emergency management during dental treatment. A 57-year-old man loses consciousness immediately after the injection of a dental local anesthetic. For medical assistance, a neighboring general practitioner is first telephoned without success. After approximately 15 minutes, an ambulance is telephoned, but the caller gave no indication of the situation being life threatening. Finally, an emergency doctor is dispatched and arrives approximately 35 minutes after the emergency situation began. The electrocardiogram shows a supraventricular tachycardia which, after an immediate cardioversion, converts to a sinus rhythm connected with a restoration of the circulatory function. This case exemplifies the consequences of an inadequate response to a sudden emergency.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"140-2"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19133938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Systemic management of Marfan's syndrome during dental treatment: a case report.","authors":"Y Hirota, K Sugiyama, H Niwa, H Matsuura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Marfan's syndrome is a dominantly inherited connective tissue disorder characterized by skeletal, ocular, and cardiovascular abnormalities, such as arachnodactyly, dolichostenomelia, kyphosis, scoliosis, pectus excavatum, ectopia lentis, aortic aneurysm and dissection, aortic valve incompetence, and mitral valve prolapse. This report describes the systemic management during dental treatment of a 26-year-old man with Marfan's syndrome. Blood pressure, electrocardiogram, echocardiography, systolic time intervals, and aortic pulse wave velocity were monitored. Nitrous oxide inhalational sedation was employed. In contrast to the vasopressin, felypressin (contained in prilocaine), epinephrine (contained in lidocaine) caused an acceleration of cardiac function--increased heart rate, cardiac output, 1/pre-ejection period (PEP), and aortic pulse wave velocity and decreased PEP and left ventricular ejection time. This experience suggests that the use of anesthetics containing epinephrine in dental patients with Marfan's syndrome needs to be carefully managed.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"162-70"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19135695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physical evaluation and the prevention of medical emergencies: vital signs.","authors":"S F Malamed","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It was assumed that dentists employ a complete system of physical evaluation for all new patients in their dental practices. Results of a survey of 1,588 dentists demonstrated that the use of a written medical history questionnaire was commonplace; however, recording of blood pressure and heart rate and rhythm on all new patients was quite limited. A greater percentage of dentists monitored blood pressure when there was a history of cardiovascular disease or high blood pressure. Monitoring of the heart rate and rhythm, even in patients with cardiovascular disease or high blood pressure, was severely limited in scope. A significant number of dentists still employ racemic epinephrine impregnated gingival retraction cord, and of these, 40% had observed \"epinephrine-reactions.\"</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"107-13"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Global differences: philosophy to technique.","authors":"P Sykes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"77-8"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A comparison of injectable local anesthesia and electronic dental anesthesia in restorative dentistry.","authors":"A C Mellor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study compares patient satisfaction and subjective pain levels with either electronic dental anesthesia (EDA) or injectable local anesthesia (LA) during the placement of direct restorations. Twenty-five patients (mean age 41 years), who each required two similar restorations in vital teeth, were selected. One restoration was placed using EDA and the other using LA. Preoperatively, all participants completed the Corah Dental Anxiety Scale, and postoperatively they completed a satisfaction questionnaire. Fifteen (60%) patients preferred EDA to LA, and 7 (28%) had no preference. Asked to rate their feelings on the prospect of having a filling placed with either EDA or LA (scale 1 to 5, very anxious to very relaxed), the patients rated LA as 3.0 and EDA as 3.6 (mean scores). Some pain or discomfort was felt by 12 patients with EDA and 14 patients with LA. On a scale of discomfort (1 to 5, very slight to very severe), the mean score was 1.0 for EDA and 1.2 for LA.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"177-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19135697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diploma in conscious sedation and pain control: the Australian experience.","authors":"J K Grainger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"193-4"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19172939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The efficacy of preoperative analgesic administration for postoperative pain management of pediatric dental patients.","authors":"R E Primosch, S J Antony, F J Courts","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Appropriate pain-management strategies for children receiving dental care continue to be poorly delineated. Recent studies have demonstrated the benefit of preoperative analgesic administration upon alteration of the postoperative pain experience in adults. It is the purpose of this study to assess the efficacy of preoperative administration of acetaminophen on the prevalence of postoperative pain-related behaviors and the frequency of postoperative analgesic use in 4- to 10-year-old children following various dental procedures. The results indicate a high prevalence of postoperative pain, independent of the type of dental procedure performed and the preoperative administration of acetaminophen. There is a trend toward reduced postoperative pain in the acetaminophen pretreatment groups. A greater sample size, with more reliable pain-assessment methods, may help to further elucidate the efficacy of preoperative analgesic administration in children. The clinician should be alerted to the potential for pain-related behaviors to occur following routine pediatric dental care.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"102-6"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intravenous sedation for third molar surgery.","authors":"J K Grainger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The surgical removal of third molars is a frequently carried out procedure under day-stay general anesthesia. Economic considerations and the demand on hospital facilities together with the reduced incidence of morbidity suggest that intravenous sedation is an excellent alternative modality. Thirty cases of third molar surgery with intravenous sedation are described wherein excellent operating conditions and reduced morbidity are reported.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"98-101"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aspiration of foreign materials in children while under general anesthesia for dental extractions.","authors":"J Davis, F C Anaes, H Alton, J Butler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Airway aspiration of foreign materials in children and adults is probably more common than has been supposed. This study investigated the possibility of such aspiration in children while under general anesthesia for dental extractions. A radiopaque fluid was used to coat the oral tissues and showed that a significant number of children did aspirate material into the trachea, bronchi, and occasionally even lung tissue. The notion that safety may be improved by operating with the patient in the supine position was not confirmed. While careful placement of an oropharyngeal pack may prevent solid material from entering the trachea and bronchi, it should be realized that fluids such as blood, saliva, and pus could still contaminate the airway.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19317462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P Svensson, L Arendt-Nielsen, S Kaaber, P Bjerring
{"title":"Vertex potentials evoked by nociceptive laser stimulation of oral mucosa: relationship to stimulus intensity.","authors":"P Svensson, L Arendt-Nielsen, S Kaaber, P Bjerring","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The present study investigated the relationship between stimulus intensity and size of vertex potentials (VPs) and methods for quantification of VPs elicited by nociceptive argon laser stimulation of the oral mucosa. VPs were evoked by warning and self-triggered stimulation of the tongue and hand. A significant increase was found in amplitude, power, and root-mean-square (RMS) values of the averaged VPs as the intensity of the laser stimuli increased. The latency of the major negative peak decreased significantly with increased stimulus intensity. The use of a warning light stimulus prior to the laser stimulus elicited a visually evoked vertex potential, which served as a control. The power and RMS values of the VPs elicited by warning stimulation of the tongue showed the largest increase and only a small variation when calculated in the 0.2 to 0.7 seconds time interval.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 1","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19317464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}