{"title":"Tolerance to intravenous midazolam as a result of oral benzodiazepine therapy: a potential problem for the provision of conscious sedation in dentistry.","authors":"N D Robb, S A Hargrave","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tolerance to the sedative effects of the benzodiazepine group of drugs is well documented. A brief review of the literature is presented. Three cases in which tolerance to intravenous midazolam became apparent and caused a significant problem during the attempted induction of conscious sedation are described. The patients were all concurrently receiving treatment with other benzodiazepines. It is recommended that patients with a history of regular, current benzodiazepine use be treated with caution with regard to this type of sedation.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"94-7"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209212","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":"Problems attaining local anesthesia with endodontic emergencies.","authors":"J L Gutmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The attainment of profound local anesthesia in the management of pulpal and periradicular pain often eludes even the most skilled clinician; various reasons for this include, but are not limited to, localized inflammation, osseous and neural variations, and poor technique of the operator. This paper reviews these potential impediments while focusing on recognizing occurrences, understanding mechanisms, and applying clinical techniques to effectively eliminate their impact on dental pain management.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"133-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19133937","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":"Parameters of achieving quality anesthesia and hemostasis in surgical endodontics.","authors":"J L Gutmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Successful management of root structures and soft tissue pathology during endodontic surgical procedures is predicated on achieving both profound anesthesia and effective tissue hemostasis. The degree of anesthesia and hemostasis required depends on the type of endodontic surgical procedure; the more complex and definitive procedures require the greatest extent of vascular control. Predictable methods for achieving successful tissue management are based on the proper use of a vasopressor drug, proper technique and rate of injection, and the use of multiple injection sites. These approaches are designed not only to enhance patient comfort but also to improve visual and manipulative access to the surgical site.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"223-6"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19170931","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":"Maxillary nerve block via the greater palatine canal: new look at an old technique.","authors":"A J Lepere","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although not widely used, maxillary nerve block via the greater palatine canal can be remarkably effective. This article is aimed at reviving its use by reviewing the indications, contraindications, and anatomy of the technique. A simplified guide to the technique is offered to place the technique within the armamentarium of the practicing dentist.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"195-7"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19172940","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":"General anesthesia and children's dental health: present trends and future needs.","authors":"J J Murray","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Attitudes toward general anesthesia and patterns of dental disease in children have changed markedly over the past 20 years. This paper reviews past and present trends to estimate future needs of general anesthesia for school-aged children. The impact of the Poswillo report on general dentistry, sedation, and resuscitation in dentistry is discussed along with the changes in patterns of dental health of children.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"209-16"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19172944","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":"An open comparative study of the analgesic effects of tenoxicam and diclofenac sodium after third molar surgery.","authors":"J A Roelofse, P van der Bijl, J J Joubert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tenoxicam and diclofenac sodium were compared as analgesics following the surgical removal of third molars. Twenty-five patients between the ages 17 and 29 years were randomly allocated into two groups. Patients in group A received a single intraoperative intravenous (i.v.) injection of 20 mg of tenoxicam followed by a 20-mg tablet given the evening after the operation; thereafter, one 20-mg tablet was given once daily for the next 6 days. Group B received a single intraoperative intramuscular injection of 75 mg of diclofenac sodium followed by a 50-mg tablet 4 to 6 hours postoperatively and during the evening; thereafter, a 50-mg tablet was taken three times daily for the next 6 days. Pain was postoperatively measured hourly for 4 hours and later in the evening. Pain was also measured in the mornings and evenings for the next 6 days. The highest pain scores were obtained 1 hour postoperatively for both groups. During the first 3 hours following administration, patients in the tenoxicam group experienced significantly more pain than those in the diclofenac group. Preoperatively, both treatments showed identical efficacy after 3 hours. It is therefore suggested that a 40-mg dose of i.v. tenoxicam should be administered at induction of anesthesia to achieve a higher level of analgesia in the immediate postoperative phase.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"217-22"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19170930","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":"Circulatory effects of vasoconstrictors combined with local anesthetics.","authors":"J Jage","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Vasoconstrictors are clinically used as adjuvants to local anesthetics to improve anesthetic action and to minimize local bleeding. Accidental intravascular injection or rapid systemic absorption of vasoconstrictors can induce a number of potentially life-threatening circulatory risks, which are described in this paper.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 2","pages":"81-6"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19209210","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, P Bjerring, S Kaaber
{"title":"Oral mucosal analgesia quantitatively assessed by argon laser-induced thresholds and single-evoked vertex potentials.","authors":"P Svensson, L Arendt-Nielsen, P Bjerring, S Kaaber","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study is to quantitate the efficacy of a new topical anesthetic applied to the oral mucosa. Nociceptive pinprick thresholds and single-evoked vertex potentials (VP) elicited by high-intensity argon laser stimuli are used as measures of analgesia. After 5 minutes of occlusion (Orahesive Oral Bandages, ConvaTec) with a eutectic mixture of local anesthetics (EMLA cream, Astra), nociceptive pinprick thresholds on the tongue and gingiva are higher than those taken during nonocclusion. In a double blind-placebo controlled experiment, VPs were elicited every 1 minute for 19 minutes by single laser stimuli applied to the mucosa of the lower lip. After occlusion with EMLA cream for 3 minutes, VPs were significantly reduced when compared to those with placebo cream. One minute after removal of the EMLA cream, the spectral power of the single-evoked VP decreased significantly by 63.3%, the root-mean-square amplitude decreased by 42.7%, and the subjective pain perception (estimated on visual analogue scales) decreased by 88%. A significant reduction in single-evoked VPs was detected until 13 minutes after the removal of the EMLA cream. Oral mucosal analgesia may be quantitated by argon laser-induced nociceptive pinprick thresholds and single-evoked VPs.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"154-61"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19133940","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 Lorenzi, M Marsili, G Manetta, M Linden, S Boncinelli
{"title":"Prevention of anaphylactic-anaphylactoid reactions to anesthetics in high-risk allergic patients.","authors":"P Lorenzi, M Marsili, G Manetta, M Linden, S Boncinelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To confirm the role of preventive procedures in high-risk allergic patients, immunological tests in vivo for anesthetics were carried out in 251 atopic patients. The 6-month follow-up showed a complete absence of adverse reactions during the clinical use of hypnotic and muscle relaxant drugs. In the case of local anesthetics, five adverse reactions were observed after dental treatment--four were related to a psychogenic mechanism, and one could not be clearly linked to the local anesthetic. It is possible to confirm that the use of a tested drug that yields negative results has a lower probability of inducing anaphylactic-anaphylactoid reactions during anesthesia.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 4","pages":"227-32"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19170932","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":"Diffusion hypoxia: another view.","authors":"M B Papageorge, L W Noonan, M Rosenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Arterial oxygen saturation (SaO2) was monitored postoperatively with pulse oximetry in 80 dental patients receiving nitrous oxide and oxygen. These patients were divided into four equal groups, three of which received nitrous oxide (N2O) and oxygen (O2) in ratios of 20:80, 40:60, and 60:40, respectively. The fourth group received 100% O2 and served as the control. The SaO2 was monitored for 15 minutes after termination of the procedure as the patient breathed room air. Continuous pulse oximetry revealed 43 episodes of SaO2 (a decrease greater than 3% from the baseline) in patients who received 20% N2O, 268 episodes in patients who received 40% N2O, 594 episodes in patients who received 60% N2O, and 21 episodes in patients who received 100% O2. The number of patients who experienced desaturation episodes increased with the increase in N2O concentration. The SaO2 values ranged from a decrease of 1.0% to 7.0% with a mean of 2.1%. Smokers experienced a greater number of desaturation episodes in the 40% N2O group and in the control group. One patient in the 40% N2O group experienced an SaO2 of less than 90%, but no patient experienced clinically significant hypoxia. In the 40% and 60% N2O groups, the percent change of SaO2 from the baseline was greater, and the SaO2 returned to baseline slower. The difference in mean SaO2 between smokers and nonsmokers was greater in the 40% N2O group.</p>","PeriodicalId":76997,"journal":{"name":"Anesthesia & pain control in dentistry","volume":"2 3","pages":"143-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19133939","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}