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Anesthetic Management of the Pregnant Patient: Part 2. 妊娠病人的麻醉管理:第二部分。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-02-12
Jaimin Shin
{"title":"Anesthetic Management of the Pregnant Patient: Part 2.","authors":"Jaimin Shin","doi":"10.2344/anpr-68-02-12","DOIUrl":"https://doi.org/10.2344/anpr-68-02-12","url":null,"abstract":"<p><p>Part 2 of \"Anesthetic Management of the Pregnant Patient\" reviews fetal development and maternal physiologic changes of interest to the dental practitioner. Part 2 of this review focuses on pharmacologic considerations, particularly the potential impact on the developing fetus. Along with a brief overview involving pharmacokinetics and pharmacodynamics of selected drugs, the following discussion focuses on currently accepted therapies and commonly used agents for pain control, sedation, and general anesthesia in the pregnant patient planned for or undergoing dental treatment.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"119-127"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258750/pdf/i0003-3006-68-2-119.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Medical Emergency Management in the Dental Office (MEMDO): A Pilot Study Assessing a Simulation-Based Training Curriculum for Dentists. 牙科诊室医疗急救管理 (MEMDO)：评估牙医模拟培训课程的试点研究。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-67-04-04
Jesse W Manton, Kelly S Kennedy, Jonathan A Lipps, Sheryl A Pfeil, Bryant W Cornelius
{"title":"Medical Emergency Management in the Dental Office (MEMDO): A Pilot Study Assessing a Simulation-Based Training Curriculum for Dentists.","authors":"Jesse W Manton, Kelly S Kennedy, Jonathan A Lipps, Sheryl A Pfeil, Bryant W Cornelius","doi":"10.2344/anpr-67-04-04","DOIUrl":"10.2344/anpr-67-04-04","url":null,"abstract":"<p><p>In the event of a medical emergency in the dental office, the dentist must be able to identify a patient in distress, assess the situation, and institute proper management. This study assessed the impact of a simulation-based medical emergency preparedness curriculum on a resident's ability to manage medical emergencies. This interventional and pre-post educational pilot study included 8 participants who completed a standard curriculum and 8 who completed a modified curriculum (N = 16). The intervention consisted of a comprehensive medical emergency preparedness curriculum that replaced lecture sessions in a standard curriculum. Participants completed performance assessments using scenario-based objective structured clinical examinations (OSCEs) that were recorded and evaluated by calibrated faculty reviewers using a customized scoring grid. The intervention group performed significantly better than the control group on their summative OSCEs, averaging 90.9 versus 61.2 points out of 128 (p = .0009). All participants from the intervention group passed their summative OSCE with scores >60%, while none from the control group received passing scores. Completion of a simulation-based medical emergency preparedness curriculum significantly improved resident performance during simulated medical emergencies.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"76-84"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258755/pdf/i0003-3006-68-2-76.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of Chest Compressions Performed on Patients in Dental Chairs Versus on the Floor. 在牙科椅上与在地板上进行胸外按压的疗效比较。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-07
Yoshitaka Shimizu, Takuma Sadamori, Noboru Saeki, Akari Mukai, Mitsuru Doi, Kana Oue, Mitsuhiro Yoshida, Masahiro Irifune
{"title":"Efficacy of Chest Compressions Performed on Patients in Dental Chairs Versus on the Floor.","authors":"Yoshitaka Shimizu,&nbsp;Takuma Sadamori,&nbsp;Noboru Saeki,&nbsp;Akari Mukai,&nbsp;Mitsuru Doi,&nbsp;Kana Oue,&nbsp;Mitsuhiro Yoshida,&nbsp;Masahiro Irifune","doi":"10.2344/anpr-68-01-07","DOIUrl":"https://doi.org/10.2344/anpr-68-01-07","url":null,"abstract":"<p><p>This study aimed to investigate the characteristics of chest compressions performed in dental chairs (DCs) with 2 different structural support designs and on the floor. This randomized prospective study was conducted to compare the effectiveness of chest compressions (rate and depth) using a feedback device and a manikin reporting system. The mean anterior chest wall motion measurements captured using the feedback device were significantly increased in the DCs than on the floor, whereas the percentage of net chest compression depths ≥5 cm as measured using the manikin reporting system were significantly decreased in the DCs than on the floor. These findings suggest that cardiopulmonary resuscitation performed in a DC without the use of a supporting stool or stiff backboard is not likely to be effective even if a DC design that incorporates a supportive steel column is utilized.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"85-89"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258752/pdf/i0003-3006-68-2-85.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ambulatory Anesthesia for a Case of Idiopathic Bronchiolitis Obliterans. 为一例特发性支气管炎患者实施非卧床麻醉。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-05
Michelle Wong
{"title":"Ambulatory Anesthesia for a Case of Idiopathic Bronchiolitis Obliterans.","authors":"Michelle Wong","doi":"10.2344/anpr-68-01-05","DOIUrl":"10.2344/anpr-68-01-05","url":null,"abstract":"<p><p>Bronchiolitis obliterans is rarely described in the nonlung transplant anesthesia literature. This case report describes a 27-year-old female patient with idiopathic bronchiolitis obliterans and dental anxiety who safely received intravenous deep sedation using diphenhydramine, dexmedetomidine, and ketamine in an ambulatory community dental clinic. This report outlines the anesthetic plan developed following a thorough preoperative assessment and review of the key anesthetic considerations of idiopathic bronchiolitis obliterans (eg, potential respiratory complications and appropriateness for the ambulatory dental environment) and discusses the careful anesthetic management of this patient using deep sedation to facilitate comprehensive restorative dentistry.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"98-106"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258746/pdf/i0003-3006-68-2-98.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
So Good It Hurts? 好到让人心痛?
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-02-10
Kyle J Kramer
{"title":"So Good It Hurts?","authors":"Kyle J Kramer","doi":"10.2344/anpr-68-02-10","DOIUrl":"https://doi.org/10.2344/anpr-68-02-10","url":null,"abstract":"","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"67-68"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258749/pdf/i0003-3006-68-2-67.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nitrous Oxide/Oxygen Effect on IANB Injection Pain and Mandibular Pulpal Anesthesia in Asymptomatic Subjects. 氧化亚氮/氧气对IANB注射疼痛和下颌牙髓麻醉的影响。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-10
Ben Kushnir, Sara Fowler, Melissa Drum, John Nusstein, Al Reader, Mike Beck Dds
{"title":"Nitrous Oxide/Oxygen Effect on IANB Injection Pain and Mandibular Pulpal Anesthesia in Asymptomatic Subjects.","authors":"Ben Kushnir,&nbsp;Sara Fowler,&nbsp;Melissa Drum,&nbsp;John Nusstein,&nbsp;Al Reader,&nbsp;Mike Beck Dds","doi":"10.2344/anpr-68-01-10","DOIUrl":"https://doi.org/10.2344/anpr-68-01-10","url":null,"abstract":"<p><p>The inferior alveolar nerve block (IANB) does not always result in successful pulpal anesthesia. Nitrous oxide may increase the success of the IANB. The purpose of this investigation was to study the effect of nitrous oxide/oxygen (N2O/O2) on IANB injection pain and mandibular pulpal anesthesia in asymptomatic subjects. One hundred five asymptomatic subjects received an IANB after the administration of N2O/O2 or room air/oxygen (air/O2) at 2 separate appointments. After the IANB, subjects rated their level of pain for each phase of the injection (needle insertion, needle placement, and solution deposition) using a Heft Parker visual analog scale. Pulpal anesthesia was evaluated with an electric pulp tester for 60 minutes. The mean pain rating for all 3 injection phases showed a statistically significant reduction in pain when N2O/O2 was used compared with Air/O2 (P < .05). Odds ratios demonstrated a statistically significant increase in IANB success for the N2O/O2 group compared with the air/O2 group. N2O/O2 administration statistically decreased pain for all 3 injection phases of the IANB. In addition, nitrous oxide statistically increased the likelihood of pulpal anesthesia for posterior mandibular teeth. However, the incidence of pulpal anesthesia was not 100%.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258745/pdf/i0003-3006-68-2-69.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Modified Retrograde Nasal Intubation: A New Airway Technique and Devices. 改良逆行鼻插管:一种新的气道技术和设备。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-02-03
Vernon H Vivian, Dip Anaes, Tyson L Pardon, Andre A J Van Zundert
{"title":"Modified Retrograde Nasal Intubation: A New Airway Technique and Devices.","authors":"Vernon H Vivian,&nbsp;Dip Anaes,&nbsp;Tyson L Pardon,&nbsp;Andre A J Van Zundert","doi":"10.2344/anpr-68-02-03","DOIUrl":"https://doi.org/10.2344/anpr-68-02-03","url":null,"abstract":"<p><p>Nasotracheal intubation remains an underused but invaluable technique for securely managing the airway during oral and maxillofacial surgery. In this article, we present a modified clinical technique that allows for the potential introduction into clinical practice of 2 new airway devices: a nasal laryngeal mask airway and an interchangeable oral/nasal endotracheal tube. We hypothesize that with the use of proper techniques, these devices can add new and safer alternatives for securing an airway by the nasal route. The advantage of this novel technique is that the airway is secured by the oral route prior to performing a modified retrograde nasal intubation, eliminating the danger of profuse epistaxis precipitating a \"cannot intubate, cannot ventilate\" scenario. In addition, the design and materials used in the components of the devices may minimize trauma. The authors aim to inform clinicians about the indications, physical characteristics, and insertion/removal techniques related to these new devices.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258754/pdf/i0003-3006-68-2-107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Case of Laryngeal Granulomas After Oral and Maxillofacial Surgery With Prolonged Intubation. 口腔颌面外科术后喉肉芽肿长时间插管1例。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-03
Masanori Tsukamoto, Shiori Taura, Takashi Hitosugi, Takeshi Yokoyama
{"title":"A Case of Laryngeal Granulomas After Oral and Maxillofacial Surgery With Prolonged Intubation.","authors":"Masanori Tsukamoto,&nbsp;Shiori Taura,&nbsp;Takashi Hitosugi,&nbsp;Takeshi Yokoyama","doi":"10.2344/anpr-68-01-03","DOIUrl":"https://doi.org/10.2344/anpr-68-01-03","url":null,"abstract":"<p><p>Laryngeal granuloma development can be a postoperative complication of laryngeal trauma or irritation resulting from general anesthesia and endotracheal intubation. These rare benign lesions are located primarily over the cartilaginous portions of the larynx, particularly the vocal processes of the arytenoids. Airway manipulation during the intubation process and prolonged intubation periods can be contributing factors to intubation-related laryngeal granulomas, which may manifest 1 to 4 months after intubation. The patient in this case was a female who returned with complaints of throat pain without hoarseness or sensations of a \"lump in her throat\" 3 months following surgery, during which she was intubated with a 7.0-mm nasotracheal tube for 30 hours, likely contributing to her bilateral laryngeal granulomas. The patient underwent successful conservative medical management consisting of a proton pump inhibitor and an inhaled corticosteroid.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"94-97"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258747/pdf/i0003-3006-68-2-94.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Case of Childhood-Onset Basedow-Graves' Disease Diagnosed as a Result of the Fourth Time of General Anesthesia for Oral and Maxillofacial Surgery. 口腔颌面外科手术第四次全身麻醉诊断为儿童期基底格雷夫斯病1例。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-02
Mayumi Hashimoto, Yoko Okumura, Aiji Sato, Naoko Tachi, Akane Kikuchi, Izumi Kuroda, Riho Tanase, Masahiro Okuda
{"title":"A Case of Childhood-Onset Basedow-Graves' Disease Diagnosed as a Result of the Fourth Time of General Anesthesia for Oral and Maxillofacial Surgery.","authors":"Mayumi Hashimoto,&nbsp;Yoko Okumura,&nbsp;Aiji Sato,&nbsp;Naoko Tachi,&nbsp;Akane Kikuchi,&nbsp;Izumi Kuroda,&nbsp;Riho Tanase,&nbsp;Masahiro Okuda","doi":"10.2344/anpr-68-01-02","DOIUrl":"https://doi.org/10.2344/anpr-68-01-02","url":null,"abstract":"<p><p>The incidence of childhood-onset Basedow's (Graves') disease is approximately 5% of all cases. Herein, we report a teenage female patient diagnosed with childhood-onset Graves' disease immediately following general anesthesia. Her signs and symptoms included tachycardia immediately prior to general anesthesia, delirium upon emerging from anesthesia, persistent postoperative tachycardia and anxiety, and prolonged nausea and vomiting.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"114-116"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258744/pdf/i0003-3006-68-2-114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation. 对一名伴有肢体瘫痪和颈椎活动受限的幼年碱性纤维瘤病患者的麻醉处理。
Anesthesia progress Pub Date : 2021-06-01 DOI: 10.2344/anpr-68-01-04
Asako Yasuda, Noriko Miyazawa, Emiko Inoue, Tomoaki Imai, Yoshiki Shionoya, Kiminari Nakamura
{"title":"Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation.","authors":"Asako Yasuda, Noriko Miyazawa, Emiko Inoue, Tomoaki Imai, Yoshiki Shionoya, Kiminari Nakamura","doi":"10.2344/anpr-68-01-04","DOIUrl":"10.2344/anpr-68-01-04","url":null,"abstract":"<p><p>Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive disease characterized by the presence of tissue nodules, joint contractures, and gingival hyperplasia. With a 1-year-9-month-old female patient scheduled for a gingivectomy and excision of a lower lip mass under general anesthesia, it was anticipated that airway management would be difficult because of trismus and limited cervical movement. Intubation with video-laryngoscopic assistance could not be achieved because gingival hyperplasia and trismus prevented blade insertion and manipulation. Therefore, 2 endotracheal tubes were used: 1 used as a nasopharyngeal airway for assisted ventilation, and 1 used for intubation along with a flexible fiberoptic scope. This case demonstrated a useful method for managing ventilation and intubation in patients with JHF, particularly when the use of oral airway devices is difficult.</p>","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 2","pages":"117-118"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258748/pdf/i0003-3006-68-2-117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39119627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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