Anesthesia progress最新文献_第2页

Immunohistochemical Analysis of Maxillary Nerve Distribution in Rats. 大鼠上颌神经分布的免疫组织化学分析

Anesthesia progress Pub Date : 2025-09-09 DOI: 10.2344/23-0035

Hikaru Moriyama, Yuki Nakase, Kimiharu Ambe, Hiroyosi Kawaai, Shinya Yamazaki

{"title":"Immunohistochemical Analysis of Maxillary Nerve Distribution in Rats.","authors":"Hikaru Moriyama, Yuki Nakase, Kimiharu Ambe, Hiroyosi Kawaai, Shinya Yamazaki","doi":"10.2344/23-0035","DOIUrl":"10.2344/23-0035","url":null,"abstract":"Objective: Previous studies of nerve distribution in the orofacial complex have focused primarily on the anatomic courses of nerve fibers and have rarely addressed the density of nerve distribution. The nerve distribution in the mandible was described in only one report which showed an increase in nerve distribution density moving from the alveolar crest toward the inferior alveolar nerve. However, no previous reports have focused on the nerve distribution density in the maxilla.Methods: In this study involving 6 Wistar rats, tissue samples from the maxillary molar region were obtained and sectioned for staining and analysis. All nerves including nociceptive nerves in 5 regions of the maxilla samples, ranging from the alveolar crest to the superior alveolar nerve, were immunohistochemically stained with antibodies to protein gene product (PGP) and calcitonin gene-related peptide (CGRP) to identify and measure the vertical and horizontal nerve distribution densities in the 5 regions under an optical microscope. We also determined the ratio of nociceptive (CGRP-positive) nerves to all (PGP-positive) nerves.Results: The densities of both PGP- and CGRP-positive nerves increased vertically from the alveolar crest to the superior alveolar nerve and horizontally from the periosteal side to the periodontal ligament side within the maxilla. The ratio of CGRP- to PGP-positive nerves was on average greater than 80%.Conclusion: These findings were consistent with those of the previous report on mandibular nerve distribution. However, our results suggest that the overall nerve distribution density in the maxilla is approximately one-third of that in the mandible. The results of this study, which report the nerve distribution density in the posterior maxilla, may support future research on pain and local anesthesia.","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 3","pages":"151-158"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031546","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

Difficulty Controlling Sedation Level Using Processed Electroencephalography Monitoring in a Patient With Intellectual Disability, Fontan Circulation, and a Severe Gag Reflex. 智障、方坦循环和严重呕吐反射患者的处理脑电图监测难以控制镇静水平。

Anesthesia progress Pub Date : 2025-09-09 DOI: 10.2344/anesthesiaprog-D-24-00005

Riko Umemoto, Satoshi Tachikawa, Daisuke Kikuchi, Aoi Ooshio, Risa Kajiwara, Rie Nishida, Asuka Taguchi, Takehiko Iijima, Rikuo Masuda

{"title":"Difficulty Controlling Sedation Level Using Processed Electroencephalography Monitoring in a Patient With Intellectual Disability, Fontan Circulation, and a Severe Gag Reflex.","authors":"Riko Umemoto, Satoshi Tachikawa, Daisuke Kikuchi, Aoi Ooshio, Risa Kajiwara, Rie Nishida, Asuka Taguchi, Takehiko Iijima, Rikuo Masuda","doi":"10.2344/anesthesiaprog-D-24-00005","DOIUrl":"10.2344/anesthesiaprog-D-24-00005","url":null,"abstract":"Patients with cardiovascular compromise are likely to develop hypotension upon receiving even small doses of sedatives. On the other hand, patients with severe dental phobias or with intellectual disability who have a severe gag reflex often require deeper levels of anesthesia. Thus, achieving an optimal level of anesthesia can be difficult in patients with cardiovascular compromise because of the relatively narrow range of sedative dosing capable of providing sufficient sedation to prevent the gag reflex without compromising hemodynamics. We present a patient with Fontan circulation, severe intellectual disability, and a severe gag reflex who underwent dental treatment using intravenous sedation. Processed electroencephalography (EEG) via a SedLine (Masimo Corporation) monitor was used to identify anesthetic depth, and propofol infusion rates were adjusted based on changes in Patient State Index (PSI) values. However, the PSI values fluctuated greatly in response to stimuli and changes in the depth of anesthesia. In summary, the indications for using feedback control of the sedation level by way of EEG analysis and adjusting propofol infusion rates might be limited in patients with cardiovascular compromise and severe gag reflex because such monitoring may be incapable of keeping pace with rapid changes in the balance between stimulation and the level of anesthesia.","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 3","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031535","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

The Temporo-Masseteric Nerve Block (TMNB) for Alleviating Acute Postextraction Masticatory Myalgia: A Case Series. 颞-咬肌神经阻滞（TMNB）缓解急性拔牙后咀嚼肌痛：一个病例系列。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/24-0001

Gayathri Subramanian, Samuel Y P Quek

引用次数: 0

Obtaining Written Informed Consent for the Administration of Local Anesthetics in Dentistry in 2024, a 20-Year Follow-Up Study. 在2024年获得牙科局麻药管理的书面知情同意，一项20年随访研究。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/24-0039

Daniel L Orr, Zane P Jenkins, Timothy M Orr

{"title":"Obtaining Written Informed Consent for the Administration of Local Anesthetics in Dentistry in 2024, a 20-Year Follow-Up Study.","authors":"Daniel L Orr, Zane P Jenkins, Timothy M Orr","doi":"10.2344/24-0039","DOIUrl":"10.2344/24-0039","url":null,"abstract":"Objective: This study revisited data obtained in 2004 regarding whether dentists routinely obtain informed consent (IC) for the administration of local anesthetics and compared those findings with newer data obtained in 2024.Methods: A previous survey from 2004 which utilized 3 questions including identification of provider type (generalist or specialist) and whether IC is always obtained for local anesthetic administration was replicated in 2024. While the 2004 survey was performed on paper, the 2024 survey was done via a brief oral interview. Both efforts were completed at the annual meetings of The American Dental Society of Anesthesiology (ADSA) in Las Vegas, NV.Results: A total of 249 respondents opted to participate in the 2024 survey as compared with the 252 respondents from 2004. During the past 20 years, the number of dentists who reported always obtaining IC for the administration of local anesthetics appears to have increased significantly. A total of 196 (79%) of the 2024 participants reported always obtaining IC for local anesthesia compared with 158 (63%) in 2004. Except for dentists limiting their practice to anesthesiology, all other provider categories reported an increase in IC use from 2004 to 2024, and specialists still reported obtaining IC for local anesthesia more frequently than generalists.Conclusion: The prevalence of including local anesthetic administration with the IC process is increasing in the profession. It is likely that generalists administer many more local anesthetics than specialists overall. The IC subject matter is too nuanced to recommend a single \"yes or no\" treatment plan as the standard of care for all clinical situations.","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 1","pages":"24-27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628405","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

Time Limits for Anesthesia in Dentistry? 牙科麻醉的时间限制？

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/72.1.1

Kyle J Kramer

引用次数: 0

Cuff Inflation Technique During Fiberoptic Nasal Intubation in Patients With Limited Mouth Opening. 袖口充气技术在有限开口患者纤维鼻插管中的应用。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/23-0056

Masanori Tsukamoto, Kazuhiro Hano, Takeshi Yokoyama

引用次数: 0

Local Perfusion Failure Caused by the Incorrect Attachment of an SpO2 Sensor During General Anesthesia. 全身麻醉时SpO2传感器不正确附着导致局部灌注失败。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/24-0022

Emi Sawada, Toru Yamamoto, Naotaka Kishimoto, Yutaka Tanaka, Kenji Seo

引用次数: 0

Anesthetic Management for an Elderly Patient With Severe Bronchiectasis. 老年重度支气管扩张患者的麻醉处理。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/23-0036

Tamayo Takahashi, Mitsuhiro Yoshida, Nanako Ito, Koichi Koizumi, Hisanobu Kamio, Aya Oda, Kana Oue, Mitsuru Doi, Yoshitaka Shimizu

{"title":"Anesthetic Management for an Elderly Patient With Severe Bronchiectasis.","authors":"Tamayo Takahashi, Mitsuhiro Yoshida, Nanako Ito, Koichi Koizumi, Hisanobu Kamio, Aya Oda, Kana Oue, Mitsuru Doi, Yoshitaka Shimizu","doi":"10.2344/23-0036","DOIUrl":"10.2344/23-0036","url":null,"abstract":"Bronchiectasis is a clinical syndrome characterized by coughing and sputum production in the presence of abnormal thickening and dilatation of the bronchial walls. We report the successful anesthetic management of a 91-year-old patient with severe bronchiectasis undergoing left marginal mandibulectomy for squamous cell carcinoma of the mandibular gingiva. In this case, we utilized respiratory prehabilitation for preoperative optimization of the patient's respiratory function and intravenous moderate sedation with dexmedetomidine and pentazocine plus excellent local anesthesia intraoperatively rather than an intubated general anesthetic. During the procedure, the patient's vital signs were stable, and she did not have any psychological or physical complaints like anxiety or pain and was discharged from the hospital without any complications. Considering the high risk of respiratory complications, intravenous moderate sedation may be a better option than general anesthesia for some surgeries in patients with severe bronchiectasis. These strategies may be useful options for older patients with impaired respiratory function undergoing oral surgery procedures.","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628486","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

Implications of GLP-1 Agonists on Office-Based Sedation and General Anesthesia for Dentistry. GLP-1激动剂对牙科办公室镇静和全身麻醉的影响。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/anpr-72-1-ANPR_Agonists

Craig McKenzie, Alexander DeBernardo, Paul Schwartz

{"title":"Implications of GLP-1 Agonists on Office-Based Sedation and General Anesthesia for Dentistry.","authors":"Craig McKenzie, Alexander DeBernardo, Paul Schwartz","doi":"10.2344/anpr-72-1-ANPR_Agonists","DOIUrl":"10.2344/anpr-72-1-ANPR_Agonists","url":null,"abstract":"Incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are produced in the gut and play critical roles linking the processes of eating and digestion with the release of insulin from the pancreas and glucose homeostasis. GLP-1 receptor agonist and combination GLP-1/GIP receptor agonist medications are exogenous incretins that mimic their endogenous counterparts, but their significantly longer half-lives allow them to be clinically useful for managing diabetes mellitus type 2 (DMT2) and obesity. Recently, their use for weight loss has grown exponentially, increasing the potential that a provider of sedation or general anesthesia for dentistry will encounter a patient taking a GLP-1 or GLP-1/GIP combination receptor agonist. One of the clinical effects produced by these medications is decreased gastric emptying which increases satiety and decreases oral intake. While these medications are effective in the management of DMT2 and obesity, delayed gastric emptying can cause concerns for sedation and general anesthesia providers. Retained gastric contents can increase risks for emesis and subsequent pulmonary aspiration in the perioperative period. In 2024, a multisociety guidance document was published to provide recommendations for the management of these patients in the perioperative period. Recommendations emphasized risk stratification of individual patients and weighing the risks vs the benefits of holding or continuing GLP-1 and GLP-1/GIP combination receptor agonist medications. The recommendations also suggested shared decision making between the sedation or general anesthesia provider, the prescribing physician, and the patient should be used when developing a plan regarding the preoperative use of these medications.","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628492","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

A Review of Current Literature of Interest to the Office-Based Anesthesiologist. 对办公室麻醉师感兴趣的当前文献综述。

Anesthesia progress Pub Date : 2025-03-12 DOI: 10.2344/72.1.59

Mark A Saxen, Craig P McKenzie

引用次数: 0