Anesthesia progress最新文献

{"title":"Impact of a Dental Vibratory Device on Self-Perceived Pain With a Dental Anesthetic Injection: A Systematic Review of Randomized Controlled Studies.","authors":"Maryam Altuhafy, Ruqaya Lilo, Virda Baig, Vikranth Ravipati, Ghida Askar, Junad Khan","doi":"10.2344/24-0038","DOIUrl":"10.2344/24-0038","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to evaluate the potential of dental vibratory devices (DVD) in dental anesthetic injections to improve patient comfort.</p><p><strong>Methods: </strong>A systematic review followed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and was registered with PROSPERO (CRD42024552433). A comprehensive electronic search of PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library was performed up to August 2024 using keywords related to dental vibratory devices, local anesthesia, and pain, and 1,081,360 manuscripts were revealed. Only randomized controlled trials (RCTs) were included comparing dental vibratory devices to other interventions or no intervention in patients receiving dental anesthetic injections. Two independent reviewers screened articles, extracted data, and assessed study quality using the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>A total of 12 RCTs were included, following the eligibility requirements. Various self-assessed pain tools, like the Visual Analog Scale, Wong-Baker Faces Pain Rating Scale, and Faces, Legs, Activity, Cry, Consolability Scale, were used. Across 8 RCTs evaluating methods to reduce pain during dental needle injections, most reported a positive impact of distraction (eg, DVD) or vibration techniques on pain reduction, with significant improvements in patient comfort. Although some variability existed, most studies demonstrated reduced pain scores compared to controls, particularly when vibration was used. Only 2 studies showed less consistent or neutral outcomes. No significant adverse effects were reported across the interventions.</p><p><strong>Conclusion: </strong>Based on the current evidence, a DVD may reduce pain related to dental anesthetic injections. Although effective, such devices may cause mild discomfort or tingling in sensitive patients and may be ineffective for those with high anxiety. Future standardized studies are needed to conclude the significance of dental vibratory devices for reducing pain in patients who receive dental anesthetic injections.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"73 1","pages":"22-32"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370933","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}

{"title":"General Anesthesia for a Child With Sjögren-Larsson Syndrome.","authors":"Yoshinao Asahi, Shiro Omichi, Hiroko Tsukamoto, Yukiyo Toyohara, Chiaki Kato, Yuka Sugimoto, Miho Hyodo, Yoshito Takasaki","doi":"10.2344/24-0053","DOIUrl":"10.2344/24-0053","url":null,"abstract":"<p><p>This case report describes the dental treatment performed under general anesthesia for a boy with Sjögren-Larsson syndrome (SLS), a rare autosomal recessive genetic disorder. The main symptoms of SLS are congenital ichthyosis, limb paraplegia or tetraplegia, and intellectual disability. The main concerns regarding the administration of general anesthesia to patients with SLS include difficulty with adhesion of the electrocardiogram electrodes and intravenous (IV) catheter dressings due to ichthyosis and heat intolerance secondary to hypohidrosis. Although it was first described approximately 70 years ago, there is little in the existing literature on general anesthesia for patients with SLS. We administered deep sedation/general anesthesia using continuous IV infusions of propofol and remifentanil along with a laryngeal mask airway in a 6-year-old boy with SLS to successfully obtain radiographic studies and extract a supernumerary tooth. No problems occurred other than difficulties with adhesives and soft tissue obstruction of the airway.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"73 1","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370977","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}

{"title":"Marijuana Use and Its Impact on Outpatient Anesthesia.","authors":"Deepika K Mann, Jason Portnof, Edward Adlesic","doi":"10.2344/25-0009","DOIUrl":"10.2344/25-0009","url":null,"abstract":"<p><p>Cannabis is one of the most common psychoactive substances used worldwide, and its use is increasing. Modern products vary widely in tetrahydrocannabinol (THC) concentrations and usage routes, creating challenges for anesthesia providers. This review summarizes current evidence on the pharmacology, pharmacokinetics, physiologic effects, and perioperative considerations of cannabis to help guide safe anesthetic management of cannabis-using patients. Cannabis contains over 100 phytocannabinoids, chiefly psychoactive Δ9-THC and nonpsychoactive cannabidiol (CBD), which act on cannabinoid type-1 (CB1) and type-2 (CB2) receptors. Chronic use downregulates CB1 signaling, contributing to tolerance, dependence, and withdrawal. Cannabis exerts widespread physiologic effects, including neuropsychiatric complications, cardiovascular changes, respiratory issues, delayed gastric emptying, appetite stimulation, and reproductive endocrine disruption. Cannabis use has been associated with increased propofol requirements, possibly via cytochrome P450 enzyme induction and CB1 receptor downregulation. It may also alter responses to opioids, ketamine, and gabapentinoids, and chronic users often report higher postoperative pain. Cannabis use influences anesthetic dosing, airway and cardiovascular stability, and postoperative pain control. Thorough preoperative assessment, individualized anesthetic planning, and vigilant monitoring are essential, and further research is needed to establish evidence-based perioperative guidelines.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"73 1","pages":"53-64"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370956","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}

{"title":"Intravenous Sedation of a Patient With Morbid Obesity and Severe Sleep Apnea Syndrome for Dental Treatment: A Case Report.","authors":"Tomoya Onozawa, Yuri Hase, Yukifumi Kimura, Kanta Kido","doi":"10.2344/24-0051","DOIUrl":"10.2344/24-0051","url":null,"abstract":"<p><p>Obesity and sleep apnea syndrome (SAS) are significant risk factors for airway management, necessitating comprehensive preoperative evaluation, careful preparation, and adaptive strategies to prevent complications, such as hypoxemia, during sedation and general anesthesia. We report the use of intravenous moderate/deep sedation to manage a patient with morbid obesity and severe SAS undergoing dental treatment using a high-flow nasal cannula (HFNC) system. The sedation was performed with a propofol infusion and was closely monitored using bispectral index (BIS) monitoring and capnography. Preparations for general anesthesia were made in case of severe apnea or hypoxemia. No significant airway obstruction or desaturation was observed perioperatively. The successful use of a HFNC system in this patient highlights the importance of tailored preoperative planning and meticulous airway management during dental sedations for patients with severe obesity and SAS.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"73 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370978","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}

{"title":"Ondansetron Prevents Nausea and Vomiting After Orthognathic Surgery.","authors":"Emi Fujioka, Hiroshi Hanamoto, Fumi Kozu, Yayoi Morita, Risa Kimura, Hiromu Nagira, Hitoshi Niwa","doi":"10.2344/24-0055","DOIUrl":"10.2344/24-0055","url":null,"abstract":"<p><p>We compared the incidence of postoperative nausea and vomiting (PONV) in patients undergoing orthognathic surgery under total intravenous anesthesia using propofol with and without ondansetron. Data on PONV within 24 hours after surgery, fentanyl and ondansetron dosing, demographic parameters, smoking history, and prior PONV were retrospectively extracted from the medical records of 291 patients. After propensity score matching, 78 patients were included in the ondansetron and control groups. The incidence of PONV was significantly lower in the ondansetron group (21%) than in the control group (36%; P = .033), whereas the incidence of postoperative headache was comparable. Ondansetron effectively reduced PONV without increasing headaches.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"73 1","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370970","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}

{"title":"Mortality and Morbidity Associated With Out-of-Hospital Deep Sedation and General Anesthesia for Dental Treatment: A 36-Year Retrospective Study in British Columbia, Canada (1984-2019).","authors":"Paul Azzopardi, Carlos Quiñonez, Daniel A Haas, Carilynne Yarascavitch","doi":"10.2344/24-0031","DOIUrl":"10.2344/24-0031","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies in Canada suggest that mortality and serious morbidity during deep sedation and/or general anesthesia (DS/GA) for dentistry in out-of-hospital facilities are low. The purpose of this study was to estimate the period prevalence of mortality and serious morbidity associated with outpatient DS/GA for dentistry in British Columbia, Canada.</p><p><strong>Methods: </strong>Events were identified by retrospectively searching the Chief Coroner of British Columbia database from 1987 to 2019, the College of Dental Surgeons of British Columbia database from 1984 to 2019, and gray literature from 1984 to 2019. A survey of DS/GA providers was conducted to estimate the number of DS/GA procedures provided.</p><p><strong>Results: </strong>A total of 3 linked mortality events in which anesthesia could not be ruled out as a contributing factor were identified. No cases of serious morbidity met the inclusion criteria for the study. An estimated 1,019,853 out-of-hospital DS/GA procedures for dental treatment were provided during the study period. This study estimated a period prevalence of mortality and serious morbidity of 2.94 per 1 million out-of-hospital DS/GA procedures for dental treatment when administered by qualified providers over the 36-year study period.</p><p><strong>Conclusion: </strong>These findings suggest that the provision of out-of-hospital DS/GA for dental treatment in British Columbia carries a low risk of mortality or serious morbidity.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 4","pages":"205-217"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710492","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}

{"title":"Anesthetic Management of a Patient With Myhre Syndrome.","authors":"Yayoi Morita, Chiho Kudo, Hikaru Nakagawa, Ken Mihara, Toshihiro Watanabe, Hitoshi Niwa","doi":"10.2344/24-0037","DOIUrl":"10.2344/24-0037","url":null,"abstract":"<p><p>Myhre syndrome (MS) is a rare genetic connective tissue disorder characterized by intellectual disability, growth deficiency, muscular pseudohypertrophy, hearing loss, restricted joint mobility, laryngotracheal stenosis, choanal stenosis, and facial deformities. We encountered a case of difficult endotracheal intubation in a patient with MS. A 17-year-old girl with trismus, macroglossia, and difficulty with neck flexion was scheduled to undergo general anesthesia for dental treatment. Because of these characteristic clinical manifestations, endotracheal intubation was performed with a flexible fiber-optic bronchoscope. When providing general anesthesia for patients with MS, preoperative evaluation of the airway and preparation for potentially difficult tracheal intubation are required.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 4","pages":"249-250"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709117","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}

{"title":"Anesthetic Management of a Dental Patient With Familial Mediterranean Fever.","authors":"Aki Kawauchi, Shin Sato, Ayumi Nakayama, Masami Hasegawa, Shigeru Maeda","doi":"10.2344/24-0048","DOIUrl":"10.2344/24-0048","url":null,"abstract":"<p><p>We present the anesthetic management of a 32-year-old patient diagnosed with familial Mediterranean fever (FMF) who underwent dental surgery. To minimize the risk of triggering an FMF attack, careful perioperative planning was implemented. Key preventive measures included avoiding known FMF triggers like cold exposure as well as maintaining stable vital signs and ensuring close temperature control throughout the procedure. The patient had shown resistance to colchicine therapy in the past, necessitating careful consideration of alternative treatments, including the potential use of IL-1 inhibitors. General anesthesia was successfully administered without inducing an FMF acute attack. Effective postoperative pain management was provided, and no FMF-related complications arose during the recovery period. This successful outcome highlights the importance of close collaboration and ongoing communication with the patient's primary physician and specialists familiar with FMF. Achieving safe anesthetic management for patients with FMF requires meticulous perioperative planning, proactive avoidance of potential FMF triggers, and a collaborative approach across disciplines. These elements are essential to preventing perioperative FMF exacerbations and ensuring smooth, complication-free recovery for patients.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 4","pages":"237-240"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710643","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}

{"title":"Historical Selection: Peskin Robert M. Contemporary intravenous anesthetic agents and delivery systems: Propofol. Anesth Prog. 1992;39:178-184.","authors":"Jeffrey Bennett","doi":"10.2344/ANPR_Commentary","DOIUrl":"10.2344/ANPR_Commentary","url":null,"abstract":"","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 4","pages":"253-255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710511","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}

{"title":"Anesthetic Management Using Remimazolam for Dental Treatment in a Pediatric Patient With Dravet Syndrome.","authors":"Musashi Sawada, Shoichi Honma, Akira Iida, Ryo Atsuta, Yoshiyuki Ishida, Kazuaki Fukushima","doi":"10.2344/24-0045","DOIUrl":"10.2344/24-0045","url":null,"abstract":"<p><p>Dravet syndrome (DS) is a rare, severe form of epilepsy characterized by seizures often triggered by fevers and other nonfebrile increases in body temperature. We report the case of a girl aged 3 years 5 months who underwent an intubated general anesthetic for dental treatment using remimazolam (RMZ). After a slow mask induction with sevoflurane, RMZ, remifentanil, and rocuronium were administered to facilitate oral intubation, after which general anesthesia was maintained with air, oxygen, and continuous infusions of RMZ and remifentanil. Intraoperative temperature and other vital signs were stable, and no fever or convulsions were observed during the perioperative period. RMZ is an ultrashort-acting benzodiazepine that may be useful for the anesthetic management of pediatric patients with DS because of its potential to prevent seizures.</p>","PeriodicalId":94296,"journal":{"name":"Anesthesia progress","volume":"72 4","pages":"246-248"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710129","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}