Journal of dental anesthesia and pain medicine最新文献

{"title":"Association between preoperative anxiety, intraoperative discomfort, and postoperative pain across different dental extraction types: a prospective observational study.","authors":"Ramon Cesar Godoy Gonçalves, Vanessa Carvajal Soto, Carolina Ruppel, Helen Heloene Rosa, Fábio André Dos Santos, Marcelo Carlos Bortoluzzi","doi":"10.17245/jdapm.2025.25.4.273","DOIUrl":"10.17245/jdapm.2025.25.4.273","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association among preoperative dental anxiety, intraoperative discomfort, and postoperative pain perception across various types of dental extractions, ranging from simple to complex procedures.</p><p><strong>Methods: </strong>A prospective observational clinical trial was conducted in 573 patients who underwent dental extractions. Preoperative anxiety was assessed by using a self-reported verbal scale. Intraoperative discomfort was measured using the Self-Perception Questionnaire for Dentoalveolar Oral Surgery. Postoperative pain was assessed on the seventh day using a verbal categorical rating scale.</p><p><strong>Results: </strong>Preoperative anxiety levels were significantly higher in patients who underwent mandibular third molar extraction. Intraoperative discomfort was significantly influenced by surgical technical complexity, surgical duration, and preoperative anxiety. Mediation analysis revealed that anxiety indirectly influenced postoperative pain through intraoperative discomfort with no direct effect. The analysis confirmed the interplay between anxiety, surgical factors, intraoperative discomfort, and patient demographics in shaping the surgical experience.</p><p><strong>Conclusions: </strong>The findings indicate that Anxiety did not directly predict postoperative pain in most surgical groups; however, it appeared to contribute to increased intraoperative discomfort, which subsequently elevated postoperative pain levels.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"273-285"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818970","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":"Predictors of hypoxemia during moderate sedation for periodontal surgery: a series of 2,221 sedations.","authors":"Toria L Koutras, Denise M Cacho, Chelsea E Harris, Claudia P Millan, Brian W Stancoven, Kimberly Ann Inouye, Adam R Lincicum, Richard Topolski, Thomas M Johnson","doi":"10.17245/jdapm.2025.25.4.251","DOIUrl":"10.17245/jdapm.2025.25.4.251","url":null,"abstract":"<p><strong>Background: </strong>Moderate sedation reliably alleviates procedure-related anxiety in dental patients, enabling the comfortable delivery of surgical periodontal therapy. The principal cause of sedation-related morbidity is hypoxemia, secondary to medication-induced hypoventilation and airway obstruction. The objectives of this investigation were to determine the incidence of hypoxemia during moderate sedation for periodontal or implant surgery and to identify statistically significant predictors of hypoxemia.</p><p><strong>Methods: </strong>Records of patients who received moderate sedation for periodontal or dental implant surgery were assessed for hypoxemic events, defined as oxygen saturation ≤ 90%. Binomial logistic regression analysis was conducted to evaluate the influence of patient-, sedation-, and procedure-related variables on the occurrence of hypoxemia.</p><p><strong>Results: </strong>Records from 2,221 sedations were available for analysis. At least one hypoxemic event occurred in 117 (5.3%) sedations. Only 22 (1.0%) sedations involved more than one event. Age (odds ratio [OR]: 1.022; 95% confidence interval [CI]: 1.004 - 1.039; P = 0.02) and total midazolam dose (OR: 1.118; 95% CI: 1.024 - 1.220; P = 0.01) were significant predictors of hypoxemia. The association between body mass index and hypoxemia did not reach statistical significance (OR: 1.042; 95% CI: 0.995 - 1.091; P = 0.08).</p><p><strong>Conclusions: </strong>The incidence of hypoxemia observed in this study was substantially lower than that reported in patients receiving moderate sedation for minor oral/maxillofacial surgery or gastrointestinal endoscopy. Although further research is warranted, it is possible that patients receiving moderate sedation for periodontal or implant surgery are less likely to experience hypoxemia due to smaller total doses of sedatives, titration of sedatives over longer procedure durations, and the greater need for intraoperative patient cooperation.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"251-262"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818984","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 during dental treatment in a pediatric patient with Fontan circulation using a minimally invasive cardiac output monitoring device.","authors":"Shouji Saitou, Kentaro Ouchi, Yuichiro Nakamura, Shigeki Joseph Luke Fujiwara","doi":"10.17245/jdapm.2025.25.4.291","DOIUrl":"10.17245/jdapm.2025.25.4.291","url":null,"abstract":"<p><p>This case report presents the hemodynamic management of a 3-year-old patient with Fontan circulation who underwent dental treatment under general anesthesia using minimally invasive cardiac output monitoring devices. To avoid the use of monitoring methods more invasive than the dental procedure itself, cardiac output was continuously assessed using FloTrac™ and BioZ.com™ systems. The bispectral index was maintained between 40 and 67 during anesthesia. Although the patient's body surface area (BSA) was 0.5 m², which is below the validated threshold for both devices, monitoring was cautiously conducted to observe hemodynamic trends. Discrepancies in the cardiac output and index values were observed between the two modalities. Although the absolute values were less reliable owing to the patient's low BSA, hemodynamic stability was maintained by tracking the dynamic changes in cardiac parameters. These observations underscore both the limitations and the potential of noninvasive cardiac monitoring in pediatric patients with Fontan circulation undergoing general anesthesia. Accordingly, future development of monitoring technologies that can accurately measure cardiac output in pediatric patients with BSA < 1 m² is warranted.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"291-295"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818982","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":"Effect of working length determination methods on postoperative pain after root canal treatment: a systematic review and meta-analysis.","authors":"Gaurav Kumar, Sumit Mohan, Butta Viswanath, Harsh Priyank","doi":"10.17245/jdapm.2025.25.4.239","DOIUrl":"10.17245/jdapm.2025.25.4.239","url":null,"abstract":"<p><p>This systematic review aimed to assess the effect of various working length determination methods on the incidence of postoperative pain after root canal treatment. A comprehensive literature search was conducted across three electronic databases to identify randomized clinical trials. Two reviewers independently screened the articles, extracted relevant data, and assessed methodological quality using the Cochrane risk-of-bias assessment tool. For quantitative synthesis, a random-effects model was employed to compute the pooled mean difference by comparing the simultaneous and separate working-length determination methods. Sensitivity analyses were conducted after excluding studies that contributed disproportionately to overall heterogeneity. Seven studies met the criteria for qualitative review and three were included in the meta-analysis. The findings suggest that simultaneous determination of working length using integrated electronic apex locators may offer an advantage in reducing postoperative pain. However, this interpretation is limited by the substantial heterogeneity observed across the included studies. This review highlights the necessity for robust and well-designed clinical trials with large sample sizes and standardized protocols to obtain conclusive evidence.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"239-250"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818972","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":"Effectiveness of combined extraoral vibration and cooling on pain perception due to inferior alveolar nerve block administration in children: a systematic review and meta-analysis.","authors":"Harsh Baldawa, Sunnypriyatham Tirupathi, Mahesh Ramakrishnan, Deepa Gurunathan, Ganesh Jeevanandan, Vignesh Ravindran, Lavanya Govindaraju","doi":"10.17245/jdapm.2025.25.4.227","DOIUrl":"10.17245/jdapm.2025.25.4.227","url":null,"abstract":"<p><p>The inferior alveolar nerve block (IANB) is one of the most painful procedures, especially in children. Effective pain management during IANB is a critical prerequisite for the successful treatment of pediatric patients. This systematic review aimed to evaluate the combined effectiveness of extraoral vibration and cooling (EVC) in reducing pain perception during IANB in children. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for the compilation of this systematic review. PROSPERO registration was performed using registration number CRD42024558538. PubMed, ScienceDirect, Cochrane, Google Scholar, and LILACS were searched for relevant studies published from the inception of the databases until January 1, 2025. Studies that compared the use of EVC with conventional methods for IANB in children were selected. The primary and secondary outcomes were subjective and objective measures of pain, respectively. The initial search of the five electronic databases yielded 483 records. After excluding 113 duplicates and screening 309 irrelevant titles and abstracts, 61 studies were included. Of these, six were selected for full-text analysis, and three studies met the inclusion criteria for the final systematic review. Meta-analysis was feasible for two of these studies because of their comparable methodologies and outcome measures. All included studies involved pediatric patients aged 5-12 years undergoing IANB. The intervention group underwent IANB using a combination of EVC, whereas the control group underwent conventional IANB without adjuncts. Pain and anxiety were assessed using both subjective (Wong-Baker Faces Pain Scale) and objective (Face, Legs, Activity, Cry, Consolability) scoring systems. The results indicated a statistically significant reduction in pain scores in the EVC group than in the control group, suggesting that EVC may be an effective adjunct for improving pain perception during IANB in children. Pain perception during IANB was significantly lower in the combined EVC group than in the control group. However, meta-analysis reports indicated that there was no significant difference in pain perception between the intervention and control groups.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"227-237"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818981","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":"Effect of low-level laser therapy on pain perception and anxiety levels in conventional local anesthesia injection.","authors":"Lalasa Gaddam, Deepa Anumala, Kishore Kumar Katuri, Divya Pedapudi, Shaik Shazia Begum, Ramanarayana Boyapati","doi":"10.17245/jdapm.2025.25.4.263","DOIUrl":"10.17245/jdapm.2025.25.4.263","url":null,"abstract":"<p><strong>Background: </strong>The goal of dental practice is to ensure painless treatments. This study aimed to assess the effectiveness of Low-level Laser Therapy (LLLT) in reducing pain perception and anxiety associated with conventional local anesthetic injections.</p><p><strong>Methods: </strong>This was a randomized, single-blind, split-mouth study involving 36 participants divided into two groups. Group I underwent LLLT prior to local anesthesia injection, whereas Group II underwent the procedure without laser activation. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HAM-A), and pain was evaluated using the Visual Analog Scale (VAS) and Wong-Baker Faces Rating Scale (WBFRS).</p><p><strong>Results: </strong>Statistical analyses were performed using the SPSS 22 software (IBM, Armonk, NY, USA). Post-intervention analysis of the HAM-A scores showed a reduction in anxiety levels following LLLT, with mild anxiety increasing from 52.8% to 69.44%, and moderate anxiety decreasing from 47.2% to 30.56%. In terms of pain assessment, VAS scores revealed that 38.9% of patients in Group I reported no pain compared to 0% of patients in Group II. Moderate pain was reported by 50% of patients in Group I and 75% of patients in Group II, while severe pain was reported by 11.1% and 25% of patients, respectively. Pain distribution (WBFRS) showed that 63.9% of patients in Group I reported no pain versus 0% of patients in Group II. Little pain was experienced by 36.1% of Group I and 58.3% of Group II patients, whereas 41.7% of Group II patients reported slightly more pain. Statistical comparison showed that Group I had significantly lower mean VAS (1.72 ± 0.659) and WBFRS (1.36 ± 0.487) scores than Group II (VAS: 2.25 ± 0.439; WBFRS: 2.42 ± 0.500), with both results being statistically significant (P < 0.001).</p><p><strong>Conclusion: </strong>LLLT was effective in reducing pain associated with injections. It can be used successfully to manage procedures that patients commonly perceive as painful, thereby providing a natural analgesic effect. Additionally, LLLT contributes to creating positive treatment experiences, which play a key role in fostering a long-term, trusting relationship between the patient and clinician.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"263-271"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818971","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":"Usefulness of transnasal humidified rapid insufflation ventilatory exchange during rapid sequence induction for a patient with a hiatal hernia.","authors":"Yuzo Imai, Toru Yamamoto, Naotaka Kishimoto, Yutaka Tanaka, Shigenobu Kurata, Kenji Seo","doi":"10.17245/jdapm.2025.25.4.287","DOIUrl":"10.17245/jdapm.2025.25.4.287","url":null,"abstract":"<p><p>A hiatal hernia can increase abdominal pressure, potentially leading to vomiting after the induction of general anesthesia. Therefore, rapid sequence induction is the preferred method for inducing general anesthesia in patients with hiatal hernias. The use of high-flow nasal cannula oxygen (HFNC) has become increasingly common to reduce the risk of oxygen desaturation during rapid induction. This report describes a case in which a hiatal hernia was successfully induced using HFNC. A 90-year-old woman with a history of reflux esophagitis was under medical management. Preoperative chest radiography revealed hiatal hernia. Anesthesia was induced after admission to the operating room and preoxygenation with HFNC. The oxygen flow was then increased to 70 L/min, and tracheal intubation was performed. SpO₂ remained at ≥99% during apnea for approximately 2 min, and no gastric reflux occurred. Rapid sequence induction combined with HFNC may be an effective option for patients with hiatal hernias who are at a high risk of gastric reflux during anesthetic induction.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"287-290"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818985","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":"Is remimazolam a suitable alternative to midazolam for dental sedation?","authors":"Takutoshi Inoue, Toru Yamamoto, Naotaka Kishimoto, Kenji Seo","doi":"10.17245/jdapm.2025.25.4.297","DOIUrl":"10.17245/jdapm.2025.25.4.297","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 4","pages":"297-298"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818983","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":"Respiratory monitoring during intravenous sedation using a digital auscultation device.","authors":"Naotaka Kishimoto, Toru Yamamoto, Rina Sakagami, Kenji Seo","doi":"10.17245/jdapm.2025.25.3.215","DOIUrl":"10.17245/jdapm.2025.25.3.215","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"215-217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304260","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":"Kampo medicine in dental anesthesia: a promising adjunct for perioperative management.","authors":"Toru Yamamoto, Naotaka Kishimoto, Shigenobu Kurata, Yutaka Tanaka, Kenji Seo","doi":"10.17245/jdapm.2025.25.3.223","DOIUrl":"10.17245/jdapm.2025.25.3.223","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 3","pages":"223-226"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304259","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}