Jared Joseph Tuttle, Andrew Doran Davidson, Gregory Kent Tuttle
{"title":"Bending 30-gauge needles using a needle guide: fatigue life evaluation.","authors":"Jared Joseph Tuttle, Andrew Doran Davidson, Gregory Kent Tuttle","doi":"10.17245/jdapm.2023.23.5.281","DOIUrl":"10.17245/jdapm.2023.23.5.281","url":null,"abstract":"<p><strong>Background: </strong>Dentists bend needles prior to certain injections; however, there are concerns regarding needle fracture, lumen occlusion, and sharps handling. A previous study found that a 30-gauge needle fractures after four to nine 90° bends. This fatigue life study evaluated how many 90° bends a 30-gauge dental needle will sustain before fracture when bent using a needle guide.</p><p><strong>Methods: </strong>Two operators at Element Materials Technology, an independent testing, inspection, and certification company tested 48 30-gauge needles. After applying the needle guide, the operators bent the needle to a 90° angle and expressed the anesthetic from the tip. The needle was then bent back to a 0° angle, and the functionality was tested again. This process was repeated until the anesthetic failed to pass through the end of the needle due to fracture or obstruction. Each operator tested 24 needles (12 needles from each lot), and the number of sustained bends before the needle fracture was recorded.</p><p><strong>Results: </strong>The average number of sustained bends before needle failure was 40.33 (95% confidence interval = 37.41-43.26), with a minimum of 20, median of 40, and a maximum of 54. In each trial, the lumen remained patent until the needle fractured. The difference between the operators was statistically significant (P < 0.001). No significant differences in performance between needle lots were observed (P = 0.504).</p><p><strong>Conclusion: </strong>Our results suggest that using a needle guide increases the number of sustained bends before needle fracture (P < 0.000001) than those reported in previous studies. Future studies should further evaluate the use of needle guides with other needle types across a variety of operators. Furthermore, additional opportunities lie in exploring workplace safety considerations and clinical applications of anesthetic delivery using a bent needle.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"23 5","pages":"281-285"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/43/jdapm-23-281.PMC10567543.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242936","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}
Seung-Hyun Rhee, Sang-Hun Park, Seung-Hwa Ryoo, Myong-Hwan Karm
{"title":"Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia.","authors":"Seung-Hyun Rhee, Sang-Hun Park, Seung-Hwa Ryoo, Myong-Hwan Karm","doi":"10.17245/jdapm.2019.19.4.181","DOIUrl":"https://doi.org/10.17245/jdapm.2019.19.4.181","url":null,"abstract":"<p><p>Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor , confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"19 4","pages":"181-189"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/ce/jdapm-19-181.PMC6726891.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224816","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}