Journal of dental anesthesia and pain medicine最新文献

{"title":"Anesthesia management for dental procedures in a patient with aromatic L-amino acid decarboxylase deficiency: a case report.","authors":"Edvin Bihorac, Akkan Mahmud, Ahmed Uslu, Nedim Çekmen","doi":"10.17245/jdapm.2025.25.1.77","DOIUrl":"10.17245/jdapm.2025.25.1.77","url":null,"abstract":"<p><p>Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare autosomal recessive neurometabolic synthesis disease with sympathetic autoregulation deficiency. Perioperative management of AADCD presents unique challenges due to autonomic dysfunction, impaired sympathetic regulation of heart rate, and potential airway complications. Herein, we report the successful anesthetic management of a 14-year-old male patient with AADCD under total intravenous anesthesia during extensive dental procedures. We applied the rapid sequence induction and intubation method with cricoid pressure to minimize the risk of pulmonary aspiration due to the potential difficulty in mask ventilation and intubation, limited mouth opening, microcephaly, micrognathia, and poor cooperation. Intubation was performed without any complications. Due to the autonomic dysfunction, potential airway complications, and developmental, mental, and motor delays in this disorder, perioperative management requires a multidisciplinary approach with comprehensive preoperative evaluation.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 1","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412167","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":"Efficacy of intranasal sedation for pediatric dental procedures: a systematic review and meta-analysis.","authors":"Kavitha Swaminathan, Sushmita Shan, Monika Sri Ss, Apathsakayan Renugalakshmi, Ramanathan Ravi, Selvakumar Haridoss","doi":"10.17245/jdapm.2025.25.1.1","DOIUrl":"10.17245/jdapm.2025.25.1.1","url":null,"abstract":"<p><p>Dental fear and anxiety management in children is considered one of the biggest challenges in pediatric dentistry. Intranasal sedation is a promising technique for managing unco-operative pediatric patients with rapid onset, ease of administration, and minimal invasiveness. We aimed to review the efficacy, onset time, duration, and behavioral success of intranasal sedation agents in pediatric dental procedures and identify the most effective regimens for clinical practice. This systematic review followed the PRISMA 2020 guidelines and included randomized controlled trials (RCTs) assessing intranasal sedation in children undergoing dental procedures. Primary outcomes were onset time, duration of sedation, and sedation success rates. The inclusion criteria were applied through search in six databases. Risk of bias was evaluated using the Cochrane RoB 2 tool. Meta-analyses were carried out using RevMan software, where pooled odds ratios and weighted mean differences were calculated on efficacy outcomes. Eighteen RCTs fulfilled the inclusion criteria, where intranasal agents such as midazolam, ketamine, dexmedetomidine, and their combinations were used. Meta analyses demonstrated intranasal sedation generally has a faster onset (moderate heterogeneity, I² = 40%) and is associated with greater success rates for achieving sedation than other methods. A combination of midazolam with ketamine or dexmedetomidine provided better results for both onset and behavioral success. The duration of sedation appears equivalent to oral or intravenous routes. Overall risk of bias was moderate due to blinding and selective reporting concerns. Midazolam, especially when combined with ketamine or dexmedetomidine, yielded promising results in relation to rapid onset and success of sedation. However, further large-scale RCTs are necessary to standardize dosing protocols and ensure that these findings are validated and optimized for clinical applications.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412172","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":"Safety and efficacy of remimazolam in sedation dentistry: a scoping review.","authors":"Toru Yamamoto, Takutoshi Inoue, Naotaka Kishimoto, Kenji Seo","doi":"10.17245/jdapm.2025.25.1.15","DOIUrl":"10.17245/jdapm.2025.25.1.15","url":null,"abstract":"<p><p>This review aims to evaluate the safety of remimazolam for intravenous sedation during dental treatment and oral surgery. The protocol was registered in the Open Science Framework (registration DOI: 10.17605/OSF.IO/RFPSZ), and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Literature searches and screenings were conducted using PubMed and the Cochrane database, with additional records manually reviewed from various sources. The selected studies, published in English, investigated the safety of remimazolam for sedation in dental and oral surgery. An initial search identified 20 studies, of which five prospective studies met the inclusion criteria. All included studies used an initial bolus administration of remimazolam. Primary outcomes assessed were the sedation success rate, incidence of adverse effects, onset time, awakening time, recovery time, and postoperative side effects. This scoping review indicates that all studies validated the superiority of remimazolam over other sedatives for dental treatment and oral surgery. The development and research of innovative technologies to reduce dental pain and anxiety presents opportunities for interdisciplinary collaboration and improved patient care in dental practice. Future clinical studies should focus on determining the optimal timing for additional dosing and discontinuation when remimazolam is administered continuously.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 1","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412179","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":"Accuracy of continuous and real-time total hemoglobin during bimaxillary orthognathic surgery.","authors":"Cheul-Hong Kim, Ji-Young Yoon, Giyoung Yun, Hee Young Kim, Eun-Jung Kim","doi":"10.17245/jdapm.2025.25.1.23","DOIUrl":"10.17245/jdapm.2025.25.1.23","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative hemoglobin (Hb) monitoring is critical for ensuring patient safety during bimaxillary orthognathic surgery. Intraoperative Hb monitoring performed using portable devices with arterial blood samples is invasive, is time-consuming, and lacks the ability to provide real-time information. This retrospective study investigated the correlation between continuous and real-time total Hb (SpHb) using a Masimo Radical 7 device and Hb levels derived by portable devices during bimaxillary orthognathic surgery.</p><p><strong>Methods: </strong>Patients who underwent elective bimaxillary orthognathic surgery were enrolled. The correlation between SpHb and laboratory Hb (Lab-Hb) was evaluated immediately after the induction of anesthesia (T1) and at surgical closure (T2) and compared with postoperative Hb.</p><p><strong>Results: </strong>Eighty-eight patients were included. The correlation coefficients between SpHb and Lab-Hb were 0.795 and 0.859 at T1 and T2, respectively. The correlation coefficient between Lab-Hb at T2 and postoperative Hb was 0.918. A Bland-Altman analysis of the Lab-Hb at T2 and postoperative Hb showed a mean bias of 0.49.</p><p><strong>Conclusion: </strong>In conclusion, here we demonstrated acceptable accuracy of the SpHb measured by the Masimo Radical 7 device during bimaxillary orthognathic surgery. However, SpHb is valuable as an adjunct value to Lab-Hb and a substitute for Hb monitoring due to its wide limits of agreement. These findings suggest that SpHb can help guide the timing of invasive blood sampling for Hb measurements, which may facilitate earlier intervention and treatment.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 1","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412157","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":"Recovery of sedation and psychomotor and equilibrium functions following remimazolam anesthesia with or without flumazenil: a randomized, double-blind, controlled trial.","authors":"Mariko (Mariko Iimura) Suzuki, Kyotaro Koshika, Tatsuya Ichinohe","doi":"10.17245/jdapm.2025.25.1.55","DOIUrl":"10.17245/jdapm.2025.25.1.55","url":null,"abstract":"<p><strong>Background: </strong>Prompt awakening and sufficient recovery of psychomotor and equilibrium functions are important for day surgery. Flumazenil accelerates recovery of consciousness after remimazolam anesthesia, but its effects on psychomotor and equilibrium functions are not well known. The purpose of this study was to determine whether flumazenil improves time to recovery, psychomotor, and equilibrium functions in subjects undergoing remimazolam anesthesia.</p><p><strong>Methods: </strong>The design was a single-center, double-blind, randomized, controlled trial. Inclusion criteria were patients aged 18-64 years scheduled for oral surgery under remimazolam anesthesia, with American Society of Anesthesiologists physical status I or II. The predictor variable was the use of a reversal agent (flumazenil group) versus placebo (non-flumazenil group). The primary outcome variable was recovery from sedation measured using the Modified Observer's Alertness/Sedation (MOAA/S) scale for wakefulness. Secondary outcome variables were psychomotor function measured using the Trieger Dot Test (number of dots missed [NDM], maximum distance of dots missed [MDDM]), and the digit symbol substitution test (DSST), as well as equilibrium function measured using the timed up and go test (TUG), and gravimetric area and speed. Statistical analyses were performed using the Mann-Whitney U test, χ² test, Student's t-test, two-way ANOVA, and Bonferroni correction. P-values < 0.05 were considered significant.</p><p><strong>Results: </strong>Sixty-eight subjects were included (male: 33, female: 35). The mean time from extubation to an MOAA/S score of 5 (minutes) was 6.5 (1.5-10.5) in the flumazenil group and 13.5 (6.8-19.3) in the non-flumazenil group (P = 0.01). There was no significant difference in the recovery of psychomotor and balance functions between the two groups. However, the following measurements were significantly increased compared to baseline: NDM (P < 0.001) and DSST (P < 0.001) at 30 minutes, MDDM (P < 0.001), TUG (P < 0.001), and gravimetric speed (P < 0.001) at 60 minutes, and gravimetric area (P = 0.03) at 90 minutes.</p><p><strong>Conclusion: </strong>Administration of flumazenil after remimazolam anesthesia resulted in faster recovery of consciousness, but it did not affect the recovery of psychomotor and equilibrium functions. The time until patients were safe to return home was 120 minutes. Flumazenil did not improve the time until it was safe for patients to return home.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 1","pages":"55-65"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412177","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":"Comparative evaluation of the influence of the palatal root length on the efficacy of maxillary buccal infiltration by open and closed mouth technique: a randomized control trial.","authors":"Yogesh K M, Srirekha A, Champa C, Suditi Pal, Aditya Narayanan, Lipika Jain","doi":"10.17245/jdapm.2024.24.6.407","DOIUrl":"10.17245/jdapm.2024.24.6.407","url":null,"abstract":"<p><strong>Background: </strong>Maxillary molars are commonly anesthetized via buccal infiltration. A patient's mouth opening during maxillary buccal infiltration can influence dental treatment. Hence, this study aimed to evaluate and compare the influence of palatal root length on the efficacy of 2% lidocaine in 1:80000 adrenaline for maxillary buccal infiltration (MBI) between the open- and closed-mouth techniques.</p><p><strong>Methods: </strong>Sixty patients were selected based on inclusion and exclusion criteria. The intensity of pre-operative pain was measured using a visual analog scale (VAS). Samples were randomly divided using the chit method, with odd numbers in group 1 and multiples of two in group 2. In group 1 (n = 30), MBI was performed using the open-mouth technique, and in group 2 (n = 30), MBI was performed using the closed-mouth technique. Five minutes after injection, electric pulp testing was performed. For a negative response, patients were asked to rate their level of discomfort using the VAS. The palatal root length was measured after opening the access point using an apex locator. The groups were evaluated for patient discomfort using VAS.</p><p><strong>Results: </strong>Results were analyzed using the Wilcoxon signed-rank test and Mann-Whitney test. A comparison of MBI between the open- and closed-mouth techniques showed that the closed-mouth technique had significantly better efficacy than the open-mouth technique when the palatal root length was greater than 19 mm (P < 0.05).</p><p><strong>Conclusion: </strong>Within the limitations of the study, when the palatal root length was greater than 19 mm, the closed-mouth technique resulted in less patient discomfort, improved visibility, and better needle penetration.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"24 6","pages":"407-414"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857371","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":"Articaine buccal infiltration and lidocaine intraosseous anesthesia in carious mandibular molars.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.17245/jdapm.2024.24.6.431","DOIUrl":"10.17245/jdapm.2024.24.6.431","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"24 6","pages":"431-432"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857369","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":"Screen-based telesimulation training for medical emergencies in dental clinics.","authors":"Naotaka Kishimoto, Toru Yamamoto, Simon D Tran, Takuro Sanuki, Kenji Seo","doi":"10.17245/jdapm.2024.24.6.427","DOIUrl":"10.17245/jdapm.2024.24.6.427","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"24 6","pages":"427-430"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857469","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":"Efficacy of local anesthesia with cryotherapy on teeth with molar incisal hypomineralization: a randomized control trial.","authors":"Faizal C Peedikayil, Soni Kottayi, Athira Aravind, Aswathi Sreedharan, Athul Ramesh","doi":"10.17245/jdapm.2024.24.6.385","DOIUrl":"10.17245/jdapm.2024.24.6.385","url":null,"abstract":"<p><strong>Background: </strong>Tooth hypersensitivity presents a significant clinical challenge in managing molar-incisal hypomineralization (MIH), potentially compromising the effectiveness of restorative treatments. Cryotherapy has emerged as a promising approach to reduce pain and inflammation. This study aimed to evaluate and compare the effects of cryotherapy as an adjuvant to nerve blocks in reducing operative pain and sensitivity in patients.</p><p><strong>Methods: </strong>A split-mouth randomized controlled trial was conducted in 28 patients with MIH of the right and left lower molars. ie, 56 teeth. Group (1) control group (n = 28) was administered an Inferior Alveolar Nerve block and group (2) was administered cryotherapy spray after the Inferior Alveolar Nerve block. The Visual Analog Scale (VAS) and Legs, Activity, Cry, Consolability (FLACC) scales were used to compare intraoperative pain. The Mann-Whitney U test was used to test the significance across the study groups, and the chi-square test was used to compare success rates between the two groups; a value of less than 0.05 was considered significant.</p><p><strong>Results: </strong>For VAS scale, the mean value in Group A is 8.89 ± 0.79, whereas in Group B, the values are 4.71 ± 1.46. For the FLACC scale, Group A scores were 7.14 ± 1.04, and Group B scores were 4.48 ± 1.37. When intergroup values were compared, the FLACC and VAS scores were statistically significant at P < 0.001.</p><p><strong>Conclusion: </strong>Within the limitations of this study, applying cryotherapy to tooth surfaces following an Inferior Alveolar Nerve block effectively reduces pain and sensitivity in teeth affected by MIH.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"24 6","pages":"385-393"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857464","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":"Severe bilateral subcutaneous emphysema after prophylactic treatment: a case report.","authors":"Yong-Seung Kim, Joonyoung Huh, Hoon Myoung, Soung Min Kim, Mi Hyun Seo","doi":"10.17245/jdapm.2024.24.6.421","DOIUrl":"10.17245/jdapm.2024.24.6.421","url":null,"abstract":"<p><p>Subcutaneous emphysema is the accumulation of gas or air in loose subcutaneous connective tissue. The use of air-driven handpieces in dental procedures is a common iatrogenic cause of intraoral mucogingival barrier disruption by high-pressure air. This case report describes a 60-year-old woman who underwent prophylactic periodontal treatment with an air-abrasive device and subsequently developed severe bilateral subcutaneous emphysema, extending from the temporal region to the thoracic and mediastinal spaces. Subcutaneous emphysema was suspected based on clinical examination, and paranasal CT was performed for definitive diagnosis. Chest CT was conducted for further evaluation, followed by consultation with the Department of Thoracic Surgery. The patient was admitted for supportive care and prophylactic antibiotics. After 4 days of hospitalization, the symptoms had nearly resolved, and a follow-up paranasal CT showed significant air resorption. The patient was discharged without complications. Although generally benign and self-limiting, subcutaneous emphysema can lead to serious complications such as systemic infection, pneumothorax, and air embolism. This case highlights the importance of prompt diagnosis and appropriate management to prevent further complications.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"24 6","pages":"421-425"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857470","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}