The British journal of oral & maxillofacial surgery
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The effect of intravenous midazolam on the somatosensory evoked potentials (SEP's) elicited from median nerve stimulation was investigated in a study on 20 volunteers. SEP's were recorded from contralateral scalp before and at 5, 30, and 60 min after drug administration. Relative amplitudes of the early components (N18-N20) were essentially stable, while relative amplitudes of the late components (N50-P90, P90-N160, N160-P250 and P250-N380) were reduced significantly after midazolam administration and had not returned to baseline 60 min after administration. Given the correlation between late SEP amplitude and subjective reports of experimental pain, the data support the possibility that administration of midazolam in conscious sedation doses may have some effect on pain in addition to its better documented sedative and amnesic properties.
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Four simple tests which can be used for routine sensory testing following trigeminal nerve injuries are suggested. The methods for constructing the equipment needed for these tests are described.
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Br J Oral Maxillofac Surg · Oct 1991
The characteristics of midfacial fractures and the association with ocular injury: a prospective study.
Ocular injuries commonly occur in patients with facial fractures. This prospective study was set up to determine the incidence of ocular injuries, as assessed by an ophthalmologist, in patients who had sustained midfacial fractures. Over a 2-year period, a study of 363 patients who had sustained midfacial trauma sufficient to lead to a facial bone fracture (438 fractures) was undertaken and patients received a comprehensive examination by an ophthalmologist and an orthoptist within 1 week of injury. ⋯ Decrease in visual acuity was the main clinical finding accompanying the majority of significant eye injuries. When ocular injuries were related to aetiology, it was apparent that road traffic accidents and assaults associated with alcohol abuse showed the highest incidence of major ocular dysfunction. It is suggested that all patients sustaining midfacial fracture associated with a significant decrease in visual acuity either pre- or postoperatively should have an early ophthalmological review.
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Br J Oral Maxillofac Surg · Jun 1991
Case ReportsHazard warning. A case of postoperative pulmonary barotrauma.
A case is described in which extensive pulmonary barotrauma occurred due to the application of a face mask to an indwelling cuffed endotracheal tube. The design of the mask is such that a seal was made between the mask and the tube. The design of mask is widely used in theatre recovery areas and clinicians are alerted to this potential hazard.
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Br J Oral Maxillofac Surg · Apr 1991
Effects of glycerol on the rat infraorbital nerve: an experimental study.
Glycerol was injected into the infraorbital canal of 12 rats to determine neurolytic effects on the peripheral trigeminal nerve. Saline and 90% ethanol were injected in control animals. One week after the injection, histopathological changes were noted in both glycerol and alcohol groups. ⋯ Four weeks after the injection in the glycerol group, small sized axons with thin myelin replaced damaged axons at the periphery of the bundle. No signs of regeneration were noted in the alcohol group. A possible mode of action of glycerol injected at the peripheral trigeminal nerve in relieving trigeminal neuralgia is described.