Anesthesia progress
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Anesthesia progress · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialEffective postoperative pain prevention through administration of bupivacaine and diclofenac.
The efficacies of bupivacaine and lidocaine together with a preoperatively administered single-dose oral combination of normal- and sustained-release preparations of diclofenac in preventing postoperative pain after third molar removal were compared in a double-blind crossover study. Bilaterally impacted lower third molars were removed in two sessions. Each patient was given one type of local anesthetic on one session and the other in the second. ⋯ When the diclofenac combination (150 mg) was given before the operation, postoperative analgesia was better with bupivacaine plus diclofenac than with lidocaine plus diclofenac. Twenty-five out of 40 patients preferred bupivacaine to lidocaine for local anesthesia. It is possible to achieve effective postoperative pain prevention by combining bupivacaine and preoperative normal- and sustained-release preparations of diclofenac.
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Anesthesia progress · Jan 1994
Review Case ReportsAsystole and bradycardia during maxillofacial surgery.
A Chinese female undergoing maxillary osteotomy developed asystole when the maxillary tuberosity was cut. Surgery was stopped. ⋯ Atropine was administered intravenously, resulting in an increase in heart rate. No further episodes of asystole or bradycardia were encountered.
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Anesthesia progress · Jan 1994
Comparative StudyRespiratory effects of a balanced anesthetic technique--revisited fifteen years later.
Five hundred and fifty patients underwent general anesthesia with fentanyl, diazepam, and methohexital. Forty-seven (8.5%) developed signs of hypoventilation or airway obstruction. Arterial blood gas analysis revealed mild hypoxemia in three of the 47 cases and mild hypercarbia in six. Airway obstruction was more predictive of abnormal blood gas values than was hypoventilation.
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Anesthesia progress · Jan 1994
Case ReportsPulse oximetry signals local anesthetic-induced methemoglobinemia.
An otherwise healthy patient with a fractured mandible was scheduled to undergo an open reduction under general anesthesia. Just before transport to the operating room, bimaxillary arch bars were placed under local anesthesia with 4% prilocaine and 1:200,000 epinephrine. ⋯ A total of 150 mg of methylene blue administered in two doses corrected the problem. The oral surgeon, having recently switched to prilocaine because of a manufacturer's recall of lidocaine, was unaware of the potential of prilocaine to cause this disorder.
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Anesthesia progress · Jan 1994
Case ReportsTENS-induced pain control in a malignant hyperthermia-susceptible patient.
Malignant hyperthermia (MH) is a severe and often fatal disease that is triggered by exposure to the neuromuscular blocking drug succinylcholine and/or volatile general anesthetics (eg, halothane). Although all local anesthetics are now considered to be safe in malignant hyperthermia patients, some individuals still prefer not to use amide-type anesthetics. Here we report a case of a MH-susceptible patient who successfully received restorative dental treatment with transcutaneous electrical nerve stimulation. We suggest that this may be a safe alternative to consider in patients who have an aversion to chemical anesthetic agents.