Anesthesia progress
-
Anesthesia progress · Jan 2002
Pharmacokinetics of oral tramadol drops for postoperative pain relief in children aged 4 to 7 years--a pilot study.
Tramadol hydrochloride is an analgesic with mu receptor activity suitable for administration to children as oral drops. As the serum concentration profile and pharmacokinetic parameters in young children are not known via this route, we studied 24 healthy ASA 1 children to determine those parameters. The children's mean age was 5.3 +/- 1.1 years and their mean weight was 17.8 +/- 3.1 kg. ⋯ The M1 elimination half-life was 5.8 +/- 1.7 hours. Apart from the rapid rise in the serum concentration, these kinetic parameters are similar to those seen in healthy young adults. The concentration profile supports an effective clinical duration in the region of 7 hours.
-
Anesthesia progress · Jan 2002
The relationship of placement accuracy and insertion times for the laryngeal mask airway to the training of inexperienced dental students.
Any health care professional can be faced with a medical emergency in which the patient needs ventilatory support. Bag-valve-mask ventilation with the assistance of an oropharyngeal airway that uses 100% oxygen is currently the preferred method for artificial ventilation. This procedure is generally performed ineffectively by most dentists inexperienced in airway management. ⋯ A dental anesthesiologist graded the placement of the LMA with a tracheobroncho-fiberscope (fiberoptic bronchoscope). Those who practiced inserting the LMA 5 times faired better than those who received no training; however, those who practiced 10 times did not do any better than the second group. The LMA can be inserted rapidly and effectively by dentists inexperienced in airway management after a short period of simple training that may be critical when personnel experienced in intubation are not readily available.
-
Anesthesia progress · Jan 2002
Comparative StudyClinical recovery time from conscious sedation for dental outpatients.
For dental outpatients undergoing conscious sedation, recovery from sedation must be sufficient to allow safe discharge home, and many researchers have defined "recovery time" as the time until the patient was permitted to return home after the end of dental treatment. But it is frequently observed that patients remain in the clinic after receiving permission to go home. The present study investigated "clinical recovery time," which is defined as the time until discharge from the clinic after a dental procedure. ⋯ The clinical recovery time was about twice as long as the recovery time described in previous studies. In a comparison of the sedation methods, clinical recovery time differed (P = .0008), being longer in the midazolam sedation group than in the nitrous oxide-oxygen sedation group (P = .018). These results suggest the need for changes in treatment planning for dental outpatients undergoing conscious sedation.
-
Anesthesia progress · Jan 2002
Randomized Controlled Trial Clinical TrialAnesthetic efficacy of an infiltration in mandibular anterior teeth following an inferior alveolar nerve block.
The purpose of this prospective, randomized, blinded study was to measure the degree of pulpal anesthesia obtained with an inferior alveolar nerve (IAN) block followed by an infiltration in mandibular anterior teeth. Through use of a repeated-measures design, 40 patients randomly received 3 injection combinations at 3 separate appointments: an IAN block followed by a mock lingual infiltration and a mock labial infiltration, an IAN block followed by a mock lingual infiltration and a labial infiltration, and an IAN block followed by a mock labial infiltration and a lingual infiltration. Each IAN block used 3.6 mL of 2% lidocaine with 1:100,000 epinephrine, and each infiltration used 1.8 mL of 2% lidocaine with 1:100,000 epinephrine administered over the lateral incisor apex. ⋯ For the IAN block plus labial infiltration, the success rate was 62% and the failure rate was 12% for the lateral incisor. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration. In conclusion, a labial infiltration, over the lateral incisor apex, of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine following an IAN block significantly improved pulpal anesthesia for the lateral incisor compared with the IAN block alone.
-
Anesthesia progress · Jan 2002
Randomized Controlled Trial Clinical TrialA comparison of intraoral injection discomfort produced by plain and epinephrine-containing lidocaine local anesthetic solutions: a randomized, double-blind, split-mouth, volunteer investigation.
The authors report a clinical trial designed to compare the discomfort produced by plain and epinephrine-containing lidocaine solutions during local anesthesia in the maxilla. Twenty-four healthy volunteers were recruited; each received buccal and palatal infiltrations on each side of the maxilla in the premolar region. The solutions were 2% lidocaine and 2% lidocaine with 1:80,000 epinephrine. ⋯ Palatal injection discomfort did not differ between the solutions; however, the second palatal injection was more uncomfortable than the first palatal injection (P = .046). These results suggest that plain lidocaine produces less discomfort than lidocaine with epinephrine when administered into the maxillary premolar buccal sulcus in individuals who report moderate pain during this injection. Palatal injection discomfort does not differ between these solutions.