Anesthesia progress
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Anesthesia progress · Jan 2004
ReviewDental anesthesia management of methemoglobinemia-susceptible patients: a case report and review of literature.
A healthy but slightly pale 24-year-old female patient with a history of "turning blue" following dental procedures performed under local anesthesia claimed allergies to sulfa drugs, aspirin, Benadryl, and "all caines." The patient also acknowledged mild cyanosis after extreme exertion, Native American ancestry, and a 1996 diagnosis of methemoglobinemia following administration of a sulfa drug. Previous medical and dental records were reviewed. Restoration of several teeth and extraction of 2 third-molar teeth were completed under general anesthesia. ⋯ Vital signs, including pulse oximetry, remained stable, and the patient was dismissed after a 2-hour recovery/observation period. The patient experienced no postoperative complications. This case report provides a review of literature and clinical guidelines for management of methemoglobinemia-susceptible patients.
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Anesthesia progress · Jan 2004
Case ReportsAllergic reaction to epinephrine preparation in 2% lidocaine: two case reports.
We report 2 cases of hypersensitivity to an epinephrine preparation in local anesthetics which were found by skin tests for local anesthetics. Both patients had uncomfortable episodes to local anesthetics at dental treatment. ⋯ Furthermore drug lymphocyte stimulation test revealed positive reaction to epinephrine hydrochloride, epinephrine bitartrate in case 1, whereas in case 2, the drug lymphocyte stimulation test showed positive response to epinephrine bitartrate. Attention should be paid to exogenous epinephrine preparations that have the potential to induce hypersensitivity during dental treatment.
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Anesthesia progress · Jan 2004
Case ReportsAcute obstruction of an endotracheal tube: a case report.
This report describes a case of sudden ventilatory failure, originally diagnosed as bronchospasm, in a child during general anesthesia. A blood clot impaction in the nasotracheal tube was detected using flexible fiberoptic bronchoscopy. The clot was successfully treated as a result of its passage. We hope this report will stress to dental anesthesiologists the intraoperative importance of fiberoptic bronchoscopy not only as an intubation-aiding device but also as a diagnostic and therapeutic tool.
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Anesthesia progress · Jan 2004
Editorial CommentWhat is meant by a "safe and effective sedation technique"?
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Anesthesia progress · Jan 2004
Randomized Controlled Trial Clinical TrialIntranasal sufentanil/midazolam versus ketamine/midazolam for analgesia/sedation in the pediatric population prior to undergoing multiple dental extractions under general anesthesia: a prospective, double-blind, randomized comparison.
This article details a double-blind, randomized study evaluating the efficacy and safety of intranasal sufentanil and intranasal midazolam (S/M) when compared with intranasal ketamine and intranasal midazolam (K/M) for sedation and analgesia in pediatric patients undergoing dental surgery. Fifty healthy ASA status 1 children aged 5-7 years, weighing 15-20 kg, and having 6 or more teeth extracted, were randomly allocated to 2 groups of 25 patients each (n = 50). In the S/M group, 25 children received intranasal sufentanil 20 microg, and intranasal midazolam 0.3 mg/kg 20 minutes before the induction of anesthesia. ⋯ A smooth mask induction of anesthesia was experienced in the majority of children. Effective postoperative analgesia for multiple dental extractions was provided. The intranasal administration of drugs for sedation and analgesia has some promising features in preschool children undergoing multiple dental extractions.