Anesthesia progress
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Anesthesia progress · Jan 2004
Randomized Controlled Trial Clinical TrialA randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.
The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine. ⋯ Nine percent of children required supplementary local anesthetic: 4 of 52 (7.7%) in the block/long buccal group and 5 of 49 (10.2%) in the infiltration/intrapapillary group (P = .07). The hypothesis that block/long buccal would be more effective than infiltration/intrapapillary was not supported. There was no difference in pain control effectiveness between infiltration/intrapapillary injection and inferior alveolar block/long buccal infiltration using 2% lidocaine with 1:100,000 epinephrine when mandibular primary molars received pulpotomy treatment and stainless steel crowns.
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Anesthesia progress · Jan 2004
Randomized Controlled Trial Clinical TrialThe feasibility of bispectral index monitoring for intravenous sedation during dental treatment.
Intravenous sedation during dental treatment is primarily used in outpatient clinics. Maintenance of a level of sedation sufficient to allow treatment while using the minimum dose possible and to induce faster waking is very important. The benefits of bispectral index monitoring have recently been reported for many applications, and it is expected to prove useful in intravenous sedation during dental treatment. ⋯ Thus, we investigated the usefulness of bispectral index monitoring for patients under intravenous sedation during dental treatment. The incidence of "good" electroencephalograms, for which the electromyogram was less than 50 dB, signal quality index was more than 25%, and impedance was less than 10 kOhms, was 82.4% +/- 9.2%. These findings suggest that bispectral index monitoring will prove effective for intravenous sedation during dental treatment.
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Anesthesia progress · Jan 2004
Case ReportsAnesthetic management of a child with congenital central hypoventilation syndrome (CCHS, Ondine's curse) for dental treatment.
Congenital Central Hypoventilation Syndrome (CCHS, also known as Ondine's Curse) is a rare syndrome characterized by apnea, cyanosis, and hypotonia. A 4-year-old, 90-cm, 12-kg girl with CCHS, mental retardation (MR), and Hischsprung's disease (HD) was treated under general anesthesia. ⋯ There was no trouble during the perioperative period. We safely performed general anesthesia and dental treatment for a girl who had CCHS with HD and MR.
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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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There is very little information about the practice of sedation in Japan. Despite the remarkable advances in dentistry, fear and anxiety continue to be significant deterrents for seeking dental services. Most dental procedures can fortunately be undertaken with the aid of sedation. ⋯ The results indicate that there was a broad range in sedation practices. The Japanese Dental Society of Anesthesiology may wish to examine the findings of this study and may wish to formulate guidelines appropriate for the practice of sedation in Japan. Others may also wish to compare their own practices with those of Japan.