Anesthesia progress
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Anesthesia progress · Jan 2018
Case ReportsSugammadex: Efficacy and Practicality in the Dental Office.
Sugammadex is a novel drug capable of reversing paralysis induced by the common steroidal nondepolarizing neuromuscular blocking drugs, rocuronium and vecuronium. Reversal is complete at any depth of blockade dependent on the dose of sugammadex administered. ⋯ Sugammadex is considered a safe drug with minimal side effects compared with traditional reversal with neostigmine and glycopyrrolate. This article features a case report where succinylcholine was undesirable and rapid reversal of paralysis with sugammadex was used during general anesthesia for dentistry.
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Anesthesia progress · Jan 2018
Randomized Controlled TrialEffect of Nitrous Oxide on Pulpal Anesthesia: A Preliminary Study.
To compare the success of perceived pulpal anesthesia between groups using nitrous oxide/oxygen (N2O/O2) and oxygen (O2) in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. Thirty-three children (mean age 10.4 ± 1.9 years) with 33 symptomatic irreversible pulpitis permanent teeth were included in this preliminary study. All children were premedicated with ibuprofen and randomly assigned to receive either N2O/O2 (17 participants) or O2 (16 participants). ⋯ The success in the N2O/O2 group was 52% higher than that in the O2 group (confidence interval = 22.9% to 80.7%; significant difference p = .003). From the result of this preliminary study, N2O/O2 significantly increased the success of perceived pulpal anesthesia in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. However, further study with a larger sample is required to confirm this result.
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Anesthesia progress · Jan 2018
Review Case ReportsTrue Allergy to Amide Local Anesthetics: A Review and Case Presentation.
Adverse reactions to local anesthetics are usually a reaction to epinephrine, vasovagal syncope, or overdose toxicity. Allergic reactions to local anesthetics are often attributed to additives such as metabisulfite or methylparaben. True allergic reactions to amide local anesthetics are extremely rare but have been documented. ⋯ Often, these patients may be treated under general anesthesia. We report a case of a 43-year-old female patient that presented to NYU Lutheran Medical Center Dental Clinic with a documented history of allergy to amide local anesthetics. This case report reviews the use of 1% diphenhydramine with 1:100,000 epinephrine as an alternative local anesthetic and reviews the relevant literature.
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Anesthesia progress · Jan 2018
Case ReportsSedation With a Combination of Dexmedetomidine and Midazolam for Pediatric Dental Surgery.
Intravenous sedation (IVS) is commonly used to complete dental treatment for uncooperative pediatric patients. Propofol (PRO) is widely used for IVS because of its short context sensitive half-time and amnestic effect. However, administering PRO to patients who have a history of egg anaphylaxis is still somewhat controversial. ⋯ Dexmedetomidine (DEX), a selective α-2 agonist, has antianxiety and sedative properties and has been widely used not only for procedural sedation with mild inhibitory effects on respiration but also during minor surgeries for its analgesic effect. In this paper, we describe the successful administration of a combination of DEX and low-dose midazolam (MDZ) for sedation in an uncooperative pediatric patient. Both DEX and MDZ have been reported as safe and useful sedatives for dental treatment, and their combination may provide a helpful option for IVS of pediatric patients for whom PRO is not preferred.