Anesthesia & pain control in dentistry
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Anesth Pain Control Dent · Jan 1993
Case ReportsAn anaphylactoid reaction following local anesthesia: a case report.
A case report of an adverse reaction to a preparation of an amide local anesthetic, prilocaine with epinephrine, is presented. Signs and symptoms were consistent with an anaphylactic reaction and the patient responded positively to treatment based on this assumption. Treatment included administration of epinephrine injected sublingually and oxygen by inhalation. ⋯ A number of explanations are possible and a final diagnosis of an anaphylactoid reaction was made. Local anesthetic allergies and their management are reviewed. The literature demonstrates that an allergic reaction to amide local anesthetics can occur and a thorough history, intradermal testing, and subcutaneous challenge are reasonable approaches to determine a safe agent for subsequent use.
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Arterial oxygen saturation (SaO2) was monitored postoperatively with pulse oximetry in 80 dental patients receiving nitrous oxide and oxygen. These patients were divided into four equal groups, three of which received nitrous oxide (N2O) and oxygen (O2) in ratios of 20:80, 40:60, and 60:40, respectively. The fourth group received 100% O2 and served as the control. ⋯ One patient in the 40% N2O group experienced an SaO2 of less than 90%, but no patient experienced clinically significant hypoxia. In the 40% and 60% N2O groups, the percent change of SaO2 from the baseline was greater, and the SaO2 returned to baseline slower. The difference in mean SaO2 between smokers and nonsmokers was greater in the 40% N2O group.
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Anesth Pain Control Dent · Jan 1993
ReviewCirculatory effects of vasoconstrictors combined with local anesthetics.
Vasoconstrictors are clinically used as adjuvants to local anesthetics to improve anesthetic action and to minimize local bleeding. Accidental intravascular injection or rapid systemic absorption of vasoconstrictors can induce a number of potentially life-threatening circulatory risks, which are described in this paper.
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Anesth Pain Control Dent · Jan 1993
Practice Guideline GuidelineChanges in guidelines for cardiopulmonary resuscitation and emergency cardiac care.
At the Fifth National Conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care held in Dallas in February 1992, changes in the guidelines for basic life support and advanced cardiac life support were recommended. These changes are defined and explained in this article.