Anesthesia & pain control in dentistry
-
Anesth Pain Control Dent · Jan 1992
Multicenter StudyProtocol for studying depth of anesthesia using the spectral edge frequency.
The preliminary results of a multicenter study designed to determine the utility of the processed EEG in combination with heart rate and blood pressure for estimating anesthetic depth are reported. The study is planned to include 1,000 ASA I, II, and III patients undergoing surgery with at least a 60-minute duration of anesthesia. The preliminary results indicate that the use of EEG and clinical signs may provide better control of anesthetic depth. The study design provides ideal conditions for determining whether spectral edge frequency is a useful criterion for management of routine general anesthesia in a typical clinical environment.
-
Anesth Pain Control Dent · Jan 1992
Randomized Controlled Trial Clinical TrialClinical investigation of potency and onset of different lidocaine sprays for topical anesthesia in dentistry.
The clinical effects of three lidocaine-containing solutions with and without frigen (freon-113) as a propellant, after different waiting periods, and with different dosages applied were investigated in 130 outpatients who were undergoing dental treatment in the maxilla under local anesthesia. They were divided randomly into five groups (A through E): (A) Xylocaine spray with frigen, two applications (20 mg lidocaine); (B) Xylestesin spray with frigen, two applications (14 mg lidocaine); (C) Xylestesin spray with frigen, three applications (21 mg lidocaine); (D) Xylestesin pump spray without frigen, two applications (14 mg lidocaine); and (E) no topical anesthesia. They were further divided into 12 subgroups to evaluate waiting periods between the application of the topical anesthesia and the injection (1, 2, or 3 minutes). ⋯ However, a 3-minute waiting period may be appropriate for sensitive patients. An increase in the dosage failed to show better analgesia. The pump spray without frigen proved to be effective.
-
Anesth Pain Control Dent · Jan 1992
Displacement of the endotracheal tube caused by postural change: evaluation by fiberoptic observation.
Unexpected displacement of the endotracheal tube during anesthesia caused by postural change of the neck or passive compression by the mouth gag was investigated under transluminal fiberoptic observation. Twenty-two patients were divided into orotracheal and nasotracheal intubation groups according to the technical requirements of the planned oral and maxillofacial surgery. ⋯ Under orotracheal intubation, the mean length of displacement from the carina was 12 mm by extension of the neck and almost 28 mm with application of the mouth gag. To avoid accidental extubation or one-sided bronchial intubation during anesthesia, the tip (distal end) of the endotracheal tube should be located less than 32 mm from the carina before extension of the neck and more than 41 mm from the carina before application of the mouth gag.
-
Anesth Pain Control Dent · Jan 1992
Comparative StudyIntraoral conduction anesthesia with epinephrine-containing local anesthetics and arterial epinephrine plasma concentration.
Following conduction anesthesia using either lidocaine 2% with epinephrine 1:80,000, articaine 4% with epinephrine 1:100,000, or articaine 4% with epinephrine 1:200,000, the arterial plasma epinephrine concentration was measured. Eighteen healthy young patients scheduled for osteotomy of a mandibular third molar were studied. Each local anesthetic-epinephrine combination was tested in six patients. ⋯ The result was explained by the concentration difference in the local anesthetics. Although the vasodilating action of lidocaine and articaine is almost identical, there will be enhanced vasodilation by the doubled concentration in the case of articaine (4%) and the local resorption of epinephrine may be facilitated. There were no significant changes in the measured cardiovascular parameters.
-
Anesth Pain Control Dent · Jan 1992
Biography Historical ArticleVictory over pain: an historical perspective.
Horace Wells, a dentist, is credited with the discovery of anesthesia. However, there are others who experimented with inhalation agents long before Wells' time. This paper reviews the history of anesthesia and recounts its discovery by Wells in 1844 as we approach the 150th anniversary of the event.