Articles: general-anesthesia.
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Anasth Intensivther Notfallmed · Apr 1986
[Methods of automatic feedback regulation for anesthesia. Concepts and clinical use].
Dosing of drugs used in general anaesthetic practice is largely based on experience and trial-and-error. From the very beginning, anaesthesiological research has always attempted to supply a rational description of the rules governing the dose-response relationship. During the last few decades it became possible to identify pharmacokinetics as a main constituent of the relationship, since the rate of efficacy is primarily governed by the kinetics of the drug and the dose. ⋯ It was shown in all cases that adaptive, model-based feedback control is superior to non-adaptive methods. Pharmacokinetic and/or pharmacodynamic models were successfully applied to the servocontrol of volatile anaesthetics, intravenous hypnotics and neuromuscular blocking agents. Over and above these three applications, directly related to anaesthesia, the impact of feedback control on the regulation of blood pressure and blood glucose is reviewed.
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J. Oral Maxillofac. Surg. · Apr 1986
Prevention of complications associated with intravenous sedation and general anesthesia.
An analysis of three time phases--induction, maintenance, and recovery from anesthesia--is presented to clarify specific risk situations and the treatment necessary to decrease morbidity and mortality in the dental office.
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Surveyed were 133 directors of training programs in anesthesiology. The directors reported an average incidence of 1:1,000 dental injuries during or after 1,135,212 tracheal intubations in 1 year. A well-documented dental evaluation before delivery of anesthetics and appropriate precautions and protective devices during intubation will prevent most dental trauma related to the delivery of general anesthetics. Also, early use of dental and risk management services often will ensure timely resolution of such problems.
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A survey of predoctoral pediatric dentistry programs in American dental schools was conducted to determine the extent of didactic and clinical training in pediatric conscious sedation. Fifty-four of 59 programs (92 percent) returned usable surveys. The results indicated that there exists a wide range of teaching practices, both in numbers and types of sedations experienced. ⋯ Predoctoral programs without an affiliated postdoctoral program were much more likely to practice conscious sedation than those that trained postdoctoral students. The reason most frequently listed for the nonuse of sedation in the predoctoral clinic was philosophical opposition to pharmacological management at this level of training. A majority of the respondents believed that improved monitoring practices and documentation of cases would result from the recent adoption by the American Academy of Pediatric Dentistry of guidelines for conscious sedation.