Anesthesia progress
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Anesthesia progress · Jan 2004
Randomized Controlled Trial Clinical TrialComparison of injection pain, heart rate increase, and postinjection pain of articaine and lidocaine in a primary intraligamentary injection administered with a computer-controlled local anesthetic delivery system.
The purpose of this prospective, randomized, double-blind study was to compare the pain of injection, heart rate increase, and postinjection pain of the intraligamentary injection of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine administered with a computer-controlled local anesthetic delivery system. Using a crossover design, intraligamentary injections of 1.4 mL of 4% articaine with 1:100,000 epinephrine and 1.4 mL of 2% lidocaine with 1:100,000 epinephrine were randomly administered on the mesial and distal aspects of the mandibular first molar with a computer-controlled local anesthetic delivery system in a double-blind manner at 2 separate appointments to 51 subjects. The results demonstrated the incidence of moderate pain was 14%-27% with needle insertion, with 0%-4% reporting severe pain. ⋯ There were no significant differences between the articaine and lidocaine solutions. We concluded that the intraligamentary injection of 4% articaine with 1:100,000 epinephrine was similar to 2% lidocaine with 1:100,000 epinephrine for injection pain and postinjection pain in the mandibular first molar when administered with a computer-controlled local anesthetic delivery system. For both anesthetic solutions, heart rate did not significantly increase with the intraligamentary injection using the computer-controlled local anesthetic system.
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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
ReviewDental anesthesia management of methemoglobinemia-susceptible patients: a case report and review of literature.
A healthy but slightly pale 24-year-old female patient with a history of "turning blue" following dental procedures performed under local anesthesia claimed allergies to sulfa drugs, aspirin, Benadryl, and "all caines." The patient also acknowledged mild cyanosis after extreme exertion, Native American ancestry, and a 1996 diagnosis of methemoglobinemia following administration of a sulfa drug. Previous medical and dental records were reviewed. Restoration of several teeth and extraction of 2 third-molar teeth were completed under general anesthesia. ⋯ Vital signs, including pulse oximetry, remained stable, and the patient was dismissed after a 2-hour recovery/observation period. The patient experienced no postoperative complications. This case report provides a review of literature and clinical guidelines for management of methemoglobinemia-susceptible patients.
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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.