Anesthesia progress
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Anesthesia progress · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialFlumazenil reversal of conscious sedation induced with intravenous fentanyl and diazepam.
The addition of a benzodiazepine antagonist to the dental anesthesiologist's armamentarium should provide added safety for conscious sedation using benzodiazepines. A double-blind, placebo-controlled clinical trial of flumazenil, the first available benzodiazepine antagonist, was performed to evaluate its safety and efficacy following conscious sedation induced by diazepam and fentanyl. Flumazenil was found to reverse rapidly much of the central nervous system depression induced by fentanyl and diazepam conscious sedation. Flumazenil appears to be a valuable adjunct for dentists who administer intravenous benzodiazepines for conscious sedation.
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Anesthesia progress · Jan 1995
Case ReportsType I second-degree AV block after neostigmine administration in a child with renal failure.
Neostigmine is commonly used to reverse neuromuscular blockade. A side effect can be parasympathetic stimulation, which may result in heart block. Renal failure can decrease the clearance and increase the half-life of the drug, thus increasing the likelihood of a vagomimetic response. A case is presented where a child with renal failure developed a type I second-degree heart block after neostigmine was given.
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Anesthesia progress · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the effects of EMLA cream and topical 5% lidocaine on discomfort during gingival probing.
This investigation compared the use of a 5% eutectic mixture of local anesthetics (EMLA) cream to a "standard" intraoral topical anesthetic (5% lidocaine) as a means of anesthetizing the gingival sulcus in a double-blind, split-mouth study with human volunteers. A 5-min application of EMLA in a customized intraoral splint resulted in a significant increase in the depth of probing of the gingival sulcus without discomfort compared to a similar application of 5% lidocaine. Following application of EMLA, the pain-free probing depth measured at three sites in the upper premolar region increased by a mean total of 2.8 mm compared to an increase of 1.9 mm with lidocaine. This study suggests EMLA may be advantageous in providing periodontal anesthesia where manipulation of the gingiva is necessary.