Anesthesia progress
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Anesthesia progress · Jan 2015
Case ReportsAnesthetic management by laryngeal mask airway in a patient with a history of difficult intubation resulting in dental injuries.
Disabled patients may face respiratory problems during general anesthesia because of head and neck anomalies. We describe a case of dental treatment under general anesthesia using a laryngeal mask airway in a disabled patient who faced difficulty in endotracheal intubation on several occasions, 5 of which resulted in dental injuries.
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Anesthesia progress · Jan 2015
Randomized Controlled Trial Comparative StudyEfficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial.
The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18-50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. ⋯ A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN.
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Anesthesia progress · Jan 2015
ReviewIntraoperative Fluids and Fluid Management for Ambulatory Dental Sedation and General Anesthesia.
Intravenous fluids are administered in virtually every parenteral sedation and general anesthetic. The purpose of this article is to review the physiology of body-water distribution and fluid dynamics at the vascular endothelium, evaluation of fluid status, calculation of fluid requirements, and the clinical rationale for the use of various crystalloid and colloid solutions. In the setting of elective dental outpatient procedures with minor blood loss, isotonic balanced crystalloid solutions are the fluids of choice. Colloids, on the other hand, have no use in outpatient sedation or general anesthesia for dental or minor oral surgery procedures but may have several desirable properties in long and invasive maxillofacial surgical procedures where advanced hemodynamic monitoring may assess the adequacy of intravascular volume.
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Anesthesia progress · Jan 2015
Case ReportsAnaphylactoid-like Reaction to Midazolam During Oral and Maxillofacial Surgery.
We experienced a case of life-threatening hypotension and bronchoconstriction associated with edema in a patient undergoing resection of a tumor of the right mandible following intravenous midazolam for induction of general anesthesia. We decided to postpone surgery for further examination of a possible drug-induced allergic reaction, and we rescheduled surgery for 1 week later. After administering H1 and H2 histamine antagonists, we administered a slow induction with sevoflurane in nitrous oxide and oxygen plus intravenous atropine sulfate after performing a test dose injection. We safely induced and maintained anesthesia with nitrous oxide, oxygen, and sevoflurane.
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Anesthesia progress · Jan 2015
Case ReportsSevoflurane-Based General Anesthesia Induction via Nasopharyngeal Endotracheal Tube Prior to Definitive Airway Control in Pediatric Oral Tumors.
Airway-related tumors in pediatrics are always challenging for anesthesiologists. We present 2 cases of friable, bleeding large tumors in the oral cavity where conventional methods of securing the airway were not possible. Induction of general anesthesia could potentially lead to complete airway collapse and catastrophic obstruction in such cases. ⋯ This allowed us to bypass the anatomical obstruction and induce anesthesia using sevoflurane in high-flow oxygen. By the described technique, we were able to maintain and assist the spontaneous breathing of the child as well. We also highlight limitations of the use of a conventional nasopharyngeal airway in such situations.