Anesthesia & pain control in dentistry
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Arterial oxygen saturation (SaO2) was monitored postoperatively with pulse oximetry in 80 dental patients receiving nitrous oxide and oxygen. These patients were divided into four equal groups, three of which received nitrous oxide (N2O) and oxygen (O2) in ratios of 20:80, 40:60, and 60:40, respectively. The fourth group received 100% O2 and served as the control. ⋯ One patient in the 40% N2O group experienced an SaO2 of less than 90%, but no patient experienced clinically significant hypoxia. In the 40% and 60% N2O groups, the percent change of SaO2 from the baseline was greater, and the SaO2 returned to baseline slower. The difference in mean SaO2 between smokers and nonsmokers was greater in the 40% N2O group.
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Anesth Pain Control Dent · Jan 1993
Prevention of anaphylactic-anaphylactoid reactions to anesthetics in high-risk allergic patients.
To confirm the role of preventive procedures in high-risk allergic patients, immunological tests in vivo for anesthetics were carried out in 251 atopic patients. The 6-month follow-up showed a complete absence of adverse reactions during the clinical use of hypnotic and muscle relaxant drugs. In the case of local anesthetics, five adverse reactions were observed after dental treatment--four were related to a psychogenic mechanism, and one could not be clearly linked to the local anesthetic. It is possible to confirm that the use of a tested drug that yields negative results has a lower probability of inducing anaphylactic-anaphylactoid reactions during anesthesia.
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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.
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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.
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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.