scholarly journals Use of Local Anesthesia During Dental Rehabilitation With General Anesthesia: A Survey of Dentist Anesthesiologists

2014 ◽  
Vol 61 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Janice A. Townsend ◽  
Joseph L. Hagan ◽  
Megann Smiley
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Vital Signs ◽  
Rare Exception ◽  
Dental Rehabilitation ◽  
American Society ◽  
E Mail ◽  
Current Practices

AbstractThe purpose of this study was to document current practices of dentist anesthesiologists who are members of the American Society of Dentist Anesthesiologists regarding the supplemental use of local anesthesia for children undergoing dental rehabilitation under general anesthesia. A survey was administered via e-mail to the membership of the American Society of Dentist Anesthesiologists to document the use of local anesthetic during dental rehabilitations under general anesthesia and the rationale for its use. Seventy-seven (42.1%) of the 183 members responded to this survey. The majority of dentist anesthesiologists prefer use of local anesthetic during general anesthesia for dental rehabilitation almost always or sometimes (90%, 63/70) and 40% (28/70) prefer its use with rare exception. For dentist anesthesiologists who prefer the administration of local anesthesia almost always, they listed the following factors as very important: “stabilization of vital signs/decreased depth of general anesthesia” (92.9%, 26/28) and “improved patient recovery” (82.1%, 23/28). There was a significant association between the type of practice and who determines whether or not local anesthesia is administered during cases. The majority of respondents favor the use of local anesthesia during dental rehabilitation under general anesthesia.

scholarly journals The Effect of Local Anesthetic on Quality of Recovery Characteristics Following Dental Rehabilitation Under General Anesthesia in Children

2009 ◽  
Vol 56 (4) ◽  
pp. 115-122 ◽  
Author(s):  
Janice A. Townsend ◽  
Steven Ganzberg ◽  
S. Thikkurissy
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Postanesthesia Care Unit ◽  
Ketorolac Tromethamine ◽  
Pain Behaviors ◽  
Quality Of Recovery ◽  
Dental Rehabilitation ◽  
Intravenous Ketorolac

Abstract This study is a randomized, prospective, double-blind study to evaluate the effects of the combination of local anesthetics and an intravenous nonsteroidal anti-inflammatory drug (NSAID) vs NSAID alone on quality of recovery following dental rehabilitation under general anesthesia (GA). Twenty-seven healthy children aged 3–5.5 years underwent dental rehabilitation under GA. Fifteen children in the experimental group received oral infiltration of local anesthetic in addition to intravenous ketorolac tromethamine, while 12 children in the control group received intravenous ketorolac tromethamine alone for postoperative pain management. Pain behaviors were evaluated immediately postoperatively using a FLACC scale and 4 hours postoperatively by self-report using various scales. Parents reported perception of child pain and comfort and any occurrences of postoperative cheek biting. The use of intraoral infiltration local anesthesia for complete dental rehabilitation under general anesthesia for children aged 3–5.5 years did not result in improved pain behaviors in the postanesthesia care unit (PACU), nor did it result in improved pain behaviors 4–6 hours postoperatively as measured by the FLACC scale, FACES scale, and subjective reports of parents or a PACU nurse. Those children receiving local anesthesia had a higher incidence of negative symptoms related to local anesthetic administration, including a higher incidence of lip and cheek biting, which was of clinical importance, but not statistically significant. Infiltration of local anesthetic for dental rehabilitation under general anesthesia did not improve quality of recovery in children aged 3–5.5 years.

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Breast Feeding ◽  
Local Anesthetic ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Cesarean Section Delivery ◽  
Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

scholarly journals Oxycodone for prevention of etomidate-induced myoclonus: a randomized double-blind controlled trial

2018 ◽  
Vol 46 (5) ◽  
pp. 1839-1845
Author(s):  
Wei Wang ◽  
Jie Lv ◽  
Qi Wang ◽  
Lei Yang ◽  
Wanyou Yu
Keyword(s):  
General Anesthesia ◽  
Intravenous Injection ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physical Status ◽  
Double Blind ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0.3 mg/kg of etomidate (n = 54). The incidence and severity of myoclonus was evaluated 2 minutes after etomidate administration. The patients’ vital signs, coughing, nausea, dizziness, and other related adverse reactions were also recorded. Results The incidence of myoclonus was significantly lower in Group O (0.0%) than in Group F (31.5%) and Group S (72.2%); the intensity was also lowest in Group O. All patients in each group had stable cardiovascular profiles. Conclusions Intravenous injection of 0.1 mg/kg of oxycodone 2 minutes prior to etomidate is more effective in preventing etomidate-induced myoclonus during general anesthesia than is 1 µg/kg of fentanyl.

scholarly journals Examination of cardiovascular function variables in tooth extraction under local anesthesia

2006 ◽  
Vol 63 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Mirjana Zivotic-Vanovic ◽  
Marjan Marjanovic
Keyword(s):  
Blood Pressure ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Tooth Extraction ◽  
System Disease ◽  
Arterial Blood ◽  
Cardiovascular Patients ◽  
Anesthetic Solution ◽  
American Society ◽  
Healthy Persons

Background/Aim. Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline) in healthy persons, and in the patients with a certain cardiovascular system disease. The aim of this study was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. Methods. The examinees were divided into the group with cardiovascular diseases (CV, n = 57) of II and III type, according to the American Society of Anesthesiologists (ASA) qualification, and healthy persons (H, n = 55). Both groups were randomly divided into two subgroups: CVa and Ha - where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1 : 100 000 adrenaline); CVb and Hb - where the anesthetic solution was without the vasoconstrictor (3% lidocaine). During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc), systolic (TAs) and diastolic arterial blood pressure (TAd) and ECG were registered. Results. The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05) from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05). The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. Conclusion. This research shoved that tooth extraction under local anesthesia did not cause complications in cardiovascular patients who were in II or III ASA qualification group, regardless the presence of a vasoconstrictor in the local anesthetic solution.

scholarly journals Bispectral Index Monitoring (BIS) as a Guide for Intubation Without Neuromuscular Blockade in Office-Based Pediatric General Anesthesia: A Retrospective Evaluation

2011 ◽  
Vol 58 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Zakaria S Messieha ◽  
Samuel Guirguis ◽  
Sherine Hanna
Keyword(s):  
General Anesthesia ◽  
Neuromuscular Blockade ◽  
Bispectral Index ◽  
Index System ◽  
Muscle Relaxation ◽  
Pediatric Anesthesia ◽  
Vital Signs ◽  
Mean Value ◽  
American Society ◽  
End Tidal

The Bispectral Index System is a useful guide for timing of adequate intubation conditions in office-based pediatric general anesthesia without neuromuscular blockade. As the number of cases in the office-based setting increase, many clinicians opt to intubate patients without neuromuscular blockade to avoid airway complications associated with skeletal muscle relaxation. Conventionally, this technique is conducted using the traditional monitoring criteria of vital signs, end-tidal inhalation agents, as well as anesthesiologist timing and knowledge of the pharmacodynamics of the anesthetic agent to help determine the proper depth of anesthesia for adequate intubating conditions. This study retrospectively assesses the use of the Bispectral Index System (BIS) as a guide for timing of nonparalytic tracheal intubation in pediatric office-based general anesthesia. Anesthetic records for 168 children, American Society of Anesthesiology physical status I and II, and ranging in age from 18 months to 17 years were retrospectively analyzed. Intubation outcomes were based on 6 preset criteria to reflect the adequacy of the technique. The mean BIS value during the time of intubation was 34.7. There were no complications encountered. A BIS mean value of 34.7 provided adequate intubation conditions without muscle relaxation in office-based pediatric anesthesia without complications.

scholarly journals Methemoglobin Levels in Generally Anesthetized Pediatric Dental Patients Receiving Prilocaine Versus Lidocaine

2013 ◽  
Vol 60 (3) ◽  
pp. 99-108 ◽  
Author(s):  
Lauren L. Gutenberg ◽  
Jung-Wei Chen ◽  
Larry Trapp
Keyword(s):  
General Anesthesia ◽  
Local Anesthetic ◽  
Dental Treatment ◽  
Pearson Correlation ◽  
Dental Patients ◽  
Time To Peak ◽  
Dental Rehabilitation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3–6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1 : 100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P &lt; .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

scholarly journals Severe Bradycardia Possibly due to a Local Anesthetic Oral Mucosal Injection during General Anesthesia

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Kenichi Satoh ◽  
Ayako Ohashi ◽  
Miho Kumagai ◽  
Hideki Hoshi ◽  
Kousei Otaka ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Parasympathetic Activity ◽  
Dental Surgery ◽  
Systemic Complications ◽  
Injection Needle ◽  
Severe Bradycardia

Local anesthesia may induce systemic complications leading to parasympathetic activity leading to bradycardia and hypotension. We report a case of a 50-year-old man undergoing dental surgery under general anesthesia who experienced severe bradycardia and hypotension after local anesthesia infiltration. Concerns regarding the utilization of a relatively large lumen injection needle for local anesthesia during general anesthesia are discussed.

scholarly journals Oral and maxillofacial surgery and dental rehabilitation under sedation and general anesthesia

2019 ◽  
Vol 9 (3) ◽  
pp. 111-118
Author(s):  
Utku Nezih Yilmaz
Keyword(s):  
General Anesthesia ◽  
Deep Sedation ◽  
Systemic Disease ◽  
Maxillofacial Surgery ◽  
Patient Characteristics ◽  
Oral And Maxillofacial Surgery ◽  
Dental Procedures ◽  
Dental Rehabilitation ◽  
Native Speakers Of English ◽  
American Society

Aim: The aim of this study was to retrospectively analyze dental procedures performed under general anesthesia (GA) or deep sedation at Dicle University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery from May 2013 to May 2018. Methodology: This study included 182 patients treated under GA and sedation from May 2013 to May 2018. The records of these cases were reviewed retrospectively in terms of patient demographic characteristics, medical history, dental procedures, and treatment duration. Children and adults were compared in terms of general anesthesia (GA) and deep sedation (SD). Results: Of 182 patients (age range: 1–61 years), 63 were had an American Society of Anesthesiology (ASA) status of I (completely healthy) and 119 were of ASA II status (mild systemic disease). A total of 143 patients (60 children and 83 adults) underwent GA, while 39 patients (18 children and 21 adults) underwent deep sedation. The mean duration of the procedures performed under GA and deep sedation was 75 and 40 min, respectively. Following the procedure, 103 patients were discharged on the same day, whereas 78 patients required postoperative care and were discharged on the following day. The rnumber of patients exposed to GA and SD were 143 and 39, respectively. The number of child patients exposed to GA waas 60, while that of adults was 83. Conclusions: The frequency of dental rehabilitation under GA or sedation is increasing. Patients who cannot undergo dental procedures under local anesthesia can be treated under preferably GA, as long as the indications, patient characteristics, and anesthesia plan are carefully considered. Data suggest that adults are more suitable for GA than children. However, due to the risks associated with GA, anesthetic procedures should only be performed by experienced anesthetists under operating room conditions.   How to cite this article: Yılmaz UN. Oral and maxillofacial surgery and dental rehabilitation under sedation and general anesthesia. Int Dent Res 2019;9(3):111-8.   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

scholarly journals Comparative Study of Ondansetron Versus Dexamethasone in the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia

2021 ◽  
Vol 4 (1) ◽  
pp. 81-84
Author(s):  
Sundar Prasad Hyoju
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Vital Signs ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Double Blind ◽  
American Society ◽  
American Society Of Anesthesiologists

Introduction: Postoperative nausea and vomiting (PONV) have been termed as the “big little problem” for anesthesiology during laparoscopic surgery. Pain and postoperative nausea and vomiting are the most common causes of morbidity after anesthesia and surgery. We aimed to evaluate the effects of Ondansetron and Dexamethasone in preventing postoperative nausea and vomiting following laparoscopic cholecystectomy, as well as to note any pharmacological side effects that occurred after their usage. Methods: In this prospective, randomized, double blind controlled study, trial was done after approval from the IRB and trail registry, 60 female patients of American Society of Anesthesiologists physical status I and II, aged 18 to 65 years, weighing 50-60 kg, and standing 150 to 160 cm, were given institutional ethical committee clearance and written informed consent before undergoing laparoscopic cholecystectomy (duration 90 minutes) under general anesthesia. Patients arriving in the operating room were sorted into two groups of 30 patients each. All patients were monitored after surgery, documenting vital signs and any difficulties that arose. For the first 12 hours after surgery, all bouts of PONV (nausea, vomiting, and retching) were documented. Each patient's data was gathered and tallied. Results: The patients in the study group were similar in age, weight, height, ASA status, and operation duration (p 0.05), and there was no significant statistical difference between the data gathered throughout the study Conclusions: Ondansetron is just as effective as Dexamethasone at lowering nausea and vomiting after laparoscopic cholecystectomy, and it comes with less adverse effects.

scholarly journals Analysis  of  Percutaneous Kyphoplasty under Different Types of Anesthesia for the Treatment of Multiple Osteoporotic Vertebral Fractures

2020 ◽  
Author(s):  
Shuai Zhang ◽  
Shuang Xu ◽  
Jin Yang ◽  
Song Wang ◽  
Qing Wang
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Operative Time ◽  
Vital Signs ◽  
General Situation ◽  
General Anesthesia Group ◽  
Vas Score ◽  
Anesthesia Group ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background Surgeons believe that the advantage of PKP under local anesthesia for the treatment of OVF in preventing interference with the general situation of elderly patients with multiple organ dysfunction. Surgeons can directly assess whether a spinal cord nerve injury occurs while the patient is awake. However, when patients with m-OVFs receive local anesthesia, fluoroscopy time often has to be increased,the operative time has to be extended, or the operation has to be terminated because of body posture-related discomfort, the toxic reaction of bone cement, and abrupt fluctuation of vital signs. No relevant study has thus far been conducted on the choice of the type of anesthesia to administer to patients undergoing PKP for m-OVFs.This study aimed to determine which of the two types of anesthesia is more suitable for PKP for m-OVFs. Methods A retrospective study was conducted for 159 patients who underwent PKP for m-OVFs from January 2016 to January 2020; 81 patients underwent PKP under general anesthesia(Group G), and 78 patients underwent PKP under local anesthesia(Group L). Clinical and adverse events were compared between the two groups. Results No difference in baseline information was found between the two groups. The intraoperative mean arterial pressure, average heart rate, average fluoroscopy times of each vertebral body, and operative time were less in Group G than in Group L. The VAS score was significantly lower than that before operation. The AVH, MVH, and the KA were significantly improved in both groups postoperation. The improvement in VAS score, AVH, MVH, and KA in Group G were higher than those in Group L. No significant difference in the incidence of complications was observed between the two groups. Conclusion PKP under either general anesthesia or local anesthesia was reliable. Compared with PKP under local anesthesia, that under general anesthesia could more reliably maintain the stability of vital signs, alleviate preoperative pain in patients, and attain a better orthopedic effect. Moreover, the latter does not increase the complications of patients with m-OVFs. However, the high medical expense of PKP under general anesthesia is a factor to consider when choosing the type of anesthesia.

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