scholarly journals Anesthetic Management of a Patient With a History of Rhabdomyolysis for Dental Treatment

2017 ◽  
Vol 64 (4) ◽  
pp. 251-252
Author(s):  
Hitomi Terasaki ◽  
Shinichi Ito
Keyword(s):  
Nitrous Oxide ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Fluid Management ◽  
Volatile Anesthetics ◽  
Electrolyte Balance ◽  
Rocuronium Bromide ◽  
History Of ◽  
Thiamylal Sodium

When general anesthesia is administered for patients considered at high risk for rhabdomyolysis, appropriate precautions are warranted. The use of suitable anesthetics, with attention to intravenous fluid management, electrolyte balance, respiration, and metabolism, should be addressed. We performed general anesthesia for dental treatment and biopsy for fibrous hyperplasia of the buccal mucosa in a patient with a history of rhabdomyolysis. We utilized thiamylal sodium, midazolam, rocuronium bromide, nitrous oxide, fentanyl, and remifentanil without using volatile anesthetics and propofol for this case. No complications of rhabdomyolysis were noted.

scholarly journals Anesthetic Management by Laryngeal Mask Airway in a Patient With a History of Difficult Intubation Resulting in Dental Injuries

2015 ◽  
Vol 62 (1) ◽  
pp. 20-21 ◽  
Author(s):  
Yoshinao Asahi ◽  
Ryosuke Fujii ◽  
Naoko Usui ◽  
Hajime Kagamiuchi ◽  
Shiro Omichi ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Difficult Intubation ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Laryngeal Mask ◽  
Respiratory Problems ◽  
History Of ◽  
Disabled Patients ◽  
Dental Injuries

Abstract 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.

scholarly journals Special Care Dentistry in a Patient with Prader–Willi Syndrome through the Use of Atraumatic Restorative Treatment under General Anesthesia

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Caio Vinícius Gonçalves Roman-Torres ◽  
Sérgio Takashi Kussaba ◽  
Yasmin Comoti Vita Bantim ◽  
Roberta de Barros Antunes Almeida de Oliveira
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Atraumatic Restorative Treatment ◽  
Prader Willi Syndrome ◽  
Genetic Origin ◽  
Restorative Treatment ◽  
Single Section ◽  
History Of ◽  
Grade Ii

Prader–Willi syndrome described in 1956 has a genetic origin, affecting both genders, varying in presence and intensity from individual to individual. A precocious diagnosis, before the manifestation of symptoms, has brought some improvement in the quality of life of the carriers in the last years. The objective of this case report was to describe the treatment realized in a 3-year-old boy who presented grade II obesity, difficulty of locomotion, hypotonia, and history of cardiopathy. A dental treatment under general anesthesia was defined, allowing an oral adequation in a single section, in which it was planned the extraction of the element 74 and atraumatic restorative treatment (ART) technique in the other teeth. The precocious intervention in this 3-year-old patient by the therapy realized with ART under general anesthesia was done with success, avoiding unnecessary extractions, preserving dental elements, and maintaining the oral cavity in adequate function.

scholarly journals Repeated General Anesthesia in a Patient With Noonan Syndrome

2015 ◽  
Vol 62 (2) ◽  
pp. 71-73 ◽  
Author(s):  
Yoshinao Asahi ◽  
Ryosuke Fujii ◽  
Naoko Usui ◽  
Hajime Kagamiuchi ◽  
Shiro Omichi ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Noonan Syndrome ◽  
Congenital Heart ◽  
Dental Treatment ◽  
Heart Diseases ◽  
Anesthetic Management ◽  
Nasotracheal Intubation ◽  
Suction Catheter ◽  
Congenital Heart Diseases ◽  
Autosomal Dominant Disorder

Abstract Noonan syndrome (NS) is an autosomal dominant disorder characterized by facial anomalies, short stature, chest deformity, congenital heart diseases, and other comorbidities. The challenges faced during anesthetic management of patients with NS could be due to congenital heart diseases, hemostatic disorders, and airway anomalies. Here we describe dental treatment under general anesthesia performed for a 28-year-old man with NS. He had characteristic features of NS along with mild pulmonary valve stenosis. Dental treatment under general anesthesia was performed successfully on 13 occasions with nasotracheal intubation under curve-tipped suction catheter guidance or insertion of a reinforced laryngeal mask airway. This case suggests that for patients with NS, who might present several challenges, dental anesthesiologists should consider the extent of the patient's disorders to enable them to perform dental treatment safely under general anesthesia.

scholarly journals Anesthetic Management of a Patient With Systemic Sclerosis and Microstomia

2020 ◽  
Vol 67 (1) ◽  
pp. 28-34
Author(s):  
Yoshiki Shionoya ◽  
Hatsuko Kamiga ◽  
Gentarou Tsujimoto ◽  
Eishi Nakamura ◽  
Kiminari Nakamura ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Respiratory Depression ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Moderate Sedation ◽  
Emergency Airway ◽  
Analgesic Effects ◽  
Anesthetic Agents ◽  
History Of ◽  
Skin Blood Vessels

Systemic sclerosis (SSc) is an autoimmune disease that can cause fibrosis in vital organs, often resulting in damage to the skin, blood vessels, gastrointestinal system, lungs, heart, and/or kidneys. Patients with SSc are also likely to develop microstomia, which can render dental treatment difficult and painful, thereby necessitating advanced anesthetic management. This is a case report of a 61-year-old woman with a history of SSc with microstomia, interstitial pneumonia, and gastroesophageal reflux disease in whom intravenous moderate sedation was performed using a combination of dexmedetomidine and ketamine for dental extractions. Both anesthetic agents are known to have analgesic effects while minimizing respiratory depression. Consequently, the increased discomfort caused by opening the patient's mouth and stretching the buccal mucosa was sufficiently managed, permitting an increase in maximum interincisal opening and completion of treatment without complications. Patients with SSc present with serious comorbidities that can negatively impact anesthetic management, so the implementation of an anesthetic plan that takes such risks into account is required. Furthermore, emergency airway management is likely to be difficult in patients with microstomia. For intravenous moderate sedation, combined use of dexmedetomidine and ketamine, which have analgesic effects while minimizing respiratory depression, may be particularly effective in patients with SSc and microstomia.

Comparative analysis of oral cavity sanation in children under general anesthesia and inhalation anesthesia with nitrogen oxide

2021 ◽  
pp. 36-38
Author(s):  
S. V. Proskokova ◽  
N. M. Khosrovyan ◽  
D. A. Eremin ◽  
G. S. Kabisova ◽  
N. G. Meskhiya ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Comparative Analysis ◽  
Oral Cavity ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Inhalation Anesthesia ◽  
Anesthesia Group ◽  
Number Of Visits ◽  
Sedation Group ◽  
Endotracheal Anesthesia

The aim of this study was to carry out a comparative analysis of the volume of dental intervention under conditions of combined endotracheal anesthesia and inhalation anesthesia of nitrous oxide in pediatric dentistry.Materials and methods. Within the framework of this study, the results of oral cavity sanitation were analyzed in 300 patients aged 2 to 5 years. The median age was 3.7 years. The participants were divided into 2 equal samples: 150 patients underwent sanitation under general anesthesia (anesthesia group), 150 under conditions of inhalation anesthesia of nitrous oxide (sedation group). In the sedation group, there were 83 (55.3%) boys and 67 (44.7%) girls, in the anesthesia group – 89 participants (59.3%) were male, and 61 (40.7%) were female. The patients included in this study had comparable dental status. Also, when performing dental interventions in both groups, according to indications, local anesthesia was performed: children under 4 years old – lidocaine, children over 4 years old – articaine.Results. Based on the results of the analysis of the data obtained, it was found that the number of visits required for full-fledged dental treatment was statistically significantly lower in the anesthesia group compared to the sedation group: thus, all patients who underwent combined endotracheal anesthesia required only one visit to the clinic for necessary treatment. But it was also found that the total time of dental treatment differed depending on the anesthetic aid used: in the anesthesia group, it usually took from 1 to 2 hours (in 98% of patients), during this time a complete sanitation of the oral cavity was carried out, and in the sedation group varied more widely, with half of the patients in the range from 30 minutes to 1 hour (14% and 36.7% of children, respectively), but the number of visits for complete oral cavity sanitation increased to 8.Conclusions. In the present work, it was revealed that dental treatment under general anesthesia in children was more effective than the same treatment under conditions of inhalation anesthesia of nitrous oxide with preserved consciousness. The use of combined endotracheal anesthesia allows to reduce the number of visits to the clinic and avoid refusals from further dental treatment. General anesthesia was also more effective than sedation in terms of the number of cured teeth with caries, chronic pulpitis and extracted teeth. Nitrous oxide inhalation anesthesia provides partial retention of consciousness, is more manageable and better tolerated by children.

scholarly journals Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Galeotti ◽  
Annelyse Garret Bernardin ◽  
Vincenzo D’Antò ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Tina Gentile ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Adverse Effects ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Young Patients ◽  
Dental Patients ◽  
Dental Procedures ◽  
Significant Difference ◽  
Disabled Patients

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment.Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

Absence of Bronchodilation during Desflurane Anesthesia

2000 ◽  
Vol 93 (2) ◽  
pp. 404-408 ◽  
Author(s):  
Mitchell J. Goff ◽  
Shahbaz R. Arain ◽  
David J. Ficke ◽  
Toni D. Uhrich ◽  
Thomas J. Ebert
Keyword(s):  
General Anesthesia ◽  
Elective Surgery ◽  
Volatile Anesthetics ◽  
Smoking History ◽  
Respiratory Resistance ◽  
Volatile Anesthesia ◽  
History Of ◽  
Respiratory System Resistance ◽  
American Society ◽  
American Society Of Anesthesiologists

Background Bronchospasm is a potential complication in anyone undergoing general anesthesia. Because volatile anesthetics relax bronchial smooth muscle, the effects of two newer volatile anesthetics, desflurane and sevoflurane, on respiratory resistance were evaluated. The authors hypothesized that desflurane would have greater bronchodilating effects because of its ability to increase sympathetic nervous system activity. Methods Informed consent was obtained from patients undergoing elective surgery with general anesthesia. We recorded airway flow and pressure after thiopental induction and tracheal intubation (baseline) and for 10 min after beginning volatile anesthesia ( approximately 1 minimum alveolar concentration inspired). Respiratory system resistance was determined using the isovolume technique. Results Fifty subjects were randomized to receive sevoflurane (n = 20), desflurane (n = 20), or thiopental infusion (n = 10, 0.25 mg. kg-1. h-1). There were no differences between groups for age, height, weight, smoking history, and American Society of Anesthesiologists physical class. On average, sevoflurane reduced respiratory resistance 15% below baseline, whereas both desflurane (+5%) and thiopental (+10%) did not decrease respiratory resistance. The respiratory resistance changes did not differ in patients with and without a history of smoking during sevoflurane or thiopental. In contrast, administration of desflurane to smokers resulted in the greatest increase in respiratory resistance. Conclusions Sevoflurane causes moderate bronchodilation that is not observed with desflurane or sodium thiopental. The bronchoconstriction produced by desflurane was primarily noted in patients who currently smoked. (Key words: Bronchospasm; respiratory resistance; volatile anesthetics.)

Women Emerge from General Anesthesia with Propofol/Alfentanil/Nitrous Oxide Faster than Men 

1999 ◽  
Vol 90 (5) ◽  
pp. 1283-1287 ◽  
Author(s):  
Tong J. Gan ◽  
Peter S. Glass ◽  
Jeff Sigl ◽  
Peter Sebel ◽  
Fredrick Payne ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
General Anesthesia ◽  
Bispectral Index ◽  
Anesthetic Management ◽  
Important Variable ◽  
Significant Independent Predictor ◽  
Verbal Command ◽  
Anesthetic Drugs ◽  
Recovery Times ◽  
Eye Opening

Background Recovery from general anesthesia is governed by pharmacodynamic and pharmacokinetic factors. Gender has not previously been recognized as a factor influencing the time to emergence from general anesthesia. Methods This multicenter study was originally designed to measure the effects of the bispectral index on intraoperative anesthetic management and patient recovery. We compared the wake-up and recovery times of 274 adults after propofol/alfentanil/nitrous oxide anesthesia. Patients were randomly assigned to have the titration of propofol performed with or without the use of bispectral index monitoring. Specific guidelines were given for the titration of drugs. The aim in all cases was to provide a safe anesthetic with the fastest possible recovery. Results There was a significant reduction in propofol dose, time to eye opening, and response to verbal command when the anesthetic was titrated using the bispectral index. Unexpectedly, gender proved to be a highly significant independent predictor for recovery time. Women woke significantly faster than men: the time from end of anesthesia to eye opening was 7.05 versus 11.22 min, P < 0.05, and response to verbal command was 8.12 versus 11.67 min, P < 0.05. These differences were significant at all four study sites and in each treatment group. Men consistently had prolonged recovery times compared to women, P < 0.001. There was no difference in the dose of anesthetic used between gender. Conclusions Gender appears to be an important variable in recovery from general anesthesia. These findings may explain the increased reported incidence of awareness in women (three times more frequent) and support the need to include gender as a variable in pharmacokinetic and pharmacodynamic studies of anesthetic drugs.

scholarly journals Atrio-Ventricular Septal Defect in Pregnant Women, How to Deal with It : A Case Study

2018 ◽  
Vol 3 (2) ◽  
pp. 100
Author(s):  
Devie Caroline ◽  
Moh. Yogiarto
Keyword(s):  
Ventricular Septal Defect ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Septal Defect ◽  
Anesthetic Management ◽  
Mode Of Delivery ◽  
Fluid Management ◽  
Pulmonary Artery Hypertension ◽  
Team Approach ◽  
Partial Type

Pregnancy is not always well tolerated in women with congenital heart disease (CHD) such as atrio-ventricular septal defect (AVSD), predominantly due to heart failure deterioration and increasing pulmonary hypertension (PH). Managements of those patients are challenging, especially during third trimester and after delivery care. Decision about time of termination, mode of delivery and anesthetic management are also debatable. In this article we report two similarcases of pregnant women with AVSD and severe PH. The frst patient was 27 years old, 28-29 weeks pregnant came with shortness of breath. She had history of miscarriage once. Based on her transthoracal echocardiography, she was diagnosed with AVSD partial type (primum ASD) with severe PH and then treated with intravenous furosemide, oral beraprost and oral sildenafl. The second patient was 27 years old 30-31 weeks pregnant with shortness of breathand appeared cyanotic. She delivered her frst child spontaneously without any symptoms. Based on her transthoracal echocardiography she was diagnosed with AVSD transitional type (large primum ASD with small inlet VSD) and Eisenmenger syndrome. She was treated with intravenous furosemide and oral beraprost. Those two patients underwent planned C-section under general anesthesia, both babies were survived but the patient did not survived severaldays after the procedure due to PH crisis. Until now, management PH associated with CHD in pregnant women is complex. Fluid management and pulmonary artery hypertension (PAH)- targeted therapies are important. Mode of delivery on this cases is also remain debated. Some studies stated planned C-section might be a better choice and combination epidural and lowdose spinal anesthesia might be better than general anesthesia. At the end, when a woman with CHD and PH chooses to continue pregnancy, multidisciplinary team approach is crucial to achieve good outcomes.

Neuraxial Anesthesia and Analgesia for Pediatric Surgery

2018 ◽  
Author(s):  
Heather Ballard ◽  
Ravi Shah ◽  
Santhanam Suresh
Keyword(s):  
General Anesthesia ◽  
Postoperative Analgesia ◽  
Pediatric Surgery ◽  
Volatile Anesthetics ◽  
Neuraxial Anesthesia ◽  
Single Shot ◽  
Long Term Effects ◽  
History Of ◽  
History Of Use ◽  
Upper Abdomen

Neuraxial anesthesia has a long history of use in pediatric surgery. It can be used as a sole anesthetic or as an adjunct to sedation or general anesthesia. Neonatal spinals and single-shot caudal anesthesia are effective for lower abdominal, urological, and lower extremity orthopedic surgeries. When a thoracic, lumbar, or caudal epidural catheter is utilized, postoperative analgesia can also be provided to surgeries involving the chest and upper abdomen. There is renewed interest in neuraxial anesthesia due to concerns of the effect of volatile anesthetics on the developing brain. Though research studies on the long-term effects of volatile anesthetics are still inconclusive, neuraxial anesthesia has been shown to provide effective surgical anesthesia and postoperative analgesia. When used in combination with general anesthesia, it has the benefit of reducing the amount of sedatives required. The use of ultrasound may increase success and margin of safety.

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