scholarly journals Hemodynamic Impact of Drug Interactions With Epinephrine and Antipsychotics Under General Anesthesia With Propofol

2021 ◽  
Vol 68 (3) ◽  
pp. 141-145
Author(s):  
Yoshiki Shionoya ◽  
Eishi Nakamura ◽  
Gentaro Tsujimoto ◽  
Takayuki Koyata ◽  
Asako Yasuda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Antipsychotic Drugs ◽  
Dental Treatment ◽  
Hemodynamic Parameters ◽  
Dental Procedures ◽  
Dunnett Test ◽  
Baseline Systolic Blood Pressure ◽  
Relevant Dose ◽  
Dental Setting

Objective: Antipsychotic drugs exhibit α-1 adrenergic receptor-blocking activity. When epinephrine and antipsychotic drugs are administered in combination, β-2 adrenergic effects are thought to predominate and induce hypotension. This study aimed to assess hemodynamic parameters in patients regularly taking antipsychotics who were administered epinephrine-containing lidocaine under general anesthesia in a dental setting. Methods: Thirty patients taking typical and/or atypical antipsychotics and scheduled for dental procedures under general anesthesia were enrolled. Five minutes after tracheal intubation, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and percutaneous oxygen saturation (SpO2) measurements were taken. The SBP, DBP, HR, and SpO2 measurements were repeated 2, 4, 6, 8, and 10 minutes after the injection of 1.8 mL of 2% lidocaine (36 mg) with 1:80,000 epinephrine (22.5 mcg) via buccal infiltration. Results: Differences between the baseline measurements and those of each time point were analyzed using Dunnett test, and no statistically significant changes were observed. Conclusions: Our findings demonstrate that the use of epinephrine at a clinically relevant dose of 22.5 mcg for dental treatment under general anesthesia is unlikely to affect the hemodynamic parameters of patients taking antipsychotic medications.

Hemodynamic changes in regular antipsychotic users after adrenaline-containing lidocaine injection under general anesthesia: a prospective study

2020 ◽  
Author(s):  
Yoshiki Shionoya ◽  
Eishi Nakamura ◽  
Gentaro Tsujimoto ◽  
Takayuki Koyata ◽  
Asako Yasuda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Dental Treatment ◽  
General Anesthetics ◽  
Dental Procedure ◽  
Hemodynamic Changes ◽  
Lidocaine Injection ◽  
A Prospective Study ◽  
Β Adrenergic Receptors ◽  
Circulation Dynamics

Abstract Background: Local anesthetic containing adrenaline is commonly used in many operations to maintain hemostasis and prolong the duration of anesthesia. Antipsychotic drugs have an α-adrenergic receptor blocking action, and it is thought that β-adrenergic receptors predominate when adrenaline is administered in combination, thus inducing hypotension. Many general anesthetics have vasodilatory effects, and it is possible that blood pressure may decrease further if adrenaline-containing lidocaine is administered to antipsychotic users during anesthesia. This study aimed to assess the circulation dynamics in regular antipsychotics users administered adrenaline-containing lidocaine under general anesthesia in a dental procedure. Methods: Participants included 30 patients regularly using antipsychotics (butyrophenone, phenothiazine, and/or atypical antipsychotics) who were scheduled for dental treatment to be performed under general anesthesia. At five minutes after tracheal intubation, the systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and percutaneous oxygen saturation (SpO2) were measured as a baseline. SBP, DBP, HR, and SpO2 were measured 2, 4, 6, 8, and 10 minutes after the injection of 1.8 mL of 2% lidocaine (32 mg) with 1:80,000 adrenaline (22.5 μg) into the oral cavity. Differences in the SBP, DBP, HR, and SpO2 between baseline and at each time point were analyzed using Dunnett’s test.Results: No significant changes were observed in the SBP, DBP, HR, and SpO2 compared to baseline until ten minutes after the administration of adrenaline-containing lidocaine. No adverse events were observed up to one hour after the administration of adrenaline-containing lidocaine.Conclusions: This study demonstrated that adrenaline used at the usual dose for dental treatment under general anesthesia is unlikely to affect the circulation dynamics of regular antipsychotic users.

A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period

2018 ◽  
Vol 42 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Sreekanth Kumar Mallineni ◽  
Cynthia Kar Y Yiu
Keyword(s):  
Stainless Steel ◽  
General Anesthesia ◽  
Special Needs ◽  
Recovery Time ◽  
Dental Treatment ◽  
Composite Restorations ◽  
Dental Procedures ◽  
Significant Difference ◽  
Operative Recovery ◽  
Amalgam Restorations

Objective: The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Study design: Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (<6years, 6–12 years, >12 years). One-way ANOVA was used to evaluate the effect of “age group” on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. Results: A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (p<0.05). No significant difference in post-operative recovery time was observed among the three age groups (p>0.05). The <6 years group received significantly less preventive, but more restorative procedures (p<0.05). Significantly fewer extractions were performed in the 6–12 years group (p<0.05). The use of composite restorations was significantly higher in the <6 years group; while amalgam restorations were more frequently used in the >12 years group (P<0.05). Stainless steel crowns were more frequently employed in SNP under 12 years of age (p<0.05). Intra-examiner reliability was good (k=0.94). Conclusions: Most of the dental procedures performed under GA on SNP were restorative procedures. For children less than 6 years of age, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

Clinical Dentistry -The Pandemic’s Late Effects

2021 ◽  
Author(s):  
Mithra N. Hegde
Keyword(s):  
Oral Health ◽  
Dental Treatment ◽  
Medical Attention ◽  
Infected Person ◽  
Infection Transmission ◽  
Dental Procedures ◽  
Dental Office ◽  
The World ◽  
Dental Setting ◽  
Closed Environment

Coronavirus disease 2019 (covid-19) is the most recent HCID (highly contagious infectious diseases) pandemic to hit the world. The respiratory disease (sars-cov-2) has been shown to spread from symptomatic patients through droplets and aerosols. Because of the closed environment and the use of high and low-speed handpieces, ultrasonic scalers, infection spreads even more easily in a dental setting. During these times, our priority should be inward to protect ourselves as well as the patients who need medical attention. Various methods for controlling infection transmission from aerosol-generating dental procedures are recommended to accomplish this. In light of the effect of oral health on the seriousness of the Covid 19 pandemic, and to protect ourselves financially during this pandemic it is critical to explain patients that we dentists are using the most up-to-date approaches to keep them safe by reducing the risk of them contracting the virus from the dental office in order to maximise the number of outpatients. And it is important to treat every patient as a Covid -19 infected person and take the appropriate precautions to ensure our safety while rendering dental treatment.

Epidemiological profile of patients with disabilities undergoing dental treatment under general anesthesia

2021 ◽  
Vol 50 ◽  
Author(s):  
Cyntia Paula Oliveira de Souza LIMA ◽  
Graziane Ribeiro COUTO ◽  
Alina Lúcia de Oliveira BARROS ◽  
Gabriela Mancia de GUTIERREZ ◽  
Maria Teresa Botti Rodrigues SANTOS
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
The State ◽  
Radiographic Examination ◽  
Preventive Actions ◽  
Dental Procedures ◽  
Dental Intervention ◽  
Patients With Special Needs ◽  
Epidemiological Profile

Abstract Introduction General anesthesia is commonly used in the dental treatment of people with disabilities, anxious or difficult behavior, who need complex and/or extensive treatments. Objective The aim of this study was to evaluate the epidemiological profile of patients with disabilities undergoing dental treatment under general anesthesia by the team of the Dental Unit for Patients with Special Needs of the Federal University of Sergipe. Material and method Through the analysis of 371 dental records of patients assisted between August 2002 and March 2019. Result The analysis showed that 56.1% of patients were male, the most prevalent age group was 11-20 years, and the most frequent medical conditions were intellectual disability, followed by multiple disabilities. Relative to dental procedures, in 94.1% of the patients, it was observed that 4,056 dental extractions were performed and in 52.3% of patients, 1,156 restorations were performed. In 30.2% of patients, total multiple extractions were performed. Radiographic examination was performed in 51.8% of patients. As regards the origin of patients, 58.8% were from municipalities in the state, other than the capital. Return to the service for follow-up and prevention was observed in 38.5% of patients. Conclusion There is great need for early dental intervention, with specific preventive actions for this group of patients, focusing on those from interior regions of the state.

The Use of General Anesthesia in Pediatric Dental Care of Children at Multi-Dental Centers in Saudi Arabia

2008 ◽  
Vol 33 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Rania Ba'akdah ◽  
Najat Farsi ◽  
Abdulaziz Boker ◽  
Abdullah Al Mushayt
Keyword(s):  
Saudi Arabia ◽  
General Anesthesia ◽  
Dental Care ◽  
Dental Treatment ◽  
Medical Condition ◽  
Medical Status ◽  
Dental Procedures ◽  
The Mean ◽  
Admission Type ◽  
First Time

Objective: High caries reports in young Saudi children strongly suggest the need occasionally for general anesthesia to provide quality dental work. The purpose of this study was to investigate the characteristics of patients, dental procedures and hospital protocols for Pediatric Dental General Anesthesia (PDGA) procedure at multi-dental centers in Jeddah, Saudi Arabia. Study Design: Study sample included 90 children attending PDGA treatment at three governmental hospitals in Jeddah. Collected data included patient's demographics, medical condition, admission type, intra-operative protocols, and dental procedures.Results: Results showed the mean age of treated children was 5±2 years and the majority of them (93%)were treated for the first time under general anesthesia (GA). Long waiting duration for PDGA procedure was reported regardless of the patient age and medical status. Being very young with extensive caries was the major indication for GA (58%). Children mean preoperative fasting times were 10 ± 2 hours. Hospitals were significantly different in some protocols for PDGA procedures. Child behavior during GA induction was significantly related to child's age, premedication use, and hospital admission type. The mean number of treated teeth per child was 14±3.8 and the treatment mostly included restorations. Age was found to significantly affect the type of dental treatment, while gender and medical status did not. Conclusions: PDGA procedure is used mostly for young children with extensive dental caries. Children treated under GA received a comprehensive dental care in Saudi hospitals. Efforts should be directed to improve some of the existing hospitals protocols with PDGA procedure. The long waiting period for PDGA operation indicated the need to improve available facilities in the three hospitals.

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.

scholarly journals Second-Degree Atrioventricular Block Occurring After Tooth Extraction

2016 ◽  
Vol 63 (3) ◽  
pp. 156-159
Author(s):  
Takaaki Kamatani ◽  
Ayako Akizuki ◽  
Seiji Kondo ◽  
Tatsuo Shirota
Keyword(s):  
General Anesthesia ◽  
Atrioventricular Block ◽  
Dental Treatment ◽  
Vital Signs ◽  
Type I ◽  
Dental Procedures ◽  
Old Japanese ◽  
Wenckebach Phenomenon ◽  
Mandibular Third Molars ◽  
Second Degree

Although cardiac arrhythmias are occasionally associated with dental extractions and dental anesthesia, atrioventricular block is rarely seen during dental procedures. We report a rare case of type I second-degree atrioventricular block (Wenckebach phenomenon) occurring after bilateral extraction of impacted mandibular third molars under general anesthesia in a 16-year-old Japanese girl. Under consultation with a cardiovascular physician, we carefully monitored the patient's vital signs postoperatively, including blood pressure, oxygen saturation, and electrocardiogram, using a bedside monitor. Her postoperative course was uneventful. A 12-lead electrocardiogram the following day revealed no abnormality. In this case, we hypothesize that extubation of the nasotracheal tube or oral/pharyngeal suction might have triggered a vagal reflex that caused type I second-degree atrioventricular block. Our experience indicates that standard cardiovascular monitoring should be used for patients undergoing dental treatment under general anesthesia, even for young, healthy patients, to prevent and detect cardiovascular emergencies.

Outcomes of dental procedures performed on children under general anesthesia

2004 ◽  
Vol 27 (2) ◽  
pp. 181-183 ◽  
Author(s):  
Ali Al-Eheideb ◽  
Neal Herman
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Positive Outcome ◽  
High Rate ◽  
Definitive Treatment ◽  
Class Iii ◽  
Posterior Teeth ◽  
Composite Restorations ◽  
Anterior Teeth ◽  
Dental Procedures

The purpose of this study was to evaluate the integrity and longevity of restorative and pulpal procedures performed on primary teeth under general anesthesia (GA). Fifty-four children, who received comprehensive dental treatment under general anesthesia between 1993 and 1995, were included. The postoperative examination period ranged from 6 to 27 months. Children were examined and the quality of the restorations were recorded and evaluated. Behavior problems and inability to cooperate were the main reasons for treatment under GA. Results showed that restoration of posterior teeth with stainless steel crowns (SSC) were more successful (95.5%) when compared to amalgam or composite restorations (50%). In the anterior teeth, strip crowns had a success rate similar to that of Class III, IV and V composite resin materials. Pulpotomies showed an extremely high rate of success (97.1%), while sealants were retained 68.3% of the time. In conclusion, SSC are more likely to be successful and last longer than multisurface amalgam or composite restorations in children treated under general anesthesia. Definitive treatment is more likely to ensure a more positive outcome for children treated under general anesthesia due to less frequent complications from failed restorations or pulpal procedures.

Physiologic and Antinociceptive Effects of Intrathecal Resiniferatoxin in a Canine Bone Cancer Model

2005 ◽  
Vol 103 (5) ◽  
pp. 1052-1059 ◽  
Author(s):  
Dorothy Cimino Brown ◽  
Michael J. Iadarola ◽  
Sandra Z. Perkowski ◽  
Hardam Erin ◽  
Frances Shofer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cancer Pain ◽  
General Anesthesia ◽  
Mean Arterial Blood Pressure ◽  
Bone Cancer ◽  
Bone Cancer Pain ◽  
Hemodynamic Parameters ◽  
Arterial Blood ◽  
Canine Population

Background Resiniferatoxin is a potent capsaicin analog. Intrathecal administration leads to selective, prolonged opening of the transient receptor potential V1 ion channel, which is localized mainly to C-fiber primary afferent nociceptive sensory neurons. Following work in laboratory animals, the authors explored the use of intrathecal resiniferatoxin to control spontaneous bone cancer pain in companion (pet) dogs. Methods Normal canine population: Behavioral testing was performed to establish baseline paw withdrawal latency; subsequently, general anesthesia was induced and resiniferatoxin was administered intrathecally while hemodynamic parameters were recorded. Behavior testing was repeated for 12 days after administration of resiniferatoxin. Clinical canine population: Twenty companion dogs with bone cancer pain were recruited. The animal's baseline level of discomfort and analgesic use were recorded. Resiniferatoxin was administered intrathecally and hemodynamic parameters were monitored while the dogs were under general anesthesia. Dogs were reevaluated up to 14 weeks after resiniferatoxin administration. Results Normal canine population: In the first minutes after resiniferatoxin injection, there were significant (P < 0.05) increases in mean arterial blood pressure and heart rate from baseline. Two days after injection, limb withdrawal latencies increased to the point of cutoff in the dogs that received at least 1.2 microg/kg resiniferatoxin. Clinical canine population: From baseline, there were significant (P < 0.05) increases in mean arterial blood pressure and heart rate after resiniferatoxin injection. Comfort scores were significantly improved at 2, 6, 10, and 14 weeks after resiniferatoxin administration (P < 0.0001). There was decreased or discontinued use of supplemental analgesics in 67% of the dogs 2 weeks after resiniferatoxin administration. Conclusions Intrathecal resiniferatoxin elicits transient hemodynamic effects. In controls, a profound and sustained blockade of thermal stimuli is produced in a dose-dependent fashion. Similar administration in dogs with bone cancer produces a prolonged antinociceptive response.

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