• Title/Summary/Keyword: Anesthesia, Local

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Stress Reduction Protocol for Proper Local Anesthesia of Advanced Infected Teeth in Medically Compromised Patients -Review of Literature & Report of Cases- (전신질환자에서 과도한 감염치아부 국소마취시 스트레스 감소법 : 문헌적 고찰 및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Mo, Dong-Yub
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.1-9
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    • 2008
  • Common dental procedures (local anesthesia and dental treatment) are potentially stress-inducing in many patients, especially medically compromised patients. The body response to dental stress involves the cardiovascular system (an increase in cardiovascular workload), the respiratory organ and the endocrine system (change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given. This protocol is predicated on the belief that the prevention of or reduction of stress ought to begin before the start of an appointment, continue throughout treatment, and, if indicated, into the postoperative period. The authors used the stress reduction protocol in the care of local anesthesia infected teeth in medically compromised patients. The final prognosis was comfortable without any complications.

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Usefulness of Ultrasonography-Assisted Closed Reduction for Nasal Fracture under Local Anesthesia

  • Kim, Dae-Hyun;Kim, Kyung-Sik
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.151-153
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    • 2015
  • Closed reduction is the treatment of choice for most nasal bone fractures. In this technique, the nasal bone cannot be directly visualized, proper reduction is confirmed by palpation of the bony contour. This confirmation-via-palpation is in most cases too uncomfortable or painful for patients, and this is the reason why most closed reductions of nasal bone fractures are performed under general anesthesia. Recently, ultrasonography has been adopted as a useful diagnostic method and operative adjunct. In this report, we report the use of ultrasonography as a means to provide palpation-less confirmation of proper reduction, which in turn allows for nasal bone reduction under local anesthesia.

Recent advances in topical anesthesia

  • Lee, Hyo-Seol
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.237-244
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    • 2016
  • Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.

The surgical retrieval of a broken dental needle: A case report

  • Lee, Jiseon;Park, Min Woo;Kim, Min Keun;Kim, Soung Min;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.97-100
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    • 2015
  • One complication related to local anesthesia in the dental clinic is a broken needle. Although rare, a broken needle may be difficult to retrieve. Dental radiographs and 3D CT have been used in the past to confirm the location of a broken needle. We present the case of a broken needle, which was successfully removed using a careful, microscopic approach.

Transient facial paralysis after myringotomy and ventilation tube insertion under sedation with sevoflurane inhalation and four-quadrant blocks with lidocaine: a case report

  • Kim, Hyunjee;Lee, Joonhee;Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.3
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    • pp.161-163
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    • 2020
  • Myringotomy and ventilation tube insertion are widely performed in pediatric patients with chronic otitis media. This procedure is performed under general anesthesia or sedation with local anesthesia infiltration in pediatric patients. In this case report, we report a case of transient facial paralysis in a pediatric patient who underwent myringotomy and ventilation tube insertion using sevoflurane inhalation and four-quadrant blocks with lidocaine.

Alternative techniques for failure of conventional inferior alveolar nerve block

  • Lee, Choi Ryang;Yang, Hoon Joo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.3
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    • pp.125-134
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    • 2019
  • Successful local anesthesia in dental treatment is the most important prerequisite for pain control of patients. However, unlike that in the maxilla, it is difficult to administer local anesthesia in the mandible, and the success rate of conventional inferior alveolar nerve block (IANB) is only 80-85%. It is attributed to various causes such as anatomical variations, extreme anxiety, and technical errors; thus, various alternatives have been devised to improve this. We will analyze the causes of failure in conventional IANB and examine various alternatives that can be applied in these cases.

Advances in pediatric dentistry: new approaches to pain control and anxiety reduction in children - a narrative review

  • Ravi Vijaya Remi;Athimuthu Anantharaj;Prasanna Praveen;Rani Shankarappa Prathibha;Ramakrishna Sudhir
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.303-315
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    • 2023
  • Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional aspirating syringes as a symbol of fear and pain. Adequate pain control during dental procedures may help alleviate fear and anxiety and instill positive oral health attitudes in children. Newer approaches such as intranasal spray, centbucridine, jet injectors, buzzy devices, and acupressure have been developed to help dentists provide near-painless injections while reducing dental anxiety. This review aims to summarize newer approaches to alleviate pain and anxiety in children.

Epidural analgesia using xylazine in swine (돼지에서 xylazine에 의한 경막외마취)

  • Cheong, Jong-tae
    • Korean Journal of Veterinary Research
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    • v.31 no.4
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    • pp.519-522
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    • 1991
  • Pain reflex and anesthetic state in swine with xylazine epidural anesthesia were observed. In xylazine epidural anesthesia, dosages of 0.50mg/kg BW for analgesia of perineal region and 0.7550mg/kg for analgesia of low abdominal wall were required. Regional anesthesia was induced 5~20 min after epidural injection of xylazine and recovered 90~120 min after administration. The results indicated that xylazine as an epidural local anesthetic was useful in swine.

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United Kingdom pediatric dentistry specialist views on the administration of articaine in children

  • Ezzeldin, Maryam;Hanks, Gemma;Collard, Mechelle
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.303-312
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    • 2020
  • Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

Structural damage to periodontal tissues at varying rate of anesthetic injection

  • Sarapultseva, Maria;Sarapultsev, Alexey;Medvedeva, Svetlana;Danilova, Irina
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.89-95
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    • 2018
  • Background: Incorrect administration of an anesthetic during local anesthesia is one of the most important causes of pain symptoms in patients scheduled for dental procedures. The current study assessed the severity of damage to periodontal tissue following different rates of anesthetic administration. Methods: The research was conducted on 50 outbred male rats with a body mass of 180-240 g. The anesthetic used was 1% articaine. Results: The results showed that administration of the anesthetic at a rapid pace caused structural damage to the periodontal tissue. Further, signs of impaired microcirculation were noted at all rates of administration. Biochemical studies demonstrated changes in the level of glucose and enzymes with the rapid introduction of the anesthetic, indicating severe systemic stress response of the body. Conclusions: Injection of local anesthetic at any rate of introduction induces vascular congestion in the microcirculatory bloodstream and exudative reactions. Rapid introduction of an anesthetic causes progression of structural changes in the gingival tissue.