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  • 1.

    【2hr】Reply

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    机译 回复
    摘要：
  • 2.

    【2hr】Literature Review for Office-Based Anesthesia

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    机译 基于办公室麻醉的文献综述
    • 作者：Mark A. Saxen
    • 刊名：Anesthesia Progress
    • 2018年第4期
    摘要：
  • 3.

    【2hr】IFDAS 2018 Meeting News

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    机译 IFDAS 2018会议新闻
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  • 4.

    【2hr】Practice Guidelines for Intravenous Conscious Sedation in Dentistry (Second Edition, 2017)

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    机译 牙科静脉自觉镇静实践指南（2017年第二版）
    • 作者：
    • 刊名：Anesthesia Progress
    • 2018年第4期
    摘要：
  • 5.

    【2hr】When Can the Recovery Process Be Delegated to Staff?

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    机译 什么时候可以将恢复过程委托给员工？
    摘要：
  • 6.

    【2hr】Comparison of the Contact Force Exerted on Teeth by Conventional Macintosh Laryngoscope Versus Video Laryngoscopes

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    机译 常规Macintosh喉镜与视频喉镜对牙齿施加的接触力的比较
    摘要：During laryngoscopy, the laryngoscope blade sometimes comes in contact with the teeth, fracturing or dislocating them. However, no studies have compared the effects of newly marketed video laryngoscopes and the Macintosh laryngoscope (Mac) on teeth. In this study, we measured and compared the force exerted on the teeth of an intubating manikin by the Mac, the Airway Scope (Pentax), and the McGrath MAC (Covidien). The mean force exerted was 141.1 ± 15.7 kg by the Mac, 39.2 ± 10.3 kg by the Airway Scope, and 48.7 ± 6.7 kg by the McGrath MAC. No significant difference was observed between the Airway Scope and the McGrath MAC. When the Mac is inserted, the glottis has to be visually located from outside the oral cavity. However, a significant force is not necessary when inserting video laryngoscopes because a camera is mounted on the blade tip. In this laboratory model, the lower force exerted by the video laryngoscopes should contribute to a reduction in their impact on fracture or dislocation of teeth.
  • 7.

    【2hr】Effect of Nitrous Oxide on Pulpal Anesthesia: A Preliminary Study

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    机译 一氧化二氮对髓腔麻醉的影响：初步研究
    摘要：To compare the success of perceived pulpal anesthesia between groups using nitrous oxide/oxygen (N2O/O2) and oxygen (O2) in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. Thirty-three children (mean age 10.4 ± 1.9 years) with 33 symptomatic irreversible pulpitis permanent teeth were included in this preliminary study. All children were premedicated with ibuprofen and randomly assigned to receive either N2O/O2 (17 participants) or O2 (16 participants). Four percent articaine with epinephrine 1:100,000 was administered, and vital pulp therapy was performed. Children used the Wong-Baker FACES Pain Rating Scale (WBFPS) to report their pain at baseline as well as during carious dentin removal, pulpal exposure, and pulpal tissue removal steps. The success was determined when the reported WBFPS score was ≤4. The chi-square test was used to compare the success between both groups. The success of pulpal anesthesia was 71% (12/17) and 19% (3/16) in the N2O/O2 and O2 groups, respectively. The success in the N2O/O2 group was 52% higher than that in the O2 group (confidence interval = 22.9% to 80.7%; significant difference p = .003). From the result of this preliminary study, N2O/O2 significantly increased the success of perceived pulpal anesthesia in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. However, further study with a larger sample is required to confirm this result.
  • 8.

    【2hr】Comparison of Risk Factors in Patients With Acute and Chronic Orofacial Pain

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    机译 急性和慢性口腔颌面疼痛的危险因素比较
    摘要：Management of patients with orofacial pain may benefit from a better understanding about patient factors that may lead pain chronicity. In this study, we retrospectively compared physical and psychological factors in patients with acute and chronic orofacial pain. We analyzed data from 854 patients presenting to the Orofacial Pain Center, Department of Dental Anesthesiology, Tokyo Dental College, Suidobashi Hospital between April 2010 and March 2014. We categorized patients into the acute group if their condition had persisted <6 months and the chronic group if their condition had lasted 6 months or longer, based on the classification by the International Association for the Study of Pain. The retrospective data were analyzed by using univariate analysis on background factors from a health questionnaire, pain evaluation sheet, and psychological test completed at the time of presentation. Multiple logistic regression was applied on these factors. Our results suggest that female gender and high trait anxiety may be involved in orofacial pain becoming chronic.
  • 9.

    【2hr】The Effect of Dexmedetomidine on Oral Mucosal Blood Flow and the Absorption of Lidocaine

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    机译 右美托咪定对口腔粘膜血流量和利多卡因吸收的影响
    摘要：Dexmedetomidine (DEX) is a sedative and analgesic agent that acts via the alpha-2 adrenoreceptor and is associated with reduced anesthetic requirements, as well as attenuated blood pressure and heart rate in response to stressful events. A previous study reported that cat gingival blood flow was controlled via sympathetic alpha-adrenergic fibers involved in vasoconstriction. In the present study, experiment 1 focused on the relationship between the effects of DEX on alpha adrenoreceptors and vasoconstriction in the tissues of the oral cavity and compared the palatal mucosal blood flow (PMBF) in rabbits between general anesthesia with sevoflurane and sedation with DEX. We found that the PMBF was decreased by DEX presumably because of the vasoconstriction of oral mucosal vessels following alpha-2 adrenoreceptor stimulation by DEX. To assess if this vasoconstriction would allow decreased use of locally administered epinephrine during DEX infusion, experiment 2 in the present study monitored the serum lidocaine concentration in rabbits to compare the absorption of lidocaine without epinephrine during general anesthesia with sevoflurane and sedation with DEX. The depression of PMBF by DEX did not affect the absorption of lidocaine. We hypothesize that this is because lidocaine dilates the blood vessels, counteracting the effects of DEX. In conclusion, despite decreased palatal blood flow with DEX infusion, local anesthetics with vasoconstrictors should be used in implant and oral surgery even with administered DEX.
  • 10.

    【2hr】Male Gender and High Trait Anxiety Are 2 Major Factors Associated With Severe Dental Fear and Avoidance

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    机译 男性性别和高特质焦虑是与严重牙科恐惧和避免相关的两个主要因素
    摘要：The purpose of this article is to investigate the association between the background characteristics of patients with severe fear of dental treatment who frequently avoid dental care and the degree of difficulty in treating them. At the time of initial presentation at a dental phobia clinic, each of 321 subjects was asked to complete the State-Trait Anxiety Inventory, the Dental Anxiety Scale, and a health questionnaire related to phobic objects. Subjects who rejected oral examination with a dental mirror were categorized as being severely difficult to treat, whereas those who were able to undergo examination were categorized as being moderately difficult to treat. In the statistical analysis, assessment items that were correlated with difficulty to treat were designated as independent variables for a logistic regression analysis. In the logistic regression analysis, significant correlations were observed for gender (male > female with adjusted odds ratio, 4.121; 95% CI, 1.96–8.65) and level of trait anxiety (2.401; 1.01–5.73). Male gender and a high trait anxiety were identified as major factors associated with severe dental fear and avoidance.
  • 11.

    【2hr】Office-Based Anesthetic and Oral Surgical Management of a Child With Hereditary Sensory Autonomic Neuropathy Type IV: A Case Report

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    机译 遗传性感觉神经自主神经病患儿的基于办公室的麻醉和口腔外科治疗：病例报告
    摘要：Hereditary sensory and autonomic neuropathy type IV (HSAN IV), or congenital insensitivity to pain with anhidrosis, is an exceptionally rare genetic disorder that results in the complete loss of pain and temperature sensation as well as anhidrosis. Anesthetic management of these patients can be difficult because of significantly increased risks during general anesthesia. Literature on perioperative anesthetic management is typically written in the context of a hospital setting. As such, our case presents a unique report on the anesthetic management of a HSAN IV patient who presented for extraction of 2 teeth in an office-based setting. In determining how to safely manage the procedure, we decided against general anesthesia as we lacked the facilities and equipment to safely handle previously reported complications. We were successful in providing sedation with nitrous oxide in oxygen and applying 20% benzocaine topical ointment on the surgical site in lieu of administering general anesthesia. We had an anesthesiologist present and obtained intravenous access prior to the surgery to help manage any complications. This report provides support that simple dental extractions can be accomplished safely in the HSAN IV patient in the office-based setting, thereby avoiding unnecessary risk.
  • 12.

    【2hr】Atrio-ventricular Block Following Neostigmine-Glycopyrrolate Reversal in Non-heart Transplant Patients: Case Report

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    机译 非心脏移植患者中新斯的明-甘草酸逆转后的房室传导阻滞：病例报告
    摘要：Neostigmine is the anticholinesterase drug most commonly used to reverse blockade or speed up recovery from neuromuscular blockade from nondepolarizing neuromuscular blocking drugs. Because of its cardiac muscarinic effects, prior or simultaneous administration of glycopyrrolate or atropine is usually recommended. There have been a few case reports of bradycardia, atrio-ventricular (AV) block, and cardiac arrest following neostigmine/glycopyrrolate administration to reverse neuromuscular block affecting several patients.In this report, we describe a case of 21-year-old with a history of seizure disorder and developmental delay that presented for dental surgery under general anesthesia and developed type I AV block following the simultaneous administration of neostigmine and glycopyrrolate to reverse a nondepolarizing neuromuscular block with rocuronium at the end of his surgery.We suggest that the chronic use of antiepileptic drugs in this patient in combination with neostigmine and glycopyrrolate lead to AV block in this patient. We also review similar cases reported in the literature and suggest an explanation for this observed phenomenon.
  • 13.

    【2hr】General Anesthetic Management of a Patient With Hypertrophic Cardiomyopathy for Oral Surgery: Did Digitalis Contribute to Bradycardia?

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    机译 肥厚型心肌病患者口腔手术的全身麻醉管理：洋地黄有助于心动过缓吗？
    摘要：Stabilization of circulatory dynamics is a critical issue in the anesthetic management of patients with hypertrophic cardiomyopathy (HCM). In this report, we managed general anesthesia for a 74-year-old male patient with nonobstructive HCM who developed circulatory instability intraoperatively. Severe bradycardia measuring 35 beats/min and hypotension measuring 78 mm Hg systolic were observed during surgery. Using stroke volume variation and stroke volume from the FloTrac as indices, successful circulatory management was performed with dopamine. The hypotension and bradycardia were thought to be the result of methyldigoxin and possibly associated with our perioperative management. Cardiology consult should have been obtained. We demonstrated that the FloTrac can be beneficial in diagnosing and managing cardiovascular instability and administration of dopamine in the anesthetic management of nonobstructive HCM patients.
  • 14.

    【2hr】American Society of Dentist Anesthesiologists: Parameters of Care

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    机译 美国牙医麻醉师学会：护理参数
    • 作者：
    • 刊名：Anesthesia Progress
    • 2018年第3期
    摘要：
  • 15.

    【2hr】AirWay Scope™ for Difficult Ventilation in a Patient With Epiglottic Cyst

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    机译 AirWay Scope™用于会厌囊肿患者的困难通气
    摘要：Epiglottic cysts often cause difficulty in airway management, with potential serious life-threatening complications. This case report describes a patient with an epiglottic cyst in whom mask ventilation became difficult after induction of anesthesia. Immediately, an AirWay Scope™ (TMAWS-S100; Pentax, Japan) was inserted orally, and the location of the epiglottis was clarified to assess the reason for difficulty with ventilation. This case demonstrates usefulness of the AirWay Scope in patients with epiglottic cyst.
  • 16.

    【2hr】Anesthetic Management of the Hypertensive Patient: Part II

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    机译 高血压患者的麻醉管理：第二部分
    摘要：Hypertension is an important health challenge that affects millions of people across the world today and is a major risk factor for cardiovascular disease. It is critical that anesthesia providers have a working knowledge of the systemic implications of hypertension. This review article will discuss the medical definitions of hypertension, the physiology of maintaining blood pressure, outpatient treatment of hypertension, anesthetic implications, and the common medications used by anesthesia providers in the treatment of hypertension. Part I provided an overview of hypertension and blood pressure regulation. In addition, drugs predominantly affecting control of hypertension via renal mechanisms such as diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and renin-inhibiting agents were discussed. In part II, the remaining major antihypertensive medications will be reviewed as well as anesthetic implications of managing patients with hypertension.
  • 17.

    【2hr】A Review of Current Literature of Interest to the Office-Based Anesthesiologist

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    机译 基于办公室麻醉师的最新兴趣文献综述
    • 作者：Mark A. Saxen
    • 刊名：Anesthesia Progress
    • 2018年第3期
    摘要：
  • 18.

    【2hr】Dr David Donaldson, BDS, FDSRCS, MDS, FADSA, FAAD, Dental Educator and Sedation Pioneer, Dies at 76

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    机译 David Donaldson博士，BDS，FDSRCS，MDS，FADSA，FAAD，牙科教育家和镇静先锋，享年76岁
    • 作者：
    • 刊名：Anesthesia Progress
    • 2018年第3期
    摘要：
  • 19.

    【2hr】Come to IFDAS in Nara, Japan

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    机译 来日本奈良参加IFDAS
    摘要：
  • 20.

    【2hr】The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

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    机译 咪唑安定在丙泊酚静脉镇静中添加对抑制牙科治疗过程中gag反射的影响
    摘要：We retrospectively investigated the efficacy and safety of propofol administration alone and in combination with midazolam for gag reflex suppression during dental treatment under intravenous sedation. We included 56 patients with an overactive gag reflex who were to undergo dental treatment under intravenous sedation. They were divided into propofol (P group, n = 22) and midazolam with propofol (MP group, n = 34) groups. The P group received propofol alone, while the MP group received midazolam (0.04 mg/kg) prior to target-controlled infusion (TCI) of propofol (titrated for adequate sedation). The patients' anesthetic records were evaluated for vital sign changes, adverse cardiovascular or respiratory event frequency, the number of forced treatment interruptions, and the TCI-predicted cerebral propofol concentration at gag reflex suppression (posterior tongue stimulation with a dental mirror). No significant differences were observed between the 2 groups preoperatively. There were no cases of forced interruptions or significant respiratory compromise in either group. Cardiovascular adverse event frequency was lower in the MP group than in the P group (all p < .05). Our results suggest that propofol, when combined with midazolam, minimized cardiovascular effects compared with propofol alone when used to suppress the gag reflex in patients during dental treatment under intravenous sedation.
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