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Aerosol-Generating Procedures and Simulated Cough in Dental Anesthesia
Brian ChanpongDDS, MSc,,
Michelle TangDDS, MSc,,
Alexander RosenczweigDMD,
Patrick LokDDS, and
Raymond TangMD, MSc
Article Category: Research Article
Volume/Issue: Volume 67: Issue 3
Online Publication Date: Jun 18, 2020
DOI: 10.2344/anpr-67-03-04
Page Range: 127 – 134

these AGPs, there are reflex-induced events such as gagging and coughing that can occur without warning and can also generate aerosols. 3 Activation of these protective reflexes is not uncommon and can be evoked during a variety of procedures. 4 In an anesthesia-based dental practice, the operating dentist, dentist anesthesiologist, or other licensed trained individual responsible for maintaining airway patency may be at highest risk of exposure because of being positioned at the patient's head. The protective reflexes may be blunted with sedation or general

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Figure 4. ; Plume and splatter captured during the simulated cough.
Brian Chanpong,
Michelle Tang,
Alexander Rosenczweig,
Patrick Lok, and
Raymond Tang
Figure 4. 
Figure 4. 

Plume and splatter captured during the simulated cough.

Figure 5. ; Splatter on anesthesiologist after a simulated cough, covering head, face, body, arms, and legs.
Brian Chanpong,
Michelle Tang,
Alexander Rosenczweig,
Patrick Lok, and
Raymond Tang
Figure 5. 
Figure 5. 

Splatter on anesthesiologist after a simulated cough, covering head, face, body, arms, and legs.

Figure 2.; Radial graph of mean scores in effective cases of 3 groups. Plotted markers indicate mean score values of effective cases in each group. In groups A1 and A2, almost all difficulties were relieved, but we must pay attention to airway management, especially in off patients in the A2 group who were administered a high dose of flunitrazepam. Values for coughing by aspiration are the same in groups A1 and A2. By contrast, in group R, clenching and uncooperative behavior were still observed, but the score related to the airway was zero in all cases.
Figure 2.
Figure 2.

Radial graph of mean scores in effective cases of 3 groups.

Plotted markers indicate mean score values of effective cases in each group. In groups A1 and A2, almost all difficulties were relieved, but we must pay attention to airway management, especially in off patients in the A2 group who were administered a high dose of flunitrazepam. Values for coughing by aspiration are the same in groups A1 and A2. By contrast, in group R, clenching and uncooperative behavior were still observed, but the score related to the airway was zero in all cases.

Figure 1. ; Splatter captured during the use of an air-water syringe and continuous high-volume evacuation suction.
Brian Chanpong,
Michelle Tang,
Alexander Rosenczweig,
Patrick Lok, and
Raymond Tang
Figure 1. 
Figure 1. 

Splatter captured during the use of an air-water syringe and continuous high-volume evacuation suction.

Figure 2. ; Splatter on dentist after aerosol-generating procedures, with the majority evident on arms.
Brian Chanpong,
Michelle Tang,
Alexander Rosenczweig,
Patrick Lok, and
Raymond Tang
Figure 2. 
Figure 2. 

Splatter on dentist after aerosol-generating procedures, with the majority evident on arms.

Figure 3. ; Splatter on dental assistant after aerosol-generating procedures, with the majority evident on arms and legs.
Brian Chanpong,
Michelle Tang,
Alexander Rosenczweig,
Patrick Lok, and
Raymond Tang
Figure 3. 
Figure 3. 

Splatter on dental assistant after aerosol-generating procedures, with the majority evident on arms and legs.

Correlation Between Body Movements and Salivary Secretion During Sedation
Yoko SasakiDDS,
Seiichi KatoDDS, PhD,
Masaaki MiuraDDS, PhD, and
Haruhisa FukayamaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 4
Online Publication Date: Jan 01, 2016
DOI: 10.2344/15-00035.1
Page Range: 185 – 191

performed in the supine position, there is often difficulty controlling upper airway patency and protective airway reflexes such as swallowing and coughing. The upper airway patency markedly decreases after transition from the conscious to the unconscious state. 1 Furthermore, the mandatory mouth opening for dental treatment also impairs upper airway patency. 2 Commonly, head tilt, neck extension, and mandibular advancement are performed to improve airway patency. 3 – 6 Simultaneously, these positions markedly compromise the swallowing action. 7 Typically, water and

Effect of Passive Smoke Exposure on General Anesthesia for Pediatric Dental Patients
S. ThikkurissyDDS, MS,
Bethany CrawfordDDS,
Judith GronerMD,
Roderick StewartEMT-B, and
Megann K. SmileyDDS, MS
Article Category: Other
Volume/Issue: Volume 59: Issue 4
Online Publication Date: Jan 01, 2012
DOI: 10.2344/0003-3006-59.4.143
Page Range: 143 – 146

, laryngospasm, bronchospasm, airway obstruction, hypersecretion, and coughing. For each type of adverse event experienced by the child, the anesthesiologist also rated the severity of the event on scale of 0 to 3, 0 being the absence of an event, 3 being the most severe manifestation of that event. At the conclusion of the procedure, the patient was carefully suctioned and extubated deep in the GA suite. The patient was allowed to recover until he or she met criteria for phase I recovery. The patient was then transported to an adjacent phase II recovery unit where he or she

Superior Laryngeal Nerve Block for Intubation in Patients With COVID-19
Yuki KojimaDDS, PhD and
Mitsutaka SugimuraDDS, PhD
Article Category: Article Commentary
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-68-01-09
Page Range: 50 – 51

. Reducing coughing during intubation could contribute to a reduction in viral transmission and exposure among health care workers. Coughing can be reduced by several techniques such as the administration of nebulized lidocaine to anesthetize the airway or intravenous boluses of opioid agonists for cough suppression, among others. In our hospital, we use moderate sedation with midazolam and fentanyl for patients with suspected difficult intubation or airway management. Once the patient is adequately sedated, a bilateral superior laryngeal nerve (SLN) block (SLNB) can be