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Pulmonary Aspiration During Induction of General Anesthesia
Reina HayashiDDS,
Shigeru MaedaDDS, PhD,
Taninishi HidekiMD, PhD,
Hitoshi HiguchiDDS, PhD, and
Takuya MiyawakiDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-03
Page Range: 214 – 218

Pulmonary aspiration of gastric contents has remained one of the most feared complications of sedation and general anesthesia because of the potential for lethal consequences secondary to lung injury from particulate matter, acid, and bacteria. 1 Prevention involves strict adherence to preoperative fasting instructions for patients before elective surgery under sedation and general anesthesia. Historically, the median duration of fasting for liquids was reported to be 6 to 9 hours in adults. 2 However, the advantages of shorter fasting

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Influence of Fasting Duration on Body Fluid and Hemodynamics
Masanori TsukamotoDDS, PhD,
Takashi HitosugiDDS, PhD, and
Takeshi YokoyamaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-65-01-01
Page Range: 226 – 229

Fasting before general anesthesia aims to reduce the volume and acidity of stomach contents, which reduces the risk of regurgitation and aspiration. 1 , 2 The introduction of the concept of enhanced recovery after surgery has altered preoperative and postoperative care, particularly for major surgery. 3 , 4 Preoperative carbohydrate loading and shortening of the fasting time potentially reduces surgical stress, and has been considered useful for perioperative management of patients. Now these concepts have been applied to a broader range

Clinical Comparison: Fast-Acting and Traditional Topical Dental Anesthetic
Arthur C. DiMarcoDMD and
Ann O'Kelley WetmoreRDH, MSDH
Article Category: Research Article
Volume/Issue: Volume 63: Issue 2
Online Publication Date: Jun 01, 2016
DOI: 10.2344/0003-3006-63.2.55
Page Range: 55 – 61

is little confidence in a future ability to perform a similar study that is truly blinded. However, other studies with a larger sample size, which compare other topical agents and other dental local anesthetic techniques, may be warranted. CONCLUSIONS Traditionally, gel anesthetics are preferred as preinjection topicals. Recognizing the importance of time management in clinical practice, a fast-onset topical agent can be of benefit. This study suggests that a brief, 5-second application of a vapocoolant has similar preinjection benefits

Heart Rate Effects of Intraosseous Injections Using Slow and Fast Rates of Anesthetic Solution Deposition
Louis SusiDDS, MS,
Al ReaderDDS, MS,
John NussteinDDS, MS,
Mike BeckDDS, MA,
Joel WeaverDDS, PhD, and
Melissa DrumDDS, MS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 1
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006(2008)55[9:HREOII]2.0.CO;2
Page Range: 9 – 15

from each subject. The 61 blinded subjects randomly received 3 sets of intraosseous injections using: the Wand local anesthetic system at a deposition rate of 45 seconds (fast injection); the Wand local anesthetic system at a deposition rate of 4 minutes and 45 seconds (slow injection); and a conventional syringe at a deposition rate of 4 minutes and 45 seconds (slow injection), in 3 separate appointments spaced at least 3 weeks apart, in a crossover design. For all intraosseous injections, 1.4 mL of 2% lidocaine with 1 : 100,000 epinephrine

Figure 4 ; Splanchnic circulation under fasting conditions. The liver receives most of its blood supply via the portal vein under fasting conditions. (Source: Barrett KE. Chapter 10. Functional anatomy of the liver and biliary system. In: Barrett KE, ed. Gastrointestinal Physiology, 2nd ed. 2014.)
Gina Chen,
Ryan Cheung, and
James W. Tom
<bold>Figure 4</bold>
Figure 4

Splanchnic circulation under fasting conditions. The liver receives most of its blood supply via the portal vein under fasting conditions. (Source: Barrett KE. Chapter 10. Functional anatomy of the liver and biliary system. In: Barrett KE, ed. Gastrointestinal Physiology, 2nd ed. 2014.)

Figure 2.  ; Flowchart of enrollment, allocation, and data analysis. 1 Change to another sedative because of not following preoperative fasting period; 2 intravenous (IV) access failure (twice; n = 1); 3 IV access failure (twice; n = 1) and trouble with heart rate variability (HRV) measurement equipment (n = 2).
Keiichiro Wakana,
Yukifumi Kimura,
Yukie Nitta, and
Toshiaki Fujisawa
<bold>Figure 2. </bold>
Figure 2. 

Flowchart of enrollment, allocation, and data analysis. 1 Change to another sedative because of not following preoperative fasting period; 2 intravenous (IV) access failure (twice; n = 1); 3 IV access failure (twice; n = 1) and trouble with heart rate variability (HRV) measurement equipment (n = 2).

General Anesthesia for a Child With Methylmalonic Acidemia Undergoing Oral Care and Dental Treatment Before Kidney Transplantation
Kazuhiro HanoDDS,
Mizuki KatoDDS,
Riho MiyajimaDDS,
Izumi KameyamaDDS,
Yu OshimaDDS, PhD;,
Masanori TsukamotoDDS, PhD;, and
Takeshi YokoyamaDDS, PhD
Article Category: Other
Volume/Issue: Volume 71: Issue 1
Online Publication Date: May 03, 2024
DOI: 10.2344/anpr-70-03-10
Page Range: 39 – 41

.2%), and the patient’s blood urea nitrogen (79 mg/dL), creatinine (1.49 mg/dL), and potassium (5.5 mmol/L) levels confirmed optimization of her metabolic status and renal dysfunction. An electrocardiogram was also obtained, which showed normal sinus rhythm at a rate of 98 beats/min. Preoperative physical examination confirmed the patient’s intellectual disability (no meaningful speech/difficulty communicating), although no other noteworthy findings were observed. As one of our anesthetic goals was to optimize her metabolism perioperatively, her fasting time was set as

A Prospective, Randomized, Double-Blind Study of the Anesthetic Efficacy of Sodium Bicarbonate Buffered 2% Lidocaine With 1 : 100,000 Epinephrine in Inferior Alveolar Nerve Blocks
Michael WhitcombDDS, MS,
Melissa DrumDDS, MS,
Al ReaderDDS, MS,
John NussteinDDS, MS, and
Mike BeckDDS, MA
Article Category: Research Article
Volume/Issue: Volume 57: Issue 2
Online Publication Date: Jan 01, 2010
DOI: 10.2344/0003-3006-57.2.59
Page Range: 59 – 66

epidurals, peripheral nerve blocks, and regional anesthesia. They found that higher-pH solutions established anesthesia of better quality. A number of authors 16 – 19 have reported faster onset with pH-adjusted anesthetic solutions. Davies 20 reviewed the literature on buffering local anesthetics to decrease the pain of injection and found that buffering local anesthetics with sodium bicarbonate significantly reduced injection pain. No studies have used a sodium bicarbonate–buffered lidocaine formulation for IAN blocks. The authors wished to determine whether a