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Patients with mental and physical limitations often pose a challenge when presenting for dental treatment. Lack of cooperation, combative behavior and physical limitations can make conventional office-based comprehensive dental treatment under local anesthesia very difficult and sometimes impossible. To avoid the risks of injury or excessive stress as well as the inability to provide high quality and well-delivered dental care, dentists often resort to the management of their special needs patients under general anesthesia. 1 , 2 The

managed on an inpatient basis. Most class 3 patients who are well controlled by their medication can be safely managed in the office, but those who have questionable stability are better managed in a hospital, especially if a general anesthetic is required. RECORDING THE MEDICAL HISTORY Anesthetic History The patient should be questioned carefully regarding past experiences with local and general anesthetics. Most patients vividly recall any unpleasant experiences, regardless of their true significance. For those who have

We report the case of a 5-year-old girl (height 111 cm; weight 20 kg; body mass index 16 kg/m 2 ) with selective immunoglobulin A (IgA) deficiency who underwent the extraction of 18 primary teeth under intubated general anesthesia. She was diagnosed with selective IgA deficiency at 4 years of age after repeated episodes of cellulitis. Preoperative blood tests showed low IgA levels and no signs of infection ( Table ). General anesthesia was induced with sevoflurane 5% along with oxygen/nitrous oxide 50%/50%, 6 L/min. After intravenous

INTRODUCTION Hypothermia during anesthesia is the most common perioperative thermal disturbance. 1 It is not uncommon for patients to become cold and exhibit uncontrollable episodes of shaking and shivering. These events are both troubling and perplexing to the anesthesia provider. The purposes of this article are to review the processes of heat loss and thermoregulation and to use this information to properly care for patients during sedation and general anesthesia. Although malignant hyperthermia is a relatively rare occurrence, we will

Tracheostomy is common in cases with a high risk of airway obstruction after head and neck surgery. Management of the tracheostomy tube requires frequent sputum aspiration and regular replacement/cleaning to ensure airway patency. Tracheostomy tube exchange is often safe because it is performed under spontaneous ventilation. During the COVID-19 pandemic, it is desirable to replace the tracheostomy tube after extinguishing spontaneous ventilations to effectively prevent coughing when performing surgery under general anesthesia

Obviously, the structure and function of receptors is a complex science and is, understandably, a casual interest for most of us. Certain principles have significant clinical value, however. If the general effects of specific receptors are understood, one can predict the indications and effects of many drugs used in clinical practice. For example, beta receptors in the heart mediate excitatory events. Drugs acting as agonists at beta receptors increase heart rate and are used to manage bradycardia. Conversely, beta-receptor antagonists decrease heart rate and can be used

Outpatient and office-based anesthesia is an integral part of the practice of dentistry. The dental profession has constantly reviewed its safety and efficacy track record in the provision of anesthesia care in the dental office. The use of pharmacologic methods of anxiety and pain control in general dental practice has been increasing. Studies demonstrate that dental fear and phobia exist in 15% to 30% of the general population in the United States. 1 Mentally challenged patients often benefit from sedation, which improves access to care

perioperative anesthesia provider of events leading to arrest and instruct for proper resuscitative efforts during the event. In the case presented below, there were a multitude of factors that likely contributed to the eventual pulseless electrical activity arrest. CASE PRESENTATION A 27-year-old Caucasian man (height 175 cm [5 ft 9 in], weight 91 kg [200 lb], and body mass index 29.5 kg/m 2 ) presented with his mother for his scheduled full-mouth dental rehabilitation under general anesthesia in the dental clinic. The patient had previously

A study by the American Society of Anesthesiologists (ASA), reported in 2010, found that a lack of understanding and fear about general anesthesia has led to as many as 25% of patients postponing necessary surgery. 1 However, the attitude of patients about having general anesthesia specifically for oral surgery procedures has never been investigated. The purpose of this study was to determine if patients who need to undergo a general anesthetic for oral surgery have the same apprehension as those needing major surgery. It was hypothesized