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Anesthetic Management for an Adult With Glycogen Storage Disease Type 0
Airi Sakamizu,
Erika Yaguchi, and
Shinsuke Hamaguchi
Article Category: Brief Report
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-06
Page Range: 233 – 234

for palatoplasty at 3 years of age, she experienced intraoperative metabolic acidosis, hypoglycemia, and fever up to 40°C, along with postoperative elevation of creatine phosphokinase. However, the hyperthermia resolved without any treatment. The patient subsequently underwent fistula closure at 12 years of age under general anesthesia with total intravenous anesthesia (TIVA) using remifentanil and propofol without any adverse events. Accordingly, we suspected a potential history of malignant hyperthermia, possibly triggered by muscle glycogen storage disease (GSD-0

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Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting: Part 2: Pharmacology and Guidelines for Perioperative Management
Bryant W. CorneliusDDS, MBA, MPH
Article Category: Other
Volume/Issue: Volume 64: Issue 1
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-01-02
Page Range: 39 – 44

introduced in the 1950s. 2 As such, there is vast experience with their usage. Sulfonylureas work by blocking potassium channels, which causes an influx of calcium into the pancreatic beta cells. 3 The result is an increase in insulin release, assuming that there are a sufficient number of functional beta cells present, which may effectively control glucose levels by lowering hemoglobin A 1c levels by 1–2%. 1 , 4 Side effects of sulfonylureas include hypoglycemia (especially when taken with aspirin), weight gain, hunger, and gastrointestinal upset. 3 There is also

Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting. Part 1: Pathophysiology and Associated Disease States
Bryant W. CorneliusDDS, MBA, MPH
Article Category: Research Article
Volume/Issue: Volume 63: Issue 4
Online Publication Date: Jan 01, 2016
DOI: 10.2344/0003-3006-63.4.208
Page Range: 208 – 215

affects insulin pharmacokinetics, insulin-dependent diabetic patients with this comorbidity have a higher risk of developing hypoglycemia. 17 Many oral antidiabetic drugs cannot be used in chronic kidney disease patients including biguanides (metformin), sulfonylureas, and alpha-glucosidase inhibitors. 17 , 23 PREANESTHETIC GLYCEMIC CONSIDERATIONS When considering the diabetic patient who is planned for anesthesia and surgery, it is important to know what level of plasma glucose or HbA1c is acceptable for elective procedures. Is there a

; Insulin receptor and glucose transport.
Bryant W. Cornelius

Insulin receptor and glucose transport.

Figure 2. ; The hypothalamic-pituitary-adrenal (HPA) axis.2 In this figure, solid arrows represent stimulation and dashed arrows indicate inhibition. The hypothalamus secretes corticotropin-releasing factor (CRF), which stimulates the pituitary to secrete corticotropin (formerly called adrenocorticotropic hormone). Corticotropin stimulates the adrenal cortex to synthesize and secrete cortisol. Provided serum concentrations are adequate, cortisol performs vital physiological functions and inhibits further activity of the HPA axis. Serum cortisol levels peak at ∼8:00 am and gradually decline over 12–16 hours. As cortisol is consumed, its serum levels diminish and inhibition of the axis wanes. This allows production of cortisol to commence again. This pattern of function is called circadian or diurnal rhythm and occurs at a normal basal rate unless the axis is excited by other factors such as hypoglycemia, trauma, or stress. Glucocorticoids produce an impressive number of physiological effects. When supraphysiologic doses are administered, the subsequent pharmacological effects consist essentially of exaggerated physiologic effects. These doses will also impart a negative feedback on the axis that eventually leads to adrenal atrophy following sustained use.
Daniel E. Becker
Figure 2. 
Figure 2. 

The hypothalamic-pituitary-adrenal (HPA) axis.2 In this figure, solid arrows represent stimulation and dashed arrows indicate inhibition. The hypothalamus secretes corticotropin-releasing factor (CRF), which stimulates the pituitary to secrete corticotropin (formerly called adrenocorticotropic hormone). Corticotropin stimulates the adrenal cortex to synthesize and secrete cortisol. Provided serum concentrations are adequate, cortisol performs vital physiological functions and inhibits further activity of the HPA axis. Serum cortisol levels peak at ∼8:00 am and gradually decline over 12–16 hours. As cortisol is consumed, its serum levels diminish and inhibition of the axis wanes. This allows production of cortisol to commence again. This pattern of function is called circadian or diurnal rhythm and occurs at a normal basal rate unless the axis is excited by other factors such as hypoglycemia, trauma, or stress. Glucocorticoids produce an impressive number of physiological effects. When supraphysiologic doses are administered, the subsequent pharmacological effects consist essentially of exaggerated physiologic effects. These doses will also impart a negative feedback on the axis that eventually leads to adrenal atrophy following sustained use.

Review of Modern Insulin Pumps and the Perioperative Management of the Type 1 Diabetic Patient for Ambulatory Dental Surgery
Philip M. YenDDS, MS and
Andrew S. YoungDDS
Article Category: Review Article
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
DOI: 10.2344/anpr-68-03-16
Page Range: 180 – 187

used to determine a patient's correction factor or how many mg/dL a patient's blood glucose level should decrease following the administration of a single unit of insulin. 8 Ideally, blood glucose readings are repeatedly sampled throughout the day with patients checking their blood glucose in the morning, before and after each meal, before bedtime, and during suspected episodes of hypoglycemia. CGM involves transcutaneous sensors implanted in the patient's subcutaneous tissues that measure interstitial glucose levels and then transmit that data to a

Subject Index
Article Category: Other
Volume/Issue: Volume 63: Issue 4
Online Publication Date: Jan 01, 2016
DOI: 10.2344/0003-3006-63.4.218
Page Range: 218 – 218

Hypersensitive gag reflex, 181 Hyperventilation, 25 Hypocapnia, 25 Hypoglycemia, 208 ICD, 95 Implant, 67 Inferior alveolar nerve, 84 Inferior alveolar nerve block, 3 Infiltration anesthesia, 17, 71, 131 Inhalational anesthesia, 42 Injection pain, 3 Injection pressure, 131 Intellectual disability, 185 Intranasal sedation, 122 Intravenous sedation, 80 Isoflurane, 42 Jawbone, 17, 131 Joint hypermobility and dislocation, 204 Kuwait, 8

Subject Index
Article Category: Research Article
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/0003-3006-64.4.267
Page Range: 267 – 267

Dentistry, 244 Dexmedetomidine, 88, 221, 230 Dexamethasone, 136 Drug interactions, 253 Early childhood caries, 212 ECC, 212 Epinephrine, 221 Fasting duration, 226 Gastroesophageal reflux disease, 248 General anesthesia, 3, 29, 144, 162, 165, 226, 235, 248, 251 General anesthesia for elderly, 88 Hemodynamics, 226 Hyperglycemia, 39 Hyperthyroidism, 173 Hypoglycemia, 39

JDSA Abstracts
Article Category: Meeting Report
Volume/Issue: Volume 58: Issue 2
Online Publication Date: Jan 01, 2011
DOI: 10.2344/0003-3006-58.2.94
Page Range: 94 – 105

Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University Niwa Hitoshi Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University Perioperative Management of an Infant with Severe Growth Hormone Deficiency 2010;38(3):284–288. Hypoglycemia can cause irreversible damage to the central nervous system. We provided anesthesia

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

management of this patient. We minimized the preoperative fasting time since prolonged hypoglycemia could cause increased catabolism. The patient was given a specially adjusted milk that excluded specific amino acids (isoleucine, valine, methionine, threonine, and glycine) to help prevent excessive production of methylmalonic acid preoperatively and postoperatively when her nutrition resumed immediately after surgery. In case of vomiting, we were prepared to immediately suction the patient, including suctioning through the gastrostomy tube as well. Arterial blood gas