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Female Patients Require a Higher Propofol Infusion Rate for Sedation
Shigeru MaedaDDS, PhD,
Yumiko TomoyasuDDS, PhD,
Hitoshi HiguchiDDS, PhD,
Yuka HondaDDS,
Minako Ishii-MaruhamaDDS, PhD, and
Takuya MiyawakiDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 2
Online Publication Date: Jan 01, 2016
DOI: 10.2344/0003-3006-63.2.67
Page Range: 67 – 70

to evaluate sedation levels. 6 – 9 However, mainly because of the high cost of BIS, it is not standard equipment for sedation during dental treatment. In our facility, sedation for implant-related surgery is performed with a continuous infusion of propofol, and the infusion rate is adjusted according to BIS in all cases. Thus, we hypothesized that a multivariate analysis of retrospective data would enable us to extract independent factors that affect the dose of propofol in sedation. The factors identified in this study are considered useful indicators of

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Tissue Blood Flow During Remifentanil Infusion With Carbon Dioxide Loading
Hiroaki KanbeDDS, PhD,
Nobuyuki MatsuuraDDS, PhD,
Masataka KasaharaDDS, PhD, and
Tatsuya IchinoheDDS, PhD
Article Category: Other
Volume/Issue: Volume 62: Issue 2
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.2.51
Page Range: 51 – 56

blood flow (LBF) in a dose-dependent manner and that a Remi infusion at a rate of 0.2 μg/kg/min decreases oral tissue blood flow without a substantial reduction of heart rate (HR) and blood pressure. Based on these findings, we suppose that changes in tissue blood flow may be modified by changes in arterial carbon dioxide level during Remi infusion. However, there has been no report that investigates the effect of a combination of Remi infusion and the change in arterial carbon dioxide level on oral tissue blood flow. In this study, therefore, we investigated the

Anesthetic Management of a Complex Regional Pain Syndrome (CRPS) Patient With Ketamine
Tarun MundluruBDS, MSc and
Mana SaraghiDMD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-07
Page Range: 219 – 225

a complete resolution of symptoms and a long-term recovery. 3 , 19 – 25 Ketamine, a noncompetitive NMDA receptor antagonist, may be effective for pain relief in patients with chronic CRPS who are resistant to other therapies as the NMDA receptor is a key component to central sensitization. 24 , 26 – 28 In 1 double-blinded, randomized, controlled trial comparing prolonged low-dose ketamine infusions (mean rate ∼5.2 mcg/kg/min for 4.2 days) to placebo, a significant decrease in pain scores persisted up to 12 weeks in the ketamine group, but patients

Propofol Drip Infusion Anesthesia for MRI Scanning: Two Case Reports
Mami Sasao-TakanoDDS, PhD,
Kan MisumiDDS,
Masayuki SuzukiDDS,
Yoko KamiyaDDS, PhD,
Izumi NoguchiDDS, PhD, and
Hiroshi KawaharaDDS, PhD
Article Category: Other
Volume/Issue: Volume 60: Issue 2
Online Publication Date: Jan 01, 2013
DOI: 10.2344/0003-3006-60.2.60
Page Range: 60 – 66

anesthesia induction. The intravenous infusion line was inserted in the MRI room. The intravenous pole stand holding the infusion bottle was a nonmagnetic metal made specifically for MRI. At first, a bolus of 60 mg of propofol was administered, intravenously. Then, we started a propofol drip infusion (4–5 mg/kg/h) using the 60 drips per 1 mL drip infusion tube with 100% oxygen by mask. Thirty milligrams of rocuronium bromide was used as a muscle relaxant for oral intubation with the aid of neuromuscular monitoring. The endotracheal tube was fixed on the corner of his left

Continuous Infusion Propofol General Anesthesia for Dental Treatment in Patients With Progressive Muscular Dystrophy
Hiroyoshi KawaaiDDS, PhD,
Kazuho TanakaDDS, PhD, and
Shinya YamazakiDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 52: Issue 1
Online Publication Date: Mar 01, 2005
DOI: 10.2344/0003-3006(2005)52[12:CIPGAF]2.0.CO;2
Page Range: 12 – 16

, and multiple joint contractures. 3 4 When compared with Duchenne muscular dystrophy (DMD), BMD has milder muscle weakness and a better prognosis, and FCMD progresses at a slower rate and demonstrates lower serum levels of creatine phosphokinase (CPK). Although few reports have addressed a continuous infusion of propofol in patients with progressive muscular dystrophy, 5–8 there is supportive consensus of opinion regarding its use. 5–14 However, an inhalational anesthetic might cause some complications in patients with DMD or BMD. 15–17 More specifically

Dexmedetomidine Infusion for Routine Dental Management of an ASA IV Patient: A Case Report
Andrew S. YoungDDS,
Nicholas A. RussellDDS, and
Joseph A. Giovannitti JrDMD
Article Category: Case Report
Volume/Issue: Volume 64: Issue 2
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-02-08
Page Range: 88 – 96

totaling 625 μg over the course of the procedure. The patient appeared mildly to moderately resistant to treatment necessitating administration of propofol to a level of deep sedation. Propofol infusion was set at a rate of 35 μg/kg/min over 2.5 hours for a total of 365 mg. The patient then received 0.45 mL of 4% articaine with epinephrine 1 : 100,000 and 3.6 mL of 3% mepivacaine local anesthetic solution for restorative dentistry. The patient experienced intermittent airway obstruction requiring placement of a 30-Fr nasopharyngeal airway during the case with BP

Figure 5; Changes in bispectral index (BIS) and Ramsay score (RS). BIS decreased significantly from 10 minutes after the start of dexmedetomidine (Dex) infusion to 30 minutes after the end of Dex infusion (P < .05). RS showed the optimal sedation level from 10 minutes to 30 minutes after the start of Dex infusion.
Sachie Ogawa,
Hiroaki Seino,
Hiroshi Ito,
Shinya Yamazaki,
Steven Ganzberg, and
Hiroyoshi Kawaai
Figure 5
Figure 5

Changes in bispectral index (BIS) and Ramsay score (RS). BIS decreased significantly from 10 minutes after the start of dexmedetomidine (Dex) infusion to 30 minutes after the end of Dex infusion (P < .05). RS showed the optimal sedation level from 10 minutes to 30 minutes after the start of Dex infusion.

Figure 3. ; Regression and correlation analysis between the mean infusion rate of propofol and frequency (total number of cases, target-controlled infusion, and step-down method). A significant positive correlation was observed between the frequency of intravenous sedation and the dosage of propofol in each situation. The step-down method exhibited the higher increase in rate of propofol infusion at 0.18 mg/kg/h per administration versus TCI at 0.07 mg/kg/h per administration.
Yoshihiro Nakaike,
Hikaru Sato,
Rina Sato,
Hikaru Moriyama,
Shota Abe,
Kenji Yoshida,
Hiroyoshi Kawaai, and
Shinya Yamazaki
<bold>Figure 3.</bold>
Figure 3.

Regression and correlation analysis between the mean infusion rate of propofol and frequency (total number of cases, target-controlled infusion, and step-down method). A significant positive correlation was observed between the frequency of intravenous sedation and the dosage of propofol in each situation. The step-down method exhibited the higher increase in rate of propofol infusion at 0.18 mg/kg/h per administration versus TCI at 0.07 mg/kg/h per administration.

Figure 8.; Representative context-sensitive half-times. The following graph compares the time required for serum concentrations to decline by 50% upon discontinuation of varied durations of continuous infusions. With the exception of remifentanil, the context-sensitive half-times increase following greater durations of infusion. Continuous infusions of diazepam and vfentanyl result in an unacceptable time for recovery. Data are adapted from Hughes et al12 and Egan et al.13
Daniel E. Becker
Figure 8.
Figure 8.

Representative context-sensitive half-times. The following graph compares the time required for serum concentrations to decline by 50% upon discontinuation of varied durations of continuous infusions. With the exception of remifentanil, the context-sensitive half-times increase following greater durations of infusion. Continuous infusions of diazepam and vfentanyl result in an unacceptable time for recovery. Data are adapted from Hughes et al12 and Egan et al.13

Figure 1.; Comparisons of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) during remifentanil (Remi) infusion with those during no Remi infusion. All variables were decreased during Remi infusion when compared under identical end-tidal carbon dioxide tension (ETCO2) level. The DBP level was increased and HR was decreased along with ETCO2 elevation during Remi infusion. Data are shown as mean ± SD (n = 8). *P < .05 versus respective values at ETCO2 30 mm Hg. #P < .05 between two values at the same ETCO2 level.
Hiroaki Kanbe,
Nobuyuki Matsuura,
Masataka Kasahara, and
Tatsuya Ichinohe
Figure 1.
Figure 1.

Comparisons of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) during remifentanil (Remi) infusion with those during no Remi infusion. All variables were decreased during Remi infusion when compared under identical end-tidal carbon dioxide tension (ETCO2) level. The DBP level was increased and HR was decreased along with ETCO2 elevation during Remi infusion. Data are shown as mean ± SD (n = 8). *P < .05 versus respective values at ETCO2 30 mm Hg. #P < .05 between two values at the same ETCO2 level.