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Accidental Intravascular Local Anesthetic Injection of the Facial Artery
Matias Garcia-BlancoDDS, PhD and
Stephanie ScanlanDDS
Article Category: Case Report
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-67-03-03
Page Range: 29 – 32

pallor or ischemia, and/or heart palpitations. 11 – 14 There are several existing reports in the literature of intravascular local anesthetic injection involving the inferior alveolar artery, 4 , 5 , 11 , 12 a few involving the posterior superior alveolar artery, 13 , 14 one report involving the superior palatine artery, 15 and one involving the buccal artery, 16 but none exist regarding direct injection into the facial artery. The aim of this clinical report is to present an accidental local anesthetic injection into the facial artery and to discuss its

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Figure 2 ; Figure 2 a R/L value (%) Figure 2b I/R value (%) a) R/L value (%), showing the risk area for ischemia expressed as a percentage of the left ventricle. After the completion of each measurement, the risk area for ischemia was determined by injecting 10% Evans Blue dye via the jugular vein following LAD re-occlusion. Statistical comparisons of the R/L values among the groups were made using the Kruskal-Wallis test, followed by Dunn's procedure. Data are reported as the group mean ± SEM (n = 8), and probability values (p) less than 0.05 were considered statistically significant. The R/L values ranged from 39.8 ± 3.9% to 48.7 ± 4.3% and revealed no significant differences among the groups, suggesting that the changes in the infarct size observed among the groups did not depend on the R/L. b) I/R value (%), showing the infarct size expressed as a percentage of the risk area for ischemia. Statistical comparisons of the I/R values among the groups were made using the Kruskal-Wallis test, followed by Dunn's procedure. Data are reported as the group mean ± SEM (n = 8), and probability values (p) less than 0.05 were considered statistically significant. The I/R value was 49.7 ± 5.7% in the Control group ; the I/R values decreased significantly to 31.3 ± 8.2% in the Pre group, 16.5 ± 7.4% in the Post group, and 19.0 ± 9.1% in the Pre + Post group. *Significant difference (p<0.05) compared with the Control group. #Significant difference (p<0.05) compared with the Pre group.
<bold>Figure 2</bold>
Figure 2

Figure 2 a R/L value (%) Figure 2b I/R value (%)

a) R/L value (%), showing the risk area for ischemia expressed as a percentage of the left ventricle. After the completion of each measurement, the risk area for ischemia was determined by injecting 10% Evans Blue dye via the jugular vein following LAD re-occlusion. Statistical comparisons of the R/L values among the groups were made using the Kruskal-Wallis test, followed by Dunn's procedure. Data are reported as the group mean ± SEM (n = 8), and probability values (p) less than 0.05 were considered statistically significant. The R/L values ranged from 39.8 ± 3.9% to 48.7 ± 4.3% and revealed no significant differences among the groups, suggesting that the changes in the infarct size observed among the groups did not depend on the R/L.

b) I/R value (%), showing the infarct size expressed as a percentage of the risk area for ischemia. Statistical comparisons of the I/R values among the groups were made using the Kruskal-Wallis test, followed by Dunn's procedure. Data are reported as the group mean ± SEM (n = 8), and probability values (p) less than 0.05 were considered statistically significant. The I/R value was 49.7 ± 5.7% in the Control group ; the I/R values decreased significantly to 31.3 ± 8.2% in the Pre group, 16.5 ± 7.4% in the Post group, and 19.0 ± 9.1% in the Pre + Post group.

*Significant difference (p<0.05) compared with the Control group.

#Significant difference (p<0.05) compared with the Pre group.

Figure 1. ; Facial pallor after the initial attempt to anesthetize the buccal nerve along the body of the mandible.
Matias Garcia-Blanco and
Stephanie Scanlan
<bold>Figure 1.</bold>
Figure 1.

Facial pallor after the initial attempt to anesthetize the buccal nerve along the body of the mandible.

Figure 2. ; Resolution of the facial pallor 23 minutes after intra-arterial injection involving the facial artery.
Matias Garcia-Blanco and
Stephanie Scanlan
<bold>Figure 2.</bold>
Figure 2.

Resolution of the facial pallor 23 minutes after intra-arterial injection involving the facial artery.

Perioperative Management of Obstructive Sleep Apnea With Nasal Continuous Positive Airway Pressure
Hirofumi ArisakaMD DDS PhD,
Shigeki SakurabaMD PhD,
Reiko KobayashiDDS,
Homare KitahamaDDS,
Naofumi NishidaDDS,
Munetaka FuruyaDDS PhD, and
Kazu-ichi YoshidaDDS PhD
Article Category: Research Article
Volume/Issue: Volume 55: Issue 4
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006-55.4.121
Page Range: 121 – 123

arrhythmias, myocardial infarction, 10 and interruptions of sleep with decreases of stage 3 and 4 non-REM sleep. Unexpected mortality still occurs in this patient group following major surgical procedures. The majority of incidents of postoperative cardiac ischemia, myocardial infarction, and sudden cardiac death occur at night. It has been suggested that OSAS may be a major cause of these unexpected cases of postoperative cardiac ischemia or death. 11 , 12 NCPAP is an effective treatment for obstructive sleep apnea. Despite the patient's diagnosis of severe

Coronary Spasm During Postoperative Sedation With Dexmedetomidine
Yu SatoDDS, PhD,
Tomoka MatsumuraDDS, PhD,
Yushi AbeDDS,
Chihiro KutsumizuDDS, and
Shigeru MaedaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 69: Issue 3
Online Publication Date: Oct 06, 2022
DOI: 10.2344/anpr-69-01-02
Page Range: 20 – 24

indicative of coronary spasm. In fact, the incidence of silent myocardial ischemia caused by coronary spasm has been reported to be more than twice that of symptomatic ischemia or angina pectoris. 6 In some elderly patients, however, ischemic heart disease might not be noticed due to a lack of subjective symptoms. In this case, the symptoms were thought to be obscured by sedation. It has been suggested that the use of DEX during cardiac surgery is effective for reducing the incidence of postoperative complications, reducing postoperative mortality, and improving

JDSA JOURNAL ABSTRACTS
Article Category: Other
Volume/Issue: Volume 61: Issue 3
Online Publication Date: Jan 01, 2014
DOI: 10.2344/0003-3006-61.3.120
Page Range: 120 – 127

-ichi Pre- and Post-conditioning Effects of Sevoflurane on Myocardial Ischemia/Reperfusion Injury J Jpan Dent Soc Anesthesiol 2014;42(2):196–203 Recent investigations have demonstrated that anesthetic pre- and post-conditioning reduce the myocardial infarct size to a degree comparable to that achieved with ischemic preconditioning. We hypothesized that the combination of sevoflurane-induced pre- and post-conditioning would result in a greater preservation of the myocardium. In vivo rabbit hearts (n = 32) were subjected to

Anesthetic Management of a Patient With Takayasu Arteritis
Mitsuhiro YoshidaDDS, PhD,
Toru YamamotoDDS, PhD,
Shunji ShiibaDDS, PhD,
Nozomu HaranoDDS, PhD,
Teppei SagoDDS, PhD,
Masahito NunomakiDDS, PhD, and
Seiji WatanabeMD, PhD
Article Category: Case Report
Volume/Issue: Volume 63: Issue 1
Online Publication Date: Jan 01, 2016
DOI: 10.2344/14-00006R1.1
Page Range: 31 – 33

Takayasu arteritis is an idiopathic and chronic inflammatory disease characterized by the formation of stenoses or abnormal aneurysms in large vessels, resulting in life-threatening ischemia in major organs. Takayasu arteritis predominantly affects young females under 40. The etiology of this disease has not been defined. 1 , 2 Some reports have emphasized problems in the anesthetic management of a patient with Takayasu arteritis. 3 – 6 However, limited information is available. We present a case of general anesthesia in a patient

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Phillip YenDDS, MS, DADBA and
Lenny NaftalinDDS, DADBA
Article Category: Other
Volume/Issue: Volume 62: Issue 1
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.1.40
Page Range: 40 – 41

bradycardia, hypotension, and peripheral vasodilation. Chemical stimulation by prostacyclin and other agents (such as those released during myocardial ischemia) may produce the same cascade of events. When looking at the end results of this reflex and its ability to override other cardiac sympathetic stimulation, it is presumably initiated to help restore cardiac output and protect the myocardium in states where increased myocardial demand will cause damage. The mechanism behind the BJR is complex, and its role in cardiac physiology is still being investigated. In

Hair Tourniquet Syndrome in the Dental Patient
Jason R. FloresRN, DDS
Article Category: Other
Volume/Issue: Volume 61: Issue 3
Online Publication Date: Jan 01, 2014
DOI: 10.2344/0003-3006-61.3.111
Page Range: 111 – 112

Hair tourniquet syndrome (HTS) is a condition where a hair strand will circle and become entangled around an appendage. In some cases a formidable knot will form, and the resulting tightened noose will slowly strangulate the appendage. Unfortunately, the first instinct of the patient or parent is to tug at the loose hair, which only further complicates the problem, and pain from ischemia may start. Without immediate release, the appendage may be lost. HTS usually affects the fingers, toes, wrists, penis or scrotum, vaginal labium