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being partly or entirely halogenated, making them more stable and less toxic. 8 Fluroxene was introduced in 1951, the same year halothane was first synthesized. Halothane, an ethane, was then introduced for clinical use in 1956, followed by methoxyflurane, the first of the methyl-ethyl ethers, in 1960. Enflurane was introduced in 1972 and isoflurane in 1980, and both of these agents limited the nephrotoxicity and hepatotoxicity of methoxyflurane. Desflurane and sevoflurane were synthesized in the 1960s and 1970s but did not become commercially available for clinical

administration during permissive hypercapnia were investigated in anesthetized rabbits. METHODS Eight male Japanese white rabbits (2.2–2.7 kg) were used (Sankyo Labo Co, Tokyo, Japan). This study was performed according to The Guidelines for the Treatment of Experimental Animals of Tokyo Dental College. 19 All animals were allowed food and water ad libitum until the morning of the experiment. Anesthesia was induced by inhalation of isoflurane (4.0%) (Abbot Japan, Tokyo, Japan) and oxygen delivered using a mask. Before skin incisions for

groups. Anesthesia and Experimental Preparation General anesthesia was induced with isoflurane (4%) and oxygen delivered using a mask. Before skin incisions for each of the experimental procedures, 2% lidocaine (0.5 mL) was injected into the surgical field. A #20 Fr, noncuffed, pediatric tracheal tube 10 cm in length 6 was inserted into the trachea through a tracheostomy. The left auricular marginal vein and right femoral artery were cannulated with 22- and 20-gauge indwelling catheters, respectively. After intravenous (IV) acetated Ringer

cost of ivAPAP, routine use of this preparation for perioperative pain management in the dental surgical setting cannot be justified on the basis of current evidence. (Summary MA Saxen) Fong R, Wang L, Zacny JP, et al. Caffeine accelerates emergence from isoflurane anesthesia in humans a randomized, double-blind, crossover. Anesthesiology. 2018;129:912–920. This study was carried out to test the hypothesis that caffeine accelerates emergence from anesthesia in humans. A single-center, randomized, double-blind crossover study was

Dental College. All animals were allowed food and water ad libitum until the morning of the experiment. The animals were randomly allocated to 1 of 2 groups: epinephrine continuous infusion at 0.01 μg/kg/min (Ep-0.01 group, n = 8) and epinephrine continuous infusion at 0.1 μg/kg/min (Ep-0.1 group, n = 8). Anesthesia was induced by inhalation of 4.0% isoflurane (Forane, Abbott Japan, Tokyo, Japan) in oxygen delivered using a mask. Before skin incisions for each of the experimental procedures, appropriate doses of lidocaine (Xylocaine, Astra Zeneca, Osaka

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

the anesthesia machine into a gaseous state prior to its delivery to the patient. N 2 O and/or inhaled volatile agents are administered to the patient via a mask or breathing tube which is connected to a corrugated circuit to the anesthesia machine. The 3 most commonly used inhaled anesthetics—isoflurane, sevoflurane, and desflurane—undergo very little in vivo metabolism in clinical use. 2 Less than 5% of these volatile anesthetics is metabolized by the patient. 3 Because they undergo very little metabolic change inside the body, upon exhalation by the patient

points could be argued. For example, Dr Malamed reports that fentanyl should be used with caution in patients taking monoamine oxidase inhibitors within 14 days. This certainly applies to meperidine (Demerol). Also, the cautious use of atropine in asthma is certainly now controversial. The suggested use of Innovar for premedication would often alarm many anesthesiologists! In addition, there is no mention—however controversial—of droperidol causing prolongation of the QT interval. Similarly, many anesthesiologists could argue about the notion that isoflurane “has a

agents such as isoflurane or sevoflurane. In patients with CFC syndrome experiencing respiratory muscle weakness, the rapid elimination of desflurane effectively prevents respiratory depression. Additionally, as with all volatile anesthetics, desflurane demonstrates anticonvulsant effects and adequately suppresses refractory status epilepticus 5 ; therefore, it may be effective for maintaining general anesthesia in patients with CFC syndrome who experience frequent seizures. Moreover, use of remifentanil may aid in a faster recovery and decrease the risks of prolonged

phenobarbital sodium and 0.5 mg of atropine intramuscularly, 1 hour prior to surgery. When the patient arrived in the operating room, routine monitors were applied and intravenous access was secured. Anesthesia was induced with propofol (2 mg/kg) and fentanyl (1.5 μg/kg); vecuronium (0.1 mg/kg) was used for tracheal intubation. Anesthesia was maintained with isoflurane (1–2 vol%) in oxygen using a circle system with a carbon dioxide absorber. After the patient underwent mechanical ventilation for 40 minutes, a sinus tachycardia of 150–170 beats/min developed, and