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Complications After Dental Sedation: A Myotonic Mystery Case Report
Milad KaramlouDDS,
Iman AsariaDDS,
Jaime BarronDDS,
Petra BoutrosDMD,
Vincent FisherDDS,
Rachel GrandinettiDMD,
Julian JohnsonDMD,
Emily RichardDMD,
David SuskoDMD,
Cristobal UrrutiaDDS,
Bryce WoolseyDDS,
Ronald BaumannDDS,
James CottleDDS,
Richard SweaneyDDS,
Mark WenzelDDS,
John NussteinDDS, MS, and
David HallDDS
Article Category: Case Report
Volume/Issue: Volume 69: Issue 4
Online Publication Date: Dec 19, 2022
Page Range: 26 – 31

slight ST elevation. Approximately 110 minutes after the last articaine injections and 125 minutes after the lidocaine injections, the patient arrived in the ED with stable vital signs and slight ST elevation. IV lipid emulsion (ILE; Liposyn II 20%; 50 mL) therapy was started with minimal improvement of the patient's overall condition, although ST elevation did resolve shortly afterward. Arterial blood gas analysis and cardiac biomarkers (troponins and creatine kinase) were all normal, tentatively ruling out an ST-elevation myocardial infarction. The patient

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Figure 2.; Postop transient coronary spasm. While sedated 8 hours postoperatively with DEX, an AV junctional rhythm, 2 mm ST elevation, and biphasic T waves were detected in lead II, which lasted for 3 minutes before returning to normal sinus rhythm.
Yu Sato,
Tomoka Matsumura,
Yushi Abe,
Chihiro Kutsumizu, and
Shigeru Maeda
Figure 2.
Figure 2.

Postop transient coronary spasm. While sedated 8 hours postoperatively with DEX, an AV junctional rhythm, 2 mm ST elevation, and biphasic T waves were detected in lead II, which lasted for 3 minutes before returning to normal sinus rhythm.


Brian Crump,
Al Reader,
John Nusstein,
Melissa Drum,
Sara Fowler, and
John Draper
<bold>Figure 3.</bold>
 
Figure 3.

Pain ratings by VAS category. The first 4 columns represent needle insertion and solution deposition for the PDL and mock PDL injections. The last 4 columns represent needle insertion and solution deposition for the PDL-aPI injections and the mPDL-cPI injections. VAS indicates visual analog scale; PDL, periodontal ligament; PDL-aPI, PDL injection and alternative palatal infiltration; mPDL-cPI, mock PDL injection and conventional palatal infiltration.


Maho ShinodaDDS,
Akiko NishimuraDDS, PhD,
Erika SugiyamaPhD,
Hitoshi SatoPhD, and
Takehiko IijimaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
Page Range: 3 – 10

IV APAP can be expected ∼90 minutes after administration in adults, and its effect lasts longer than 5 hours. Planned continuous maintenance of APAP medication based on the PK/PD model should result in an optimal administration regimen and could reduce the unnecessary or excessive use of NSAIDs and opioids for postoperative pain management. CONCLUSION The developed PK-PD model of IV APAP suggests the appropriate timing for administration to maximize postoperative analgesia. At least 90 minutes is required to achieve the analgesic effect

James TomDDS, MS
Article Category: Research Article
Volume/Issue: Volume 63: Issue 2
Online Publication Date: Jan 01, 2016
Page Range: 95 – 104

unit to respond to the sensed rate, and the last position describes the pacer's response to controlling tachycardias. It is important to note that the fifth position describes not only pacing, but also the delivery of shocks for life-threatening tachyarrhythmias. 2 Pacemaker Terminology: North American Society of Pacing and the British Pacing and Electrophysiology Group* * From: McMullan J, Valento M, Attari M, Venkat A. 13 Care of the pacemaker

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
Page Range: 20 – 24

patient ward. She maintained spontaneous breathing with the DEX and fentanyl infusions. Fentanyl was stopped 5 hours postoperatively to avoid oversedation. At 8 hours after the operation, an atrioventricular (AV) junctional rhythm without P waves, a 2-mm ST segment elevation, and biphasic T waves were detected in lead II that lasted ∼3 minutes ( Figure 2 a). The patient's systolic blood pressure decreased from 120 mm Hg to 78 mm Hg, and her heart rate slightly decreased to 31 bpm. However, her ECG returned to normal without any treatment ( Figure 2 b). During this time

S. MaedaDDS, PhD,
T. MiyawakiDDS, PhD,
H. HiguchiDDS, PhD, and
M. ShimadaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 55: Issue 3
Online Publication Date: Jan 01, 2008
Page Range: 73 – 77

Sedation and general anesthesia are often used for oral surgery as well as dental treatments in patients with intellectual disability or dental phobia. 1 – 3 In intravenous sedation, benzodiazepine injection is useful owing to its outstanding amnesic effect. Propofol has become a major anesthetic drug for intravenous sedation as well as general anesthesia in the last decade because of its short half-life. However, the amnesic effect of propofol is considered weaker than that of benzodiazepines, and vessel pain occurs when it is administered

William FlickDDS, MPH and
Michael LloydDMD, MD
Article Category: Research Article
Volume/Issue: Volume 66: Issue 2
Online Publication Date: Jan 01, 2019
Page Range: 77 – 86

to having only 1 assistant. Lack of emergency preparedness plan. Only 96% compliance was reported. Only 80% reported having semiannual emergency drills and exercises. Lack of current ACLS (or PALS) certification by Permit A and Permit B holders—this should be 100% compliant. The 2016 survey final question asked providers if there were any deaths, disabilities, or injuries during or after treatment under sedation or GA over the last 10 years. It

Paul A. MooreDMD, PhD, MPH,
Elliot V. HershDMD, MS, PhD,
Athena S. PapasDMD, PhD,
J. Max GoodsonDDS, PhD,
John A. YagielaDDS, PhD,
Bruce RutherfordDDS, PhD,
Seigried RogyPhD, and
Laura NavaltaMS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 2
Online Publication Date: Jan 01, 2008
Page Range: 40 – 48

Soft tissue and pulpal anesthesia induced by the administration of local anesthetic agents containing a vasoconstrictor (epinephrine or levonordefrin) is an essential part of outpatient dentistry. 1 – 3 A shortcoming of most dental local anesthetic agents is that the duration of soft tissue anesthesia (numbness to the lip and tongue) typically lasts for 3–5 hours. 4 Persistent anesthesia, which is often associated with difficulty in eating, drinking, and speaking and with inadvertent biting of the lips, tongue, and/or cheek, is considered

Eman A. El-SharrawyMBBCh, MSc, MD,
Ibrahim E. El-HakimBDS, MDS, PhD, and
Elham SameehBDS, MDS
Article Category: Research Article
Volume/Issue: Volume 53: Issue 3
Online Publication Date: Jan 01, 2006
Page Range: 78 – 82

third patient received ibuprofen after the first surgery and combined tramadol and ibuprofen after the second operation. For the first patient, there was an 84.8% increase in the CRP level after tramadol treatment and a 3% increase after combined tramadol and ibuprofen treatment. For the second patient, there was a 46.8% increase in the CRP level after tramadol treatment and a 3.47% increase after combined tramadol and ibuprofen treatment. For the last patient with bilateral impaction, who received ibuprofen after first surgery, there was a 43% increase in the CRP