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Figure 1. ; Schematic of the experimental protocol. Each rat was placed in a wire net container on a heated glass base 10 minutes prior to the start of the experiment. Baseline values were recorded 5 minutes prior to subcutaneous injection. Paw withdrawal latency was monitored immediately after the injection of the test solution; latency was then monitored every 5 minutes thereafter for 40 minutes.
Yukako Tsutsui and
Katsuhisa Sunada
Figure 1. 
Figure 1. 

Schematic of the experimental protocol. Each rat was placed in a wire net container on a heated glass base 10 minutes prior to the start of the experiment. Baseline values were recorded 5 minutes prior to subcutaneous injection. Paw withdrawal latency was monitored immediately after the injection of the test solution; latency was then monitored every 5 minutes thereafter for 40 minutes.

Figure 2. ; Paw withdrawal latency over time. NS indicates normal saline; A, 4% articaine (2 mg); DA, 5 μg/kg dexmedetomidine (1.25 μg) + 4% articaine (2 mg); and EA, 1:100,000 epinephrine (0.9 μg) + 4% articaine (2 mg). Paw withdrawal latency was monitored from 0 to 40 minutes after injection; n = 11 per study group. *Statistically significant difference compared to baseline. †Statistically significant difference compared to NS. ‡Statistically significant difference compared to A.
Yukako Tsutsui and
Katsuhisa Sunada
Figure 2. 
Figure 2. 

Paw withdrawal latency over time. NS indicates normal saline; A, 4% articaine (2 mg); DA, 5 μg/kg dexmedetomidine (1.25 μg) + 4% articaine (2 mg); and EA, 1:100,000 epinephrine (0.9 μg) + 4% articaine (2 mg). Paw withdrawal latency was monitored from 0 to 40 minutes after injection; n = 11 per study group. *Statistically significant difference compared to baseline. †Statistically significant difference compared to NS. ‡Statistically significant difference compared to A.

Adding Dexmedetomidine to Articaine Increases the Latency of Thermal Antinociception in Rats
Yukako TsutsuiDDS, PhD and
Katsuhisa SunadaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 67: Issue 2
Online Publication Date: Jul 06, 2020
DOI: 10.2344/anpr-66-04-06
Page Range: 72 – 78

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A Review of Current Literature of Interest to the Office-Based Anesthesiologist
Mark A. SaxenDDS, PhD
Article Category: Review Article
Volume/Issue: Volume 71: Issue 2
Online Publication Date: Jul 08, 2024
DOI: 10.2344/809216
Page Range: 96 – 98

significant limitation of this study for dental anesthesia providers is the fact that the data were drawn from a population with a mean age of 55 years with each individual drug administered as an adjunct to inhalational anesthesia. Direct application of these results to dental anesthesia, which most often involves intravenous anesthesia administered to pediatric and young adult patients, is difficult. Laferriere-Langlois P, Morisson L, Jeffries S, et al. Depth of anesthesia and nociception monitoring: current state and vision for 2050. Anesth Analg . 2024

Nothing After Midnight?
Kyle J. KramerDDS, MS
Article Category: Editorial
Volume/Issue: Volume 70: Issue 1
Online Publication Date: Mar 28, 2023
DOI: 10.2344/anpr-70-02-03
Page Range: 1 – 2

.13381 3.  Özaltun F, Zengin SÜ, Orhon Ergün M, Çorman Dinçer P, Umuroğlu T. Determination of the relationship between postoperative delirium development and analgesia nociception index values in

Commentary
Christine L. QuinnDDS, MS
Article Category: Article Commentary
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-04-08
Page Range: 245 – 247

mixture of local anesthetics (EMLA), which ultimately gained US Food and Drug Administration approval in 1992. EMLA (2.5% lidocaine and 2.5% prilocaine) is now widely used both as a topical cream for anesthesia prior to venipuncture or a gel for intraoral topical anesthesia. Another drug that Dr Yagiela discussed is capsaicin and its application for relief of chronic pain. Capsaicin provides a prolonged loss of nociception in an area wherever it is topically applied. The primary problem with capsaicin is that it causes acute pain upon initial application

Literature Review for Office-Based Anesthesia
Mark A. SaxenDDS, PhD
Article Category: Book Review
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/0003-3006-68.2.128
Page Range: 128 – 130

study, the report illustrates that avoidance of opioids may pose new risks that might not outweigh the known risks of opioids. It is noteworthy that all patients in this study received 9 other pharmacologic agents as part of their balanced anesthetic. Whether or not profound bradycardia or hypotension would occur with a simpler, streamlined balanced anesthetic technique remains unknown. Several other limitations of the report were described, including the lack of specific monitoring for depth of anesthesia and nociception and the fact that the optimal dosing

COMMENTARY
Stuart E. LieblichDMD
Article Category: Article Commentary
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
DOI: 10.2344/0003-3006-64.3.125
Page Range: 125 – 126

, it is more effective than that administered after the surgery, ie, before nociception has started. Thus there is controversy as to whether there is a benefit to preemptively administered medications as opposed to preventive administration. 2 One could argue that taking a medication with potential gastrointestinal side effects, such as ibuprofen, on an empty stomach could cause more adverse effects than waiting until after surgery, while the local anesthetic is still effective, and taking the NSAID with a small amount of food. I presume that most of us in

A Survey of Pain, Pressure, and Discomfort Induced by Commonly Used Oral Local Anesthesia Injections
Eliezer Kaufman DMD,
Joel B. EpsteinDMD, MSD, FRCD(C),
Eitan NavehDSc,
Meir GorskyDMD,
Anat GrossDMD, and
Galit CohenDMD
Article Category: Other
Volume/Issue: Volume 52: Issue 4
Online Publication Date: Jan 01, 2005
DOI: 10.2344/0003-3006(2005)52[122:ASP]2.0.CO;2
Page Range: 122 – 127

Local anesthetics (LAs) are the most widely used drugs in medicine and dentistry. 1 They prevent nociception generated during surgical and dental procedures, and without LAs, many medical and dental procedures could not be performed. The injection of LAs is often the only perceived painful part of the medical or dental procedure, and fear associated with LA injection has been reported to be a factor in avoiding dental treatment. 2 Numerous studies have examined possible variables that lead to this phenomenon. The purpose of this study was to assess the

Anesthetic Management of a Patient With Restless Legs Syndrome: A Case Report
Naohiro OhshitaDDS, PhD,
Koji YamagataPhD,
Akio HimejimaDDS, PhD,
Kazuhiro KanedaDDS, PhD,
Teruyuki YasutomeDDS, PhD,
Yoshiko MatsudaDDS, PhD,
Yasuo M. TsutsumiMD, PhD, and
Yoshihiro MomotaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-10
Page Range: 226 – 229

postoperative respiratory depression. In this case, dexamethasone was used as a supplement for postoperative edema, but ideally non-steroidal anti-inflammatory drugs could have also been administered for additional management of postoperative swelling and pain. Dexmedetomidine is associated with spinal nociceptive processing and, unlike fentanyl, enhances the descending inhibition and decreases the descending facilitation to modulate pain and nociception. 13 As an α2-agonist, dexmedetomidine produces potent antinociceptive effects and reduces release of the spinal