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The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory

contribute to the development of skeletal muscle wasting, osteoporosis, ischemic heart disease, anemia, diabetes, and metabolic symptoms. 27 SEDATION AND GENERAL ANESTHESIA CONCERNS IN COPD PATIENTS: PREOPERATIVE PERIOD COPD is a common condition that presents multiple challenges for dental sedation and general anesthesia (GA) providers. Increased risk of perioperative pulmonary complications (PPCs) is compounded by the fact that many dental anesthetics are administered in the office-based setting. It is the responsibility of the

Office-based sedation and anesthesia is a critical component of the modern pediatric dental practice. This is especially true for the management of special populations that include patients with cognitive impairments, developmental delay, precooperative age, and other conditions that limit the effectiveness of behavior management techniques. Some pediatric dentists provide minimal or moderate sedation while simultaneously performing dentistry. Although this practice has been a cornerstone of pediatric dental practice for generations, there are limitations

pediatric anesthesiologists and PACU nurses. These findings confirm a greater risk of clinically significant injection errors with the injection of small, concentrated volumes. Comment: The use of small, concentrated drug preparations is appealing to the mobile office-based anesthesiologist who provides all needed drugs and anesthesia armamentarium in each location. However, this study demonstrated that as much as a threefold overdose of some commonly used anesthetic drugs can occur when injecting with a tuberculin syringe and 18-gauge needle, even when injection

pediatric intubation, the unanticipated difficult airway, cardiopulmonary resuscitation, and the cost and practical aspects of maintaining proper infection control for routine use of video laryngoscopes. Although recommendations for the office-based setting are not specifically addressed, the debate tends to support a recommendation for having both DL and an appropriate method of VL available, depending upon the experience of the provider and nature of the procedure. Xiao H, Liu M, Man Y, Wei Y, Ji F. Effect of low-dose propofol combined with

recovery period following office-based anesthesia for patients with increased risk of OSA. (Summary MA Saxen) Morwald EE, Poeran J, Zubizarreta N, et al. Intravenous acetaminophen does not reduce inpatient opioid prescription or opioid-related adverse events among patients undergoing spine surgery. Anesth Analg . 2018;127:1221–1228. The perioperative role of intravenous acetaminophen (ivAPAP) remains to be established for several surgeries. Patients undergoing spinal surgery suffer from significant procedure-related pain that is often

survey included cell phones, tablets, and other portable devices. An accompanying editorial to this article acknowledges the ubiquity of cell phone usage alone, noting the number of cell phones alone has outnumbered the world's population since 2019. Strategies are discussed for using PEDs while maintaining vigilance during patient care. Summaries and comments provided by: Mark A. Saxen, DDS, PhD Indiana Office-Based Anesthesia Indiana University School of Dentistry Indianapolis, IN REFERENCE 1

intensive care unit, were not as directly applicable the use in the office-based anesthesia setting. Ockerman A, Bornstein MM, Leung YY, Li SK, Jacobs PR. Incidence of bleeding after minor oral surgery in patients on dual antiplatelet therapy: a systematic review and meta-analysis. Int J Oral Maxillofac Surg . 2020;49:90–98. Dual antiplatelet therapy (the daily, prophylactic use of acetylsalicylic acid plus a PY2Y12 inhibitor) has become the first choice for patients with acute or stable coronary artery disease to prevent thrombotic

but questions the broad conclusions by the authors, noting the limitations of the study. The trial was not randomized, nor was it blinded, leaving readers to consider the real possibility of unintended bias in these results. Blinding and randomization are introduced into a research design to minimize the effect of factors that are both known and unknown at the time of the investigation. Although the size and clinical setting of the trial are compelling, a blinded, randomized, multicenter trial would provide more definitive conclusions. 3 That said, many office-based

tools to get the job done. (S. L. Cohen) Applebaum JL, Agarkar M, Connis RT, Nickinovich DG, Warner MA. Practice advisory for the prevention of postoperative peripheral neuropathies 2018. Anesthesiology . 2018;128:11–26. This updated report by the American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies applies to adult patients undergoing sedation or anesthesia in operating rooms, recovery rooms, intensive care units, outpatient procedural units, and office-based practices. Seven hundred