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As a critical component of general anesthesia, anesthesiologists are primarily responsible for successful and safe airway management throughout the perioperative period. 1 , 2 Ultimately, the responsibility for trauma to the airway, including dental injury, during the perioperative period is considered to lie with the anesthesiologist. 1 , 2 Direct laryngoscopy is still the most common method of visualizing the airway during tracheal intubation. Although direct laryngoscopy has been thought to be significantly related to dental injury

PERIOPERATIVE MANAGEMENT OF PATIENTS TAKING ORAL ANTITHROMBOTICS Management of oral antithrombotics (OATs) for patients undergoing dental procedures with sedation or general anesthesia requires understanding the factors used to weigh the risks and benefits of continuing or stopping OATs perioperatively and framing treatment modifications to fit with the proposed surgical and anesthetic procedures. Questions that must be addressed include the following: 1) whether OAT agents should be continued, “bridged” (ie, temporarily substituted), or

Many reports concerning anesthetic management in patients with obstructive sleep apnea syndrome (OSAS) have been addressed. 1 – 7 These underline the higher risks associated with general anesthesia in OSAS patients. Those risks of perioperative complications might cause physicians to limit their administration of pain and anxiety relief drugs in the perioperative period. We report the case of an OSAS patient who was managed with nasal continuous positive airway pressure (NCPAP) and treated safely with anesthetic and analgesic drugs

levels of rivaroxaban similarly peak 3 hours after a dose, and the terminal half-life is 5 to 13 hours. Approximately 66% of rivaroxaban undergoes oxidative metabolism by CYP3A4 and CYP2J2 prior to excretion, while the remaining third is renally excreted unchanged. 17 CONCLUSION During the perioperative milieu, patients on OAP and OAC agents are at an elevated risk of significant bleeding due to impaired hemostasis. With these patients presenting in the dental setting more frequently, it is critical for sedation and

complications. 1 For example, nonsteroidal anti-inflammatory drugs carry a substantial complication risk for patients with gastrointestinal or renal impairment. 2 Opioids are also commonly used for perioperative analgesia after oral and maxillofacial surgery; however, their use in elderly patients can increase the risk of delirium and postoperative nausea and vomiting. 3 Peripheral nerve blocks using an indwelling catheter and infusion pump system for continuous local anesthetic delivery have been demonstrated to be effective in various surgeries including those

basal insulin rate is highly specific to the patient's individual physiologic needs and often multiple basal rates (ie, alternate or temporary basal rates) are used over a 24-hour period. This can help account for physiologic variations in insulin demand over episodes of increased exercise or periods of fasting concomitant with work or sleep schedules. These programmable changes can have perioperative implications because an optimal basal rate for surgery can be easily selected. Bolus infusions are also tailored to individual patient's needs and are optimal when the

Pulmonary hypertension (PH) is a condition wherein the pulmonary artery pressure (PAP) is abnormally high (normal: mean PAP, 25 mm Hg). Key points in anesthetic management of patients with PH include maintaining systemic blood pressure (BP), avoiding hypoxemia and hypercapnia, and providing adequate analgesia. 1 An individualized preoperative risk assessment and treatment optimization along with advanced perioperative planning may improve anesthetic management outcomes for patients with PH. 2 We present the case of a patient with idiopathic pulmonary

temperatures at 3 different locations to avoid perioperative redistribution hypothermia and triggering of a FCAS/CAPS episode. CASE REPORT A 13-year-old female patient (height 162 cm; weight 42 kg; body mass index 16 kg/m 2 ) with FCAS/CAPS was scheduled to undergo the extraction of an impacted tooth (mandibular right second premolar) under general anesthesia. She had been treated with canakinumab (interleukin [IL]-1 inhibitor) every 2 months during the winter, and her symptoms were well controlled with no other systemic disease or comorbidities

anesthetics, NSAIDs, acetaminophen, steroids, ketamine, alpha-2 agonists, and lastly for severe postoperative pain or if NSAIDs are contraindicated, opioids. 30 , 32 , 33 Literature supports the administration of a preemptive local anesthetic infusion through a peripheral or neuraxial catheter, which can then continue perioperatively. 30 Another consideration for postoperative analgesia for outpatient dental and oral surgery procedures is the intraoperative administration of local anesthesia followed by a long-acting local anesthetic such as bupivacaine or Exparel (Pacira