Abstract

This study with 24 volunteers compared the discomfort produced by needle penetration in different parts of the palatal mucosa. In addition, comparing a fresh needle to one that was used for a previous penetration in the same patient, we assessed the influence of the status of the needle on insertion discomfort during buccal mucosal penetration. The results showed that needle penetration in the anterior hard palate was more uncomfortable than in the posterior palate. Although men could not differentiate between fresh and used needles for a second buccal mucosal penetration, women reported a significant increase in discomfort with used needles.

Abstract

This study quantitatively assessed injection pressure, pain, and anxiety at the start of injection of a local anesthetic into the oral mucosa, and confirmed the relationship between injection pressure and pain, as well as between injection pressure and anxiety. Twenty-eight healthy men were selected as subjects and a 0.5-inch (12 mm) 30-gauge disposable needle attached to a computer-controlled local anesthetic delivery system (the Wand) was used. A 0.5 mL volume of local anesthetic solution was injected submucosally at a speed of either 30 or 160 s/mL. Three seconds after the start of local anesthetic injection, injection pressure was measured and pain and anxiety were assessed. Injection pressure was measured continuously in real time by using an invasive sphygmomanometer and analytical software, and pain was assessed on the Visual Analogue Scale and anxiety on the Faces Anxiety Scale. A significant correlation was evident between injection pressure and pain (rs = .579, P = .00124) and between intensity of injection pressure and state anxiety (rs = .479, P = .00979). It is therefore recommended that local anesthetic be injected under low pressure (less than 306 mm Hg) to minimize pain and anxiety among dental patients.

Abstract

Tiagabine is an anticonvulsant gamma-aminobutyric acid reuptake inhibitor commonly used as an add-on treatment of refractory partial seizures in persons over 12 years old. Four of the 5 cases reported here indicate that tiagabine might also be remarkably effective in suppressing nocturnal bruxism, trismus, and consequent morning pain in the teeth, masticatory musculature, jaw, and temporomandibular joint areas. Tiagabine has a benign adverse-effect profile, is easily tolerated, and retains effectiveness over time. Bed partners of these patients report that grinding noises have stopped; therefore, the tiagabine effect is probably not simply antinociceptive. The doses used to suppress nocturnal bruxism at bedtime (4–8 mg) are lower than those used to treat seizures.

M. Haraguchi,

Address correspondence to Mitsuhiro Haraguchi, Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumiku, Yokohama 230-8501, Japan.

M. SasaoI. Noguchi

Effects of 0.75% Ropivacaine on Infiltration Anesthesia Assessed by Somatosensory Evoked Potentials in Rats: Addition of Sodium Chondroitin Sulfate to Enhance Anesthetic Effect

Abstract

This study was designed to examine the effects of infiltration anesthesia of 0.75% ropivacaine and 0.75% ropivacaine containing sodium chondroitin sulfate (SCS) assessed by using somatosensory evoked potentials (SEP) in rats.

A bipolar stimulating electrode was inserted into the upper incisor pulp. The tooth pulp was stimulated electrically, and

Effects of Remimazolam With or Without Remifentanil on Oral Tissue Blood Flow and Oxygen Tension in Rabbits

Kohei ShimazuDDS, PhD,

Masataka KasaharaDDS, PhD,

Kyotaro KoshikaDDS, PhD, and

Tatsuya IchinoheDDS, PhD

The Increasing Use of Alcohol-Based Hand Sanitizers

Office-Based Anesthesia: Requirements for Patient Safety

INTRODUCTION

Factors Influencing the Discomfort of Intraoral Needle Penetration

Abstract

Initial Injection Pressure for Dental Local Anesthesia: Effects on Pain and Anxiety

Abstract

Tiagabine May Reduce Bruxism and Associated Temporomandibular Joint Pain

Abstract

Literature Abstracts

Pediatric Anesthesia

JDSA Journal Abstracts

Effects of 0.75% Ropivacaine on Infiltration Anesthesia Assessed by Somatosensory Evoked Potentials in Rats: Addition of Sodium Chondroitin Sulfate to Enhance Anesthetic Effect

IFDAS Newsletter

Effects of Remimazolam With or Without Remifentanil on Oral Tissue Blood Flow and Oxygen Tension in Rabbits

Limited Nasal Intubation Route After Pharyngeal Flap Surgery: A Case Report

Challenges in Developing an Effective Inferior Alveolar Nerve Block Guide

Anesthetic Management of a Pregnant Patient Undergoing Oral Surgery

A Review of Current Literature of Interest to the Office-Based Anesthesiologist