The American College of Gastroenterology, the American Gastroenterological Association, and the American Society of Gastrointestinal Endoscopy issued a joint statement on propofol sedation for endoscopy. Among their recommendations that have important implications for dentistry are:

Compared to standard doses of benzodiazepines and narcotics, propofol may provide faster onset and deeper sedation.… More rapid cognitive and functional recovery can be expected with the use of propofol as a single agent.
There are data to support the use of propofol by adequately trained nonanesthesiologists. Large case series indicate that with adequate training, physician-supervised nurse administration of propofol sedation can be done safely

Abstract

Clonidine is a preferential alpha-2 agonist drug that has been used for over 35 years to treat hypertension. Recently, it has also been used as a preoperative medication and as a sedative/anxiolytic drug. This randomized, double-blind, placebo-controlled crossover clinical trial characterized the effects of oral clonidine pretreatment on intravenous catheter placement in 13 patients. Parameters measured included the bispectral index (BIS), Observer's Assessment of Alertness/Sedation Scale (OAA/S), frontal temporal electromyogram (EMG), 30-Second Blink Count (Blink), Digit Symbol Substitution Test (DSST), State Anxiety Inventory (SAI), fingertip versus forearm skin temperatures, and multiple questionnaires. Oral clonidine significantly decreased SAI scores, OAA/S, EMG, and Blink, but did not cause statistically significant BIS or DSST reductions. Subjects preferred oral clonidine pretreatment prior to venipuncture compared to placebo. Questionnaires also indicated that clonidine provided minimal sedation, considerable anxiolysis, and some analgesia. Fingertip versus forearm skin temperature differentials were decreased. Reduced fingertip versus forearm temperature differentials suggest increased peripheral cutaneous blood flow prior to venous cannulation. Oral clonidine pretreatment not only helped control patient anxiety and pain but also provided cardiovascular stability.

Abstract

The purpose of this follow-up study was to assess and compare the quantity and quality of dental undergraduate teaching in conscious sedation with comparisons to a previous study conducted in 1998. Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final-year dental undergraduates at the 15 dental schools in the United Kingdom and Ireland. Staff responses from 9 schools (60%) and student responses from 11 schools (73%) were received. From the students' responses, the mean (range) number of cases observed in inhalational sedation was 7 (0–17) and the mean (range) number performed in inhalational sedation was 4 (0–8). The mean (range) number of cases observed in intravenous sedation was 9 (2–19), and the mean (range) number performed was 5 (0–8). There has been an increase in didactic teaching. There has been a decrease in the observing of inhalational cases, but an increase in the hands-on performance of this type of sedation. There is an increase in the hands-on teaching of intravenous sedation.

Abstract

A healthy young male patient was scheduled for dental care under nasotracheal intubated general anesthesia. The presence of a plastic calculator key complicated the intubation. This case report describes the event and reviews some possible techniques for coping with an airway that becomes obstructed by a foreign object.

A Case in Which the Hole in the Inflation Line Was Not Closed at the Tip of the Tracheal Tube

Yoshinari MorimotoDDS, PhD,

Megumi HayashiDDS, PhD,

Kanae TsukawakiDDS,

Kouji TakanoDDS, PhD,

Hiroko KuboDH, and

Eri IidaDH

The Great Debate On Nurse-Administered Propofol Sedation (NAPS)—Where Should We Stand?

Oral Clonidine Pretreatment Prior to Venous Cannulation

Abstract

A Follow-up Survey of the Teaching of Conscious Sedation in Dental Schools of the United Kingdom and Ireland

Abstract

Foreign Body Obstruction Preventing Blind Nasal Intubation

Abstract

Fundamentals of Electrocardiography Interpretation

Abstract

JDSA Journal Abstracts

A Case in Which the Hole in the Inflation Line Was Not Closed at the Tip of the Tracheal Tube

Comparison of the Length and Shape of Various Preformed Nasotracheal Tubes

Virtual Reality Distraction vs Nitrous Oxide for Reducing Anxiety and Injection Pain

Single-Agent Total Intravenous Anesthesia With Remimazolam for an Elderly Man Undergoing Ambulatory Oral Surgery: A Case Report

Commentary: Are Anesthesiologists Still “Darting” Their Patients?

Tissue Blood Flow During Remifentanil Infusion With Carbon Dioxide Loading

Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery

Pulseless Ventricular Tachycardia During Office-Based Anesthetic in a Four-Year-Old Child

Partially Withdrawn Nasotracheal Tube: An Alternative to the Nasal Trumpet

Hair Tourniquet Syndrome in the Dental Patient