Anesthesia Progress Volume 54: Issue 3

Just before the deadline for submitting my editorial to our publisher, the American Dental Association released their final revision of their total re-write of the Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry, their Guidelines for the Use of Conscious Sedation, Deep Sedation and General Anesthesia For Dentists and their associated Policy Statement on sedation and anesthesia in dentistry. Your editor carefully read through the entire proposed major revision of these documents. They have been masterfully crafted compared to the original rough draft that was submitted to the entire ADA membership for scrutiny and suggested changes

Abstract

As increasing attention is paid to disparities in oral health care, cross-cultural means for assessing dental fear, a significant barrier to dental care, are in high demand. There is, however, a surprising shortage of Spanish-language dental fear measures in the literature, despite evidence of dental fear and avoidance in Spanish-speaking populations. The goals of the current series of studies were to develop and validate a Spanish-language version of the Interval Scale of Anxiety Response (ISAR). Magnitude estimation, a technique in which participants are asked to assign a number to indicate the perceived intensity of a stimulus or phrase, was used to compare the Spanish ISAR to the original English ISAR during the development studies. As a result of the 4 initial development studies, modifications were made to both the Spanish and English scales. Once 2 seemingly equivalent scales were established, validation studies were completed with native Spanish- and English-speaking dental patients. The results suggest that both the Spanish and modified English ISAR scales are valid measures of state anxiety associated with dental treatment. Additionally, the results of these studies highlight the importance of thoroughly testing translated measures to ensure they are accurately assessing that which they purport to measure.

Abstract

Endotracheal intubation has been proposed as a risk factor for temporomandibular joint dysfunction (TMD) in a limited number of published case reports and systematic studies. Symptoms may result from forces applied with the laryngoscope, or manually in an attempt to complete the intubation, and may be related to the duration in which temporomandibular joint (TMJ) structures are stressed. The objective of this study was to examine risk factors for TMD complaints associated with endotracheal intubation. One hundred twenty-two patients who underwent endotracheal intubation for surgery at the University of Washington Medical Center participated. Exclusions included surgery of the head or neck, cognitive deficit, or emergency surgery. Subjects were assessed presurgically, and at 7 and 14 days postoperatively. Gender, interincisal distance, and age were found to be significantly associated with TMD symptoms lasting as long as 14 days following intubation. For both TMD pain and TMD nonpain symptoms, the most reliable predictor of a complaint following intubation was a history of TMD complaints within a year preoperatively. Any association between endotracheal intubation and the development of short-term TMD symptoms is likely to be found in patients with prior report of such conditions, and we therefore recommend a review of TMD complaint history when planning general anesthesia.

Abstract

Dapsone is a leprostatic agent commonly prescribed for the management of leprosy, malaria, and the immunosuppression-induced infections of Pneumocystis carinii and Toxoplasma gondii. In susceptible patients, methemoglobinemia, a potentially life-threatening event, can occur. We report a case of dapsone-induced methemoglobinemia which was observed during general anesthesia for the management of a fractured mandible. The pathophysiology, diagnosis, and management of dapsone-induced methemoglobinemia will be discussed.

ADA Sedation-Anesthesia Guidelines Revisions Deserve our Support

Development and Validation of the Spanish Interval Scale of Anxiety Response (ISAR)

Abstract

Intubation Risk Factors for Temporomandibular Joint/Facial Pain

Abstract

The Recognition, Physiology, and Treatment of Medication-Induced Methemoglobinemia: A Case Report

Abstract

Oral Sedation: A Primer on Anxiolysis for the Adult Patient

Abstract

11th International Dental Congress on Modern Pain Control The Essential Role of Dental Anesthesiology in the 21st Century Safe and Comfortable Dentistry 4th–7th October, 2006

JDSA Journal Abstracts

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

A New ACLS Option for Anesthesia Providers

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

General Anesthesia for a Child With a Living Donor Liver Transplant After Hepatoblastoma and Metastatic Lung Tumor Resection

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

Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery

Letter to the Editor

Monheim LM. Analgesia in dentistry now and in the future. Anesth Prog. 1971;18(5):100–106 and J Am Analg Soc. 1971:9:1(abstract).

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

Perfect Time for a Fresh Perspective