In a 1985 editorial published in Anesthesia Progress, Dr. Ted Jastak advocated for the need for and the critical importance of acquiring accreditation for graduate dental anesthesiology programs.1 He described the “clout” that is afforded training programs that receive formal accreditation. He explained that the survival of hospital-based dental anesthesia programs and the maintenance of privileges that we enjoy as dentist anesthesiologists would require the authorized approval obtained through an officially recognized accreditation process.

Three years after this 1985 opinion article was published, the American Dental Association and the American Dental Society of Anesthesiology continued this

Abstract

Benzodiazepines in intravenous sedation are useful, owing to their outstanding amnesic effect when used for oral surgery as well as dental treatments on patients with intellectual disability or dental phobia. However, compared with propofol, the effect of benzodiazepine lasts longer and may impede discharge, especially when it is administered orally because of fear of injections. Although flumazenil antagonizes the effects of benzodiazepine quickly, its effect on the equilibrium function (EF) has never been tested. Since EF is more objective than other tests, the purpose of this study is to assess the sedation level and EF using a computerized static posturographic platform. The collection of control values was followed by the injection of 0.075 mg/kg of midazolam. Thirty minutes later, 0.5 mg or 1.0 mg of flumazenil was administered, and the sedation level and EF were measured until 150 minutes after flumazenil administration. Flumazenil antagonized sedation, and there was no apparent resedation; however, it failed to antagonize the disturbance in EF. This finding may be due to differences in the difficulty of assessing the sedation level and performing the EF test, and a greater amount of flumazenil may effectively antagonize the disturbance in EF.

Abstract

The Airtraq laryngoscope is a new intubation device that provides a non–line-of-sight view of the glottis. We evaluated this device by comparing the ease of nasotracheal intubation on a manikin with the use of Airtraq versus the Macintosh laryngoscope with and without Magill forceps. Nasotracheal intubation on a manikin was performed by 20 anesthesiologists and 20 residents with the Airtraq or Macintosh laryngoscope. The mean (± SD) time required for nasotracheal intubation by the residents was significantly shorter with the Airtraq laryngoscope than with the Macintosh laryngoscope (16 ± 7 sec vs 22 ± 10 sec; P < .001), but no difference in intubation time was observed between Airtraq (15 ± 11 sec) and Macintosh (13 ± 6 sec) laryngoscopy by the anesthesiologists. The Magill forceps was used more frequently to facilitate intubation with the Macintosh laryngoscope than with the Airtraq laryngoscope in both groups of operators 7(P < .001). The Airtraq laryngoscope scored better on the visual analog scale than did the Macintosh laryngoscope in both groups of operators (P < .05). The Airtraq laryngoscope offers potential advantages over standard direct laryngoscopy for nasotracheal intubation.

Abstract

This study investigated the physiologic and sedative parameters associated with a low-dose infusion of dexmedetomidine (Dex). Thirteen healthy volunteers were sedated with Dex at a loading dose of 6 mcg/kg/h for 5 minutes and a continuous infusion dose of 0.2 mcg/kg/h for 25 minutes. The recovery process was observed for 60 minutes post infusion. The tidal volume decreased significantly despite nonsignificant changes in respiratory rate, minute ventilation, oxygen saturation, and end-tidal carbon dioxide. The mean arterial pressure and heart rate also decreased significantly but within clinically acceptable levels. Amnesia to pin prick was present in 69% of subjects. A Trieger dot test plot error ratio did not show a significant change at 30 minutes post infusion despite a continued significant decrease in bispectral index. We conclude that sedation with a low dose of Dex appears to be safe and potentially efficacious for young healthy patients undergoing dental procedures.

Dr Norman Trieger and Dr Eliezer Kaufman of Hebrew University's Hadassah School of Dental Medicine celebrated the grand opening of a new clinical center. Professor Eliezer Kaufman, serving as Chairperson of the new facility, welcomed members of the European Federation for the Advancement of Anesthesia in Dentistry (EFAAD) and the Israeli Society for Sedation, Analgesia, and General Anesthesia in Dentistry (ISSAAD) on March 27, 2008.

Dr Norman Trieger and Dr Eliezer Kaufman

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(Left to right) Noam Yaron, Sharone Elad, Organizing Committee of Herzliya, Israel-ISSAAD; Norman Trieger, Past President ADSA and Guest Speaker; Salomon

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Coda's Accreditation Of Graduate Dental Anesthesiology Programs: A Benefit To All Dental Education

Effect of Flumazenil on Disturbance of Equilibrium Function Induced by Midazolam

Abstract

Nasotracheal Intubation Using the Airtraq Versus Macintosh Laryngoscope: A Manikin Study

Abstract

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

Abstract

Psychotropic Drugs: Implications For Dental Practice

Abstract

New Center for Sedation and Anesthesiology Dedicated

New Center for Sedation and Anesthesiology Dedicated

Coda's Accreditation Of Graduate Dental Anesthesiology Programs: A Benefit To All Dental Education

Effect of Flumazenil on Disturbance of Equilibrium Function Induced by Midazolam

Nasotracheal Intubation Using the Airtraq Versus Macintosh Laryngoscope: A Manikin Study

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry