Abstract

The objective of this study was to examine the public health relevance of the prevalence of dental fear in Kuwait and the resultant barrier that it creates regarding access to dental care. The study analysis demonstrated a high prevalence of dental fear and anxiety in the Kuwaiti population and a perceived need for anesthesia services by dental care providers. The telephone survey of the general population showed nearly 35% of respondents reported being somewhat nervous, very nervous, or terrified about going to the dentist. In addition, about 36% of the population postponed their dental treatment because of fear. Respondents showed a preference to receive sedation and anesthesia services as a means of anxiety relief, and they were willing to go to the dentist more often when such services were available. People with high fear and anxiety preferred to receive some type of medication to relieve their anxiety. In conclusion, the significance and importance of the need for anesthesia services to enhance the public health of dental patients in Kuwait has been demonstrated, and improvements are needed in anesthesia and sedation training of Kuwaiti dental care providers.

Abstract

The present study investigated the physiologic and sedative effects between two different continuous infusion doses of dexmedetomidine (DEX). Thirteen subjects were separately sedated with DEX at a continuous infusion dose of 0.2 µg/kg/hr for 25 minutes after a loading dose of 6 µg/kg/hr for 5 minutes (0.2 group) and a continuous infusion dose of 0.4 µg/kg/hr for 25 minutes after a loading dose of 6 µg/kg/hr for 5 minutes (0.4 group). The recovery process was then observed for 60 minutes post infusion. The tidal volume, mean arterial pressure, and heart rate in both groups decreased significantly during infusion, but they were within a clinically acceptable level. A Trieger dot test plot error ratio in the 0.4 group was significantly higher than that in the 0.2 group until 15 minutes post infusion. Sedation appears to be safe at the infusion doses of DEX studied. However, increasing maintenance infusion doses of DEX from 0.2 µg/kg/hr to 0.4 µg/kg/hr delays some recovery parameters.

Abstract

Alterations in arterial PaCO₂ can influence local anesthetic toxicity. The objective of this study was to evaluate the effect of stress-induced changes in PaCO₂ and PaO₂ on the seizure threshold of lidocaine and articaine. Lidocaine (2% with 1 ∶ 100,000 epinephrine) or articaine (4% with 1 ∶ 100,000 epinephrine) was administered intravenously under rest or stress conditions to 36 rats separated into 4 groups. Propranolol and prazosin were administered preoperatively to minimize cardiovascular effects of epinephrine. Mean arterial pressure (MAP), heart rate (HR), and arterial pH, PaCO₂, and PaO₂ were measured. Results showed no differences in MAP, HR, or pH. Stress significantly increased the latency period for the first tonic-clonic seizure induced by a toxic dose of both lidocaine and articaine (P < .05). Seizures were brought on more rapidly by articaine. No significant difference between toxic doses of lidocaine and articaine was noted. Stress raised the seizure threshold dose for both drugs and significantly (P < .01) increased arterial PaO₂ from 94.0 ± 1.90 mm Hg to 113.0 ± 2.20 mm Hg, and reduced PaCO₂ from 36.0 ± 0.77 mm Hg to 27.0 ± 0.98 mm Hg. In conclusion, reduction in PaCO₂ and/or increase in PaO₂ raised the seizure threshold of lidocaine and articaine. This study also confirmed that lidocaine and articaine have equipotent central nervous system toxicity.

Changes in Body Temperature and Urine Output during General Anesthesia Combined with Remifentanil in Oral and Maxillofacial Surgery: Comparison of Sevoflurane vs Propofol Anesthesia

Yoko Hakumoto, Shingo Sugioka, Kayoko Hashimoto, Yuki Kan, Hideyuki Matsui,Yoko Nunotani, Naotaka Kishimoto,Yasushi Sakuma,Yoshihiro Momota, Yasuhiko Kato and Junichiro Kotani 2010;38(1):1–5.

Remifentanil is a selective μ-opioid receptor agonist. Due to its short-acting effect and is rapid elimination from the body, it has been considered effective for relatively short surgical procedures. Although there have been many reports on the efficacy and safety of remifentanil for general anesthesia, there are few reports related to

Anaphylaxis After a Third Exposure to Sugammadex

Honoka IshiharaDDS,

Yukie NittaDDS, PhD,

Yoko KudoDDS, PhD, and

Kanta KidoDDS, PhD

Why Are There So Many Drug Shortages?

Assessing the Need for Anesthesia and Sedation Services in Kuwaiti Dental Practice

Abstract

A Comparison of Intravenous Sedation With Two Doses of Dexmedetomidine: 0.2 µg/kg/hr Versus 0.4 µg/kg/hr

Abstract

Effect of PaCO₂ and PaO₂ on Lidocaine and Articaine Toxicity

Abstract

General Anesthesia for a Child With Landau-Kleffner Syndrome, a Case Report

Abstract

Application of Gum Elastic Bougie to Nasal Intubation

Abstract

Pain Management Part II: Pharmacologic Management of Chronic Orofacial Pain

Abstract

Continuing Education Program

JDSA Abstracts

Changes in Body Temperature and Urine Output during General Anesthesia Combined with Remifentanil in Oral and Maxillofacial Surgery: Comparison of Sevoflurane vs Propofol Anesthesia

ADSA/NDBA Abstracts

ABSTRACT/POSTER #001 Calculating Maximum Local Anesthetic Dose in Cartridges for the Pediatric Population

Anaphylaxis After a Third Exposure to Sugammadex

Use of Ultrasound-Guided Glossopharyngeal Nerve Block and Intravenous Sedation to Control a Gag Reflex

An Appropriate Setting for a Patient-Controlled Analgesia Pump for Continuous Local Anesthesia After Bimaxillary Osteotomy

Ramped Position Improves Oxygenation During Mechanical Ventilation for Patients With Severe Obesity

Commentary—Fasting Implications of GLP-1 Agonist Use in Pediatric Procedural Sedation