Anesthesia Progress Volume 58: Issue 1

The Bispectral Index System is a useful guide for timing of adequate intubation conditions in office‐based pediatric general anesthesia without neuromuscular blockade. As the number of cases in the office‐based setting increase, many clinicians opt to intubate patients without neuromuscular blockade to avoid airway complications associated with skeletal muscle relaxation. Conventionally, this technique is conducted using the traditional monitoring criteria of vital signs, end‐tidal inhalation agents, as well as anesthesiologist timing and knowledge of the pharmacodynamics of the anesthetic agent to help determine the proper depth of anesthesia for adequate intubating conditions. This study retrospectively assesses the use of the Bispectral Index System (BIS) as a guide for timing of nonparalytic tracheal intubation in pediatric office‐based general anesthesia. Anesthetic records for 168 children, American Society of Anesthesiology physical status I and II, and ranging in age from 18 months to 17 years were retrospectively analyzed. Intubation outcomes were based on 6 preset criteria to reflect the adequacy of the technique. The mean BIS value during the time of intubation was 34.7. There were no complications encountered. A BIS mean value of 34.7 provided adequate intubation conditions without muscle relaxation in office‐based pediatric anesthesia without complications.

Anxiety is a relevant problem in dental practice. The Visual Analogue Scale for Anxiety (VAS‐A), introduced in dentistry in 1988, has not yet been validated in large series. The aim of this study is to check VAS‐A effectiveness in more than 1000 patients submitted to implantology. The VAS‐A and the Dental Anxiety Scale (DAS) were administered preoperatively to 1114 patients (459 males and 655 females, age 54.7 ± 13.1 years). Statistical analysis was conducted with Pearson correlation coefficient, the receiver operating characteristic (ROC) curve, and McNemar tests. A close correlation between DAS and VAS‐A was found (r = 0.57, P < .0001); the VAS‐A thresholds of dental anxiety and phobia were 5.1 and 7.0 cm, respectively. Despite a significant concordance of tests in 800 cases (72%), disagreement was found in the remaining 314 cases (28%), and low DAS was associated with high VAS‐A (230 cases) or vice versa (84 cases). Our study confirms that VAS‐A is a simple, sensitive, fast, and reliable tool in dental anxiety assessment. The rate of disagreement between VAS‐A and DAS is probably due to different test sensitivities to different components of dental anxiety. VAS‐A can be used effectively in the assessment of dental patients, using the values of 5.1 cm and 7.0 cm as cutoff values for anxiety and phobia, respectively.

In order to determine if dentist anesthesiologists (DAs) actively contribute to research in the field of anesthesiology, and thus contribute new knowledge to the field, an extensive literature search was accomplished. DAs make up only 1.5% of dentists who actively contribute to anesthesia research but account for 10% of publications. To determine if the impact of DA research was similar to the American Dental Association (ADA) recognized specialties, h-indices of noted researchers in other specialties were compared to the h-indices of noted DA researchers. The results show that the impact of top DA researchers in dental anesthesiology is similar to the impact of top dental specialty researchers, despite lack of academic departments in dental schools where a large percentage of dental research is completed. Dentist anesthesiologists actively contribute to the research in anesthesiology for dentistry and thus, actively contribute to new knowledge in the field.

Nozomi Yamada ,

Department of Dental Anesthesiology, The Nippon Dental University, School of Life Dentistry at Niigata

Tetsuya Nagoh ,

Department of Dental Anesthesiology, The Nippon Dental University, School of Life Dentistry at Niigata

Asami Akiyama ,

Department of Dental Anesthesiology, The Nippon Dental University, School of Life Dentistry at Niigata

Kimito Sano ,

Department of Dental Anesthesiology, The Nippon Dental University, School of Life Dentistry at Niigata

Appropriate Head Elevation during Tracheal Intubation

2010;38(

):159–168.

We investigated the height of head elevation that facilitates good field visualization during laryngeal exposure by comparing the relation between

The Fallacy of a Lifesaving Sublingual Injection of Flumazenil

Bispectral Index Monitoring (BIS) as a Guide for Intubation Without Neuromuscular Blockade in Office‐Based Pediatric General Anesthesia: A Retrospective Evaluation

Toward the Validation of Visual Analogue Scale for Anxiety

Contribution of Dentist Anesthesiologists to Dental Anesthesiology Research

Transient Cardiac Arrest in Patient With Left Ventricular Noncompaction (Spongiform Cardiomyopathy)

Reducing Nasopharyngeal Trauma: The Urethral Catheter–Assisted Nasotracheal Intubation Technique

Adverse Drug Interactions

Continuing Education Program

JDSA Abstracts

Appropriate Head Elevation during Tracheal Intubation

The Fallacy of a Lifesaving Sublingual Injection of Flumazenil

Contribution of Dentist Anesthesiologists to Dental Anesthesiology Research

Transient Cardiac Arrest in Patient With Left Ventricular Noncompaction (Spongiform Cardiomyopathy)

Reducing Nasopharyngeal Trauma: The Urethral Catheter–Assisted Nasotracheal Intubation Technique

Bispectral Index Monitoring (BIS) as a Guide for Intubation Without Neuromuscular Blockade in Office‐Based Pediatric General Anesthesia: A Retrospective Evaluation