Anesthesia Progress Volume 65: Issue 3

During laryngoscopy, the laryngoscope blade sometimes comes in contact with the teeth, fracturing or dislocating them. However, no studies have compared the effects of newly marketed video laryngoscopes and the Macintosh laryngoscope (Mac) on teeth. In this study, we measured and compared the force exerted on the teeth of an intubating manikin by the Mac, the Airway Scope (Pentax), and the McGrath MAC (Covidien). The mean force exerted was 141.1 ± 15.7 kg by the Mac, 39.2 ± 10.3 kg by the Airway Scope, and 48.7 ± 6.7 kg by the McGrath MAC. No significant difference was observed between the Airway Scope and the McGrath MAC. When the Mac is inserted, the glottis has to be visually located from outside the oral cavity. However, a significant force is not necessary when inserting video laryngoscopes because a camera is mounted on the blade tip. In this laboratory model, the lower force exerted by the video laryngoscopes should contribute to a reduction in their impact on fracture or dislocation of teeth.

To compare the success of perceived pulpal anesthesia between groups using nitrous oxide/oxygen (N₂O/O₂) and oxygen (O₂) in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. Thirty-three children (mean age 10.4 ± 1.9 years) with 33 symptomatic irreversible pulpitis permanent teeth were included in this preliminary study. All children were premedicated with ibuprofen and randomly assigned to receive either N₂O/O₂ (17 participants) or O₂ (16 participants). Four percent articaine with epinephrine 1:100,000 was administered, and vital pulp therapy was performed. Children used the Wong-Baker FACES Pain Rating Scale (WBFPS) to report their pain at baseline as well as during carious dentin removal, pulpal exposure, and pulpal tissue removal steps. The success was determined when the reported WBFPS score was ≤4. The chi-square test was used to compare the success between both groups. The success of pulpal anesthesia was 71% (12/17) and 19% (3/16) in the N₂O/O₂ and O₂ groups, respectively. The success in the N₂O/O₂ group was 52% higher than that in the O₂ group (confidence interval = 22.9% to 80.7%; significant difference p = .003). From the result of this preliminary study, N₂O/O₂ significantly increased the success of perceived pulpal anesthesia in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. However, further study with a larger sample is required to confirm this result.

Management of patients with orofacial pain may benefit from a better understanding about patient factors that may lead pain chronicity. In this study, we retrospectively compared physical and psychological factors in patients with acute and chronic orofacial pain. We analyzed data from 854 patients presenting to the Orofacial Pain Center, Department of Dental Anesthesiology, Tokyo Dental College, Suidobashi Hospital between April 2010 and March 2014. We categorized patients into the acute group if their condition had persisted <6 months and the chronic group if their condition had lasted 6 months or longer, based on the classification by the International Association for the Study of Pain. The retrospective data were analyzed by using univariate analysis on background factors from a health questionnaire, pain evaluation sheet, and psychological test completed at the time of presentation. Multiple logistic regression was applied on these factors. Our results suggest that female gender and high trait anxiety may be involved in orofacial pain becoming chronic.

The American Society of Dentist Anesthesiologists' (ASDA) Parameters of Care describe the range of appropriate anesthetic practices by dentist anesthesiologists practicing in the United States.¹ Since anesthesiology is the practice of dentistry, these Parameters of Care include standards, guidelines, and management strategies to assist dentist anesthesiologists in maximizing the safety and comfort of patients while minimizing risk and discomfort. Individuals with expertise and broad, in-depth, clinical experience in the wide variety of anesthesia practice venues used in dentistry prepared these practice parameters. Conclusions were derived based on review of the scientific literature, various standards and guidelines, as well

Khanna P, Saini K, Sinha R, Nisa N, Kumar S, Maitra S. Correlation between duration of preoperative fasting and emergence delirium in pediatric patients undergoing ophthalmic examination under anesthesia: a prospective observational study. Pediatr Anesth. 2018;28:547–551.

Preoperative fasting in children can increase anxiety; however, no previously published data are available to determine whether duration of preoperative fasting correlates with postoperative emergence delirium. The aim of this study was to identify any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. A total of 100 children between the ages of 2

Anaphylaxis After a Third Exposure to Sugammadex

Honoka IshiharaDDS,

Yukie NittaDDS, PhD,

Yoko KudoDDS, PhD, and

Kanta KidoDDS, PhD

When Can the Recovery Process Be Delegated to Staff?

Comparison of the Contact Force Exerted on Teeth by Conventional Macintosh Laryngoscope Versus Video Laryngoscopes

Effect of Nitrous Oxide on Pulpal Anesthesia: A Preliminary Study

Comparison of Risk Factors in Patients With Acute and Chronic Orofacial Pain

The Effect of Dexmedetomidine on Oral Mucosal Blood Flow and the Absorption of Lidocaine

Male Gender and High Trait Anxiety Are 2 Major Factors Associated With Severe Dental Fear and Avoidance

Office-Based Anesthetic and Oral Surgical Management of a Child With Hereditary Sensory Autonomic Neuropathy Type IV: A Case Report

Atrio-ventricular Block Following Neostigmine-Glycopyrrolate Reversal in Non-heart Transplant Patients: Case Report

General Anesthetic Management of a Patient With Hypertrophic Cardiomyopathy for Oral Surgery: Did Digitalis Contribute to Bradycardia?

American Society of Dentist Anesthesiologists: Parameters of Care

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

Khanna P, Saini K, Sinha R, Nisa N, Kumar S, Maitra S. Correlation between duration of preoperative fasting and emergence delirium in pediatric patients undergoing ophthalmic examination under anesthesia: a prospective observational study. Pediatr Anesth. 2018;28:547–551.

Dr David Donaldson, BDS, FDSRCS, MDS, FADSA, FAAD, Dental Educator and Sedation Pioneer, Dies at 76

AirWay Scope™ for Difficult Ventilation in a Patient With Epiglottic Cyst

Anesthetic Management of the Hypertensive Patient: Part II

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