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Article Contents

  • Objective:
  • Methods:
  • Results:
  • Conclusion:
  • METHODS
  • RESULTS
  • DISCUSSION
  • STRENGTHS AND LIMITATIONS
  • CONCLUSION
  • ACKNOWLEDGMENTS
  • REFERENCES
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Objective:

The primary aim of this study was to determine the cardiovascular safety of topical racemic epinephrine pellets by measuring heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure in children receiving dental care under general anesthesia. The secondary aim was to assess clinical efficacy by measuring time to reach adequate hemostasis.

Methods:

For this pilot study utilizing a split-mouth randomized design, 13 patients requiring prefabricated zirconia crowns on both primary maxillary first molars were recruited. Patients received continuous infusions of propofol and remifentanil with 50–70% inhaled nitrous oxide and oxygen. After randomization and tooth preparation, either saline pellets (control) or racemic epinephrine pellets (experimental) were applied directly to gingival tissue. Vital signs were recorded for 5 minutes. The procedure was repeated on the contralateral side using the alternative (control or experimental) treatment.

Results:

Topical racemic epinephrine compared to saline produced a significantly larger decrease in mean diastolic blood pressure (−11.1% vs −3.9%; P < .01) and mean arterial pressure (−8.1% vs −2.1%; P < .01), although all noted decreases in cardiovascular variables were clinically insignificant. All experimental treatment teeth achieved adequate hemostasis after 2.2 minutes. Only 5 of the 13 control treatment teeth achieved adequate hemostasis during the 5-minute observation period (1.6 vs 4.2 minutes; P = .01).

Conclusion:

Overall, we conclude that use of topical racemic epinephrine pellets did not result in adverse cardiovascular effects and hemostasis was reached more quickly and predictably compared to saline pellets.

Keywords: Pellets; Topical racemic epinephrine; Pediatric; Zirconia crowns; Hemostasis
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Copyright: © 2021 by the American Dental Society of Anesthesiology
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Article Contents

Comparison of Remimazolam and Propofol for Intubated General Anesthesia for Oral and Maxillofacial Surgery

Yoshio Hayakawa DDS, PhD,
 Keiko Fujii-Abe DDS, PhD,
 Sayaka Akitomi DDS,
 Shihomi Niwa DDS,
 Michiru Abe DDS,
 Manami Otsuka DDS, PhD,
 Maho Ikeda DDS,
 Takumi Ishikawa DDS, PhD,
 Manami Yajima DDS, PhD, and
 Hiroshi Kawahara DDS, PhD

The Impact of COVID-19 on Dental Anesthesiologists: An Online Survey of Board-Certified Dental Anesthesiology Specialists of the Japanese Dental Society of Anesthesiology

Takuro Sanuki DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Norika Katagiri DDS, PhD,
 Ayako Mizutani DDS, PhD,
 Mari Ohnaka DDS,
 Shinji Kurata DDS, PhD,
 Naotaka Kishimoto DDS, PhD, and
 Kanta Kido DDS, PhD

Tracheal Bronchus Detected During General Anesthesia: A Case Report

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 Tatsuru Tsurumaki DDS, PhD,
 Hiroko Kanemaru DDS, PhD, and
 Kenji Seo DDS, PhD

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Tiffany Smith BS,
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 Raquel Rozdolski DMD
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