Archive for January, 2010

The effective induction dose of 1% propofol in healthy nonpremedicated adults is 2-2.5 mgAg IV. For individuals over 60, 1.5 mgAg is generally adequate. This induction dose is also reduced by premedication with benzodiazepines or opioids. In children, the dose requirement is increased by 1.5 times due to the shorter elimination half-life in the pediatric [...]

The most clinically significant pharmacodynamic properties of propofol deal with the neurologic, cardiovascular, and respiratory systems. Propofol produces rapid hypnosis and has synergistic activity when administered concurrently with barbiturates, benzodiazepines, and opioids. Hypnosis is induced by the action of propofol on the alpha subunit of the 7-aminobutyric acid (GABA) receptor in the brain. Anticonvulsant activity [...]

Propofol (2,6-diisopropylphenol) is a sterically hindered alkyl phenol derivative that is structurally unrelated to other sedative hypnotic agents. Since its introduction in 1985, propofol has proven to be useful in numerous clinical situations. Examples for the application of propofol include cardiovascular, ophthalmologic, and neurosurgical procedures as well as a variety of outpatient surgeries. Propofol has [...]

Pneumothorax can be caused by 1 of the following 4 mechanisms: (1) extrathoracic trauma (ie, closed-chest compressions), (2) spontaneous rupture of alveoli, (3) disruption of fascial planes in the neck (ie, traumatic intubation), or (4) abnormally high intrathoracic pressure (ie, valsalva from protracted coughing). Tension pneumothorax occurs when there is continuous loss of air from [...]

CASE REPORT
A 37-year-old black male, 5′ 3″ and 128 pounds, with a history of moderate to severe mental retardation was scheduled for elective dental rehabilitation under general anesthesia in the operating room of a small state mental hospital. Preoperative testing included an electrocardiogram (ECG), complete blood count, electrolytes, chest x-ray (CXR), and a full health [...]

Pneumothorax, the loss of air from the lung into the pleural space, is described as being spontaneous or traumatic in origin. The spontaneous pneumothorax (SP) can be further subdivided into primary (ie, no underlying pulmonary disease) and secondary (ie, related to underlying pulmonary pathology). The general pathologic mechanism of the development of SP occurs from [...]

The patient returned 24 hours later with a large 10-cm-long, 7-cm-wide raised wheal on the right forearm. It was red and itchy (Figures 4 and 5). The location of the reaction corresponded to the test dose of 2% lidocaine with 1:100,000 epinephrine. The anterior vestibule and soft tissue of the chin had mild/moderate edema as [...]

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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.

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