Problem: After a 72-year-old woman underwent cancer surgery, her surgeon prescribed patient-controlled analgesia (PCA) with a 2-mg morphine loading dose and 1 mg every 10 minutes as needed, for a maximum of 6 mg/hour. Initially, the patient was restless and agitated in the post-anesthesia care unit, but she remained obtunded (not alert) after surgery. Despite [...]
In: Health
18 Apr 2010Am n unpublicized report on pharmacy benefit managers (PBMs), issued this past August by the Federal Trade Commission (FTC), made me think of all those reports on the vulnerabilities of New Orleans that were ignored in advance of Hurricane Katrina in August/September. Mandated by Congress, the FTC report was supposed to determine whether PBMs, based [...]
In: Health
19 Nov 2009DISCUSSION
Ketamine has been used as an oral sedative in the management of uncooperative patients. Common side effects of ketamine are nausea and vomiting, which have been reported in 0-43% of patients. In this study, the addition of promethazine, a potent antiemetic drug, reduced the vomiting incidence from 27% (control group) to 0% (experimental group).
In: Health
18 Nov 2009The age range of the subjects was 21-43 months, with a mean age of 33V2 months. There were no significant differences in age (for controls, range, 21-43 months; mean, 33 months; for experimental patients, range, 25-43 months; mean, 34 months) (Table 3). Under the conditions of this study, the average time in the operatory, from [...]
In: Health
17 Nov 2009Pediatric dental patients from the Houston Medical Center Pediatric Dental Clinic, Houston, Tex, were chosen for the study, which was approved by the Committee for the Protection of Human Subjects. The selection criteria included healthy patients between IV2 and 3Vi years of age with no previous dental experience and those who demonstrated such poor behavior [...]
In: Health
16 Nov 2009Ketamine is a dissociative anesthetic agent that has been shown to be useful as a safe and effective oral sedative. The drug was first derived in 1961, and reports on human trials were begun in 1965. It is a chemical derivative of phencyclidine and cyclohexami-ne. Ketamine is unique in being effective for induction of anesthesia [...]
The encouraging combination of these 2 relatively short-acting agents with similar pharmacokinetics and complimentary pharmacological properties, which lacks ketamine’s adverse reactions, has been clearly substantiated.
Midazolam is the benzodiazepine of choice when combined with ketamine in terms of physiological homeostasis and recovery time.
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.