Paradoxical Reactions to Benzodiazepines in Intravenous Sedation
In: Main
13 Dec 2009
Since the discovery of the anesthetic properties of nitrous oxide by Horace Wells in 1844, the availability of anesthetic agents has considerably increased. The newer synthesized drugs have proved advantageous over the older agents. Benzodiazepines are used for their sedative, anxiolytic, amnesic, anticonvulsant drug, and muscle relaxant properties; however, they are associated with rare adverse effects.
Pain Relief by Stellate Ganglion Block: DISCUSSION
In: Main
10 Dec 2009DISCUSSION
This case indicates that SGB may relieve pain in some patients who are suspected to have symptomatic trigeminal neuralgia. SGB blocks sympathetic nervous activity to the head, neck, and upper extremity on the treated side. It is applied to reduce pain in patients with disor ders such as causalgia, reflex sympathetic dystrophies, peripheral vascular disease, acute herpes zoster, postherpetic neuralgia, and musculoskeletal disorders, and to improve certain vascular circulatory disorders.
Pain Relief by Stellate Ganglion Block
In: Main
9 Dec 2009
INTRODUCTION
About 5 to 10% of trigeminal neuralgia has been considered to be symptomatic trigeminal neuralgias caused by brain tumors. Some of these patients complain of severe pain, which needs to be managed before surgical treatment. We present a case of symptomatic trigeminal neuralgia in which pain was relieved by trial stellate ganglion block (SGB).
Pharmacokinetics of Lidocaine Delivered: RESULTS
In: Anesthesia
9 Dec 2009
Reactions
After removal of the patch, the site of application was examined to evaluate the area for signs of irritation. No tissue discoloration, swelling, or sloughing was noted in association with patch application in any of the patients. In addition, no drug-related adverse effects were associated with patch application. None of the patients experienced any complications, as defined by accepted hospital criteria, during the general anesthetic procedure or during the dental treatment.
Pharmacokinetics of Lidocaine Delivered: DISCUSSION
In: Anesthesia
8 Dec 2009Although plasma levels of local anesthetic are usually low in adults, plasma concentrations can be an important concern in the delivery of local anesthetics to children. The dose as a proportion of total body weight in the adult is relatively small, and thus the chance of local anesthetic toxicity is low. However, in children, particularly when premedicated with sedative drugs, the systemic effects of local anesthetic can be toxic. Therefore, it is important to determine the plasma levels of lidocaine from all sources, including the transoral lidocaine patch.
This study was approved by the institutional review board of Columbus Children’s Hospital. Eligible subjects were selected from children scheduled for operative dentistry under general anesthesia at the Children’s Hospital Outpatient Surgery Center. These children had exhibited disruptive behaviors during routine dental appointments, thus requiring general anesthesia for comprehensive dental care. Eligible patients were those children who were healthy (ASA I), weighed over 12 kg, and were 2-7 years old. The sample studied consisted of 11 children with a mean age of 56.3 months and a range of 25-85 months. The mean weight was 18.5 kg with a range of 12.6-26.3 kg. All subjects were healthy, not taking any medications, and had no history of drug-related allergies. After the study was explained to the parents, written consent was obtained.
Pharmacokinetics of Lidocaine Delivered
In: Anesthesia
6 Dec 2009
INTRODUCTION
Children most often associate pain during a dental visit with the administration of local anesthetic. Pain and discomfort perceived by pediatric patients can be severe. In a survey of 119 children, 65 thought that a “shot” or “needle” hurt more than anything else that had ever happened to them.
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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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