Bispectral EEG Index Monitoring of High-Dose Nitrous Oxide
In: Main
29 Nov 2009This study sought to characterize the effects of 3070% nitrous oxide and 0.2-0.8% sevoflurane conscious sedation on quantitative electroencephalographic (EEG) readings as measured by the bispectral index (BIS). BIS is a processed parameter (algorithm) made available in 1997 by Aspect Medical Systems (Newton, Mass). As depicted in Figure 1, it is specifically designed to correlate a 1-100 numerical output with the level of hypnosis, amnesia, and sedation induced by a wide variety of agents. This study also attempted to verify the results of 2 previously published BIS/N20 investigations to confirm the clinical effects of high-dose (5070%) N20 and low-dose (0.4-0.8%) sevoflurane sedation and to establish whether BIS is a suitable monitor for either or both gases. Read the rest of this entry »
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- Tags: Amnesia, BIS, Conscious sedation, EMG, Nitrous oxide, Sevoflurane
Anesthetic Efficacy of an Infiltration: DISCUSSION
In: Anesthesia
28 Nov 2009
DISCUSSION
The use of the 80 reading as a criterion for pulpal anesthesia was based on the studies of Dreven et al and Certosimo and Archer. These studies showed that an 80 reading ensured pulpal anesthesia in vital asymptomatic teeth. Additionally, Certosimo and Archer demonstrated that electric pulp test readings less than 80 resulted in pain during operative procedures in asymptomatic teeth.
Anesthetic Efficacy of an Infiltration: RESULTS
In: Anesthesia
27 Nov 2009RESULTS
Forty adult patients, 30 men and 10 women, aged 2034 years, with an average age of 26 years, participated in this study. One hundred percent of the patients had subjective lip anesthesia with the IAN blocks. The rates of anesthetic success are presented in Table 1. Success rates for the IAN block alone ranged from 10%-58%. Success rates for the IAN block plus labial infiltration ranged from 40%-62%. Success rates for the IAN block plus lingual infiltration ranged from 38%-68%. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration for the central and lateral incisors. For the central incisor, there was also a significant difference (P < .05) between the IAN block alone and the IAN block plus lingual infiltration.
MATERIALS AND METHODS
Forty adult patients participated in this study. The patients were in good health and were not taking any medications that would alter pain perception. The Ohio State University Human Subjects Review Committee approved the study, and written informed consent was obtained from each patient.
Anesthetic Efficacy of an Infiltration
In: Anesthesia
25 Nov 2009
The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for restorative and surgical procedures. However, the IAN block does not always result in successful pulpal anesthesia. Failure rates in anterior teeth have ranged from 10%-90%.
A number of methods may be used to reduce the discomfort of local anesthetic injections. These might include the application of topical anesthetics before needle penetration and a slow rate of injection. However, there is little evidence in the literature that the various methods proposed are reliable. Even the use of topical anesthetics before injection is not found to be universally effective.
The pH of the plain lidocaine solution was 6.6; the epi-nephrine-containing solution’s pH was 4.4.
Twelve volunteers (6 men, 6 women) recorded at least one of their buccal injections at a minimum of 30 mm on the VAS, and 17 participants (10 men, 7 women) had palatal injection scores of at least 30 mm for one injection. The results are shown in the Figure and Tables 1 and 2.
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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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