Anesthesia in Outpatient Facilities

Sims, Paul G.; Kates, Charles H.; Moyer, David J.; Rollert, M.K; Todd, David W.

doi:10.1016/j.joms.2012.07.030

Cited by 10 publications

(2 citation statements)

References 178 publications

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“…18 Several reports have warned against the use of dental local anesthetics containing AD in patients with cardiovascular diseases. [18][19][20] Therefore, felypressin, a noncatecholamine vasopressor that is chemically related to vasopressin, has been used as a safe vasoconstrictor in patients with compromised cardiovascular status in Japan and European Union nations. 21 However, there have been reports that clinical doses of felypressin are capable of inducing myocardial ischemia during surgery, 21 and, in a dog study, clinical doses of felypressin caused decreases in coronary blood flow.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Dose Dependently Enhances the Local Anesthetic Action of Lidocaine in Inferior Alveolar Nerve Block

Ouchi

Sugiyama

2016

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Dose Dependently Enhances the Local Anesthetic Action of Lidocaine in Inferior Alveolar Nerve Block

Ouchi

Sugiyama

2016

Regional Anesthesia and Pain Medicine

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“…As a result, leading associations, such as the ASA (ASA Task Force on Sedation and Analgesia by Non-Anesthesiologists 2002; ASA Standards for Basic Anesthetic Monitoring 2010; Kodali 2013), the Association of Anaesthetists of Great Britain and Ireland (AAGBI) (AAGBI Safety Statement 2011), and the American Society for Gastrointestinal Endoscopy (Lichtenstein et al 2008), have revised their recommendations on the use of capnography for moderate or deep sedation. Capnography is anticipated to have similar benefits in the dental field; hence, the ADA (ADA House of Delegates 2012) and the American Association of Oral and Maxillofacial Surgeons (AAOMS) (Sims et al 2012) have also revised their critical practice guidelines for sedation and established a similar requirement for effective office-based ambulatory anesthesia. However, there is no evidence that capnography significantly prevents hypoxia during dental sedation because the utility of capnographic monitoring during sedation for dental treatment has never been studied.…”

Section: Introductionmentioning

confidence: 99%

Capnography Prevents Hypoxia during Sedation for Dental Treatment: A Randomized Controlled Trial

Takaya

Higuchi

Ishii-Maruhama

et al. 2016

JDR Clinical & Translational Research

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Intravenous sedation is useful for dental treatment in patients with intellectual disabilities. However, it is often necessary to manage such patients with deep sedation because their cooperation cannot be obtained. During deep sedation, undetected hypoventilation can lead to severe complications, such as hypoxia. Recently, capnographic monitoring has been advocated as a useful technique for preventing hypoxia during sedation. This randomized control trial evaluated whether the use of capnography reduces the incidence of hypoxia during the deep sedation of patients for dental treatment. This study involved patients with intellectual disabilities who underwent dental treatment under sedation. The subjects were randomized to the intervention group (I-group) or control group (C-group). All of the patients underwent routine monitoring, as well as bispectral index (BIS) and capnographic monitoring; however, only an independent observer had access to the patients' capnographic data during the dental procedures. Sedation was maintained at a BIS of 50 to 70 by administration of propofol. In the I-group, the independent observer signaled to the dental anesthesiologist if the capnogram indicated that the patient had been suffering from alveolar hypoventilation or apnea for >15 s. In the C-group, the observer signaled to the dental anesthesiologist if the capnogram indicated that the patient had been suffering from alveolar hypoventilation or apnea for >60 s. In both groups, the dental anesthesiologists responded to the signals using appropriate airway management strategies. The primary endpoint of this study was the incidence of hypoxia during dental treatment, which was defined as oxygen saturation of <95%. Hypoxemic episodes occurred in 13.4% and 34.8% of cases in the I-group and C-group, respectively. The incidence of hypoxia was significantly lower in the I-group. These results suggest that capnographic monitoring during deep sedation for dental treatment prevents hypoxemic episodes by allowing the early detection of hypoventilation. Knowledge Transfer Statement: This is the first randomized controlled trial to examine whether the use of capnography reduces the incidence of hypoxia during deep sedation for dental treatment. The findings of this study can be used by clinicians to aid decision-making regarding dental sedation standards at individual clinics. Moreover, they can be used as high-level evidence during the production or updating of clinical guidelines for dental sedation by leading associations.

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Parenteral Sedation

Biron¹

2019

Office-Based Maxillofacial Surgical Procedures

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Anesthesia in Outpatient Facilities

Cited by 10 publications

References 178 publications

Dexmedetomidine Dose Dependently Enhances the Local Anesthetic Action of Lidocaine in Inferior Alveolar Nerve Block

Dexmedetomidine Dose Dependently Enhances the Local Anesthetic Action of Lidocaine in Inferior Alveolar Nerve Block

Capnography Prevents Hypoxia during Sedation for Dental Treatment: A Randomized Controlled Trial

Parenteral Sedation

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