Cardiovascular, biochemical, and hormonal responses to intravenous sedation with local analgesia versus general anesthesia in patients undergoing oral surgery

Hempenstall, P. D.; Campbell, Jan; Bajurnow, A.T.; Reade, Peter C.; McGrath, Brendan; Harrison, Len C.

doi:10.1016/s0278-2391(86)80008-8

Cited by 28 publications

(22 citation statements)

References 21 publications

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“…In conscious intravenous sedation the lowering of consciousness is minimal, the patient maintains verbal communication and cooperation, vital signs are stable, the airway is unobstructed and active reflex protectors are maintained (4). Conscious intravenous sedation with local anesthesia is a safe alternative to general anesthesia for the control of intraoperative pain and anxiety in oral surgery procedures (5). Given the growing demand for conscious intravenous sedation for oral surgery, it is interesting to know the grade of patient anxiety in dental implant surgery under conscious intravenous sedation.…”

Section: Introductionmentioning

confidence: 99%

Relationship between preoperative anxiety and postoperative satisfaction in dental implant surgery with intravenous conscious sedation

González-Lemonnier¹,

Bovaira-Forner²,

Peñarrocha-Diago³

et al. 2010

Med Oral

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Section: Introductionmentioning

confidence: 99%

Relationship between preoperative anxiety and postoperative satisfaction in dental implant surgery with intravenous conscious sedation

González-Lemonnier¹,

Bovaira-Forner²,

Peñarrocha-Diago³

et al. 2010

Med Oral

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“…Hempenstall et al 52 compared cortisol levels in patients having either a general anaesthetic or sedation for surgical removal of third molar teeth. Cortisol levels remained unchanged in the sedation group but rose significantly after surgery in patients who had a general anaesthetic.…”

Section: Anaesthesiamentioning

confidence: 99%

Steroid cover for dental patients on long-term steroid medication: proposed clinical guidelines based upon a critical review of the literature

Gibson

Ferguson

2004

Br Dent J

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Based to a great extent upon mainly anecdotal case reports and theory, there is a general acceptance that patients on longterm systemic steroid medication should receive supplementary glucocorticoids or 'steroid cover' when undergoing certain types of stressful treatment including dentistry. The theoretical basis to this practice is that exogenous steroids suppress adrenal function to an extent that insufficient levels of cortisol can be produced in response to stress, posing the risk of acute adrenal crisis with hypotension and collapse. The purpose of this paper is to review relevant literature and propose clinical guidelines for dental practitioners. Of numerous reported cases of adrenal crisis following procedural interventions, few stand up to critical evaluation. Other reviewers have reached similar conclusions. A number of studies confirm the low likelihood of significant adrenal insufficiency even following major surgical procedures. Various authors have suggested modified guidelines for management of patients on steroid medications. Patients on long-term steroid medication do not require supplementary 'steroid cover' for routine dentistry, including minor surgical procedures, under local anaesthesia. Patients undergoing general anaesthesia for surgical procedures may require supplementary steroids dependent upon the dose of steroid and duration of treatment.

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“…It is defined as a state of disharmony or disturbances in homeostasis provoked by psychological, environmental or physiological stressor situations [1,2]. These situations promote immunoinflammatory and metabolic responses that are entangled in an intricate way, as the cells involved in these key events ontogenetically originate from a unique primordial organ combining both immune and metabolic functions [3][4][5][6][7][8][9][10][11][12]. In 1932 Cubberston documented and quantified the time course of stress response and introduced the terms "ebb" and "flow" to describe an initial decrease and subsequent increase in metabolic activity due to stress [1].…”

Section: Introductionmentioning

confidence: 99%

“…The circulating catecholamines, cortisol and growth hormone result in elevated blood glucose levels. Consequently, synthesis and release of insulin is stimulated to maintain blood glucose levels within normal range [1][2][3][4][5][6][7][8][9][10][11][12][13]. In the pancreas glucagon is released and insulin secretion may be diminished.…”

Section: Introductionmentioning

confidence: 99%

“…In the pancreas glucagon is released and insulin secretion may be diminished. The overall metabolic effect of hormonal changes is increased catabolism that mobilizes substrates to provide energy sources and a mechanism to retain salt and water and maintain fluid volume and cardiovascular homeostasis [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Using Blood Glucose Estimation to Interpret Stress in Patients Undergoing Minor Oral Surgery Procedures

Murugan

kulsum

Neelak

et al. 2017

JDHODT

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Purpose: A prospective randomised case control study was conducted to evaluate the stress induced in patients during minor oral surgical procedures based on the variations in blood glucose levels, blood pressure and pulse rate and thereby to assess the relation between stress and the aforesaid parameters. Materials and methods:A total of 100 subjects who required routine minor oral surgical procedures were randomly divided into two equal groups with subjects of test Group I receiving 2 % lignocaine with adrenaline, subjects of control Group II received the same with an added oral intake of 10 mg glucose in 200 ml water after administration of local anaesthesia. The blood glucose level, blood pressure, and pulse rate were recorded before the commencement of procedure with the patient on the chair, before and immediately after local anaesthetic administration, finally after the procedure, and the obtained data was statistically analysed. Results:The blood glucose levels were found to decline at a point before extraction and then increase to a value higher than the preoperative value in group I, while in groups II the blood sugar values maintain a steady state without decline, until it progressively increases to a higher post-operative value. In all groups blood pressure was found to elevate progressively and an increase in pulse rate was observed in all stages till the administration of LA after which there was a marked decline. Conclusion:Our results point towards the phenomenon of a short lasting decline in blood glucose levels for a period of not more than four or five minutes before an elevation in blood glucose levels. In minor oral surgical procedures under local anaesthesia, this momentary hypoglycaemia is of great clinical significance as even moderate hypoglycaemia can lead to episodes of psychogenic syncope.

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Cardiovascular, biochemical, and hormonal responses to intravenous sedation with local analgesia versus general anesthesia in patients undergoing oral surgery

Cited by 28 publications

References 21 publications

Relationship between preoperative anxiety and postoperative satisfaction in dental implant surgery with intravenous conscious sedation

Relationship between preoperative anxiety and postoperative satisfaction in dental implant surgery with intravenous conscious sedation

Steroid cover for dental patients on long-term steroid medication: proposed clinical guidelines based upon a critical review of the literature

Using Blood Glucose Estimation to Interpret Stress in Patients Undergoing Minor Oral Surgery Procedures

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