BACKGROUND: Emergency room doctors run into difficulties in treating injured pediatric patients because usually they fell into panic after trauma. In these situation, deep sedation with sevoflurane is fully recommendable method. The conventional way can interrupt common dental treatment procedure. METHODS: In the present study, nasal cannula was used for sevoflurane deep sedation in 11 dental emergency treatment. Age ranged from 0 to 3 years old (average of 1.8 years). RESULTS: Treatment duration was from 10 to 35 minutes (average of 16.7 minutes). Average duration of sedation was 25.5 minutes ranging from 15 to 45 minutes. CONCLUSIONS: It has advantages to use nasal cannula for sevoflurane deep sedation rather than conventional intubation; saves time and secures good operation field.
Catheters* ; Deep Sedation* ; Emergencies* ; Emergency Service, Hospital ; Emergency Treatment ; Humans ; Intubation ; Methods ; Panic

During the perioperative period, anesthesiologists frequently observe cardiac tachyarrhythmia. Ventricular tachycardia is very rare in non-cardiac surgeries. However, it can be fatal when it occurs. Therefore, anesthesiologists should be watchful so as to not to miss ventricular tachycardia and take the appropriate steps to manage it promptly. We present a case, with a review of related literature, in which a non-sustained ventricular tachycardia was observed in a patient who visited the hospital for dental treatment.

Sevoflurane is familiar to anesthesiologists as an inhaled anesthetic to induce and maintain anesthesia; however, it has not been widely used for sedation. Recently, the use of sevoflurane for inhalational sedation has been increasing. Moreover, in Korea, the use of sevoflurane for conscious or deep sedation in dental care for children and the disabled is increasing, primarily by dental anesthesiologists. In this article, we reviewed a sedation method using sevoflurane.

During the perioperative period, anesthesiologists frequently observe cardiac tachyarrhythmia. Ventricular tachycardia is very rare in non-cardiac surgeries. However, it can be fatal when it occurs. Therefore, anesthesiologists should be watchful so as to not to miss ventricular tachycardia and take the appropriate steps to manage it promptly. We present a case, with a review of related literature, in which a non-sustained ventricular tachycardia was observed in a patient who visited the hospital for dental treatment.

Sevoflurane is familiar to anesthesiologists as an inhaled anesthetic to induce and maintain anesthesia; however, it has not been widely used for sedation. Recently, the use of sevoflurane for inhalational sedation has been increasing. Moreover, in Korea, the use of sevoflurane for conscious or deep sedation in dental care for children and the disabled is increasing, primarily by dental anesthesiologists. In this article, we reviewed a sedation method using sevoflurane.

BACKGROUND: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. METHODS: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. RESULTS: We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. CONCLUSIONS: Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.
Anesthesia ; Anesthesia, General ; Dental Clinics* ; Female ; Humans ; Male ; Reflex ; Treatment Outcome

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.
Anesthesia, General ; Antiemetics ; Deep Sedation ; Dental Care ; Dentists ; Gagging ; Humans ; Hypnotics and Sedatives ; Propofol ; Reflex*

Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia. We report a case of PEA during the induction of general anesthesia in a patient with ALS who presented for dental treatment and discuss the causes of PEA and necessary considerations for general anesthesia in patients with ALS.
Acidosis ; Amyotrophic Lateral Sclerosis* ; Anesthesia, General* ; Anoxia ; Emergencies ; Humans ; Hypovolemia ; Muscles ; Nervous System ; Peas ; Respiratory System

Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.

Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.