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1.  Patient-Controlled Sedation 
Anesthesia Progress  1998;45(3):117-126.
Patient-controlled sedation was utilized in patients aged 15 to 85 yr who were undergoing surgery under local or regional anesthesia. Midazolam, propofol, and methohexitone were used, either by themselves or in combination with fentanyl or alfentanil. Sedation was mild to moderate in the majority of patients, and operating conditions were good. The sedation method provided patients the ability to control the sedation and to vary the degree of sedation according to the environment and to the stress of the procedure. Sedation of the elderly, which tends to be problematic, was made easy using this method, and the elderly patients appeared to enjoy the option. The problems encountered were oversedation, respiratory depression, pain during injection, and postural hypotension.
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PMCID: PMC2148957  PMID: 19598717
Patient-controlled sedation; Review
2.  Cardiac Dysrhythmias With Midazolam Sedation 
Anesthesia Progress  1990;37(1):20-23.
A randomized cross-over study was made of 32 young healthy Hong Kong Chinese to compare the incidence and nature of dysrhythmias that occurred during third molar surgery done under local anesthesia, alone or supplemented with midazolam sedation. The incidence of dysrhythmias during surgery was not significantly different during the two procedures. However prior to surgery, 25% of the patients had dysrhythmias during sedation with midazolam. The majority of dysrhythmias were infrequent unifocal ventricular ectopics. During sedation with midazolam it may be beneficial to monitor the electrocardiogram, especially in high risk patients such as those suffering from ischaemic heart disease, cardiomyopathy, and those on antidysrhythmic drugs.
PMCID: PMC2163530  PMID: 2077981
3.  Cardiac Dysrhythmias with General Anesthesia during Dental Surgery 
Anesthesia Progress  1988;35(3):102-115.
Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear to decrease the incidence. It is stressed that continuous cardiac monitoring should be done in patients undergoing dental surgery under anesthesia in order to detect diagnose and treat any dysrhythmia. The great majority of dysrhythmias disappear either spontaneously or when the stimulus is stopped. In some cases there may be an obvious cause that should be immediately corrected. The need for drug intervention is rare and must be used with great care when used.
PMCID: PMC2168026  PMID: 3046439
4.  A Nasal Mask for Chinese (Rodrigo-Leung Mask) 
Anesthesia Progress  1987;34(5):195-196.
For people of Chinese descent, facial configuration differs from that of other Asians as well as Caucasians, and the standard nasal masks used in dentistry do not fit their faces well. A simple, easily sterilizable nasal mask has been developed for this purpose and is adaptable to existing nitrous oxide machines.
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PMCID: PMC2148549  PMID: 3479921
5.  Aminophylline Fails to Reverse Conscious Sedation with Midazolam in Dentistry 
Anesthesia Progress  1986;33(3):152-154.
A double blind, randomized crossover study investigated whether aminophylline reverses the conscious sedation with midazolam in dentistry to result in quicker clinical recovery than when midazolam is used alone. Twenty-five patients between 17-30 years of age (ASA Grade 1) were sedated with midazolam for bilateral third molar extractions, one side being operated on one visit. Aminophylline or normal saline was given at the end of the surgical procedure on one visit and the alternative during the second visit. No significant difference in recovery was noted with either solution, suggesting that aminophylline does not produce significant reversal of sedation to achieve quicker clinical recovery. The majority of patients preferred to be alert following the operation while some (N = 5) wished to be drowsy, indicating the necessity to question the patient as to preference before deciding to administer a reversal agent.
PMCID: PMC2175479  PMID: 2943194

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