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author:("amino, M")
1.  Delirium During Intravenous Sedation With Midazolam Alone and With Propofol in Dental Treatment 
Anesthesia Progress  2006;53(3):95-97.
A 62-year-old man visited our clinic for dental implantation under intravenous sedation. He demonstrated increased psychomotor activity and incomprehensible verbal contact during intravenous sedation. Although delirium caused by midazolam or propofol in different patients has been reported, the present case represents a delirium that developed from both drugs in the same patient, possibly because of the patient's smaller tolerance to midazolam and propofol.
doi:10.2344/0003-3006(2006)53[95:DDISWM]2.0.CO;2
PMCID: PMC1693665  PMID: 17175823
Delirium; Midazolam; Propofol; Dental treatment
2.  Unexpected atrial fibrillation during tooth extraction in a sedated elderly patient. 
Anesthesia Progress  1994;41(3):77-80.
A case is reported of unexpected atrial fibrillation in response to tooth extraction under intravenous sedation in a 70-yr-old patient with thoracic aneurysm of the aorta. Atrial fibrillation developed after the additional injection of a 2% solution of lidocaine containing 1:200,000 epinephrine. After 20 min, the arrhythmia disappeared spontaneously. The arrhythmia was associated with insufficient analgesia for tooth extraction, epinephrine in the local anesthetic, decreased blood pressure, and the presence of cardiovascular disease. Even when a low concentration of epinephrine is employed, caution should be paid to development of unexpected cardiovascular reactions in elderly patients with severe cardiovascular disease. We conclude that an electrocardiogram, blood pressure device, and pulse oximeter should be used in high-risk patients in order to prevent and detect potentially dangerous cardiovascular emergencies, even if dental treatment is scheduled under local anesthesia.
PMCID: PMC2148821  PMID: 8934964

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