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3.  The Importance of Anesthesia Progress to Dental Anesthesiology 
Anesthesia Progress  2014;61(4):133-134.
PMCID: PMC4269351  PMID: 25517547
4.  Repeated Anesthetic Management for a Patient With Klippel-Feil Syndrome 
Anesthesia Progress  2014;61(3):103-106.
Klippel-Feil syndrome (KFS) is a rare disease characterized by a classic triad comprising a short neck, a low posterior hairline, and restricted motion of the neck due to fused cervical vertebrae. We report repeated anesthetic management for orthognathic surgeries for a KFS patient with micrognathia. Because KFS can be associated with a number of other anomalies, we therefore performed a careful preoperative evaluation to exclude them. The patient had an extremely small mandible, significant retrognathia, and severe limitation of cervical mobility due to cervical vertebral fusion. As difficult intubation was predicted, awake nasal endotracheal intubation with a fiberoptic bronchoscope was our first choice for gaining control of the patient's airway. Moreover, the possibility of respiratory distress due to postoperative laryngeal edema was considered because of the surgeries on the mandible. In the operating room, tracheotomy equipment was always kept ready if a perioperative surgical airway control was required. Three orthognathic surgeries and their associated anesthetics were completed without a fatal outcome, although once the patient was transferred to the intensive care unit for precautionary postoperative airway management and observation. Careful preoperative examination and preparation for difficult airway management are important for KFS patients with micrognathia.
PMCID: PMC4156372  PMID: 25191983
Klippel-Feil syndrome; Micrognathia; Orthognathic surgeries; General anesthesia
5.  Cuffed Oropharyngeal Airway for Difficult Airway Management 
Anesthesia Progress  2014;61(3):107-110.
Difficulties with airway management are often caused by anatomic abnormalities due to previous oral surgery. We performed general anesthesia for a patient who had undergone several operations such as hemisection of the mandible and reconstructive surgery with a deltopectoralis flap, resulting in severe maxillofacial deformation. This made it impossible to ventilate with a face mask and to intubate in the normal way. An attempt at oral awake intubation using fiberoptic bronchoscopy was unsuccessful because of severe anatomical abnormality of the neck. We therefore decided to perform retrograde intubation and selected the cuffed oropharyngeal airway (COPA) for airway management. We inserted the COPA, not through the patient's mouth but through the abnormal oropharyngeal space. Retrograde nasal intubation was accomplished with controlled ventilation through the COPA, which proved to be very useful for this difficult airway management during tracheal intubation even though the method was unusual.
PMCID: PMC4156373  PMID: 25191984
Cuffed oropharyngeal airway; Difficult airway management
6.  Hair Tourniquet Syndrome in the Dental Patient 
Anesthesia Progress  2014;61(3):111-112.
Hair tourniquet syndrome is a condition where a hair becomes entangled around an appendage. In some cases a knot will form and the resulting tightened noose will slowly strangulate the appendage. Rarely, this condition will affect the oral cavity, but even more rarely, this condition will affect a dental structure.
PMCID: PMC4156374  PMID: 25191985
Hair; Tourniquet; Dental; Tooth; Oral; Cavity
7.  Essentials of Airway Management, Oxygenation, and Ventilation: Part 2: Advanced Airway Devices: Supraglottic Airways 
Anesthesia Progress  2014;61(3):113-118.
Offices and outpatient dental facilities must be properly equipped with devices for airway management, oxygenation, and ventilation. Part 1 in this series on emergency airway management focused on basic and fundamental considerations for supplying supplemental oxygen to the spontaneously breathing patient and utilizing a bag-valve-mask system including nasopharyngeal and oropharyngeal airways to deliver oxygen under positive pressure to the apneic patient. This article will review the evolution and use of advanced airway devices, specifically supraglottic airways, with the emphasis on the laryngeal mask airway, as the next intervention in difficult airway and ventilation management. The final part of the series (part 3) will address airway evaluation, equipment and devices for tracheal intubation, and invasive airway procedures.
PMCID: PMC4156375  PMID: 25191986
Airway management; Ventilation; Devices; Supraglottic airways; Laryngeal mask airways
8.  Continuing Education Program 
Anesthesia Progress  2014;61(3):119.
Please see the pdf version for the Continuing Education Program Answer Sheet.
PMCID: PMC4156376
Anesthesia Progress  2014;61(3):120-127.
PMCID: PMC4156377
10.  Confirmed Transmission of Hepatitis C in an Oral Surgery Office 
Anesthesia Progress  2014;61(3):93-94.
PMCID: PMC4156378  PMID: 25191980
11.  IV ATP Potentiates Midazolam Sedation as Assessed by Bispectral Index 
Anesthesia Progress  2014;61(3):95-98.
In this study, by measuring bispectral index (BIS), we tested the hypothesis that intravenous adenosine 5′-triphosphate (ATP) infusion would deepen the level of midazolam-induced sedation. Ten healthy volunteers underwent 2 experiments with at least 2 weeks' interval: immediately after intravenous bolus administration of midazolam (0.04 mg/kg), they received continuous infusion of either ATP infusion (100 μg/kg/min) or placebo (saline) for 40 minutes in a double-blind, randomized, crossover manner. Changes in BIS values and responsiveness to verbal command as well as cardiorespiratory variables were observed throughout the study periods. Administration of midazolam alone reduced BIS value from control: 97 ± 1 to 68 ± 18 at 25 minutes, which was accompanied by significant cardiopulmonary depressant effects, while maintaining responsiveness to verbal command (consciousness) throughout the study period. Coadministration of ATP with midazolam further reduced BIS value to 51 ± 13, associated with complete loss of consciousness without adverse effect on the cardiorespiratory systems. We conclude that the addition of ATP infusion to midazolam significantly enhances midazolam sedation without disturbing cardiorespiratory functions.
PMCID: PMC4156379  PMID: 25191981
Midazolam sedation; ATP; Central adenosine receptors
12.  OFIRMEV: An Old Drug Becomes New Again 
Anesthesia Progress  2014;61(3):99-102.
This was judged to be the first place winning submission for the American Dental Society of Anesthesiology Student Essay Award.
Acetaminophen is an old drug that is now available in an intravenous formulation. Its advantages and disadvantages are reviewed, including its potential role in multimodal postoperative pain therapy.
PMCID: PMC4156380  PMID: 25191982
Intravenous acetaminophen; Postoperative pain control; Multimodal analgesia
13.  When Can a Normal Dose Be an Overdose? Who Is at Risk? 
Anesthesia Progress  2014;61(2):45-46.
PMCID: PMC4068092  PMID: 24932976
15.  Multiple Risks for Patients Using the Transdermal Fentanyl Patch 
Anesthesia Progress  2014;61(1):1-2.
PMCID: PMC3975607  PMID: 24697818
16.  New Evidence of Enhanced Safety of Nitrous Oxide in General Anesthesia 
Anesthesia Progress  2013;60(4):143-144.
PMCID: PMC3891454  PMID: 24423416
17.  Alarm Fatigue Can Decrease the Safety of Dental Office Sedation and Anesthesia 
Anesthesia Progress  2013;60(3):93-94.
PMCID: PMC3771202  PMID: 24010985
18.  New FDA Black Box Warning for Codeine: How Will This Affect Dentists? 
Anesthesia Progress  2013;60(2):35-36.
PMCID: PMC3683877  PMID: 23763556
19.  Have You Met Your Production Quota Today? 
Anesthesia Progress  2012;59(4):141-142.
PMCID: PMC3522490  PMID: 23241035
20.  Prevention of Fire in the Dental Chair 
Anesthesia Progress  2012;59(3):105-106.
PMCID: PMC3468287  PMID: 23050749
21.  What Else Can We Learn from the Anesthesia Specialty Application? 
Anesthesia Progress  2012;59(1):1-2.
PMCID: PMC3309295  PMID: 22428967
22.  Improving the Quality and Fairness of Sedation and Anesthesia Evaluations 
Anesthesia Progress  2011;58(4):155-156.
PMCID: PMC3237324  PMID: 22168804
23.  The Latest ASA Mandate: CO2 Monitoring For Moderate and Deep Sedation 
Anesthesia Progress  2011;58(3):111-112.
PMCID: PMC3167153  PMID: 21882985
24.  The Cost of Learning From Our Mistakes 
Anesthesia Progress  2011;58(2):55-56.
PMCID: PMC3198126  PMID: 21679039
25.  The Fallacy of a Lifesaving Sublingual Injection of Flumazenil 
Anesthesia Progress  2011;58(1):1-2.
PMCID: PMC3265264  PMID: 21410357

Results 1-25 (135)