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jtitle_s:("anesti Prog")
1.  Comparative study on anesthetic potency depending on concentrations of lidocaine and epinephrine: assessment of dental local anesthetics using the jaw-opening reflex. 
Anesthesia Progress  2001;48(1):16-20.
Anesthetic potency of a local anesthetic on the dental pulp was investigated by increasing or decreasing the concentration of lidocaine and that of epinephrine. An electromyogram of the digastric muscle in Japan White male rabbits was recorded during the jaw-opening reflex induced by electrical stimulation of the dental pulp. Probit analysis was used for the determination of the 50% effective volume (ED50) values of the anesthetic. The anesthetics used were plain 2% lidocaine solution (2Lid-0 group), 2% lidocaine solution with 12.5 microgram/mL of epinephrine (2Lid-1/8 group), 2% lidocaine solution with 6.25 microgram/mL of epinephrine (2Lid-1/16 group), and 4% lidocaine solution with 5 microgram/mL of epinephrine (4Lid-1/20 group). No anesthetic effect was shown in the 2Lid-0 group. The 2Lid-1/8 group indicated adequate anesthetic potency with the smallest dosage at all observation periods. The potency in the 2Lid-1/16 group was 0.3-0.5 times, and that in the 4Lid-1/20 group was 0.3-0.4 times as much as the 2Lid-1/8 group. The decrease in epinephrine concentration produced the decrease in the anesthetic potency on the dental pulp independent of lidocaine concentration. These results suggest that the increase in lidocaine concentration may not compensate the decrease in epinephrine concentration.
PMCID: PMC2007327  PMID: 11495400
2.  Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery. 
Anesthesia Progress  2000;47(4):119-124.
The aim of the study was to investigate whether preemptive multimodal analgesia (diclofenac, butorphanol, and lidocaine) was obtained during sagittal split ramus osteotomy (SSRO). Following institutional approval and informed consent, 82 healthy patients (ASA-I) undergoing SSRO were randomly assigned to 1 of 2 groups, the preemptive multimodal analgesia group (group P, n = 41) and the control group (group C, n = 41). This study was conducted in a double-blind manner. Patients in group P received 50 mg rectal diclofenac sodium, 10 micrograms/kg intravenous 0.1% butorphanol tartrate, and 1% lidocaine solution containing 10 micrograms/mL epinephrine for regional anesthesia and for bilateral inferior alveolar nerve blocks before the start of surgery. Postoperative pain intensity at rest (POPI) was assessed on a numerical rating score (NRS) in the postanesthesia care unit (PACU) and on a visual analogue scale (VAS) at the first water intake (FWI) and at 24, 48, and 72 hours after extubation. POPI in the PACU was significantly lower in group P than in group C, whereas there were no significant differences at FWI, 24, 48, and 72 hours after extubation in both groups. Preemptive multimodal analgesia was not observed in this study.
PMCID: PMC2149035  PMID: 11432176
3.  Pain following intravenous administration of sedative agents: a comparison of propofol with three benzodiazepines. 
Anesthesia Progress  1998;45(1):18-21.
The purpose of the present study is to compare the injection pain of propofol with that of benzodiazepines when used for intravenous sedation. In addition, we evaluated the efficacy of coadministering a small dose of 1% lidocaine (20 mg) to reduce the pain accompanying propofol injection. Intravenous propofol, diazepam, midazolam, or flunitrazepam were administered on separate occasions to volunteers and outpatients. The degree of injection pain was evaluated by the Visual Analog Scale (VAS) ruler. The efficacy of premixed lidocaine with propofol was also compared among the patients. The venous pain of propofol was significantly more intense than that of the three other drugs (P < 0.05). The injection pain of diazepam was more intense than that of midazolam (P < 0.05). Many patients reported no pain when propofol was coadministered with lidocaine. The addition of a small dose (20 mg) of lidocaine reduced the VAS pain score to comparable levels observed for benzodiazepines. Because injection pain might affect the patients' comfort during sedation, the addition of lidocaine to the propofol injection is deemed useful for intravenous sedation.
PMCID: PMC2148944  PMID: 9790005
4.  Is measurement of end-tidal CO2 through a nasal cannula reliable? 
Anesthesia Progress  1997;44(1):23-26.
When using a nasal cannula to sample gases expired by a patient, air from the room may dilute the sample. For this reason, the accuracy of the partial pressure of end-tidal carbon dioxide (ETCO2) measurements is questionable. We experimentally examined the reliability of ETCO2 measurements through a nasal cannula and found that they depended on both biological factors (tidal volume and respiratory rates) and mechanical factors (the diameter and the length of the cannula and the diameter of the prongs). These results suggest that the correct use of an appropriate sampling cannula will provide reliable ETCO2 measurements without clinical problems.
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PMCID: PMC2148854  PMID: 9481977
5.  Effects of block analgesia on attenuating intraoperative stress responses during oral surgery. 
Anesthesia Progress  1997;44(3):101-105.
Surgical intervention affects cardiorespiratory function and deteriorates the homeostatic mechanisms. The aim of this study was to evaluate the effect of block analgesia, which may minimize the intraoperative stress responses during oral surgery. In addition, we evaluated whether block analgesia could lessen the anesthetic requirements. Twenty-eight operative patients were randomly allocated to one of four groups: group 1, 1.3MAC without block analgesia; group 2, 1.6MAC without block analgesia; group 3, 1.0MAC with block analgesia; and group 4, 1.3MAC with block analgesia. Systolic blood pressure (SBP), heart rate (HR), and plasma norepinephrine levels (NE) were measured and compared. Results showed that the increases in SBP, HR, and NE in groups 1 and 2 were greater than those in groups 3 and 4. SBP elevation in group 1 was the greatest among all groups. These results suggest that block analgesia appears to be effective for preventing hyperreactivity of the sympathetic nervous and endocrine systems. In conclusion, general anesthesia combined with block analgesia assures safer anesthesia for patients with cardiovascular diseases or elderly patients who require cardiovascular stability during surgery.
PMCID: PMC2148925  PMID: 9481970
6.  Epinephrine at doses used in dentistry deteriorates platelet retention rate. 
Anesthesia Progress  1997;44(2):59-63.
Epinephrine promotes platelet aggregation through alpha 2 receptor-mediated mechanisms. In this study, the change in the platelet retention rate (PRR) was investigated before and after submucosal epinephrine injection with or without lidocaine in oral surgical patients during isoflurane-nitrous oxide anesthesia. Thirty-nine consenting patients participated in this study. Subjects were allocated in one of five groups depending on the solution injected, the diclofenac supplement, and the patients' age. PRR was measured immediately before and 5 min after epinephrine injection using a modified form of Saltzman's method. Injection of epinephrine with lidocaine deteriorated PRR, although epinephrine without lidocaine produced no PRR change. Epinephrine at doses used in routine dental practices may activate the platelet aggregating function. Dentists should keep in mind that epinephrine elicits both hemodynamic and platelet-activating effects. The latter may be of clinical importance in some situations.
PMCID: PMC2148836  PMID: 9481962
7.  The influence of propranolol on the cardiovascular effects and plasma clearance of epinephrine. 
Anesthesia Progress  1991;38(6):217-220.
The purpose of the present study was to determine how propranolol modifies the circulatory effects of epinephrine infused to produce plasma concentrations achieved during dental local anesthesia and to evaluate the effects of propranolol on the plasma clearance of epinephrine. The study was performed on six healthy male volunteers ranging in age from 25 to 34 yr. Five measurement series were performed on each of these subjects at the following times: pretreatment control, 15 min after the beginning of the first epinephrine infusion (10 ng/kg/min), 15 min after the cessation of the first epinephrine infusion, 3 min after the intravenous injection of propranolol 40 micrograms/kg, and 15 min after the beginning of the second epinephrine infusion. Plasma epinephrine clearance decreased to 54.7 +/- 9.3% of the control value after propranolol was given. Epinephrine showed initially a predominantly beta-adrenergic action, but this action was inhibited by propranolol. A relative alpha-dominant state may then occur, even when a routine volume of dental local anesthetic is administered to a chronic user of a nonselective beta blocker, and it is postulated that myocardial ischemia may develop in such patients.
PMCID: PMC2148693  PMID: 1842159

Results 1-9 (9)