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jtitle_s:("anesti Prog")
3.  Pathogenesis of postoperative oral surgical pain. 
Anesthesia Progress  2003;50(1):5-17.
Pain is a major postoperative symptom in many oral surgical procedures. It is a complex and variable phenomenon that can be influenced by many factors. Good management of oral surgical pain requires a detailed understanding of the pathogenesis of surgical pain. This article aims at reviewing postoperative pain from a broad perspective by looking into the nociception, neuroanatomy, neurophysiology, and neuropharmacology of pain. Therapeutic recommendations are made after reviewing the evidence from the literature for maximizing the efficacy of pain management techniques for oral surgical pain.
PMCID: PMC2007420  PMID: 12722900
6.  Evaluation of surgical procedures for trigeminal neuralgia. 
Anesthesia Progress  2003;50(4):181-188.
Trigeminal neuralgia is a type of facial pain that is difficult to treat. The pain can be excruciating and debilitating. The wide range of treatments currently used for trigeminal neuralgia is ample evidence that there is no simple answer to how it should be managed. This review will evaluate the current surgical procedures used for the treatment of trigeminal neuralgia. A critical analysis of the evidence-based studies to date was done to evaluate and compare the efficacy of the different surgical procedures. Arguments for and against the use of surgery for trigeminal neuralgia are presented. In addition, the surgical procedures were compared with other treatments for trigeminal neuralgia.
PMCID: PMC2007453  PMID: 14959906
7.  Comparative analysis of tissue reactions to anesthetic solutions: histological analysis in subcutaneous tissue of rats. 
Anesthesia Progress  2003;50(4):169-180.
Postanesthetic pain is a relatively common complication after local anesthesia. This complication may be caused by the anesthetic technique or by the anesthetic solution used. Tissue reactions induced by the anesthetic solutions may be one of the factors resulting in pain after anesthesia. The objective of this study was to comparatively analyze tissue reactions induced by different anesthetic solutions in the subcutaneous tissue of rats. The following solutions were utilized: 2% lidocaine without vasoconstrictor; a 0.5% bupivacaine solution with 1:200,000 adrenaline; a 4% articaine solution and 2% mepivacaine, both with 1:100,000 adrenaline; and a 0.9% sodium chloride solution as a control. Sterilized absorbent paper cones packed inside polyethylene tubes were soaked in the solutions and implanted in the subcutaneous region. The sacrifice periods were 1, 2, 5, and 10 days after surgery. The specimens were prepared and stained with hematoxylin and eosin for histological analysis. The results showed that there is a difference in tissue irritability produced by the local anesthetic solutions. The results also showed that there is no relation between the concentration of the drug and the inflammatory intensity, that the mepivacaine and articaine solutions promoted less inflammatory reaction than the bupivacaine, and that the lidocaine solution produced the least intense inflammation.
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PMCID: PMC2007452  PMID: 14959905
9.  JDSA Journal Abstracts 
Anesthesia Progress  2003;50(4):192-196.
PMCID: PMC2007450
11.  Effectiveness of 20% benzocaine as a topical anesthetic for intraoral injections. 
Anesthesia Progress  2003;50(4):159-163.
The use of topical anesthetics has been advocated prior to the administration of various types of anesthetic injections. Reported results have varied between studies. The purpose of this study was to compare the effectiveness of 20% benzocaine in reducing the pain of needle insertion during maxillary posterior and anterior infiltration and inferior alveolar nerve block injections. In this retrospective study, 1080 patients received 2336 injections using a 27-gauge needle. Topical anesthetic was applied prior to 720 of the injections. Patients rated pain of needle insertion using a 0-4 pain scale. Logistic regression analysis showed no differences in pain ratings between topical and no topical groups for the inferior alveolar nerve block and posterior maxillary infiltration injections. The use of topical anesthetic did reduce the pain of needle insertion with the maxillary anterior injections (P = .0041).
PMCID: PMC2007446  PMID: 14959903
12.  Comparison of effectiveness of 4% articaine associated with 1: 100,000 or 1: 200,000 epinephrine in inferior alveolar nerve block. 
Anesthesia Progress  2003;50(4):164-168.
This comparative study using 20 healthy volunteers evaluated the anesthetic efficacy of 4% articaine in association with 2 different concentrations of epinephrine, 1:200,000 (G1) and 1:100,000 (G2). The first premolars were tested with a pulp tester to verify the anesthesia induced by the inferior alveolar nerve block. The following parameters were measured: period of latency (PL; interval between the end of anesthetic injection and absence of response to the maximum output--80 reading--of the pulp tester); complete pulpal anesthesia (CPA; period in which the subject had no response to maximal output of the pulp tester 80 reading); partial anesthesia (PA; interval between the first reading below 80 and the return to basal levels); and the anesthesia of the soft tissues (AST; period of time from onset of anesthesia until the return to normal sensation of the lip). The Wilcoxon test (alpha = 0.05) was used to analyze the data. No significant difference was found regarding PL (P = .47), CPA (P = .88), PA (P = .46), and AST (P = .85). The results indicated that both solutions presented the same clinical effectiveness in blocking the inferior alveolar nerve.
PMCID: PMC2007445  PMID: 14959904
13.  Comparison of the effect of orally versus submucosally administered meperidine on the behavior of pediatric dental patients: a retrospective study. 
Anesthesia Progress  2003;50(3):129-133.
The purpose of this study was to compare the effect of oral versus submucosal meperidine on the behavior of pediatric dental patients. Twenty charts (10 in each group) were retrospectively reviewed. The groups were matched for age and weight. Presedation and postsedation behavior was rated. No difference was found in the increase in cooperation between the oral and the submucosal meperidine groups. While no difference was found between the 2 groups, a larger prospective study is needed to confirm these findings.
PMCID: PMC2007443  PMID: 14558588
14.  Erratum 
Anesthesia Progress  2003;50(3):156.
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PMCID: PMC2007442
15.  A comparison of injection pain and postoperative pain of two intraosseous anesthetic techniques. 
Anesthesia Progress  2003;50(3):111-120.
The purpose of this prospective, randomized, blinded study was to compare injection pain and postoperative pain of an apical primary X-Tip intraosseous technique to a coronal primary Stabident intraosseous technique in mandibular first molars. Using a repeated-measures design, 41 subjects randomly received 2 primary intraosseous injections at 2 separate appointments. Using a site distal to the mandibular first molar for both injections, the subjects received 1.8 mL of 2% lidocaine with 1: 100,000 epinephrine administered with the X-Tip system using an apical location in alveolar mucosa or 1.8 mL of 2% lidocaine with 1: 100,000 epinephrine administered with the Stabident system using a coronal location in attached gingiva. The pain of infiltration, perforation, needle insertion, solution deposition, mock or actual guide sleeve removal and postoperative pain were recorded on a Heft-Parker visual analogue scale (VAS) scale for the 2 intraosseous systems. The results demonstrated that the apical primary X-Tip intraosseous technique was not statistically different (P > .05) from the coronal primary Stabident technique regarding pain ratings of infiltration, perforation, needle insertion, solution deposition, mock or actual guide sleeve removal and postoperative pain (at the time subjective anesthesia wore off). However, on postoperative days 1 through 3, significantly (P < .05) more males experienced postoperative pain with the X-Tip system than with the Stabident system.
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PMCID: PMC2007441  PMID: 14558586
16.  An evaluation of analgesic efficacy and clinical acceptability of intravenous tramadol as an adjunct to propofol sedation for third molar surgery. 
Anesthesia Progress  2003;50(3):121-128.
This article details a double-blind, randomized, placebo-controlled pilot study evaluating the analgesic efficacy and clinical acceptability of intravenous tramadol in patients undergoing surgical removal of an impacted third molar tooth under local anesthesia and intravenous sedation with propofol. Forty-five ASA status 1 dental outpatients were randomly allocated to 2 groups of 22 (group A) and 23 (group B) patients each (n = 45). Group A (T/P) received intravenous tramadol 1.5 mg/kg injected over 2 minutes, followed by a bolus dose of intravenous propofol 0.4 mg/ kg. Maintenance consisted of a continuous infusion of propofol 3 mg/kg/h, with an additional bolus dose of 0.4 mg/kg intravenously 2-3 minutes prior to the infiltration of the local anesthetic solution. Group B (P/P) patients received no tramadol but instead a saline placebo solution and an identical amount of propofol. Overall, in this study, postoperative pain was much better controlled in the group receiving tramadol 1.5 mg/kg intravenously despite there being no significant difference in the dose of propofol administered in both groups. Intravenous tramadol, when given with propofol, did not affect the cardiovascular, respiratory, and sedative effects of propofol. Following tramadol, despite being an opioid, no nausea and vomiting were reported in the early postoperative period, indicating the value of using tramadol with propofol. Thus, this pilot study demonstrated the potential use of intravenous tramadol with propofol in day-case dento-alveolar surgery.
PMCID: PMC2007436  PMID: 14558587
18.  JDSA Abstracts 
Anesthesia Progress  2003;50(2):75-92.
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PMCID: PMC2007430
19.  Maximizing the safety of nonsteroidal anti-inflammatory drug use for postoperative dental pain: an evidence-based approach. 
Anesthesia Progress  2003;50(2):62-74.
This article reviews the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for postoperative dental pain. An evidence-based approach is used to evaluate the clinical studies to date on the safe use of these drugs in dental patients. No drugs are without adverse effects or are perfectly safe, but their safe use in clinical practice would entail maximizing the therapeutic efficacy and minimizing the adverse effects. Therapeutic recommendations are made after reviewing the evidence for the safe use of NSAIDs in postoperative dental pain.
PMCID: PMC2007429  PMID: 12866802
20.  Effect of nitrous oxide on intracellular events of GT1-7 GnRH-secreting neurons. 
Anesthesia Progress  2003;50(2):53-61.
Exposure to nitrous oxide (N2O) may result in decreased fertility and other reproductive problems in women working in dental offices. This study explored direct effects of N2O on gonadotropin-releasing hormone (GnRH) neurons involved in pituitary-gonadal function. An immortalized GnRH-secreting GT1-7 cell line was used to evaluate the effects of 60% N2O exposure for 24 hours on pro-GnRH mRNA levels, KCl-stimulated GnRH levels, and certain signaling pathways. N2O exposure for 24 hours decreased pro-GnRH mRNA levels by approximately 80% without affecting cell viability or intracellular GnRH levels. The ability of KCl to release GnRH stores was also significantly reduced. Western blot analyses of ERK1/2, and p38 phosphorylation and IkappaB did not indicate any change in phosphorylation, although p63 tyrosine phosphorylation was increased after short-term N2O exposure. Levels of c-fos, a nuclear transcription factor, were not changed by N2O exposure. These results indicate that N2O significantly decreases evoked release of GnRH as well as GnRH mRNA levels either by decreased synthesis or by mRNA stability. These results may be important in understanding adverse effects of N2O on female workers in dental practice where the gas is not scavenged.
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PMCID: PMC2007428  PMID: 12866801
22.  Parental evaluation of quality of life measures following pediatric dental treatment using general anesthesia. 
Anesthesia Progress  2003;50(3):105-110.
The purpose of this study was to examine (a) parental satisfaction with the dental care their child received under general anesthesia, and (b) perception of the impact of this care on physical and social quality of life. The sample included 45 children (median age 50 months, 26 boys and 19 girls). Data were collected using a 1-page survey instrument completed by the parent at the first follow-up appointment. Dichotomous dependent variables were developed to measure parental satisfaction, dental outcome, and social impact of treatment. There was an overwhelmingly positive impression with dental outcomes (pain relief and improved masticatory efficiency). Parental perceptions in the social dimension were also positive. Parents reported more smiling, improved school performance, and increased social interaction. Relative to overall health, the majority of parents reported an improvement. Logit regression analysis revealed that absence of pain (P < .05) and increased social interaction (P < .01) had a significant impact on parents' perception of overall health. Our findings indicate that dental care under general anesthesia for preschool children has a high degree of acceptance by parents and is perceived to have a positive social impact on their child.
PMCID: PMC2007439  PMID: 14558585

Results 1-22 (22)