Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
1.
Pediatr Dent ; 46(1): 58-62, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38449042

RESUMEN

Purpose: Intraoral oxygen pooling during dental sedation, especially using supplemental oxygen, is associated with an increased risk of spontaneous perioperative fire. The purpose of this in vitro study was to examine the effectiveness of intraoral suctioning for reducing oxygen pooling to safe levels during a simulated dental procedure. Methods: Phase one: Twenty trials were completed for each of the three suctioning devices: high-volume evacuation (HVE), fixed tip saliva ejector (SE), and Yankauer suction (YS). Phase two: Twenty trials were completed for each of three suctioning scenarios: no suctioning and continuous suctioning for the HVE and SE. Results: In phase one, the slope for change (decrease) in oxygen during suction was significantly larger for SE than HVE (P<0.001) and YS (P<0.001), but for HVE and YS were not significantly different. Mean oxygen levels during suction were significantly higher for SE than HVE (P<0.001) and YS (P<0.001). In phase two, oxygen increased faster for no suction than for SE and HVE (P<0.001) and increased faster for SE than HVE (P<0.001). Mean oxygen levels were significantly lower for HVE than for SE (P<0.001) and no suction (P<0.001), and significantly lower for SE than no suction (P<0.001). Conclusion: All three devices were effective for reducing intraoral oxygen concentration to acceptable levels during the procedure. The HVE was the most effective suction device for rapidly evacuating pooled intraoral oxygen.


Asunto(s)
Procedimientos Quirúrgicos Orales , Humanos , Succión , Oxígeno
2.
Anesth Prog ; 70(1): 3-8, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36995957

RESUMEN

OBJECTIVE: The risk of a spontaneous surgical fire increases as oxygen concentrations surrounding the surgical site rise above the normal atmospheric level of 21%. Previously published in vitro findings imply this phenomenon (termed oxygen pooling) occurs during dental procedures under sedation and general anesthesia; however, it has not been clinically documented. METHODS: Thirty-one children classified as American Society of Anesthesiologists I and II between 2 and 6 years of age undergoing office-based general anesthesia for complete dental rehabilitation were monitored for intraoral ambient oxygen concentration, end-tidal CO2, and respiratory rate changes immediately following nasotracheal intubation or insertion of nasopharyngeal airways, followed by high-speed suctioning of the oral cavity during simulated dental treatment. RESULTS: Mean ambient intraoral oxygen concentrations ranging from 46.9% to 72.1%, levels consistent with oxygen pooling, occurred in the nasopharyngeal airway group prior to the introduction of high-speed oral suctioning. However, 1 minute of suctioning reversed the oxygen pooling to 31.2%. Oropharyngeal ambient oxygen concentrations in patients with uncuffed endotracheal tubes ranged from 24.1% to 26.6% prior to high-speed suctioning, which reversed the pooling to 21.1% after 1 minute. CONCLUSION: This study demonstrated significant oxygen pooling with nasopharyngeal airway use before and after high-speed suctioning. Uncuffed endotracheal intubation showed minimal pooling, which was reversed to room air ambient oxygen concentrations after 1 minute of suctioning.


Asunto(s)
Consultorios Odontológicos , Oxígeno , Niño , Humanos , Intubación Intratraqueal/efectos adversos , Intubación Intratraqueal/métodos , Anestesia General/efectos adversos , Anestesia General/métodos , Nasofaringe
4.
6.
7.
9.
Anesth Prog ; 67(2): 121-123, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32633767
10.
J Patient Saf ; 16(4): 316-319, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32217928

RESUMEN

OBJECTIVES: Surgical operatory fires continue to occur in the United States, often with devastating consequences. Because more than 21% concentrations of oxygen are necessary for the onset of such combustion, this study examined fluctuations of surgical site oxygen levels. Better understanding how these more than 21% concentrations occur will not only add to surgical fire prevention efforts generally but also potentially reduce patient or staff harm and practitioner liability as well. METHODS: Performing an in situ dental procedure with supplemental nasal-cannulated oxygen and a dental dam, we measured oxygen pooling, defined as any fraction of inspired oxygen (FIO2) greater than the 21% FIO2 of air, on top of and behind a dental dam, and during the application of high-volume intraoral suction. RESULTS: Findings indicated statistically significantly higher concentrations (as much as twice the <30% recommended safe level) behind the dental dam compared with on top of it. During real-time measurements of FIO2 for four 120-second trials per participant, oxygen levels exhibited significant fluctuation above and below a more stringent 24.9% safety threshold established in prior research. Application of high-speed intraoral dental suction reduced FIO2 to near atmospheric levels in 30 (96.7%) of 31 of the cases by 60 seconds. CONCLUSIONS: These results demonstrate the elevated risk associated with above-safe levels of oxygen pooling during a simple dental procedure. Although future research is needed to still more exactly characterize conditions leading to the onset of surgical fires, this study also demonstrates the ability of high-speed intraoral suction to dramatically and rapidly decrease that risk.


Asunto(s)
Incendios/prevención & control , Ventilación no Invasiva/métodos , Procedimientos Quirúrgicos Orales/efectos adversos , Terapia por Inhalación de Oxígeno/métodos , Oxígeno/uso terapéutico , Cánula , Femenino , Humanos , Masculino , Cirugía Bucal
11.
Anesth Prog ; 67(1): 60-62, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32191502
12.
Anesth Prog ; 67(4): 248-250, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33393608
13.
Anesth Prog ; 66(3): 173-176, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31545666
15.
Anesthesiol Clin ; 37(2): 333-348, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31047133

RESUMEN

The provision for and administration of dental office-based sedation and anesthesia requires considerations and preparations that are unique to dentistry and unlike that of any other office-based and nonoperating room procedures. Anesthesia providers who have only performed dental cases in an operating room are often unaware of the idiosyncrasies and risks associated with performing sedation and anesthesia in the dental office. This article explores the demographics, patient characteristics, morbidity, mortality, and clinical concerns with an in-depth discussion of the dental operating environment. The content is integrated with the current medical and dental guidelines for office-based anesthesia.


Asunto(s)
Anestesia Dental/métodos , Sedación Consciente/métodos , Adolescente , Niño , Preescolar , Consultorios Odontológicos , Humanos , Monitoreo Intraoperatorio , Seguridad del Paciente
16.
Anesth Prog ; 66(1): 52-54, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883230
17.
Pediatr Dent ; 41(1): 52-55, 2019 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-30803478

RESUMEN

Purpose: Use of general anesthesia (GA) for comprehensive dental treatment of children is an essential health benefit. Pediatric dentists utilize dentist anesthesiologists to provide GA for dental rehabilitation of severe early childhood caries. Dentist anesthesiologists deliver GA using intubated or nonintubated GA. The purpose of this study was to compare the incidence of respiratory complications when intubated versus nonintubated general anesthesia was completed by dentist anesthesiologists in a pediatric dentistry setting. Methods: The Society of Ambulatory Anesthesia (SAMBA) Clinical Outcomes Registry (SCOR) database was queried for pediatric dental GA cases completed by dentist anesthesiologists from January 1, 2010 to December 31, 2016. Logistic regression compared intubated GA versus nonintubated GA for differences in the incidence of respiratory complications. Results: Within 9,333 cases, there were 30 incidents of laryngospasm (0.3 percent), 19 incidents of bronchospasm (0.2 percent), two incidents of hypoxia (less than 0.1 percent), and six incidents of difficult airway (0.1 percent). When intubated versus nonintubated GA was compared for respiratory complication incidence, no significant association was found (P=0.81, odds ratio equals 0.93). Conclusion: No significant difference was found between the incidence of respiratory complications with intubated versus nonintubated GA provided by dentist anesthesiologists.


Asunto(s)
Anestesia Dental/métodos , Anestesia General/métodos , Atención Dental para Niños/métodos , Intubación Intratraqueal , Anestesia Dental/efectos adversos , Anestesia General/efectos adversos , Niño , Preescolar , Atención Dental para Niños/efectos adversos , Femenino , Humanos , Incidencia , Intubación Intratraqueal/efectos adversos , Intubación Intratraqueal/métodos , Masculino , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/etiología
18.
J Am Dent Assoc ; 150(3): 193-199, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30803491

RESUMEN

BACKGROUND: Specialty-based practice is a fundamental component of US medicine and dentistry, yet the recognition of new dental specialties has markedly diminished in the past 50 years while medical specialization has flourished. METHODS: This article reviews the history of specialty development while focusing on the underlying scientific, educational, and cultural changes in both professions. The process of dental specialty recognition is also examined. RESULTS: The current dental specialty recognition process provides a set of criteria aspiring specialties need to fulfill at the time of application, yet the relationship between the criteria and the sequence for attaining them is undefined. Scientific development and evidence-based practice have grown to become the cornerstone of contemporary health care specialization. CONCLUSIONS: A new paradigm for specialty and subspecialty development in dentistry is needed. A model is presented herein that recognizes scientific development as the basis for specialization and describes a formal, sequenced process for the development of emerging specialties and subspecialties. PRACTICAL IMPLICATIONS: This new paradigm for dental specialty recognition builds on the current criteria for specialization while encouraging cross-disciplinary interaction and nurturing the development of emerging specialties and subspecialties in dentistry. Doing so will allow dentistry to maintain its lead role in the maintenance of oral health and oral disease treatment in the US population.


Asunto(s)
Medicina , Especialidades Odontológicas , Odontología , Hospitales , Especialización , Estados Unidos
19.
Anesth Prog ; 66(4): 235-237, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31891294
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA