Subject(s)
Anesthesia, Dental/history , Anesthesia, Inhalation/history , Conscious Sedation/history , Anesthesia, Dental/instrumentation , Anesthesia, Inhalation/instrumentation , Conscious Sedation/instrumentation , Equipment Design , History, 20th Century , History, 21st Century , Humans , United KingdomABSTRACT
In the dental practice--for more than a 100 years--it has been a vital topic how to prevent, eliminate, or at least relieve pain and fear associated with dental treatments. 'Fogorvosi Szemle,' the scientific journal of the Hungarian Dental Association is now a 100 years old. Authors present how the approaches and methods of relieving pain and fear have changed in the past century, based on the reports published in this journal. The reports are grouped in three main topics: local anaesthetics and sedatives; ambulatory narcosis and sedative analgesia; hypnosis and hypnotherapy. Based on the publications of the last one hundred years, it can be concluded that the Hungarian dental practice has followed the trends and principles of the well-known international dental schools.
Subject(s)
Anesthesia, General/history , Anesthesia, Local/history , Conscious Sedation/history , Dental Anxiety/history , Dental Care/history , Hypnosis, Dental/history , Pain/history , Anesthesia, General/methods , Anesthesia, Local/methods , Conscious Sedation/methods , Dental Anxiety/prevention & control , Dental Anxiety/therapy , Dental Care/methods , History of Dentistry , History, 20th Century , History, 21st Century , Humans , Hungary , Hypnosis, Dental/methods , Journalism, Medical/history , Pain/etiology , Pain Management , Periodicals as Topic/historySubject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Anesthesia, General , Conscious Sedation/classification , Conscious Sedation , Conscious Sedation/adverse effects , Conscious Sedation/history , Conscious Sedation/instrumentation , Conscious Sedation/methods , Preoperative Care/classification , Preoperative Care/instrumentation , Preoperative Care/methods , Nitrous Oxide/administration & dosage , Nitrous Oxide , Nitrous Oxide/standards , Nitrous Oxide/therapeutic use , Oxygen/administration & dosage , Oxygen , Oxygen/standards , Oxygen/therapeutic useABSTRACT
Pain and anxiety in the dental setting prevent many patients from seeking needed treatment. As a result, various techniques of anesthesia or sedation have been developed over the last 150 years to overcome this problem. Both the historic evolution of sedation and the use of several currently popular techniques are described in this article. Also discussed is the balance between individual patient responses to drugs, dosages, and rate of administration. Currently used definitions of pharmacologic depression of consciousness are detailed, as are contemporaneous training requirements. Finally, unexpected, rare, and catastrophic events that can occur with sedation are briefly discussed.
Subject(s)
Anesthesia, Dental/methods , Conscious Sedation , Dental Anxiety/prevention & control , Administration, Intranasal , Administration, Oral , Ambulatory Surgical Procedures , Anesthesia, Dental/history , Conscious Sedation/history , Conscious Sedation/methods , Conscious Sedation/statistics & numerical data , Education, Dental , History, 18th Century , History, 20th Century , Humans , Hypnotics and Sedatives/administration & dosage , Hypnotics and Sedatives/therapeutic use , Injections, Intravenous , Nitrous Oxide , United StatesABSTRACT
In 1943, Olson described a method for administration of thiopental for anesthesia during oral surgical procedures (J Oral Surg 1:197, 1943). Patients were instructed not to eat for 4 hours before the scheduled surgery and to bring an escort. Premedication with atropine or morphine was not routinely used. Following venipuncture, a 2- to 3-mL test dose of thiopental (Pentothal, Abbott Laboratories, North Chicago, IL) was injected. After a pause of 15 to 20 seconds, 6 mL was injected slowly over 40 to 50 seconds. Additional medication was titrated slowly in intermittent doses to maintain an adequate level of anesthesia. The mouth was packed and kept meticulously dry to prevent coughing or laryngospasm. The patient's color and respiration were continually observed and the airway maintained. Initially, a 5% solution was used by Olson; later it was changed to 2%. Use of this concentration made it easier to titrate to "upper levels" of anesthesia because profound depth was not required. Also, adverse effects (eg, coughing, laryngospasm) occurred less frequently, and there was less venous irritation with the 2% solution. Based on his experience of 8,203 cases, Olson claimed that most patients tolerated the anesthetic well, but he recommended avoiding this technique for children younger than 12 years of age.