ABSTRACT
Background: Dental treatment procedures in childhood may trigger high levels of anxiety and fear. In these circumstances sedation protocols with different agents serve acceptable, safe and effective treatment environments. We aimed to investigate the better and safer sedation regimen being used in our institution
Methodology: We retrospectively investigated medical and anesthesia reports of 553 children, who underwent dental treatments with different anesthetic agents. Total anesthesia time, intraoperative vital signs [heart rates, peripheral oxygen saturation and arterial blood pressure], perioperative complications including tachycardia, bradycardia, hypo/ hypertension, respiratory depression, bronchospasm, nausea, vomiting, agitation and/or hallucinations were recorded. The results were analyzed by SPSS [version 20.0] using independent T-test, Wilcoxon, Mann-Whitney, and Pearson Chi-square tests as appropriated. Data are expressed as mean + standard deviation or median [25%-75%], [minimum-maximum], or as n [%]
Results: The shortest anesthesia time was recorded with sevoflurane anesthesia while longest was recorded in ketamine IM + ketamine IV + midazolam IM + midazolam IV group [18.88 +/- 9.45 versus 58.57 +/- 17.73 minutes]. There was no recorded side effect in 405 [73.2%] procedures while tachycardia in 114 [20.6%], hypotension or hypertension in 9 [1.6%], respiratory depression in 6 [1.15] patients and bradycardia in 5 [0.9%] patients were recorded. 4 patients [0.7%] were suffered from bronchospasm. Tachycardia was most common in ketamine IM + ketamine IV administered group [n=26, 22.8%]. In contrast there was no recorded tachycardia in patients sevoflurane alone or propofol alone groups [0 patient in both groups]. Postoperative nausea and vomiting rates were lowest in ketofol procedures. Postoperative agitation and hallucination rates were higher in ketofol bolus + ketofol infusion procedure [12.7%]
Conclusion: Sedation with different anesthetics either alone or combined during pediatric dentistry can be accepted as safe and comfortable for both patients and healthcare professionals. We suggest that less complication rates with ketofol regimens noted in this study needs to be investigated in more strongly designed future studies
ABSTRACT
Objective: Unintentional dural puncture with an epidural needle is common and indisputably one of the most important complications of epidural anesthesia. When no regression of the complaints are observed after conservative treatment, epidural blood patch [EBP] should be planned for the treatment of patients. However, EBP is not the optimal choise because the success rate is low and the risk of potential serious complications is high. Ankaferd Blood Stopper® [ABS], which is a medicinal plant extract, has been used as a antihemorrhagic agent against various types of bleeding. The purpose of this study is to investigate the effects of ABS administration, on fibrin formation and cerebro-spinal fluid [CSF] leakage after dural puncture in a rat model
Methodology: The study was performed at Gazi University Experimental Research Center, Ankara, Turkey between May and July 2013. Eighteen rats were grouped randomly as control [Group C, n=6], dural punctured [Group DPC, n=6] and ABS application after dural puncture at the level of L4-L5 [Group A, n=6]. Methylene blue was applied to the cervical level of the rat spine, in order to observe leakage from dural puncture in Group DPC, and Group A. Medulla spinalis tissues of the rats were evaluated histopathologically
Results: CSF leakage was obtained in all rats in Group DPC [100%] that were dural punctured with spinal needle and given methylene blue. However, in the group of rats that ABS was performed before methylene blue [Group A] application, CSF leakage could be obtained in only half of the rats [50%], and in none of the rats in Group C. CSF leakage ratio in Group DPC was 100% and significantly higher than that in Group C [X[2]=5.178, p=0.002]. Following Ankaferd administration, CSF leakage was identified in only 50% of rats in group A and this result was similar with achieved result in Group C [X[2]=1.778, p=0.182]
Conclusion: We opine that Ankaferd Blood Stopper® [ABS] is effective in preventing CSF leakage after post dural puncture and does not cause necrosis in rat medulla spinalis tissues