ABSTRACT
The development of diaphragmatic hernias, their associated physical and diagnostic signs and symptoms, and the potential complications with nitrous oxide use are presented with a case report. Depending upon the location and extent of the diaphragmatic defect, portions of the stomach, omentum, liver and/or intestine can occupy a portion of the thoracic cavity. Nitrous oxide's solubility properties allow for rapid expansion of the herniated bowel, resulting in compression of the thoracic organs or strangulation of the herniated abdominal viscera. The presence of a diaphragmatic hernia may necessitate a change in sedation or anesthesia plans to eliminate the use of nitrous oxide during prolonged procedures.
Subject(s)
Anesthesia, Dental/methods , Dental Care for Chronically Ill/methods , Hernias, Diaphragmatic, Congenital , Nitrous Oxide , Adult , Contraindications , Humans , MaleABSTRACT
A case is reported in which chronic urticaria developed following local anesthetic administration in a 21-year old Chinese-American male who had presented for routine dental care. An in-depth medical history and intradermal skin-testing failed to disclose a reason for this reaction. Referral to an allergist revealed a previously unknown underlying emotional tension which contributed to the development of chronic urticaria. A brief trial of hydroxyzine (Vistaril), an antihistaminic and anxiolytic medication, was successful in controlling this condition. This case illustrates the importance of the evaluation of the emotional status as a vital component of a comprehensive medical history.
Subject(s)
Anesthesia, Dental/adverse effects , Anesthesia, Local/adverse effects , Stress, Psychological/complications , Urticaria/etiology , Adult , Humans , MaleABSTRACT
Trauma to hard and soft tissues of the oral and perioral regions occurs due to laryngoscopy. This paper identifies patients predisposed to dental complication preoperatively, explains the course to be taken intra- and post-operatively should such a complication occur and presents a modification of the MacIntosh laryngoscopy blade suitable for most patients.
Subject(s)
Laryngoscopes , Mouth/injuries , Equipment Design , Humans , Tooth Fractures/prevention & control , Tooth InjuriesABSTRACT
Total brainstem anesthesia with respiratory arrest followed extraoral trigeminal V2-V3 diagnostic nerve blocks for trigeminal neuralgia using a combination of 0.25 percent Bupivacaine, Sarapin, and triamcinolone. While an untoward reaction to either the Sarapin or triamcinolone cannot be ruled out, the most probable cause for this problem was the inadvertent intrathecal injection of Bupivacaine since the reaction can be explained on the basis of a local anesthetic effect. No such effect has been attributed to either of the other components of the mixture. Proper monitoring and prompt attention permitted attenuation of this potentially life-threatening complication.
