RESUMO
A healthy 5-year-old boy presented for arch bar placement under general anesthesia in an operating room in a dental school. The patient had previously undergone general anesthesia without complication, and no family history of anesthetic problems were reported. Halothane mask induction, intravenous catheter placement, and nasal intubation proceeded uneventfully without the aid of a muscle relaxant. Halfway through the procedure, signs and symptoms of malignant hyperthermia, including muscle rigidity, hypercarbia, tachypnea, and tachycardia were noted. Immediate treatment, including discontinuation of the triggering agent, dantrolene administration, and cooling measures were applied, and once stable, the child was transferred to Columbus Children's Hospital for further management. The patient experienced no postoperative complications. Further discussion regarding the pathophysiology and management of malignant hyperthermia is provided.
Assuntos
Anestésicos Inalatórios/efeitos adversos , Halotano/efeitos adversos , Hipertermia Maligna/etiologia , Pré-Escolar , Dantroleno/uso terapêutico , Seguimentos , Humanos , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Masculino , Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Relaxantes Musculares Centrais/uso terapêuticoRESUMO
Zalpelon was compared with triazolam for oral sedation in a third molar surgery model using a double-blind crossover design. Factors such as anxiolysis, amnesia, and quality of sedation were assessed. Of the 14 participants who completed the study, zaleplon sedation was found to be similar to triazolam sedation in all regards except that recovery from zaleplon was more rapid.
Assuntos
Acetamidas/administração & dosagem , Procedimentos Cirúrgicos Ambulatórios , Sedação Consciente , Hipnóticos e Sedativos/administração & dosagem , Dente Serotino/cirurgia , Pirimidinas/administração & dosagem , Extração Dentária , Adolescente , Adulto , Período de Recuperação da Anestesia , Anestesia Dentária , Ansiolíticos/uso terapêutico , Ansiedade/prevenção & controle , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Memória/efeitos dos fármacos , Triazolam/uso terapêuticoRESUMO
A 40-yr-old woman with an unremarkable medical history and no prior surgeries presented for ambulatory surgery. Physical examination revealed normal jaw opening. On induction of general anesthesia, her jaw was found to be locked in a nearly closed position. We discuss anesthetic considerations and the pathology of temporomandibular joint anterior disk dislocation without reduction. A simple maneuver to reduce the dislocation is described.
