Office-based General Anesthesia for a Patient With a History of Neuroleptic Malignant Syndrome.

First described in 1956 subsequent to a reaction reported to the newly introduced antipsychotic drug chlorpromazine, neuroleptic malignant syndrome (NMS) is a rare, potentially life-threatening reaction to antipsychotic drugs characterized by high fever, muscle rigidity, altered mental status, and autonomic instability. All neuroleptics, including newer antipsychotics, have been linked to this condition. Due to similar symptoms, it is debatable if individuals with NMS can be susceptible to malignant hyperthermia (MH).

Prevention of sevoflurane delirium and agitation with propofol.

Emergence delirium and agitation (EAD) associated with sevoflurane general anesthesia are very commonly observed in young children. Such events pose a risk for injury as well as decreased parental satisfaction, especially in the ambulatory and office-based setting. This article reviews the different approaches described in the literature to reduce EAD.

Bispectral index monitoring (BIS) as a guide for intubation without neuromuscular blockade in office-based pediatric general anesthesia: a retrospective evaluation.

The Bispectral Index System is a useful guide for timing of adequate intubation conditions in office-based pediatric general anesthesia without neuromuscular blockade. As the number of cases in the office-based setting increase, many clinicians opt to intubate patients without neuromuscular blockade to avoid airway complications associated with skeletal muscle relaxation. Conventionally, this technique is conducted using the traditional monitoring criteria of vital signs, end-tidal inhalation agents, as well as anesthesiologist timing and knowledge of the pharmacodynamics of the anesthetic agent to help determine the proper depth of anesthesia for adequate intubating conditions.

Risks of general anesthesia for the special needs dental patient.

The risk of dental rehabilitation under general anesthesia has multiple contributing factors. The literature has addressed the general anesthetic risk of dental general anesthesia and sedation in the operating room and the office settings, but more studies are needed to address the special needs population in particular. There is still a great need for more studies to assess the risk versus benefit for special need population as well as to stratify such risk in order to assist care providers in decision making as well as in sharing such risk concerns with patients, caretakers, and guardians.

Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs.

Many people with special needs (PSN) have difficulty having good oral health or accessing oral health services because of a disability or medical condition. The number of people with these conditions living in community settings and needing oral health services is increasing dramatically due to advances in medical care, deinstitutionalization, and changing societal values. Many of these individuals require additional supports beyond local anesthesia in order to receive dental treatment services.

Retrospective outcomes evaluation of 100 parenteral moderate and deep sedations conducted in a general practice dental residency.

An abstract of this study was presented at the American Association for Dental Research (AADR) Dental Anesthesiology Research Group in Honolulu, Hawaii, in March of 2004. This study was conducted to correlate the intraoperative and postoperative morbidity associated with moderate and deep sedation, also known as monitored anesthesia care (MAC), provided in a General Practice Residency (GPR) clinic under the supervision of a dentist anesthesiologist. After internal review board approval was obtained, 100 parenteral moderate and deep sedation cases performed by the same dentist anesthesiologist in collaboration with second year GPR residents were randomly selected and reviewed by 2 independent evaluators.

Five year outcomes study of dental rehabilitation conducted under general anesthesia for special needs patients.

We assessed the safety of general anesthesia for dental treatment of special needs patients as it related to American Society of Anesthesiology Physical Status (ASAPS) classification, procedure, and other factors. After Institutional Review Board review and approval, special needs patients who were admitted to the outpatient surgical operating room for comprehensive dental rehabilitation (CDR) under general anesthesia within a period of 5 years had their medical records evaluated retrospectively for intraoperative and postoperative complications both related to anesthesia and surgery. All records were evaluated by an independent evaluator who tabulated the patients' age, gender, ASAPS, and duration of procedure.

Diabetes mellitus: an updated overview of medical management and dental implications.

Diabetes mellitus (DM) is a major worldwide public health concern. In the United States, 18.2 million people (approximately 6.

Management of a patient with Möbius syndrome: a case report.

Möbius syndrome is a rare congenital disorder with the primary diagnostic criteria of congenital facial and abducent nerve palsy. Orofacial anomalies and limb malformations may be associated with the disorder. Involvement of other cranial nerves also is common.