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Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XVI: HARMS LINKED TO DRUGS ADMINISTERED DURING ANESTHESIA

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 74-75
Publisher: Basrah University جامعة البصرة

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Abstract

MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XVI: HARMS LINKED TO DRUGS ADMINISTERED DURING ANESTHESIASalam N Asfar@ & Jasim M Salman# @MB,ChB, MSc, Professor of Anesthesiology, College of Medicine, University of Basrah. #MB,ChB, DA, FICMS, Assist. Prof. & Consultant Anesthesiologist, College of Medicine, University of Basrah, Basrah, IRAQ. Unpleasant drug incidents are common during medical action. In anesthetic practice, the probability of errors is greater because of more tension and rapidity. Morbidity and even mortality are more expected in the course of anesthesia. Apart from many hazards that patients are exposed to such as; Biological hazards, Mechanical hazards, Chemical hazards, Physical hazards, and Personal Hazards1, it seems that danger of drug problems are more.

Keywords

crises --- anesthesia


Article
Single Buccal Injection for Anesthesia of Upper First Molar

Authors: Mohamed S. Suleiman --- Wafaa K. Fathi --- Rayan S. Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2008 Volume: 8 Issue: 15 Pages: 56-60
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: A clinical trial was carried out to assess the efficiency of a single buccal injection to achieve
anesthesia of the buccal aspect of the upper first molar instead of the traditional two injections. Materials
and Methods: The subjects included in the clinical assessment were those needing extraction of
an upper first molar of either side. For the purpose of comparison, the sample was randomly divided
into two main groups: Group I (control group) which included 100 subjects who were to receive two
buccal injections and a single palatal injection before extraction. While Group II (trial group) included
100 subjects who were to receive a single buccal injection and a single palatal injection before extraction.
The following data were recorded: Pain on needle insertion, pain on deposition of solution, onset
of surgical anesthesia and adequate surgical anesthesia. Results: The first criterion recorded was pain
on needle insertion where the results showed no significant difference between both groups. The
second criterion was pain on deposition of solution. Here the results also showed no significant difference
between both groups in this aspect. For onset of surgical anesthesia, no significant difference was
shown between both groups. In regard to pain grade experienced during surgery for both groups, the
results showed that grade A anesthesia was recorded in 95% of patients in group I , whereas in 93% of
patients in group II. Grade B anesthesia was recorded in 5% of patients in group I and in 7% of patients
in group II. Statistically speaking, no significant difference was disclosed in regard to pain assessed
during the extraction of the tooth between both groups. Conclusions: The achievement of successful
local anesthesia is a continual challenge in dentistry. Any suggested new approach for achieving adequate
anesthesia for either the maxilla or mandible as long as it is safe and effective can be recommended
for routine dental care.


Article
A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Authors: Fa’iz A Al–Sultan --- Wafaa Kh Fathie --- Rayan S Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2006 Volume: 6 Issue: 11 Pages: 71-77
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To assess the effect of alkalization of local anesthetic solution for the purpose of enhancing itsefficiency in periapical surgery. Materials and Methods: A total sample of 80 patients, all needingperiapical surgery on one or more of their upper anterior tooth (teeth) was subjected to this trial. For thepurpose of comparison, the sample was randomly divided into two groups based on the local anestheticsolution that they were to receive before surgery. The first group(control) included those patients whoreceived the commercially available local anesthetic solution with a standard pH of 3.5.The secondgroup (trial group) included those patients who received a pH adjusted local anesthetic solution at 7.2(using sodium bicarbonate).Prior to, and at the completion of intended surgery, the following datawere recorded: Pain during injection, onset of achievement of surgical anesthesia, pain duringoperation and the duration of operation itself. Results: A significant difference in regard to onset ofachievement of surgical anesthesia between both groups was noticed with a faster onset in group two where the patients received a pH adjusted local anesthetic solution when compared to control group where the patients received the commercially available local anesthetic solution. Also, less pain on deposition of solution was noticed in the second group as well as less pain score levels were recorded during operation in regard to the same group. Conclusion: The pH adjusted local anesthetic solutionsmay provide certain advantages when compared to the commercially available local anesthetic solutions regarding enhancement of anesthetic efficiency, reduced pain on injection as well as during surgery.


Article
ANESTHESIA USING LARYNGEAL MASK AIRWAY FOR INTRA-NASAL SURGERY; A COMPARATIVE STUDY

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 43-49
Publisher: Basrah University جامعة البصرة

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Abstract

The purpose of the study was to compare the suitability and safety of the laryngeal mask airway (LMA), for intranasal surgery (INS) anesthesia, with endotracheal tube (ET) anesthesia.we studied 65 patients (ASA grade I and II, according to American Society of Anesthesia classification), aged (18-39) years. The study population was scheduled for elective intranasal surgery. The patients were randomly assigned into two groups: the first group (33 patients), a laryngeal mask airway (LMA Group) was inserted under propofol , fentanyl and muscle relaxant (atracrium), anesthesia was maintained by using a mixture of halothane in N2O/O2. The second Group (32 patients), an endotracheal tube (ET Group) was inserted under propofol, fentanyl and muscle relaxant (atracrium), anesthesia was maintained with a mixture of halothane in N2O/O2.All complications concerning airway insertion, removal or interruption of surgery for compromised airway and ventilation were recorded. Mean blood pressure, heart rate and pulse oxymetry, were continuously monitored and recorded before and after induction and airway device insertion, followed by 10 minutes intervals. Data were analyzed using chi square statistical test; Null hypothesis was rejected at P> 0.05.In LMA Group, there were no episodes of post removal laryngospasm. The incidence of oxyhemoglobine desaturation at removal was significantly reduced compared with that in ET Group (P< O.O2). The number of patients with oxyhemoglobine desaturation less than 92% on airway device removal was 0% in LMA Group, 3 patients (9.375%) in ET Group.In ET Group, the mean blood pressure and heart rate showed significant variation between the different time measurements (P> 0.005). Intubation and extubation resulted in significant transient increase in mean blood pressure and heart rate. In LMA Group, the mean blood pressure was less than baseline value from 1 minute after induction onwards (P< 0.005) and did not show any significant changes during the different time points measurements. LMA application or removal did not cause any significant increase in mean blood pressure or heart rate (P< 0.001).We conclude that using LMA is suitable method for intranasal surgery. It provides a safe, protected airway with a smoother emergence from anesthesia than tracheal intubations. Anesthesia using LMA for intranasal surgery provides a stable circulation.


Article
A clinical comparison between maxillary and mandibular posterior teeth using local anesthesia and normal saline by the periodontal ligament injection (An in vivo study)

Authors: Majidah K.W. AL-Hashimi ماجدة الهاشمي --- Raad S. Al-Doori رعد الدوري
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 1 Pages: 18-23
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Local anesthesia is the primary method used in dentistry to control patients’ pain. However, even in thepresence of adequate soft tissue anesthesia, there may be incomplete pulpal anesthesia. This is particularly true inthe mandible where obtaining profound pulpal anesthesia may be difficult. The periodontal ligament injection hasreceived much attention in the dental literatures. lntraligamentary anesthesia has been advocated as a primary anda supplemental injection technique. The purpose of this study is to evaluate, with electrical pulp tester, the anestheticefficacy of the periodontal ligament injection using 2% Lidocaine with 1:80000 epinephrine and normal saline in fortyvolunteers. The success rate was defined as no patient’s response to the maximum output of an electrical pulptester. Also pain rating during initial needle penetration and injection of solution were compared.Material and method: Forty adult volunteers participated in this study. The subjects were divided into four groups (10subjects each): Group Ia: each subject received a periodontal ligament injection in mandibular first premolar andfirst molar right or left side with Lidocaine injection and pulp tested each minute by EPT and Ethyl chloride. Group 1b:each subject received a periodontal ligament injection in mandibular first premolar and first molar right or left sidewith normal saline injection and pulp tested each minute by EPT and Ethyl chloride. Group IIa: each subject receiveda periodontal ligament injection in maxillary first premolar and first molar right or left side with Lidocaine injection andpulp tested each minute by EPT and Ethyl chloride. Group IIb: each subject received a periodontal ligamentinjection in maxillary first premolar and first molar right or left side with normal saline injection and pulp tested eachminute by EPT and Ethyl chloride.Results: The results showed that the duration of profound pulpal anesthesia, using 2% Lidocaine with 1:80000epinephrine, was 10 minutes and injection of anesthetic solution and normal saline in clinically healthy teeth wereonly mildly discomforting. The periodontal ligament injection using normal saline was not effective in producinganesthesia. A conclusion was drawn from the study that the periodontal ligament injection can be used effectively,as a primary injection technique, to anesthetize mandibular posterior teeth especially the first molars

Keywords

Pain --- PDL --- local anesthesia


Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XIII: REGIONAL ANESTHESIA

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 2 Pages: 74-75
Publisher: Basrah University جامعة البصرة

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Abstract

MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XIII: REGIONAL ANESTHESIA Salam N Asfar@ & Jasim M Salman# @MB, ChB, MSc, Professor of Anesthesiology, College of Medicine, University of Basrah. #MB,ChB, DA, FICMS, Assist. Prof. & Consultant Anesthesiologist, College of Medicine, University of Basrah, IRAQ.Regional anesthesia is broadly utilized and has been considered to pose few risks once the block is set up. However, dangerous issues can happen both during the establishment and maintenance periods of a regional block which require prompt recognition and management. The risks includes; local anesthetic toxicity1,2, misdirected or misplaced needles and cannulae, and a variety of other problems both amid and after blockade can lead to morbidity or mortality3–5. Some of these may be obscure and not related to the regional anesthetic method itself.


Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XV: SEPSIS

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 2 Pages: 86-87
Publisher: Basrah University جامعة البصرة

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Abstract

Sepsis which is defined as systemic response to infection may potentially causes multiple structures physiological stress and dysfunction such as; respiratory, renal, cardiovascular, and hematological. Because quick consideration should be paid to so many body systems, prepared approach during anesthesia for a septic patient is a must1. Patients with sepsis show signs of systemic inflammatory response syndrome, as result from generalized reaction to inflammation which may be caused by a wide range of infectious and non-infectious causes for example, burns, pancreatitis and multiple trauma2.

Keywords

sepsis --- crises --- anesthesia


Article
Anterior and middle superior alveolar block anesthesia: A new technique estimated

Authors: Kubais H ALASSAF --- Ahmed A ABDUL-MAWJOOD --- Faiz A AL-SULTAN
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2002 Volume: 2 Issue: 3 Pages: 56-64
Publisher: Mosul University جامعة الموصل

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Abstract

In this study, an estimation of new technique to achieve anesthesia at anteriorand middle superior alveolar nerve through palatal injection was performed.Total (25) patients who need conservative dental treatment were received this injection for treatment of (39) teeth. Success rate recorded in (72%) of patient who satisfy this new injection technique completely and (20%) failure rate reported (8%) of patients reported pain during dental work but did not need supplementary anesthesia. The complication recorded as follows; (15) patients feel pain immediately during injection, (4) patients had postoperative pain and (4) patients had swelling. In conclusion it is recommended that this new technique to be assessed clinically for other dental work and comparison with other technique utilized.


Article
The effect of different vasoconstrictor containing local anaesthetic solutions on plasma glucose in normal and diabetic-volunteers

Authors: Muhammed KH HASOUNE --- Fa,iz A AL-SULTAN
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2002 Volume: 2 Issue: 3 Pages: 112-119
Publisher: Mosul University جامعة الموصل

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Abstract

In this study, the change in plasma glucose half an hour after injection of different vasoconstrictors contained in local anaestheticsolution where measured both in normal and diabetic volunteers. Single cartridge contain (1.8) ml of plain (2%) Xylocain or that with (1:80000) concentration of a adrenaline or (3%) prilocain with (0.03) IU of felypressin injected at labial to left maxillary lateral incisor region.The result showed that half an hour after injection of a adrenaline containing solution, a very highly significant increase in plasma glucose noticed in both study groups from pre-injection base line value (p<0.001). Increase in plasma glucose in diabetic group were significantly greater than that in normal control group (p<0.05). Within diabetic volunteers, this increase were significantly greater in insulin dependent diabetic group than that in non insulin dependent volunteers. After injection of plain solution or that containing felypressin, reduction in plasma glucose noticed. In conclusion, adrenaline contained within local anaesthetic solution produce hyperglycemic effect even in dose of single dental cartridge. This response enhanced in diabetic patient in general with greater enhancement noticed in insulin dependent patient.


Article
The palatal injection: A painless approach

Authors: Wafaa KH FATHIE --- Tahani A AL-SANDOOK --- Rayan S HAMID
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2001 Volume: 1 Issue: SpIss Pages: S379-S384
Publisher: Mosul University جامعة الموصل

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Abstract

A painless approach to the well known painful palatal injection using topical application of pressure is described. Seventy dental patients requiring anesthesia of the palatal tissue (soft and hard) for:surgical procedures were chosen for the study. A highly significant value (p>0.01) of a painless injection was noticed when the ipsilateral side was compared with the contralateral side in the same patient. Further studies on this approach are recommended to further evaluate its success.

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