This study examined the relationships among 3 components of the somatosensory evoked potential (SEP) to painful stimuli. Painful stimuli were produced using intracutaneous electrical stimulation of a fingertip and two levels of non-painful stimuli were produced by superficial electrical stimulation of a neighboring fingertip. SEPs were recorded from Cz-A1 and Pz-A1, and difference waves were computed for 3 components: (1) a pain component (the difference between SEPs to painful vs. strong but non-painful stimuli); (2) an intensity component that is not related to pain (the difference between SEPs to strong non-painful vs. mild non-painful stimuli); and (3) a P300 component (the difference between SEPs to the same stimuli under Target instructions vs. Standard instructions). The positive peaks in the 3 types of difference waves differed in both latency and topography, although with latency and topography overlap. The intensity component had an earlier positive peak than the pain component, and the pain component had an earlier positive peak than the P300 component. The pain and intensity components were larger at Cz than Pz, whereas the P300 component was larger at Pz than Cz. Under certain conditions, the pain evoked SEP consists of a weighted combination of the 3 components, complicating interpretation of the positive peaks in the recorded wave forms.

Adult↗

PubMedDate not supplied

Considerations for selecting effective analgesic regimens in dental practice.

A variety of analgesic regimens can be developed, based on sound pharmacological principles, in response to the empirical estimate of pain intensity. Including optimal doses of nonopioids to reduce the amount of opioid required is recommended. Furthermore, when pain is anticipated, the nonopioid regimen can be administered on a regular schedule rather than as needed. Preventing pain is better than attempting to reduce it after full intensity has been reached. Careful selection of an effective regimen can prevent breakthrough pain, along with stress and anxiety, which are factors that often require desperate attempts for relief. Options for the dentist to consider are summarized in Table 5 and may be simulated through substitution of other NSAID or opioid equivalents.

Acetaminophen↗

PubMedDate not supplied

Pharmacological considerations for conscious sedation: clinical applications of receptor function.

Most drugs used in conscious sedation regimens act by reasonably well-defined receptor mechanisms. The variety of clinical effects produced by these agents is generally extensive, and often can be explained by their activity at more than one receptor type. Rote memorization of drug effects is a futile exercise, especially when one considers the number of new agents introduced each year. An appreciation of receptors and their effects is a more logical approach. This article reviews fundamental concepts of receptor dynamics that are applicable to agents used for conscious sedation. Using this approach, the effects and indications for various agents can be predicted based on their activity at specific receptor sites.

Anesthesia, Dental↗

PubMedDate not supplied

The autonomic nervous system and related drugs in dental practice, Part II: Adrenergic agonists and antagonists.

Explore the source record for details and available documents.

Adrenergic Agonists↗

PubMedDate not supplied

Assessment and management of cardiovascular urgencies and emergencies: cognitive and technical considerations.

Cardiovascular emergencies represent the most feared complications in dental practice. Not only do they present the greatest possibility for morbidity and mortality, but their pathogenesis and treatment are poorly understood. This article reviews fundamental physiologic and pathological concepts that will guide the clinician toward a more cognitive approach to patient assessment and management. The treatment algorithms presented develop rationally from these fundamental scientific principles.

Cardiovascular Diseases↗

PubMedDate not supplied

Continuing education in preoperative sedation: perspectives on educational methodology.

Preoperative sedation is a vital component of general dental practice. The final goal and supporting objectives for training programs have been developed. An emphasis must now be placed on effective methods for accomplishing this goal. The design found in the American Heart Association's ACLS training program may serve as an excellent model for future curriculum development.

Anesthesia, Dental↗