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Biomedical subjects

S R Koenigsberg

Publications and source records attributed to S R Koenigsberg.

9 recordsLinked to original sources
PubMed1990

A comparison of chloral hydrate and diazepam sedation in young children.

The purpose of this study was to compare a high and low dose of diazepam with chloral hydrate in the sedation of young children. Thirty healthy children between the ages of 20 and 48 months, with a mean age of 33.5 months, participated in the study. All children exhibited negative behavior during a screening visit and required at least two restorative appointments with the use of sedation. A dose of either 0.3 mg/kg or 0.6 mg/kg of diazepam at one visit and 50 mg/kg of chloral hydrate at another visit was administered in a double-blind manner. All children were restrained in a Papoose Board with auxiliary head restraint and received 50% nitrous oxide/oxygen during treatment. The degree of sleep, body movement, crying, pulse rate, respiratory rate, and blood oxygen saturation were monitored before and during the operative procedures. Vital signs remained essentially unchanged during treatment, except for transitory elevations of the pulse during periods of stimulation. There were no statistically significant differences among the three drug regimens with regard to movement and crying. Significantly more patients who received chloral hydrate were asleep than when either dose of diazepam was given during the first 60 min of treatment. The only side effect found was vomiting in one patient with both chloral hydrate and diazepam. It is concluded that the sedative effects of chloral hydrate and diazepam are similar when young children are sedated for dental treatment. The use of diazepam might be more advantageous because chloral hydrate produces more sleep during the first hour of treatment.

Anesthesia, Dental↗
PubMedDate not supplied

Prevalence of oral soft tissue lesions in HIV-infected minority children treated with highly active antiretroviral therapies.

PURPOSE: This project studied the prevalence of oral soft tissue disease in HIV-infected children treated with highly active antiretroviral therapy (HAART). METHODS: Thirty-eight HIV-infected children participated in the study. Twenty-three of these patients were treated with HAART while 14 received exclusively reverse transcriptase inhibitors (RTI) and served as controls. The children were examined three times at approximately one-month intervals while their health history and laboratory data were abstracted from medical charts. Analyses were performed to determine differences in lesion prevalence between treatment groups as well as between lesion and no lesion groups with regard to immune differences. RESULTS: Thirty patients (79%) had oral lesions detected in at least one visit. There were no differences in specific lesion prevalence between HAART compared with RTI-treated children. However, a trend for more oral candidiasis in the latter group was observed. Subjects with oral soft tissue lesions had lower CD4 counts (P = 0.04) and percentage (P = 0.01) but similar viral loads when compared to patients without oral soft tissue disease. CONCLUSIONS: HAART does not appear to significantly affect oral soft tissue disease prevalence in HIV-infected children. Presence of lesions was associated with decreased immunity and may signal advancing disease.

Adolescent↗
PubMedDate not supplied

An analysis of the effectiveness of two topical anesthetics.

This study compared the effectiveness of topical benzocaine 20%, lidocaine 5%, and a placebo in reducing the pain caused by needle insertion when the medicament was placed in the mucobuccal fold above the maxillary canine eminence. Both topical anesthetics and the placebo were randomly tested against each other bilaterally. For uniformity the agents were left in place for three minutes before needle insertion. A 27 gauge short needle mounted on an aspirating syringe was then inserted just past the bevel. Each subject rated the degree of pain on a visual analogue scale 100 mm in length. A pulse oximeter was used to record the heart rate. The results indicate that both topical anesthetics are significantly better than the placebo in reducing pain caused by needle insertion, although no statistically significant differences were found between the two topical anesthetics. Statistically significant differences in heart rate were seen, but these differences were not clinically significant. It is concluded that benzocaine 20% and lidocaine 5% significantly reduce the pain during needle insertion.

Administration, Topical↗
PubMedDate not supplied

Effects of nitrous oxide on chloral hydrate sedation of young children.

This study was performed to test the hypothesis that nitrous oxide augments the effects of chloral hydrate sedation of young children. Twenty children with a mean age of 32 months were sedated on two occasions with two different treatment regimens. All subjects received a standard dose of 50 mg/kg of chloral hydrate with or without nitrous oxide during each of two treatment visits. During one visit, the subjects received 50% nitrous oxide and 50% oxygen for a period of 20 minutes followed by 100% oxygen and, during the other visit, the reverse concentrations were used. All subjects were restrained in a Papoose Board(*) with an auxiliary head restraint. Successful sedation, as evident by lack of crying or movement which interrupted treatment, occurred in 84% of administrations. During the first twenty minutes, subjects receiving nitrous oxide moved and cried significantly less than when they were treated without nitrous oxide. During the remainder of the appointment, there was no difference in behavior between the two treatment regimens. Vital signs remained essentially unchanged throughout all treatment with the exception of transitory elevation of the pulse and respiratory rates, which usually occurred when the mouth prop was inserted and local anesthesia was administered. It is concluded that nitrous oxide augments the effect of chloral hydrate sedation of young children, but does not do so uniformly for all children receiving sedation.

Anesthesia, Dental↗
PubMedDate not supplied

Assessing chloral hydrate dosage for young children.

Results of this study demonstrate that a dose of 75 mg/kg of chloral hydrate supplemented by nitrous oxide is superior to the dose of 50 mg/kg, for behavior management of young children sedated for dental treatment.

Anesthesia, Dental↗
PubMedDate not supplied

Effects of nitrous oxide on diazepam sedation of young children.

This study was performed to test the hypothesis that nitrous oxide augments the effects of diazepam sedation of young children by reducing crying and movement and improving the overall quality of sedation. Twenty-four children (mean age of 32 months) were sedated on two occasions with two different treatment regimens. All subjects received a standard oral dose of 0.5 mg/kg of diazepam with and without nitrous oxide during each of two treatment visits. During one visit, the subjects received 50% nitrous oxide and 50% oxygen for the first 20 min followed by 100% oxygen for the balance of the procedure and, during the second visit, the reverse regimen was used. All subjects were restrained in a Papoose Board (Olympic Medical, Seattle, WA) with an auxiliary head restraint. Successful sedation, as evidenced by lack of crying or movement that interrupted treatment, occurred in 83% of administrations. Vital signs remained essentially unchanged throughout all treatment with the exception of transitory elevation of the pulse and respiratory rates, which usually occurred when the mouth prop was inserted, local anesthesia was administered, and the rubber dam was placed. When the evaluation of the overall sedation was compared with and without nitrous oxide, it was better with nitrous oxide 56% of the time, worse 13% of the time, and the same in the remaining 31% of the comparisons. It is concluded that nitrous oxide may slightly augment the effect of diazepam sedation of young children, but it does not do so uniformly for all children receiving sedation.

Anesthesia, Dental↗