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[General anesthesia conducted twice in myotonic dystrophy].

A 42-year-old woman with myotonic dystrophy underwent general anesthesia twice. In the first operation, muscle rigidity was recognized when the patient was placed on lithotomy position under anesthesia with thiopental and nitrous oxide. In the second operation, rigidity was not observed under vecuronium, sevoflurane-nitrous oxide anesthesia. Neuromuscular monitoring of this patient did not show any difference of neuromuscular blockade with vecuronium compared with other 9 normal patients. We conclude that vecuronium and sevoflurane can be used safely in a patient with myotonic dystrophy under neuromuscular monitoring.

Adult↗

[Mandibular osteomyelitis after mandibular conduction anesthesia].

Several complications following a mandibular nerve block were reported in the literature. In some cases pterygomandibular abscess formation may be caused by mandibular needle injections. There is no report of odontogenic osteomyelitis of the ascending mandibular ramus in the literature. Here two patients with osteomyelitis of the ascending ramus following a mandibular nerve block injection are presented.

Adult↗

[Studies of the effectiveness of impersonal teaching by means of a sound film: "Conduction anesthesia on the mandible"].

The thesis that students could be instructed by audio-visual aids alone equally as well as by a personal instructor was tested by experiment. A teaching program, i.e. a sound film, was made and was shown to first-year clinical dental students. At the same time the usual lecture was offered to these students. Subsequently the knowledge acquired was examined. The results support the initial thesis, but at the same time it must be concluded that the highly differentiated psychomotor teaching objectives of dentistry cannot be achieved without individual instruction.

Education, Dental↗

Foramen mandibulae as an indicator of successful conduction anesthesia.

Comparative measurements were made of 144 orthopantomographs in 50 patients with successful and 94 patients with unsuccessful inferior alveolar nerve block anesthesia. The results show that the bony lingula is prominent in 28.5% of all patients, or in 56.0% of those with unsuccessful anesthesia. The variables mandibular notch vs. mandibular foramen (MN-MF) and the anterior ramus ridge vs. mandibular foramen (ARR-MF) show greater distances in the group of patients with successful anesthesia, while the variables of posterior ramus ridge vs. mandibular foramen (PRR-MF) and mandibular angle vs. mandibular foramen (MA-MF) were greater in the group of patients with unsuccessful anesthesia (p > 0.05). It is concluded that the variability in position of the mandibular foramen among others may be responsible for an occasional failure of inferior alveolar nerve block.

Adult↗

[Conduction anesthesia in and around the mouth].

Local infiltration anaesthesia is generally used in dentistry. The so-called nerve block anaesthesia is only routinely used for the mandible. The purpose of this article is to discuss the variety of blocks that can be used by dentists, oral and maxillofacial surgeons and anaesthesiologists. Furthermore, local reactions caused by anaesthetic solutions are described.

Anesthesia, Dental↗

[Epidural conduction anesthesia versus general anesthesia. A critical evaluation of outcome studies using as examples cesarean section and patients with hip fractures].

In the field of anaesthesiology, outcome studies are undertaken to investigate the influence of different anaesthetic techniques on the intra- and postoperative course of patients in special clinical situations. The design of these studies should follow high methodological standards. In the past, most studies were undertaken in patients during Caesarean section and in the treatment of hip fractures in the elderly. Up to now, results do not clearly indicate the use of certain techniques in concrete clinical situations. Decisions must be made in accordance with clinical aspects, individual experience and in cooperation with the patient and the surgeon.

Adult↗

[Paraspinal conduction anesthesia from the viewpoint of the patient--exemplified by a selected urologic patient sample].

Patients operated because of benign prostatic hyperplasia in spinal cord close block anesthesia were interviewed by a questionnaire. The well known and accepted medical advantages of this method are completed by the results of an examination of the psychic situation. Only 6 out of 66 patients have negative feelings of awakeness during the operation.

Anesthesia, Spinal↗

[Malignant hyperthermia associated with epidural conduction anesthesia].

In a case-history the authors describe the development of malignant hyperthermia in conjunction with epidural anaesthesia. The development of this syndrome was arrested by early therapy with dantrolene and comprehensive treatment. A brief account of the character of this syndrome and its treatment is given.

Anesthesia, Epidural↗