Anesthesia Complications in the Dental Office E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1132

Veröffentlichungsjahr: 2015

Beschreibung

Anesthetic complications, which range from simple annoyances to patient mortality, are inevitable, given the many and complex interactions of doctor, patient, personnel, and facility. Anesthesia Complications in the Dental Office helps dentists minimize the frequency and severity of adverse events by providing concise and clinically relevant information that can be put to everyday use. Anesthesia Complications in the Dental Office presents the most up-to-date information on treating anesthesia complications and medical emergencies. Drs. Bosack and Lieblich and a team of expert contributors discuss patient risk assessment; considerations for special needs and medically compromised patients; routinely administered anesthetic agents; adversities that can arise before, during, and after administration of anesthesia; and emergency drugs and equipment. A must-have reference for every dental office.

Leseprobe

Table of Contents

Cover

Title Page

Copyright

Dedication

Contributors

Foreword

Preface

Acknowledgment

Section 1: Introduction

Chapter 1: Anesthetic complications—how bad things happen

Scope of Errors

The Human Condition

Scope of Complications

References

Section 2: Patient Risk Assessment

Chapter 2: History and Physical Evaluation

Introduction

Cardiovascular Risk Assessment

Pulmonary Risk Assessment

Reference

Chapter 3: Laboratory Evaluation

Introduction

Basic Metabolic Panel

Complete Blood Count

Coagulation Studies

Liver Function Tests (Table 3.5)

Pregnancy Tests

Cardiac and Cardiovascular Studies

References

Chapter 4: NPO guidelines

Preoperative Therapeutics

Summary

References

Section 3: Anesthetic Considerations for Special Patients

Chapter 5: Anesthetic Considerations for Patients with Cardiovascular Disease

Introduction

Hypertension

Coronary Artery Disease

Valvular Heart Disease

Cardiac Rhythm Disorders

Cardiac Dysrhythmias

Tachydysrhythmias

Ventricular Tachydysrhythmias

Bradydysrhythmias

Conduction Disturbances

Heart Block

Management Decisions

Congestive Heart Failure

Refererences

Chapter 6: Anesthetic Considerations for Patients with Respiratory Disease

Introduction

Asthma

Chronic Bronchitis and Emphysema

Restrictive Disease

Upper Respiratory Tract Infection

Smoking

Obstructive Sleep Apnea

References

Chapter 7: Anesthetic Considerations for Patients with Endocrinopathies

Diabetes Mellitus (DM)

Thyroid Disorders

Obesity and Post-Bariatric Surgery

Adrenocortical Insufficiency (AI)

References

Chapter 8: Anesthetic Considerations for Patients with Psychiatric Illness

Introduction

Overview of Psychiatric Disease

Anxiety Disorders

Mood Disorders

Thought Disorders

Eating Disorders

Substance Abuse

Patient Management

References

Chapter 9: Anesthetic Considerations for Patients with Neurologic Disease

Motor Neuron Disease

Parkinson Disease

Myasthenia Gravis

Muscular Dystrophy

Multiple Sclerosis

Cerebral Palsy

Seizure Disorders

Developmentally Impaired Disorders

References

Chapter 10: Anesthetic Considerations for Patients with Hepatic Disease

Introduction

Identification and Classification of Liver Disease

Risk Assessment

Anesthetic Concerns

Summary

References

Chapter 11: Anesthetic Considerations for Patients with Renal Disease

Introduction

Classification of Kidney Disease

Comorbidities

Treatment

Risk Assessment

Anesthetic Concerns

References

Chapter 12: Anesthetic Considerations for Pediatric Patients

Introduction

The Pediatric Airway (see Figure 12.1)

The Pediatric Pulmonary System

The Pediatric Cardiovascular System

Pediatric Pharmacodynamics

Preoperative Evaluation

Sedative/Anesthetic Techniques

Controversies

Safety in Pediatric Anesthesia

References

Chapter 13: Anesthetic Considerations for Geriatric Patients

Introduction

The Effects of Aging on Major Organ Systems

Pharmacologic Considerations

Preanesthetic Evaluation

Anesthetic Management

Perioperative Complications

References

Chapter 14: Anesthetic Considerations for Patients with Bleeding Disorders

Laboratory Testing of Hemostasis

Common Bleeding Disorders

Local (Topical) Hemostatic Measures

Summary

References

Chapter 15: Anesthetic Considerations for Patients with Cancer

Introduction

Classification and Treatment of Malignancy

Common Cancer Therapies

Pathophysiological Changes Associated with Malignancy

Anesthetic Concerns

References

Chapter 16: Anesthetic Considerations for Pregnant and Early Postpartum Patients

Maternal Concerns

Fetal Concerns

References

Section 4: Review of Anesthetic Agents

Chapter 17: Clinical Principles of Anesthetic Pharmacology

The Reticular Activating System

Mechanism of Action of Anesthetic Agents

Pharmacodynamics and Pharmacokinetics

References

Chapter 18: Local Anesthetic Pharmacology

References

Chapter 19: Enteral Sedation Agents

Triazolam

Zolpidem

Zaleplon

The Sublingual Incremental Dose Triazolam Technique

Summary

Reversal of Enteral Sedation

References

Chapter 20: Parenteral Anesthetic Agents

Barbiturates

Non-Barbiturate Intravenous Anesthetics Propofol

Ketamine

Benzodiazepines

Alpha-2 Agonists and Dexmedetomidine

Opioids

References

Chapter 21: Inhalational Anesthetic Agents

Nitrous Oxide Pharmacology

Potent Inhalational Anesthetic Agents

Summary

References

Chapter 22: Antimuscarinics and Antihistamines

Antimuscarinics

Antihistamines (H

1

Receptor Antagonists)

References

Chapter 23: Drug Interactions

Introduction

Types of Drug Interactions

Mechanisms of Drug Interactions

Interactions with Drugs Commonly used in Dentistry

Conclusion

References

Section 5: Monitoring

Chapter 24: Limitations of Patient Monitoring during Office-Based Anesthesia

Direct Visualization

Pretracheal Auscultation

Pulse Oximetry

Capnography

Electrocardiography (ECG)

Sphygmomanometry

References

Section 6: Preparation for Adversity

Chapter 25: Crisis Resource Management

What is CRM?

Decision-Making during Critical Incidents

Communication

Who Should Train, and How Often?

References

Chapter 26: Simulation in Dental Anesthesia

Definition and Short History

Goals and uses of Simulation

What to Simulate

Practical Tips in Designing Scenarios

References

Chapter 27: Airway Adjuncts

Nasopharyngeal Airway

Oropharyngeal Airway

Supraglottic Airways

Magill Forceps

Endotracheal Tube

Chapter 28: Intravenous Fluids

Introduction

How Does Surgery Affect Fluid Status?

How much Fluid Does the Patient Need?

What Kind of Fluid does the Patient Need?

References

Chapter 29: Emergency Drugs

Oxygen

Reversal Agents

Muscle Relaxants

Vasopressors

ANtihypertensive Agents

Anti-Arrhythmic Agents

Atropine

Aspirin

Morphine

Anticonvulsants

Antihistamines

Bronchodilators

Corticosteroids

Conclusion

References

Section 7: Anesthetic Adversity

Chapter 30: Failed Sedation

Limitations of Oral Sedation

Limitations of Parenteral Moderate Sedation

Intravenous Administration

Intramuscular and Subcutaneous Administration

Limitations of Deep Sedation

Limitations of Open Airway General Anesthesia

References

Chapter 31: Complications with the use of Local Anesthetics

Systemic Complications

Potential Adverse Drug Interactions with Vasoconstrictors

Localized Complications

References

Chapter 32: Anesthetic Adversity – Cardiovascular Problems

Introduction

General Treatment Protocols

Syncope

Perianesthetic Pressure Disorders

Sinus Tachycardia

Paroxysmal Supraventricular Tachycardia (PSVT)

Premature Ventricular Complexes

References

Chapter 33: Anesthetic Adversity—Respiratory Problems

Introduction

Physiologic Respiratory Problems

Obstructive Airway Problems

Cannot Ventilate, cannot Intubate (CVCI)

References

Chapter 34: Allergy and Anaphylaxis

Introduction

Pathophysiology

Clinical Features

Diagnosis

Prevention

Management

Summary – Management of Anaphylaxis Algorithm (Dewachter et al., 2009)

References

Chapter 35: Anesthetic Adversity–Neurologic Problems

Seizure

Preanesthetic Evaluation

Diagnosis

Management

Stroke

Diagnosis

Management

References

Chapter 36: Acute, Adverse Cognitive, Behavioral, and Neuromuscular Changes

Definitions

Serotonin Syndrome

Anticholinergic Syndrome

Benzodiazepine Disinhibition

Agitation and Violence

Malignant Hyperthermia

Summary

References

Chapter 37: Anesthetic Problems Involving Vasculature

Infiltration and Extravasation

Inadvertent Intra-Arterial Injection

Thrombophlebitis

References

Section 8: Post-Anesthetic Adversity

Chapter 38: Nausea and Vomiting

Introduction

Definition

Pathophysiology

Incidence and Risk Factors

Modification of Anesthetic Risks

Medical Management of PONV

Suggested Office Protocols

Post Discharge Nausea and Vomiting

References

Chapter 39: Post-Anesthetic Recall of Intraoperative Awareness

Definition

Etiology

Incidence

Prevention

Consequences and Treatment

Management

References

Chapter 40: Delayed Awakening from Anesthesia

Surgical Effects

Drug Effects

Pathophysiologic Changes

Management

References

Chapter 41: Safe Discharge after Office-Based Anesthesia

Discharge Criteria for Office-Based Anesthesia

References

Section 9: When Bad Things Happen

Chapter 42: Morbidity and Mortality

Analysis of Allegations of Office-Based Anesthesia Mortality

Review of Office Anesthesia Mortality

Chapter 43: Death in the Chair: a Dentist's Nightmare

Introduction

The Assumption

Questions that will be Asked

The Investigation

Finding Fault

Suggestions for Protecting your Practice

General Recommendations Concerning Anesthesia

Record Keeping Recommendations

Recommendations about Emergency Supplies and Lighting

Recommended Procedures for Handling a Patient in Distress

Recommended Procedures for Handling First Responders

Recommended Procedures for Removing the Patient to a Hospital

What to do Immediately after an Incident

Post-Emergency Don'ts

Conclusion

Chapter 44: Legal Issues of Anesthesia Complications: Risks or Malpractice

The Law of Anesthesia

Standards of Care, Generally

Violation of a Statute or Code

Licensing Agencies

Requisite Proof

Causation

Conduct of Others

Evidence and the Nature of Litigation

Complications: Risk or Substandard Care

Classifications of Complications

Preparation for Complications

Conclusions

Endnotes

Section 10: When should you say no

Chapter 45: When Should You Say No?

When you should say no

The Safety of Office-Based Anesthesia

Preparation of the Anesthesia Team

Preoperative Preparation and Testing

Organ Systems and Anesthesia Risk

References

Section 11: Appendices

Appendix A: A Pilot's Perspective on Crisis Resource Management

Appendix B: Medical Emergency Manual for the General Practitioner

History and Focused Physical Examination

Risk of a Cardiac Event during Dental Treatment

Risk of a Non-Cardiac Event during Dental Treatment

References

Appendix C: Malignant Hyperthermia Q & A

Are MHS Employees at Risk for MH in Your Office?

Are MHS Patients Safe to Sedate or Anesthetize in the Office Setting?

Must Dantrolene be kept in the Office if the Only Triggering Agent Present is Succinylcholine for Emergency Use?

How Long Do You Keep MHS Patients in the Office After a Procedure, Even if Only Local Anesthesia was Used?

Silver Bullets for MH Reactions

References

Index

End User License Agreement

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Guide

Cover

Table of Contents

Foreword

Preface

Section 1: Introduction

Begin Reading

List of Illustrations

Figure 1.1

Figure 2.1

Figure 2.2

Figure 2.3

Figure 5.1

Figure 5.2

Figure 5.3

Figure 5.4

Figure 5.5

Figure 5.6

Figure 5.7

Figure 5.8

Figure 5.9

Figure 5.10

Figure 5.11

Figure 5.12

Figure 5.13

Figure 5.15

Figure 5.14

Figure 5.16

Figure 5.17

Figure 5.18

Figure 5.19

Figure 5.20

Figure 5.21

Figure 5.22

Figure 5.23

Figure 5.24

Figure 6.1

Figure 6.2

Figure 6.3

Figure 6.4

Figure 6.5

Figure 6.6

Figure 6.7

Figure 6.8

Figure 6.9

Figure 6.10

Figure 6.11

Figure 6.12

Figure 6.13

Figure 6.14

Figure 6.15

Figure 7.1

Figure 7.2

Figure 8.1

Figure 10.1

Figure 11.1

Figure 11.2

Figure 12.1

Figure 12.2

Figure 14.1

Figure 15.1

Figure 17.1

Figure 17.2

Figure 17.3

Figure 17.4

Figure 17.5

Figure 17.6

Figure 18.1

Figure 19.1

Figure 20.1

Figure 21.1

Figure 21.2

Figure 24.1

Figure 24.2

Figure 24.3

Figure 24.4

Figure 24.5

Figure 24.6

Figure 24.7

Figure 24.8

Figure 24.9

Figure 24.10

Figure 24.11

Figure 25.1

Figure 27.1

Figure 27.2

Figure 27.3

Figure 27.4

Figure 27.5

Figure 27.6

Figure 27.7

Figure 27.8

Figure 27.9

Figure 28.1

Figure 30.1

Figure 31.1

Figure 31.2

Figure 31.4

Figure 31.3

Figure 31.5

Figure 31.6

Figure 31.7

Figure 31.8

Figure 31.9

Figure 31.10

Figure 31.11

Figure 31.12

Figure 31.13

Figure 31.14

Figure 31.15

Figure 31.16

Figure 31.17

Figure 31.18

Figure 31.19

Figure 31.20

Figure 32.1

Figure 32.2

Figure 32.4

Figure 32.3

Figure 32.5

Figure 32.6

Figure 32.7

Figure 32.8

Figure 32.9

Figure 32.10

Figure 32.11

Figure 32.12

Figure 33.1

Figure 33.2

Figure 33.3

Figure 33.4

Figure 33.5

Figure 33.6

Figure 33.7

Figure 33.8

Figure 33.9

Figure 33.10

Figure 33.11

Figure 33.12

Figure 33.15

Figure 33.16

Figure 33.17

Figure 33.18

Figure 33.19

Figure 33.20

Figure 33.21

Figure 33.22

Figure 33.23

Figure 33.24

Figure 33.25

Figure 33.26

Figure 33.27

Figure 33.28

Figure 33.29

Figure 33.30

Figure 33.31

Figure 33.32

Figure 33.33

Figure 33.34

Figure 33.35

Figure 33.36

Figure 33.38

Figure 34.1

Figure 34.2

Figure 34.3

Figure 34.4

Figure 34.5

Figure 34.6

Figure 35.1

Figure 35.2

Figure 36.1

Figure 36.2

Figure 36.3

Figure 37.1

Figure 38.1

Figure 39.1

Figure 40.1

Figure 45.1

Figure 45.2

List of Tables

Table 1.1

Table 1.2

Table 1.3

Table 2.1

Table 2.2

Table 2.3

Table 2.4

Table 3.1

Table 3.2

Table 3.3

Table 3.4

Table 3.5

Table 4.1

Table 4.2

Table 4.3

Table 5.1

Table 5.2

Table 5.3

Table 5.4

Table 5.5

Table 5.6

Table 5.7

Table 5.8

Table 5.9

Table 5.10

Table 5.11

Table 5.12

Table 5.14

Table 5.15

Table 5.16

Table 5.17

Table 5.18

Table 6.1

Table 6.2

Table 6.3

Table 6.4

Table 6.5

Table 6.6

Table 7.1

Table 7.2

Table 7.4

Table 7.5

Table 7.6

Table 7.7

Table 7.8

Table 7.9

Table 7.10

Table 7.11

Table 7.12

Table 7.13

Table 7.14

Table 8.1

Table 8.2

Table 8.3

Table 8.4

Table 8.5

Table 8.6

Table 8.7

Table 8.8

Table 8.9

Table 9.1

Table 9.2

Table 9.3

Table 9.4

Table 10.1

Table 11.1

Table 11.2

Table 12.1

Table 12.2

Table 13.1

Table 13.2

Table 13.3

Table 14.1

Table 14.2

Table 14.3

Table 15.1

Table 16.1

Table 17.1

Table 18.1

Table 18.2

Table 18.3

Table 18.4

Table 20.1

Table 21.1

Table 21.2

Table 21.3

Table 21.4

Table 21.5

Table 21.6

Table 22.1

Table 22.2

Table 23.1

Table 23.2

Table 24.1

Table 24.2

Table 24.3

Table 24.4

Table 24.5

Table 24.6

Table 24.7

Table 25.1

Table 28.1

Table 28.2

Table 28.3

Table 29.1

Table 29.2

Table 30.1

Table 30.2

Table 30.3

Table 31.1

Table 31.2

Table 31.3

Table 31.4

Table 31.5

Table 31.6

Table 32.1

Table 32.2

Table 32.3

Table 32.4

Table 32.5

Table 32.6

Table 32.7

Table 32.8

Table 32.10

Table 32.11

Table 33.1

Table 33.2

Table 33.3

Table 33.4

Table 33.5

Table 33.6

Table 33.7

Table 33.8

Table 33.9

Table 34.1

Table 34.2

Table 35.1

Table 35.2

Table 35.3

Table 35.4

Table 35.5

Table 36.1

Table 36.2

Table 36.3

Table 36.4

Table 36.5

Table 36.6

Table 36.7

Table 36.8

Table 36.9

Table 36.10

Table 36.11

Table 37.1

Table 37.2

Table 38.1

Table 39.1

Table 39.2

Table 40.1

Table 40.2

Table 41.1

Table 41.2

Table A.1

Anesthesia Complications in the Dental Office

Editors:

Robert C. Bosack, DDS

Clinical Assistant ProfessorCollege of DentistryUniversity of IllinoisChicago, Illinois, USAPrivate PracticeOral and Maxillofacial SurgeryChicago, Illinois, USA

Stuart Lieblich, DMD

Clinical ProfessorDepartment of Oral and Maxillofacial SurgeryUniversity of ConnecticutAvon, Connecticut, USAPrivate PracticeOral and Maxillofacial SurgeryAvon, Connecticut, USA

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Library of Congress Cataloging-in-Publication Data

Anesthesia complications in the dental office / editors, Robert C. Bosack, Stuart Lieblich.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-96029-5 (cloth)

I. Bosack, Robert C., editor. II. Lieblich, Stuart E., editor.

[DNLM: 1. Anesthesia, Dental–adverse effects. 2. Anesthesia, Dental–contraindications. 3. Intraoperative Complications–prevention & control. 4. Postoperative Complications–prevention & control. 5. Risk Factors. WO 460]

RK510

617.9′676–dc23

2015000738

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

To my family, with special remembrance for my Dad, S. Richard Bosack, DDS (1921–2011), to whom I promised this dedication.

Robert C. Bosack

To my family, teachers, and students; but most importantly to the patients who have trusted me with their care.

Stuart Lieblich

In memory of John Yagiela, DDS (1947–2010).

Contributors

Edward C. Adlesic, DMD

Assistant Clinical Professor

Department of Oral and Maxillofacial Surgery

University of Pittsburgh School of Dental Medicine