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Pulmonary Aspiration During Induction of General Anesthesia

Reina Hayashi DDS,

Shigeru Maeda DDS, PhD,

Taninishi Hideki MD, PhD,

Hitoshi Higuchi DDS, PhD, and

Takuya Miyawaki DDS, PhD

Article Category: Case Report

Volume/Issue: Volume 67: Issue 4

Online Publication Date: Dec 31, 2020

DOI: 10.2344/anpr-67-02-03

Page Range: 214 – 218

Pulmonary aspiration of gastric contents has remained one of the most feared complications of sedation and general anesthesia because of the potential for lethal consequences secondary to lung injury from particulate matter, acid, and bacteria. 1 Prevention involves strict adherence to preoperative fasting instructions for patients before elective surgery under sedation and general anesthesia. Historically, the median duration of fasting for liquids was reported to be 6 to 9 hours in adults. 2 However, the advantages of shorter fasting

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Figure 6.; Emergency flowchart for accidental ingestion or pulmonary aspiration This system was introduced in 2003. Dental anesthesiologists manage these cases.

Figure 6.

Emergency flowchart for accidental ingestion or pulmonary aspiration This system was introduced in 2003. Dental anesthesiologists manage these cases.

Anesthetic Management of a Rett Syndrome Patient at High Risk for Respiratory Complications

Nobuhito Kamekura DDS, PhD,

Takayuki Hojo DDS, PhD,

Yukie Nitta DDS, PhD,

Yuri Hase DDS, PhD, and

Toshiaki Fujisawa DDS, PhD

Article Category: Case Report

Volume/Issue: Volume 68: Issue 3

Online Publication Date: Oct 04, 2021

DOI: 10.2344/anpr-68-02-07

Page Range: 163 – 167

and chest deformity due to severe scoliosis, fragile bone structure, and autonomic dysfunction. These factors made her anesthetic management difficult and required particular perioperative management considerations to reduce the risk of atelectasis and aspiration. Additionally, because she was bedridden and had a chest deformity due to scoliosis, the patient had dysphagia and difficulties in sputum expectoration and postural changing. Therefore, she had several risk factors for developing postoperative respiratory complications, such as pneumonia. General

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Ingestion of a Fixed Partial Denture During General Anesthesia

Steve Neustein MD and

Mark Beicke DDS

Article Category: Research Article

Volume/Issue: Volume 54: Issue 2

Online Publication Date: Jan 01, 2007

DOI: 10.2344/0003-3006(2007)54[50:IOAFPD]2.0.CO;2

Page Range: 50 – 51

. Her mandibular right first premolar was being held in place with a denture adhesive, so a dental consult was obtained preoperatively. No other loose dentition was noted by the dentist who removed the loose crown to prevent aspiration of it during the perioperative period. The patient had previously undergone a full mouth rehabilitation, including placement of numerous crowns and 2 fixed partial dentures. It appeared that intubation would not be difficult since her mouth opened 5 cm, the thyromental distance was 6 cm, and she was classified as a Mallampati Class 1

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Figure 3; A strong bloody flow by aspiration The source of the blood is not from blood vessel but from the space since the blood is surrounded by the semitransparent gel‐like fluid (arrow).

Figure 3

A strong bloody flow by aspiration

The source of the blood is not from blood vessel but from the space since the blood is surrounded by the semitransparent gel‐like fluid (arrow).

Management of an Ingested Foreign Body in a COVID-Positive Patient

Tiffany Smith BS,

Rachel Blum BS, and

Raquel Rozdolski DMD

Article Category: Case Report

Volume/Issue: Volume 70: Issue 4

Online Publication Date: Jan 15, 2024

DOI: 10.2344/anpr-70-03-03

Page Range: 178 – 183

Accidental ingestion and pulmonary aspiration of dental materials are among some of the most common adverse events occurring during dental treatment. According to a study completed by Susini et al 1 that quantified the frequency and type of ingested or aspirated dental materials, 29% were found to be dental prostheses, 27% were burs, and 2.2% were endodontic files. These statistics reinforce the importance of using airway protection (eg, a throat pack or screen) when performing a dental procedure. Currently, the gold standard for treating

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Figure 2; Aspirated body from the space Four spheres are linked together confining the blood in them. This aspiration was performed after injection of approximately 1.8 ml of the anesthetic solution. The transparent gel‐like material seems to be an amorphous ground substance which fills the loose connective tissue in the pterygomandibular space.

Figure 2

Aspirated body from the space

Four spheres are linked together confining the blood in them. This aspiration was performed after injection of approximately 1.8 ml of the anesthetic solution. The transparent gel‐like material seems to be an amorphous ground substance which fills the loose connective tissue in the pterygomandibular space.

Figure 2.; Radial graph of mean scores in effective cases of 3 groups. Plotted markers indicate mean score values of effective cases in each group. In groups A1 and A2, almost all difficulties were relieved, but we must pay attention to airway management, especially in off patients in the A2 group who were administered a high dose of flunitrazepam. Values for coughing by aspiration are the same in groups A1 and A2. By contrast, in group R, clenching and uncooperative behavior were still observed, but the score related to the airway was zero in all cases.

Figure 2.

Radial graph of mean scores in effective cases of 3 groups.

Plotted markers indicate mean score values of effective cases in each group. In groups A1 and A2, almost all difficulties were relieved, but we must pay attention to airway management, especially in off patients in the A2 group who were administered a high dose of flunitrazepam. Values for coughing by aspiration are the same in groups A1 and A2. By contrast, in group R, clenching and uncooperative behavior were still observed, but the score related to the airway was zero in all cases.