Explore the vast range of titles available.

This study aimed to compare parental satisfaction between two pediatric dental anesthesia techniques, computerized intraosseous anesthesia (CIA) and inferior alveolar nerve block (IANB). This study was designed as a split-mouth randomized controlled clinical trial. A total of 52 parents of children undergoing dental treatment were enrolled in the study. Each participant received both CIA and IANB anesthesia, with the order of administration randomized. Parental satisfaction was evaluated using the parental satisfaction of dental local anesthetic techniques scale (PSLAS). Statistical analysis revealed that parental satisfaction regarding CIA was higher than that for IANB with a significant difference ( P ˂ 0.05). However, there was no difference regarding the age, gender or the education level of the parents. ( P  > 0.05). This study provides insights into parental satisfaction with pediatric dental anesthesia techniques and highlights the influence of socioeconomic factors on anesthesia decision-making. Within the limitations of this trial, it was concluded that CIA was significantly superior to IANB in overall parental satisfaction. However, parental satisfaction values were lower in CIA group regarding costs and concern from complications. In addition, it was concluded that there was no difference in satisfaction levels regarding the gender, age and education level of the parents.

ABSTRACT Objective: To compare post-operative pain of Bupivacaine vs placebo in patients undergoing percutaneous nephrolithotomy. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi Pakistan, from Aug 21 to Aug 22. Methodology: Eighty-eight patients undergoing percutaneous nephrolithotomy who fulfilled the inclusion criteria were included in study and randomized in two equal groups (44 patients each) by lottery method, Group-A received 20ml/50mg of 0.25% Bupivacaine and Group-B received 20ml normal saline around nephrostomy tube. Post-operatively, the visual analogue scale used to measure pain score at 6, 12 and 24 hours by an independent observer, blinded to randomization. After 24 hours mean of VAS calculated and noted. Results: Mean age of patient in Group-A was 39.40±8.42 years and in Group-B 38.00±8.67 years. There were 65 male (73.86%) and 23 female (26.13%) patients. Mean stone size was 3.00±0.68 cm and 3.006±0.63 cm in Group-A and B respectively. Median pain at 6, 12 and 24 hours was low in Group-A in comparison to Group-B with p-value <0.001. Similarly, overall pain score in 24 hours was also low in Group-A in comparison to Group-B with median (IQR) score being 4(4.33-3.67) vs 6.33(7.24-4), p<0.001. Demand of first post-operative analgesia was significantly prolonged in Group-A (256.68±23.70 minutes) than Group-B (168.72±30.86 minutes, p-value<0.001). Conclusion: The peritubal Bupivacaine infiltration is highly effective in reducing postoperative pain for patients undergoing PCNL as compared to placebo.

This study aimed to assess the scientific accuracy, content quality, and educational value of YouTube™ videos related to computer-controlled local anesthesia (CCLA) techniques in dentistry. A total of 100 videos were screened using predefined keywords, and 48 met the inclusion criteria. Videos were assessed using the Global Quality Scale (GQS), DISCERN tool, JAMA benchmark criteria, and the Video Information and Quality Index (VIQI). Scientific content was scored using a structured rubric across six domains. Interobserver reliability was evaluated using Weighted Kappa and Intraclass Correlation Coefficient (ICC). Confidence intervals were calculated for key metrics. Group comparisons were performed using the Mann-Whitney U test, and correlations were analyzed using Spearman's rho (p < 0.05). Videos from academic sources had significantly higher scores across all quality and reliability indicators. The mean GQS was 2.6 (95% CI: 2.3-2.9), DISCERN 11.7 (95% CI: 10.8-12.6), JAMA 1.8 (95% CI: 1.7-1.9), and VIQI 12.5 (95% CI: 11.7-13.3). Strong positive correlations were found between DISCERN and VIQI (r = 0.809), and between total content score and both DISCERN (r = 0.803) and VIQI (r = 0.655). Although YouTube™ provides accessible information on CCLA, many videos lack scientific rigor and educational depth. Content produced by academic institutions is significantly more reliable. Dental educators are encouraged to integrate high-quality video content into curricula to improve media literacy and student learning outcomes.

Background Anxiety is common preceding tooth extraction; hence, it is crucial to identify patients with dental anxiety (DA) and to manage DA. This study assessed the level of DA and influencing factors in tooth extraction patients in a dental hospital in China and changes in their blood pressure (BP) and heart rate (HR) during the tooth-extraction procedure. Methods The study was a cohort study. The Dental Anxiety Scale (DAS) was used to assess the level of DA of 120 patients before tooth extraction. A Demographics and Oral Health Self-Assessment Form was used to assess factors influencing DA. The correlations of DAS scores with HR and BP were measured. The effects of local anesthesia and general anesthesia on HR and BP were also compared using a Datex-Ohmeda anesthesia monitor to detect HR and BP continuously before and after anesthesia. Independent sample t-tests, OLS multiple regression model and one-way analysis of variance were applied to analysis the results. Results Based on the DAS score, 12.5% of the participants were identified as suffering from DA. DA was related to age, gender, and the self-assessment of oral health. The DAS score was correlated with increased BP ( P  < 0.05). BP showed an overall upward trend after local anesthesia, while it was generally stable after general anesthesia. The systolic BP at 4 and 5 min and the HR at 2 and 4 min increased remarkably ( P  < 0.05) after local anesthesia compared with those before anesthesia. The HR and BP of patients under local anesthesia were generally higher than those of patients under general anesthesia were during the operation. Conclusions The prevalence of DA in adults was 12.5% in this study population. DA was related to gender, age, and the self-assessment of oral health. The score of DAS was correlated with BP. Compare to local anesthesia, general anesthesia can make the vital signs of tooth extraction patients more stable.

Background: Dental procedures, especially local anesthetic administration, are a source of great anxiety to children. Diaphragmatic breathing is defined as an efficient integrative body-mind training for dealing with stress and psychosomatic conditions. Pinwheel exercise is also a highly effective technique of \"play therapy.\" Aim: This study aimed to compare dental anxiety using pinwheel breathing exercise and diaphragmatic breathing exercise during buccal infiltration anesthesia. Methodology: Sixty children in the age group of 6-12 years with Frankel's behavior rating score of 3 who required buccal infiltration local anesthesia were selected. Subjects were divided randomly into two groups, i.e., Group A: children who performed pinwheel breathing exercise and Group B: children who performed diaphragmatic breathing exercise. The level of anxiety of the patients was recorded using an animated emoji scale. The data were analyzed using IBM SPSS version 20 software with paired t-test and Chi-square test. Results: There was a significant reduction in dental anxiety score from score 1 (before the anesthetic procedure) to score 2 (after the anesthetic procedure) in both the groups. On intergroup analysis, children who performed pinwheel breathing exercise (Group A) showed higher values than children who performed deep breathing exercise without pinwheel (Group B) with a t value of 1.42 but was not statistically significant with a P value of 0.161. Conclusion: Pinwheel breathing exercise as well as diaphragmatic breathing exercise proved to be significantly effective in reducing dental anxiety during local anesthesia.

Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS). Prospective, randomized, double-blinded, placebo-controlled trial. Single institution, tertiary university hospital. Adult patients who scheduled for VATS under general anesthesia were enrolled in the study. We randomly allocated patients to receive preoperative ultrasound-guided ESPB with 25 ml of either 0.5% ropivacaine (ESPB group) or normal saline (Control group). The primary outcome was QoR as measured by the 40-item QoR questionnaire (QoR-40) score at postoperative day 1. Secondary results were post-anesthesia care unit (PACU) discharge time, acute postoperative pain, cumulative opioid consumption, the incidence of postoperative nausea or vomiting (PONV), and patient satisfaction. The global QoR-40 score at postoperative day 1 (median, interquartile range) was significantly higher in the ESPB group (174, 170 to 177) than the control group (161.5, 160 to 165), estimated median difference 11 (95% CI 9 to 13, P < 0.001). Compared with the control group, single-injection of ESPB reduced PACU discharge time, acute postoperative pain, and cumulative opioid consumption. Correspondingly, the median patient satisfaction scores were higher in the ESPB group than the control group (9 versus 7, P < 0.001). Preoperative single-injection thoracic ESPB with ropivacaine improves QoR, postoperative analgesia, and patient satisfaction after VATS. •Erector spinae plane block enhances the quality of recovery after video-assisted thoracic surgery.•Erector spinae plane block reduces postoperative pain and opioid consumption.•Erector spinae plane block improves patient satisfaction after video-assisted thoracic surgery.

Background. Pain control is one of the most important aspects that can affect parental satisfaction of the dental care provided for children. Dental local anesthesia has the highest impact on pain sensation of the children. However, there is no scale in the literature to assess parental satisfaction of dental local anesthetic techniques. Objectives. This study was aimed to assess the parental satisfaction with dental local anesthetic techniques for their children through designing a scale that reflects satisfaction and to study the validity and reliability of this scale. Methods. A cross-sectional observational study was conducted on 150 parents (102 mothers and 48 fathers). Two techniques of local anesthesia were used for each child participated in this study (inferior alveolar nerve block and computerized intraosseous anesthesia). The developed scale consisted of 20 items in a 5-point Likert scale. Half of the items were written in a negative format. Internal consistency, validity, and factor analysis were performed in this study. Independent t-test was used to compare between the two techniques of anesthesia, between boys and girls and among fathers and mothers. Results. Parental satisfaction mean values were higher in the computerized intraosseous anesthesia group in comparison to inferior alveolar nerve block (P value <0.05). The T-test showed that there was no difference between boys and girls regarding parental satisfaction (P value >0.05). Furthermore, fathers show lower satisfaction in the computerized interosseous anesthesia group (P value <0.05). Excellent internal consistency of this scale was resulted as Cronbach’s alpha reliability coefficient was 0.985. After factor analysis, seven factor components were retained by using varimax rotation. Conclusions. Findings of this study reported that the designed parental satisfaction of dental local anesthetic techniques scale (PSLAS) is a valid and reliable scale to be used. Moreover, this study showed that parental satisfaction was higher when computerized intraosseous anesthesia was used in comparison to inferior alveolar nerve block.

General anesthesia (GA), which is routinely applied in patients who undergo percutaneous endoscopic interlaminar lumbar discectomy (PEILD) of L5-S1 disc herniation, is closely associated with postoperative cognitive dysfunction (POCD) in the elderly. Local anesthesia (LA) is an alternative pain control protocol that has not yet been fully evaluated. To evaluate the feasibility of LA in PEILD compared with GA. A retrospective study. This study took place at the First Affiliated Hospital of Harbin Medical University. A total of 120 patients (aged 60-85 years) diagnosed with L5-S1 disc herniation and with American Society of Anesthesiologists fitness grade I or II between March 2016 and August 2017 were enrolled in the current study. Patients were randomly divided into LA group and GA group. For LA, 0.25% lidocaine was injected layer-by-layer into skin, subcutaneous tissue, fasciae, lumbar facet joint, muscle, and ligamentum flavum followed by injection of 1.33% lidocaine into epidural space; for GA, propofol, sufentanil, and cisatracurium were infused intravenously at 1 to 2 mg/kg, 0.3 µg/kg, and 0.15 mg/kg, respectively. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and MacNab Criteria (MNC) evaluated the feasibility of LA as pain control protocol in comparison to GA before and after operation. The development of POCD was assessed by the Mini-Mental State Examination 1 and 7 days postsurgery. Feasibility of LA as a pain control protocol was also evaluated by patient's willingness to receive the same surgical procedure immediately and 24 hours after the surgery, and intraoperative fluoroscopy use, blood loss, surgery duration, postoperative bed confinement, and duration and cost of hospital stay were also evaluated. Patients in both LA and GA groups had comparable VAS grade, ODI, and MNC pre- and post-PEILD, with significant pain reduction after operation. However, POCD developed only in GA group but not in LA group. In addition, compared with GA, LA group did not require postoperative bed confinement, had significantly shorter hospital stay, and lower hospital cost. Low intraoperative VAS grade and willingness to receive the same procedure reflected the acceptance of LA by patients. The development of POCD was examined only 7 days after operation. The follow-up should be extended to 3 months and 2 years postoperation. LA has satisfactory pain control and low-risk of POCD in PEILD and is well accepted by patients. The benefits of LA are no postoperative bed confinement, faster recovery, shorter hospital stay, and lower hospital cost. L5-S1 disc herniation, older patients, percutaneous endoscopic interlaminar lumbar discectomy, local anesthesia, general anesthesia, postoperative cognitive dysfunction, American Society of Anesthesiologists grade, Oswestry Disability Index, MacNab Criteria, Mini-Mental State Examination.

BackgroundThe first choice to treat acute subdural hematoma (SDH) is a large craniotomy under general anesthesia. However, increasing age or comorbid burden of the patients may render invasive treatment strategy inappropriate. These medically frail patients with SDH may benefit from a combination of small craniotomy and endoscopic hematoma removal, which is less invasive and even available under local anesthesia. Although hematoma evacuation with a rigid endoscope for acute or subacute SDHs has been reported in the literature, use of a flexible endoscope may have distinct advantages. In this article, we attempted to clarify the utility of small craniotomy evacuation with a flexible endoscope for acute and subacute SDH in the elderly patients.MethodBetween November 2013 and September 2016, a total of 17 patients with acute SDH (15 patients), subacute SDH (1 patient), or acute aggravation of chronic SDH (1 patient) underwent hematoma evacuation with a flexible endoscope at our hospital and were enrolled in this retrospective study. Either under local or general anesthesia, the SDH was removed with a flexible suction tube with the aid of the flexible endoscope through the small craniotomy (3 × 4 cm). Hematoma evacuation rate, improvement of clinical symptoms, and procedure-related complications were evaluated.ResultsHematoma evacuation rate was satisfactory, and statistically significant clinical improvement was observed in postoperative Glasgow Coma Scale in all cases compared to the preoperative assessment. No procedure-related hemorrhagic complications were observed.ConclusionsThe results reported here suggest that small craniotomy evacuation with a flexible endoscope is a safe, effective, and minimally invasive treatment for acute and subacute SDH in selected cases.

Despite the common clinical impression that patients with a history of drug use are challenging to anesthetize with local anesthesia, literature on this clinical phenomenon is sparse. The objective of this pilot study was to assess if differences in local anesthetic efficacy for dental treatment exist between marijuana users and nonusers. Subjects were healthy adult males and females who qualified as either chronic marijuana users or nonusers. All subjects had an asymptomatic, vital maxillary lateral incisor that responded to an electric pulp test (EPT). A standard maxillary infiltration injection technique was employed using 1.7 mL 2% lidocaine with 1:100,000 epinephrine over the test tooth, and the tooth was tested with an EPT at 3-minute intervals. A total of 88% of nonusers (15/17) and 61% of users (11/18) were successfully anesthetized, defined as anesthesia onset within 10 minutes and lasting at least 15 minutes. The difference in the proportion of anesthetized subjects was not statistically significant (P = .073). For subjects with successful anesthesia, there was no significant difference between nonusers and users in the onset or duration of anesthesia. No significant differences in local anesthetic efficacy with respect to local anesthetic success, onset, or duration of action were found between chronic marijuana users and nonusers. However, larger studies are likely needed to provide more definitive evidence.