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Thesis (MD (Anaesthesiology))--University of Pretoria, 2003. / Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Thesis (M.Sc.Eng.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Status asthmaticus (SA) is a severe, acute exacerbation of asthma that is refractory to traditional therapies using standard bronchodilators such as β-agonists and corticosteroids. Inhaled volatile anesthetics are currently used as a rescue therapy for SA due to their potent bronchodilator effects. However, it is unclear whether these agents act in vivo via 1) direct action on airway smooth muscle (ASM); 2) systemic re-circulation; or 3) autonomic reflexes from the central nervous system. Treatment with these agents can also lead to negative side effects, notably hypotension and arrhythmias, especially during prolonged pediatric use. The goals of this thesis were to compare direct versus systemic effects of these inhaled anesthetic agents, and to determine whether sufficient bronchodilation can be achieved via direct diffusion from the airway lumen to the ASM. We designed and developed a computer-actuated, ventilator-valve system to control the serial composition of the inspired gas. Using this system, we delivered inhaled anesthetic agents either a) to the anatomic dead space selectively (direct), or b) continuously throughout inspiration (systemic) in three mongrel canines (20-25 kg) with methacholine-induced bronchoconstriction. Measurements of lung resistance (RL), elastance (EL), and anatomic dead space (VD) demonstrated that isoflurane and sevoflurane result in bronchodilation for both delivery regimes. This suggests that the mechanism of action for these agents is at least partly via direct effects. Fluctuations in VD were not directly coupled with those for RL or EL. Furthermore, there may exist a limit to maximal bronchodilation using inhaled anesthetics, with isoflurane being more potent. In summary, this study illustrates the feasibility of using a targeted anesthetic delivery to treat severe, acute bronchoconstriction. Such a delivery system has the potential to define a rapidly translatable treatment paradigm for SA while increasing patient safety. / 2031-01-01

Paresthesia is a possible adverse event associated with the administration of local anesthetics in dentistry. The purpose of this study was to analyze the 182 cases of non-surgical paresthesia associated with local anesthetic injection that were reported to Ontario’s Professional Liability Program from 1999 to 2008. Examined case parameters included patient age and gender, type and volume of local anesthetic, site of nerve injury, and other symptoms. All but two cases involved mandibular block injection. From 2006 to 2008 alone, 64 cases were reported; this projects to a reported incidence of 1 in 609,000 injections. For both anesthetic drugs available as 4% solutions, namely articaine and prilocaine, the observed frequencies for reporting were significantly greater than expected (chi-square, exact binomial distribution; P<0.01) based on the distribution of local anesthetic use by Ontario dentists. These data suggest that local anesthetic neurotoxicity may be involved in the development of post-injection paresthesia.

Paresthesia is a possible adverse event associated with the administration of local anesthetics in dentistry. The purpose of this study was to analyze the 182 cases of non-surgical paresthesia associated with local anesthetic injection that were reported to Ontario’s Professional Liability Program from 1999 to 2008. Examined case parameters included patient age and gender, type and volume of local anesthetic, site of nerve injury, and other symptoms. All but two cases involved mandibular block injection. From 2006 to 2008 alone, 64 cases were reported; this projects to a reported incidence of 1 in 609,000 injections. For both anesthetic drugs available as 4% solutions, namely articaine and prilocaine, the observed frequencies for reporting were significantly greater than expected (chi-square, exact binomial distribution; P<0.01) based on the distribution of local anesthetic use by Ontario dentists. These data suggest that local anesthetic neurotoxicity may be involved in the development of post-injection paresthesia.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (Ph. D.)--University of Chicago, Dept. of Neurobiology, Pharmacology and Physiology, June 2000. / Includes bibliographical references. Also available on the Internet.