Additional Information
Book Details
Abstract
Combining essential theory with “how-to technical instruction, this concise guide is the leading reference for basic techniques in sedation and anxiety control in the dental office. The latest guidelines from the ADA and the American Society of Anesthesiologists keep you up-to-date with the latest medical standards. Content on patient management for pediatric, geriatric, physically compromised, and medically compromised patients helps you successfully treat any patient population.
- In-depth discussions of the pharmacology of commonly used sedative agents allow you to fully understand properties and characteristics of drugs used.
- Combines all aspects of sedation with essential theory and instruction
- Boxes and tables highlight key information and make it easy to find important content.
- Chapter 40-Legal Considerations includes the current liability standards for patient treatment to help you protect yourself and your patients.
- Chapter 41-The Controversial Development of Anesthesiology in Dentistry focuses on the growing controversies, legal and otherwise, from both without and within the profession.
- Updated patient management procedures provide the most current guidelines on everything from AHA CPR standards to the safest sedative procedures.
- Full-color art program shows anatomy and other important concepts in vibrant detail.
- Photos of the newest sedation and emergency equipment ensure you have the latest information on developments in the field.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Sedation | iii | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Preface | vii | ||
| REFERENCE | vii | ||
| About This Book | viii | ||
| New to This Edition | ix | ||
| ART PROGRAM | ix | ||
| WEBSITE | ix | ||
| two NEW CHAPTERS | ix | ||
| Acknowlegments | x | ||
| Sedation in DentistryA Historic Perspective | xi | ||
| REFERENCES | xiii | ||
| Table of Contents | xv | ||
| I INTRODUCTION | 1 | ||
| 1 Pain and Anxiety in Dentistry | 2 | ||
| CHAPTER OUTLINE | 2 | ||
| BASIC FEARS | 4 | ||
| DENTAL FEARS | 5 | ||
| REFERENCES | 6 | ||
| II SPECTRUM OF PAIN AND ANXIETY CONTROL | 8 | ||
| REFERENCE | 9 | ||
| 2 Introduction to Sedation | 10 | ||
| CHAPTER OUTLINE | 10 | ||
| DEFINITIONS | 10 | ||
| The Concept of “Rescue” | 12 | ||
| SUMMARY | 12 | ||
| REFERENCES | 13 | ||
| 3 The Spectrum of Pain and Anxiety Control | 14 | ||
| CHAPTER OUTLINE | 14 | ||
| NO ANESTHESIA | 15 | ||
| IATROSEDATION | 16 | ||
| OTHER NONDRUG PSYCHOSEDATIVE TECHNIQUES | 16 | ||
| ROUTES OF DRUG ADMINISTRATION | 16 | ||
| Oral | 16 | ||
| Rectal | 18 | ||
| Topical | 18 | ||
| Sublingual | 18 | ||
| Intranasal | 18 | ||
| Transdermal | 18 | ||
| Subcutaneous | 18 | ||
| Intramuscular | 18 | ||
| Inhalation (Pulmonary) | 19 | ||
| Intravenous | 20 | ||
| GENERAL ANESTHESIA | 21 | ||
| REFERENCES | 21 | ||
| 4 Physical and Psychological Evaluation | 23 | ||
| CHAPTER OUTLINE | 23 | ||
| GOALS OF PHYSICAL AND PSYCHOLOGICAL EVALUATION | 23 | ||
| PHYSICAL EVALUATION | 24 | ||
| Medical History Questionnaire | 24 | ||
| Physical Examination | 47 | ||
| Vital Signs | 47 | ||
| Blood Pressure | 47 | ||
| Technique. | 47 | ||
| Common errors in technique. | 48 | ||
| Guidelines for clinical evaluation. | 49 | ||
| Heart Rate and Rhythm | 51 | ||
| III ORAL, RECTAL, AND INTRAMUSCULAR SEDATION | 94 | ||
| ORAL, RECTAL, AND INTRAMUSCULAR SEDATION | 94 | ||
| 7 Oral Sedation | 95 | ||
| CHAPTER OUTLINE | 95 | ||
| ADVANTAGES | 95 | ||
| DISADVANTAGES | 96 | ||
| Absorption | 97 | ||
| Bioavailability | 98 | ||
| RATIONALE FOR USE | 98 | ||
| DRUGS | 99 | ||
| ANTIANXIETY DRUGS | 100 | ||
| Benzodiazepine Antianxiety Agents | 100 | ||
| Pharmacology | 100 | ||
| Mode of Action | 100 | ||
| Central Nervous System | 101 | ||
| Respiratory System | 101 | ||
| Cardiovascular System | 101 | ||
| Liver | 101 | ||
| Absorption, Metabolism, Excretion | 102 | ||
| Dependence | 102 | ||
| Oral Benzodiazepines in Dentistry | 102 | ||
| Contraindications | 103 | ||
| Warnings | 103 | ||
| Benzodiazepines in Children | 103 | ||
| Drug Interactions | 103 | ||
| Precautions | 103 | ||
| Adverse Reactions | 103 | ||
| Chlordiazepoxide | 103 | ||
| Diazepam | 103 | ||
| IV INHALATION SEDATION | 163 | ||
| ACKNOWLEDGMENTS | 164 | ||
| REFERENCES | 164 | ||
| 11 Inhalation Sedation: Historical Perspective | 165 | ||
| CHAPTER OUTLINE | 165 | ||
| BEGINNINGS (PRE-1844) | 165 | ||
| THE EARLY DAYS (1844-1862) | 166 | ||
| ANESTHESIA DEVELOPS (1863-1898) | 172 | ||
| THE TWENTIETH CENTURY | 173 | ||
| MODERN TIMES (1950-PRESENT) | 175 | ||
| The Development of Courses and Guidelines | 175 | ||
| The Early Anesthesia Machine | 176 | ||
| REFERENCES | 177 | ||
| 12 Inhalation Sedation: Rationale | 179 | ||
| CHAPTER OUTLINE | 179 | ||
| ADVANTAGES | 180 | ||
| Disadvantages | 182 | ||
| INDICATIONS | 182 | ||
| Anxiety | 182 | ||
| Medically Compromised Patients | 182 | ||
| Cardiovascular Disease | 182 | ||
| Respiratory Disease | 183 | ||
| Cerebrovascular Disease | 183 | ||
| Hepatic Disease | 183 | ||
| Epilepsy and Seizure Disorders | 184 | ||
| Pregnancy | 184 | ||
| Allergy | 184 | ||
| Diabetes | 184 | ||
| Gagging | 184 | ||
| CONTRAINDICATIONS | 184 | ||
| Patients With a Compulsive Personality | 184 | ||
| Claustrophobic Patients | 184 | ||
| Children With Severe Behavior Problems | 184 | ||
| Patients With Severe Personality Disorders | 185 | ||
| Upper Respiratory Tract Infection or Other Acute Respiratory Conditions | 185 | ||
| Chronic Obstructive Pulmonary Disease | 185 | ||
| The Patient Who Does Not Want N2O-O2 | 185 | ||
| Pregnancy | 185 | ||
| RESTORATIVE DENTISTRY | 185 | ||
| Initial Dental Examination | 185 | ||
| Removal of Provisional Crowns or Bridges | 186 | ||
| Occlusal Adjustment | 186 | ||
| Insertion of Matrix Bands or Wedges | 186 | ||
| PERIODONTICS AND DENTAL HYGIENE | 186 | ||
| Initial Periodontal Examination | 186 | ||
| Scaling, Curettage, and Root Planing | 186 | ||
| Emergency Management of Necrotizing Ulcerative Gingivitis | 186 | ||
| Use of Ultrasonic Instruments | 186 | ||
| Periodontal Surgery | 186 | ||
| ORAL AND MAXILLOFACIAL SURGERY | 186 | ||
| Lengthy Surgical Procedures | 186 | ||
| Management of Abscesses | 186 | ||
| Management of Postoperative Complications | 187 | ||
| Suture Removal | 187 | ||
| ENDODONTICS | 187 | ||
| Rubber Dam Clamps | 187 | ||
| Gaining Access to the Pulp Chamber | 187 | ||
| Instrumenting Canals | 187 | ||
| Filling of Root Canals | 187 | ||
| FIXED PROSTHODONTICS | 187 | ||
| Impression Taking | 187 | ||
| Removal of Provisional Crowns and Bridges | 187 | ||
| Adjustment of Castings | 187 | ||
| REMOVABLE PROSTHODONTICS | 188 | ||
| Preparation of Abutment Teeth | 188 | ||
| Determination of Centric Relationships | 188 | ||
| Occlusal Adjustments and Impression Taking | 188 | ||
| Fitting of Immediate Dentures | 188 | ||
| ORAL RADIOLOGY | 188 | ||
| ORTHODONTICS | 188 | ||
| PEDIATRIC DENTISTRY | 188 | ||
| REFERENCES | 188 | ||
| 13 Pharmacology, Anatomy, and Physiology | 190 | ||
| CHAPTER OUTLINE | 190 | ||
| NITROUS OXIDE | 190 | ||
| Preparation | 190 | ||
| Properties | 191 | ||
| Physical Properties | 191 | ||
| Chemical Properties | 191 | ||
| Solubility | 191 | ||
| Potency | 192 | ||
| Pharmacology | 193 | ||
| Central Nervous System | 194 | ||
| Cardiovascular System | 194 | ||
| Respiratory System | 194 | ||
| Gastrointestinal Tract | 194 | ||
| Kidneys | 194 | ||
| Hematopoiesis | 194 | ||
| Skeletal Muscle | 194 | ||
| Uterus and Pregnancy | 195 | ||
| Physiologic Contraindications | 195 | ||
| OXYGEN | 195 | ||
| Preparation | 195 | ||
| Properties | 195 | ||
| Effects of 100% Oxygen | 195 | ||
| Central Nervous System | 195 | ||
| Cardiovascular System | 195 | ||
| Respiratory System | 195 | ||
| RESPIRATORY SYSTEM | 196 | ||
| Nose | 196 | ||
| Mouth | 196 | ||
| Pharynx | 196 | ||
| Epiglottis | 197 | ||
| Larynx | 198 | ||
| Trachea | 198 | ||
| Bronchi | 198 | ||
| Bronchioles | 199 | ||
| Alveolus | 199 | ||
| RESPIRATION | 199 | ||
| Mechanics of Respiration | 200 | ||
| Composition of Respiratory Gases | 200 | ||
| REFERENCES | 201 | ||
| 14 Inhalation Sedation Equipment | 203 | ||
| CHAPTER OUTLINE | 203 | ||
| TYPES OF INHALATION SEDATION UNITS | 203 | ||
| Demand-Flow Units | 203 | ||
| Continuous-Flow Units | 205 | ||
| Portable System | 205 | ||
| Central Storage System | 205 | ||
| Central Storage System With Mobile Heads | 206 | ||
| Compressed-Gas Cylinders | 207 | ||
| Oxygen Cylinder and Contents | 209 | ||
| Nitrous Oxide Cylinder and Contents | 209 | ||
| Regulators | 211 | ||
| Manifolds (Central System Only) | 211 | ||
| Yokes (Portable System Only) | 212 | ||
| Flowmeters | 213 | ||
| Flowmeter Advancements | 213 | ||
| Emergency Air Intake Valve | 215 | ||
| Latex-Free Accessory Equipment | 215 | ||
| Reservoir Bag | 215 | ||
| Conducting Tubes | 216 | ||
| Breathing Apparatus | 217 | ||
| Full Face Mask | 217 | ||
| Nasal Cannula | 217 | ||
| Nasal Hood | 218 | ||
| Scavenging Nasal Hood | 219 | ||
| SAFETY FEATURES | 221 | ||
| Pin Index Safety System | 221 | ||
| Diameter Index Safety System | 221 | ||
| Minimum Oxygen Liter Flow | 221 | ||
| Minimum Oxygen Percentage | 221 | ||
| Oxygen Fail Safe | 222 | ||
| Emergency Air Inlet | 222 | ||
| Alarm | 222 | ||
| Oxygen Flush Button | 222 | ||
| Reservoir Bag | 223 | ||
| Color Coding | 223 | ||
| Lock | 223 | ||
| Quick Connect for Positive-Pressure Oxygen | 224 | ||
| AVAILABLE INHALATION SEDATION UNITS | 224 | ||
| REFERENCES | 227 | ||
| 15 Inhalation Sedation: Techniques of Administration | 228 | ||
| CHAPTER OUTLINE | 228 | ||
| GENERAL DESCRIPTION | 228 | ||
| ADMINISTRATION | 229 | ||
| Pretreatment Visit and Instructions | 229 | ||
| Day of Appointment | 230 | ||
| Monitoring During Inhalation Sedation | 230 | ||
| Preparation of the Equipment | 230 | ||
| Preparation of the Patient | 230 | ||
| Technique of Administration | 230 | ||
| Subsequent Appointments | 243 | ||
| COMPARISON OF TECHNIQUES OF ADMINISTRATION | 243 | ||
| Constant Liter Flow Technique | 243 | ||
| Summary of Technique | 243 | ||
| V INTRAVENOUS SEDATION | 269 | ||
| REFERENCES | 270 | ||
| 20 Intravenous Sedation: Historical Perspective | 271 | ||
| CHAPTER OUTLINE | 271 | ||
| THE EARLY DAYS | 271 | ||
| THE 1800s | 272 | ||
| THE 1900s | 272 | ||
| REFERENCES | 273 | ||
| 21 Intravenous Moderate Sedation: Rationale | 274 | ||
| CHAPTER OUTLINE | 274 | ||
| ADVANTAGES | 274 | ||
| DISADVANTAGES | 275 | ||
| CONTRAINDICATIONS | 276 | ||
| INDICATIONS | 277 | ||
| Anxiety | 277 | ||
| Amnesia | 278 | ||
| Medically Compromised Patients | 278 | ||
| Previous Cerebrovascular Accident | 278 | ||
| Epilepsy | 278 | ||
| Control of Secretions | 279 | ||
| Analgesia | 279 | ||
| Diminished Gagging | 279 | ||
| REFERENCES | 279 | ||
| 22 Armamentarium | 280 | ||
| CHAPTER OUTLINE | 280 | ||
| INTRAVENOUS DRUG ADMINISTRATION | 280 | ||
| Direct Intravenous Administration | 280 | ||
| Needle Maintained in the Vein Without Continuous Infusion | 280 | ||
| Continuous Intravenous Infusion | 281 | ||
| ADVANTAGES AND DISADVANTAGES OF VARIOUS METHODS | 281 | ||
| INTRAVENOUS INFUSION SOLUTION | 282 | ||
| Choice of Solution | 282 | ||
| Volume of Solution | 282 | ||
| INTRAVENOUS ADMINISTRATION SET | 283 | ||
| NEEDLES | 285 | ||
| Gauge | 285 | ||
| Types | 286 | ||
| OTHER ITEMS | 288 | ||
| REFERENCES | 291 | ||
| 23 Anatomy for Venipuncture | 292 | ||
| CHAPTER OUTLINE | 292 | ||
| ARTERIES OF THE UPPER LIMB | 292 | ||
| VEINS OF THE UPPER LIMB | 294 | ||
| ANATOMY | 294 | ||
| Dorsum of the Hand | 295 | ||
| Wrist | 295 | ||
| Forearm | 296 | ||
| Antecubital Fossa | 296 | ||
| Foot | 297 | ||
| SELECTION OF VENIPUNCTURE SITE | 298 | ||
| Condition of the Superficial Veins | 298 | ||
| Relationship of the Vein to Other Anatomic Structures | 298 | ||
| Duration of the Venipuncture | 298 | ||
| Clinical Status of the Patient | 298 | ||
| Age (Size) of the Patient | 298 | ||
| Type of Intravenous Procedure | 299 | ||
| RECOMMENDED SITES FOR VENIPUNCTURE | 299 | ||
| REFERENCES | 301 | ||
| 24 Venipuncture Technique | 302 | ||
| CHAPTER OUTLINE | 302 | ||
| PREPARATION OF EQUIPMENT | 302 | ||
| PREPARATION FOR VENIPUNCTURE | 304 | ||
| INDWELLING CATHETER | 308 | ||
| WINGED INFUSION SET | 310 | ||
| Basic Technique—Winged Infusion Set | 310 | ||
| HOLLOW METAL NEEDLE | 310 | ||
| Basic Technique—Hollow Metal Needle | 310 | ||
| VENIPUNCTURE TECHNIQUE | 311 | ||
| Dorsum of Hand | 311 | ||
| Dorsum of Wrist | 312 | ||
| Ventral Forearm | 313 | ||
| Antecubital Fossa | 313 | ||
| TERMINATING THE INTRAVENOUS INFUSION | 315 | ||
| REFERENCES | 315 | ||
| 25 Pharmacology | 316 | ||
| CHAPTER OUTLINE | 316 | ||
| BENZODIAZEPINES | 317 | ||
| Diazepam | 317 | ||
| Chemistry | 318 | ||
| General Pharmacology | 318 | ||
| Fate of Intravenous Diazepam | 318 | ||
| Phase 1: 0 to 15 minutes. | 318 | ||
| Phase 2: 16 to 30 minutes. | 318 | ||
| Phase 3: 31 to 45 minutes. | 318 | ||
| Phase 4: 46 to 60 minutes. | 319 | ||
| Biotransformation | 319 | ||
| Effects of Age and Disease | 319 | ||
| Skeletal Muscle Relaxation | 320 | ||
| Anticonvulsant Activity | 320 | ||
| Cardiovascular System | 320 | ||
| Respiratory System | 320 | ||
| Hepatic Disease | 320 | ||
| Pain | 320 | ||
| Amnesia | 320 | ||
| Contraindications | 321 | ||
| Warnings | 321 | ||
| Use in Pregnancy | 321 | ||
| Pediatric Use | 321 | ||
| Precautions | 321 | ||
| Adverse Reactions | 322 | ||
| Dosage | 322 | ||
| Availability | 322 | ||
| Midazolam | 323 | ||
| Pharmacokinetics and Biotransformation | 323 | ||
| Amnesia | 323 | ||
| Duration of Clinical Activity | 324 | ||
| Cardiorespiratory Activity | 324 | ||
| Side Effects | 324 | ||
| Dosage and Administration | 324 | ||
| Availability | 324 | ||
| Lorazepam | 325 | ||
| Warnings and Precautions | 325 | ||
| Pediatric Use | 326 | ||
| Adverse Reactions | 326 | ||
| Dosage | 326 | ||
| Administration | 326 | ||
| Availability | 326 | ||
| Flunitrazepam | 326 | ||
| Side Effects and Complications | 327 | ||
| Flunitrazepam Sedation in Dentistry | 327 | ||
| Availability | 327 | ||
| Chlordiazepoxide | 327 | ||
| VI GENERAL ANESTHESIA | 401 | ||
| REFERENCEs | 402 | ||
| 30 Fundamentals of General Anesthesia | 403 | ||
| CHAPTER OUTLINE | 403 | ||
| ADVANTAGES | 404 | ||
| DISADVANTAGES | 406 | ||
| CONTRAINDICATIONS | 407 | ||
| INDICATIONS | 407 | ||
| TYPES OF GENERAL ANESTHESIA | 408 | ||
| Outpatient General Anesthesia | 408 | ||
| Intravenous Propofol or Barbiturates | 408 | ||
| Conventional Operating Room Type of General Anesthesia in an Outpatient Environment | 409 | ||
| Inpatient General Anesthesia | 409 | ||
| EDUCATION IN GENERAL ANESTHESIA | 410 | ||
| Guidelines Relative to the Establishment of a Dental Residency in Anesthesiology | 410 | ||
| ACCREDITED ANESTHESIOLOGY RESIDENCIES IN WHICH DENTISTS CAN ENROLL | 412 | ||
| REFERENCES | 412 | ||
| 31 Armamentarium, Drugs, and Techniques | 413 | ||
| CHAPTER OUTLINE | 413 | ||
| ARMAMENTARIUM | 413 | ||
| Anesthesia Machine | 413 | ||
| Intravenous Equipment | 414 | ||
| Ancillary Anesthesia Equipment | 414 | ||
| Face Masks | 414 | ||
| Laryngoscopes | 415 | ||
| Endotracheal Tubes and Connectors | 416 | ||
| Laryngeal Mask Airway (LMA) | 416 | ||
| Oropharyngeal and Nasopharyngeal Airways | 417 | ||
| Tonsillar Suction Tips | 418 | ||
| Magill Intubation Forceps | 419 | ||
| Sphygmomanometers and Stethoscopes | 419 | ||
| Monitoring Equipment | 419 | ||
| Emergency Equipment and Drugs | 421 | ||
| DRUGS | 421 | ||
| Intravenous Induction Agents | 422 | ||
| Barbiturates | 422 | ||
| Benzodiazepines | 422 | ||
| Other Agents | 422 | ||
| Opioids | 423 | ||
| Neuroleptanalgesia-Neuroleptanesthesia | 423 | ||
| Dissociative Anesthesia | 424 | ||
| Muscle Relaxants (Neuromuscular Blocking Drugs) | 425 | ||
| Inhalation Anesthetics | 426 | ||
| TECHNIQUES | 428 | ||
| Inpatient General Anesthesia | 428 | ||
| Ambulatory General Anesthesia | 430 | ||
| Conventional General Anesthetics | 430 | ||
| Intravenous General Anesthesia | 431 | ||
| SUMMARY | 433 | ||
| REFERENCES | 433 | ||
| VII EMERGENCY PREPARATION AND MANAGEMENT | 435 | ||
| REFERENCES | 437 | ||
| 32 Preparation for Emergencies | 438 | ||
| CHAPTER OUTLINE | 438 | ||
| OFFICE | 438 | ||
| OFFICE PERSONNEL | 438 | ||
| Basic Life Support | 438 | ||
| Advanced Cardiovascular Life Support | 439 | ||
| Pediatric Advanced Life Support | 439 | ||
| Team Approach to Emergency Management | 439 | ||
| EMERGENCY PRACTICE DRILLS | 440 | ||
| The Institute of Medical Emergency Preparedness (IMEP)* | 440 | ||
| OUTSIDE MEDICAL ASSISTANCE | 440 | ||
| SUMMARY | 441 | ||
| REFERENCES | 441 | ||
| 33 Emergency Drugs and Equipment | 442 | ||
| CHAPTER OUTLINE | 442 | ||
| LEVEL 1: BASIC EMERGENCY KIT | 443 | ||
| Injectable Drugs | 443 | ||
| Noninjectable Drugs | 446 | ||
| Primary (Basic) Emergency Equipment | 446 | ||
| LEVEL 2: SECONDARY (NONCRITICAL) DRUGS AND EQUIPMENT | 448 | ||
| Injectable Drugs | 448 | ||
| Noninjectable Drugs | 449 | ||
| Secondary (Advanced) Emergency Equipment | 450 | ||
| LEVEL 3: ADVANCED CARDIAC LIFE SUPPORT | 451 | ||
| LEVEL 4: ANTIDOTAL DRUGS | 451 | ||
| SUMMARY | 452 | ||
| REFERENCES | 452 | ||
| 34 Management of Emergencies | 454 | ||
| CHAPTER OUTLINE | 454 | ||
| OVERDOSE | 455 | ||
| Predisposing Factors and Prevention | 456 | ||
| Clinical Manifestations | 457 | ||
| Sedative-Hypnotics, Including Barbiturates | 457 | ||
| Minimal Sedation, Moderate Sedation, and Deep Sedation | 457 | ||
| General Anesthesia | 457 | ||
| Respiratory Arrest | 458 | ||
| Opioid Agonists | 458 | ||
| Management | 458 | ||
| Sedative-Hypnotic Drugs | 458 | ||
| Opioid Analgesics | 461 | ||
| SUMMARY | 463 | ||
| ALLERGY | 465 | ||
| Prevention of Allergic Reactions | 466 | ||
| Clinical Manifestations | 466 | ||
| Onset | 466 | ||
| Skin Reaction | 467 | ||
| Respiratory Reactions | 467 | ||
| Generalized Anaphylaxis | 467 | ||
| Management | 468 | ||
| Skin Reactions | 468 | ||
| Delayed Skin Reactions | 468 | ||
| Immediate Skin Reactions | 468 | ||
| Respiratory Reactions | 468 | ||
| Bronchospasm | 468 | ||
| Laryngeal Edema | 469 | ||
| Generalized Anaphylaxis | 470 | ||
| Signs of Allergy Present | 471 | ||
| No Signs of Allergy Present | 472 | ||
| HYPOTENSION | 473 | ||
| Causes of Hypotension | 474 | ||
| Management of Hypotension | 475 | ||
| Hypotension in Patients Receiving Corticosteroid Therapy | 476 | ||
| Hypotension in Patients Receiving β-Blockers | 476 | ||
| HYPERTENSIVE EPISODES | 477 | ||
| Management of a Hypertensive Crisis | 477 | ||
| CARDIAC DYSRHYTHMIAS | 478 | ||
| Precipitating Factors | 479 | ||
| ANGINA PECTORIS | 480 | ||
| VIII SPECIAL CONSIDERATIONS | 493 | ||
| REFERENCEs | 494 | ||
| 35 The Pediatric Patient | 495 | ||
| CHAPTER OUTLINE | 495 | ||
| FACTORS INFLUENCING PATIENT RESPONSE | 495 | ||
| BEHAVIORAL EVALUATION OF THE PEDIATRIC PATIENT | 496 | ||
| DETERMINING THE NEED FOR SEDATION | 497 | ||
| GOALS AND TECHNIQUES | 498 | ||
| MONITORING | 500 | ||
| PHYSICAL RESTRAINT | 501 | ||
| MOUTH-STABILIZING DEVICES | 501 | ||
| DRUGS | 501 | ||
| General Rules for Preoperative Medication | 502 | ||
| Oral Sedation | 502 | ||
| Chloral Hydrate | 503 | ||
| Hydroxyzine | 504 | ||
| Dosage | 504 | ||
| Promethazine | 504 | ||
| Initial Dosage | 504 | ||
| Midazolam | 505 | ||
| appendix Guidelines for the Use of Parenteral Sedation: University of Southern California School of Dentistry | 585 | ||
| PRELIMINARY EVALUATION | 585 | ||
| MONITORING | 585 | ||
| EMERGENCY DRUGS AND EQUIPMENT | 585 | ||
| TECHNIQUE | 586 | ||
| Day of Treatment | 586 | ||
| Suggested Protocol | 586 | ||
| MAXIMUM SEDATION/ANESTHESIA DRUG DOSAGES | 587 | ||
| Recovery | 587 | ||
| Discharge | 587 | ||
| Posttreatment Follow-Up | 587 | ||
| PRESEDATION INSTRUCTIONS | 587 | ||
| PARENTERAL SEDATION DISCHARGE CRITERIA | 587 | ||
| POSTSEDATION INSTRUCTIONS | 588 | ||
| Index | 589 | ||
| A | 589 | ||
| B | 591 | ||
| C | 592 | ||
| D | 593 | ||
| E | 594 | ||
| F | 595 | ||
| G | 596 | ||
| H | 596 | ||
| I | 597 | ||
| J | 599 | ||
| K | 599 | ||
| L | 599 | ||
| M | 600 | ||
| N | 601 | ||
| O | 602 | ||
| P | 602 | ||
| Q | 604 | ||
| R | 604 | ||
| S | 605 | ||
| T | 606 | ||
| U | 607 | ||
| V | 607 | ||
| W | 608 | ||
| Y | 608 | ||
| Z | 608 |