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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Lu, D. P. Lu, G. P. Hersh, E. V. |
| Description | Country affiliation: United States Author Affiliation: Lu DP ( Department of Oral Medicine, University of Pennsylvania, Allentown, USA.) |
| Abstract | The successful use of conscious sedation in patients physically dependent on centrally acting drugs is problematic for the dental anesthesiologist because of the concomitant development of tolerance to standard sedative agents. Dosage requirements necessary to adequately sedate these patients are often higher than recommended and carry an increased risk of drug overdose. The following report summarizes our experience with 18 drug-dependent patients in whom hypnosis was employed in conjunction with a standard sedation regimen. Attempts to complete various dental procedures while employing sedation alone on these patients had previously failed. All patients exhibited highly fearful or phobic behavior toward dental treatment as assessed by the Corah Dental Anxiety Scale. If an intravenous sedative regimen (midazolam or diazepam plus methohexital) was employed, hypnotic induction preceded the administration of the sedative drugs. If an intramuscular sedative regimen was employed (meperidine plus promethazine), the hypnotic induction took place after drug administration. With the combined hypno-sedative approach, treatment outcomes were judged to be good or excellent in 11 of 18 patients. Interestingly, in five of seven patients for whom the treatment outcome was rated poor or fair, the possibility of tolerance or cross-tolerance existed between a drug being abused and the sedative regimen. In contrast, this possibility existed in only 1 of 11 patients with good or excellent treatment outcomes. We conclude that hypnosis can augment the effects of sedation in this patient population. However, it is also important to choose a sedative regimen where tolerance is unlikely to exist. |
| File Format | HTM / HTML |
| ISSN | 00033006 |
| e-ISSN | 18787177 |
| Journal | Anesthesia Progress |
| Issue Number | 3-4 |
| Volume Number | 42 |
| Language | English |
| Publisher | American Dental Society of Anesthesiology |
| Publisher Date | 1995-01-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline Anesthesiology Conscious Sedation Dental Care For Chronically Ill Hypnosis, Dental Substance-related Disorders Adolescent Dental Anxiety Prevention & Control Complications |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine |
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