Enrique Hernández-Cortez

By Enrique Hernández-Cortez, Cecilia G. Sandoval Larios and Juan Carlos Flores-Carrillo

Pain has been a faithful companion of human beings and is a result of most of the dental procedures and illness; therefore a good control of dental pain is inevitable and feasible. The administration of local anesthetics has come to be the standard of care of dental profession. All local anesthetics are effective and high safety margin in all patients including childhood. The choice of using a local anesthetic depends on time of the surgical procedure, patient’s medical history, and the interaction between local anesthetics and patient usual medications. The use of vasoconstrictors is priority in surgical/dental bleeding, but it must be used with caution in patients with cardiovascular disease to avoid a dental catastrophe. Dentists should be experts in dental-anesthetic techniques and in pharmacology of local anesthetics, since they are the most used medications in odontology. The accidental injection or a high absorption of local anesthetics in blood results in systemic toxicity. In such situation sedation, stunning, diplopia, sensory disturbances, disorientation, muscles spasm, respiratory depression, seizures, or cardiac arrest may be present; the dentist must immediately recognize this clinical complication to stablish an early treatment.

Part of the book: Topics in Local Anesthetics

By Enrique Hernández-Cortez, Yolanda M. Martínez-Barragán and Karen L. Iñiguez-Lopéz

The survival of preterm newborn patients (PNB) depends in a great extent on the anesthetic technique used. Spinal anesthesia (SA) is considered the best-tolerated regional anesthetic method for highly unstable newborn infants (NB) with high risk of complications during the perioperative period. SA has been recommended for children at high risk for postoperative apnea due to general anesthetics or prematurity. Bronchopulmonary dysplasia (BPD) in the newborn is a disease that accompanies the patient to the operating room with a high incidence of mortality. SA in emergency surgery is a well-tolerated anesthetic procedure with proven effectiveness, with less hemodynamic and respiratory repercussions. At the same time, it produces greater protection against surgical stress in the NB weakened by the premature condition. Hemodynamic stability remains constant even in the newborn with heart disease.

Part of the book: Topics in Regional Anesthesia