Pain

Intravenous Ketamine During Surgery

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A review articled carried out by the Cochrane Database of Systematic Reviews titled “Perioperative intravenous ketamine for acute postoperative pain in adults” written by Brinck et al. in 2018 (no. 12, art. no. CD012033) explored the efficacy and safety of intravenous ketamine in adults for pain management while having surgery under general anesthesia. The authors sought randomized, double-blind, controlled trials for inclusion in their analysis. The main outcomes were opioid consumption and pain intensity at 24 and 48 hours after surgery. The authors included 130 studies with 8,341 participants. Types of surgery included wisdom teeth extraction and among many others like lumbar fusion surgery, anterior cruciate ligament (ACL) repair, abdominal surgery, and elective caesarean section. The researchers found by looking at 65 of these studies that perioperative intravenous ketamine reduced postoperative opioid consumption over 24 hours by 8 mg morphine … Read more

FDA warns about dental problems from buprenorphine

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The U.S. Food and Drug Administration (FDA) has issued a safety concern regarding the medication buprenorphine which is a medication used to treat opioid use disorder, acute pain, and chronic pain. Buprenorphine is often used to reduce opioid withdrawal symptoms and the desire to use opioids, without causing the cycle of highs and lows associated with abusing opioid. The FDA warning issued on January 12, 2022, states that dental problems have occured when patients take medicines containing buprenorphine that are dissolved in the mouth. In the warning, the FDA said that the dental problems can include those of tooth decay, cavities, loss of teeth, and oral infections, and can occur in those without prior dental issues. As a result of this warning, the risk of dental problems occuring will be added to the prescribing information and the patient Medication Guide … Read more

FDA Issues Alert to Prevent Lidocaine 2 Percent Solution to Not be Used for Teething Pain for Children

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On June 26, 2014, the FDA issued an alert warning health professionals and providers that “…prescription oral viscous lidocaine 2% solution should not be used to treat infants and children with teething pain.” The FDA says that topical pain relievers and other medications that are rubbed on the gums are not useful for infants because they wash out of the mouth within minutes. Furthermore, when too much viscous lidocaine is given to children and is swallowed it can result in brain injury, seizures, heart problems, and even death. The FDA alert is located over at http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm402790.htm. In the background information it states “In 2014, FDA reviewed 22 case reports of serious adverse reactions, including deaths, in infants and young children 5 months to 3.5 years of age who were given oral viscous lidocaine 2 percent solution for the treatment of … Read more

How to Manage Pain Patients in Dental Practice

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An interesting article appears in J Can Dent Assoc 2012;78:c83 titled “Neuropathic Orofacial Pain Patients in Need of Dental Care,” written by Gary D. Klasser and Henry A. Gremillion. It was posted online on August 17, 2012, over at http://www.jcda.ca/article/c83. The abstract of the article states “Dental pain is a common complaint among the general population. Most pain is a result of traumatic injury or bacterial infection in pulpal and periapical tissues, and dental practitioners are successful at diagnosing these conditions and providing prompt relief. However, in some cases, patients continue to complain of persistent pain, which may be categorized as neuropathic. These people may avoid or neglect routine dental treatment or interventions to prevent precipitation, perpetuation or exacerbation of their pain condition, and practitioners may have to modify their procedures when managing the dental needs of this unique population.” … Read more

Western Dental injuries and pain

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I found some interesting pieces from ABC 7 KGO-TV San Francisco, CA. The articles and videos are about the second largest HMO in the state of California called Western Dental. Numerous people are profiled talking about things such as nerve damage following wisdom teeth removal, people’s healthy teeth being pulled out and being replaced with dentures,  a syringe injecting bleech into a girl’s sinus during a root canal, and putting too much filler into the root of a woman’s teeth during a root canal and causing severe pain. Of course Western Dental defends by not admitting wrongdoing but then lawsuits result and a settlement is reached in some cases. In other cases Western Dental has not paid for subsequent follow up treatment. To see the videos and read more of the articles visit these 2 links. http://abclocal.go.com/kgo/story?section=news/iteam&id=7583317 http://abclocal.go.com/kgo/story?section=news/iteam&id=7585208