start-ver=1.4
cd-journal=joma
no-vol=37
cd-vols=
no-issue=4
article-no=
start-page=e13265
end-page=
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2024
dt-pub=20240611
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Optimising the oral midazolam dose for premedication in people with intellectual disabilities and/or autism spectrum disorder
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Background: In people with intellectual disabilities and/or autism spectrum disorder, oral midazolam (OM) is very effective as premedication for facilitating medical treatment. In this retrospective study, we investigated the optimal dosage of OM for premedication.
Methods: Patients with intellectual disability and/or autism spectrum disorder who were given OM as a premedication were selected from anaesthesia records. The primary outcome variable was the dose of OM (mg/kg) required to produce an adequate sedation.
Results: The mean OM dose required was 0.32 ± 0.10 mg/kg. The required OM dose decreased significantly as age and weight increased, and age and weight were also shown to be significantly associated with the dose of OM in the multivariate linear regression analysis.
Conclusion: The dosage of OM to achieve adequate sedation should decrease as the patient ages. Furthermore, adequate sedation can be achieved with even lower doses of OM in obese people.
en-copyright=
kn-copyright=
en-aut-name=HiguchiHitoshi
en-aut-sei=Higuchi
en-aut-mei=Hitoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=MiyakeKota
en-aut-sei=Miyake
en-aut-mei=Kota
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MiyakeSaki
en-aut-sei=Miyake
en-aut-mei=Saki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=FujimotoMaki
en-aut-sei=Fujimoto
en-aut-mei=Maki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=NishiokaYukiko
en-aut-sei=Nishioka
en-aut-mei=Yukiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=MaedaShigeru
en-aut-sei=Maeda
en-aut-mei=Shigeru
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=MiyawakiTakuya
en-aut-sei=Miyawaki
en-aut-mei=Takuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
affil-num=1
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=2
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=3
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=4
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=5
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=6
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=7
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
en-keyword=autism spectrum disorder
kn-keyword=autism spectrum disorder
en-keyword=intellectual disabilities
kn-keyword=intellectual disabilities
en-keyword=oral midazolam
kn-keyword=oral midazolam
en-keyword=premedication
kn-keyword=premedication
en-keyword=sedation
kn-keyword=sedation
END
start-ver=1.4
cd-journal=joma
no-vol=79
cd-vols=
no-issue=9
article-no=
start-page=1842
end-page=1850
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2021
dt-pub=20219
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Comparison of Oxygen Saturation Between Nasal High-Flow Oxygen and Conventional Nasal Cannula in Obese Patients Undergoing Dental Procedures With Deep Sedation: A Randomized Crossover Trial
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Purpose:
In anesthetic management, it is widely accepted that obese patients are more likely to suffer airway obstructions and reductions in arterial oxygen saturation (SpO2). Therefore, it is important to take special measures to prevent oxygen desaturation during the deep sedation of obese patients. This clinical study examined whether the use of nasal high-flow systems (NHFS) keep higher SpO2 and reduced hypoxemia than conventional nasal cannula during the deep sedation of obese patients with intellectual disabilities for dental treatment.
Materials and Methods:
Eighteen obese patients (body mass index: >25) with intellectual disabilities who underwent dental sedation were enrolled. In each case, sedation was induced using propofol and
maintained at a bispectral index of 50–70. The subjects were randomly assigned to the control oxygen administration (5 L/min via a nasal cannula) or NHFS (40% O2, 40 L/min, 37°C) arm in alternate shifts as a crossover trial. The primary endpoint was the minimum SpO2 value, and the incidence of hypoxemia during dental treatment was also evaluated.
Results:
The mean minimum SpO2 value was significantly higher in the NHFS arm than in the
4
control arm (95.8 ± 2.1 % vs. 93.6 ± 4.1 %, p=0.0052, 95% confidence interval: 0.608–3.947). Hypoxemic episodes (SpO2: ≤94%) occurred 3 cases (16.7%) in the NHFS arm and 11 case (61.1%) in the control arm (P=0.0076, odds ratio: 0.127, 95% confidence interval 0.0324 to 0.630).
Conclusion:
NHFS resulted in higher minimum SpO2 and reduced hypoxemia than nasal cannula in obese patients during deep sedation for dental treatment
en-copyright=
kn-copyright=
en-aut-name=HiguchiHitoshi
en-aut-sei=Higuchi
en-aut-mei=Hitoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=Takaya-IshidaKumiko
en-aut-sei=Takaya-Ishida
en-aut-mei=Kumiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MiyakeSaki
en-aut-sei=Miyake
en-aut-mei=Saki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=FujimotoMaki
en-aut-sei=Fujimoto
en-aut-mei=Maki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=NishiokaYukiko
en-aut-sei=Nishioka
en-aut-mei=Yukiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=MaedaShigeru
en-aut-sei=Maeda
en-aut-mei=Shigeru
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=MiyawakiTakuya
en-aut-sei=Miyawaki
en-aut-mei=Takuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
affil-num=1
en-affil=Department of Dental Anesthesiology, Okayama University Hospita
kn-affil=
affil-num=2
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=3
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=4
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=5
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=6
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=7
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
END
start-ver=1.4
cd-journal=joma
no-vol=10
cd-vols=
no-issue=1
article-no=
start-page=1578
end-page=
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=20200131
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Multi-drug therapy for epilepsy influenced bispectral index after a bolus propofol administration without affecting propofol's pharmacokinetics: a prospective cohort study
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Some previous studies have indicated that valproate (VPA) might change the pharmacokinetics and enhance the effects of propofol. We evaluated whether clinical VPA therapy affected the propofol blood level, the protein-unbound free propofol level, and/or the anesthetic effects of propofol in the clinical setting. The subjects were divided into the control group (not medicated with antiepileptics), the mono-VPA group (medicated with VPA alone), and the poly-VPA group (medicated with VPA, other antiepileptics, and/or psychoactive drugs). General anesthesia was induced via the administration of a single bolus of propofol and a remifentanil infusion, and when the bispectral index (BIS) exceeded 60 sevoflurane was started. There were no significant differences in the total blood propofol level at 5, 10, 15, and 20 min or the protein-unbound free propofol level at 5 min after the intravenous administration of propofol between the 3 groups. However, the minimum BIS was significantly lower and the time until the BIS exceeded 60 was significantly longer in the poly-VPA group. In the multivariate regression analysis, belonging to the poly-VPA group was found to be independently associated with the minimum BIS value and the time until the BIS exceeded 60. Clinical VPA therapy did not influence the pharmacokinetics of propofol. However, multi-drug therapy involving VPA might enhance the anesthetic effects of propofol.
en-copyright=
kn-copyright=
en-aut-name=KodamaMatsuri
en-aut-sei=Kodama
en-aut-mei=Matsuri
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=HiguchiHitoshi
en-aut-sei=Higuchi
en-aut-mei=Hitoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=Ishii-MaruhamaMinako
en-aut-sei=Ishii-Maruhama
en-aut-mei=Minako
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=NakanoMai
en-aut-sei=Nakano
en-aut-mei=Mai
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=Honda-WakasugiYuka
en-aut-sei=Honda-Wakasugi
en-aut-mei=Yuka
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=MaedaShigeru
en-aut-sei=Maeda
en-aut-mei=Shigeru
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=MiyawakiTakuya
en-aut-sei=Miyawaki
en-aut-mei=Takuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
affil-num=1
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=2
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=3
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=4
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=5
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=6
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=7
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
en-keyword=Drug regulation
kn-keyword=Drug regulation
en-keyword=Phase IV trials
kn-keyword=Phase IV trials
END
start-ver=1.4
cd-journal=joma
no-vol=98
cd-vols=
no-issue=
article-no=
start-page=38
end-page=46
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2019
dt-pub=20190228
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Hyperoxia reduces salivary secretion by inducing oxidative stress in mice
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=OBJECTIVE:
The aim of this study was to determine the effects of prolonged hyperoxia on salivary glands and salivary secretion in mice.
DESIGN:
Male C57BL/6 J mice were kept in a 75% oxygen chamber (hyperoxia group) or a 21% oxygen chamber for 5 days. We measured the secretion volume, protein concentration, and amylase activity of saliva after the injection of pilocarpine. In addition, we evaluated the histological changes induced in the submandibular glands using hematoxylin and eosin and Alcian blue staining and assessed apoptotic changes using the TdT-mediated dUTP nick end labeling (TUNEL) assay. We also compared the submandibular gland expression levels of heme oxygenase-1 (HO-1), superoxide dismutase (SOD)-1, and SOD-2 using the real-time polymerase chain reaction.
RESULTS:
In the hyperoxia group, salivary secretion was significantly inhibited at 5 and 10 min after the injection of pilocarpine, and the total salivary secretion volume was significantly decreased. The salivary protein concentration and amylase activity were also significantly higher in the hyperoxia group. In the histological examinations, enlargement of the mucous acini and the accumulation of mucins were observed in the submandibular region in the hyperoxia group, and the number of TUNEL-positive cells was also significantly increased in the hyperoxia group. Moreover, the expression levels of HO-1, SOD-1, and SOD-2 were significantly higher in the hyperoxia group.
CONCLUSION:
Our results suggest that hyperoxia reduces salivary secretion, and oxidative stress reactions might be involved in this.
en-copyright=
kn-copyright=
en-aut-name=TajiriAyako
en-aut-sei=Tajiri
en-aut-mei=Ayako
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=HiguchiHitoshi
en-aut-sei=Higuchi
en-aut-mei=Hitoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MiyawakiTakuya
en-aut-sei=Miyawaki
en-aut-mei=Takuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
affil-num=1
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=2
en-affil=Department of Dental Anesthesiology, Okayama University Hospital
kn-affil=
affil-num=3
en-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
en-keyword=Hyperoxia
kn-keyword=Hyperoxia
en-keyword=Hyposalivation
kn-keyword=Hyposalivation
en-keyword=Oxidative stress
kn-keyword=Oxidative stress
en-keyword=Saliva
kn-keyword=Saliva
END
start-ver=1.4
cd-journal=joma
no-vol=68
cd-vols=
no-issue=5
article-no=
start-page=269
end-page=275
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2014
dt-pub=201410
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Chronic Orofacial Pain in Dental Patients: Retrospective Investigation over 12 years
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Orofacial pain is often difficult to diagnose and treat. However, there have been few reports on the clinical observation of dental patients with orofacial pain. We retrospectively investigated the characteristics of 221 dental patients who had suffered from persistent orofacial pain. Data were collected from the outpatient medical records in our clinic over the past 12 years. More than half of the patients (53.8%) had suffered with pain for more than 6 months from pain onset until the first visit to our clinic. The main diagnoses were neuropathic pain (30.3%), myofascial pain (23.5%), psychogenic pain (20.4%), odontogenic toothache (17.2%), and others (7.7%) such as temporomandibular disorders and glossitis. The treatments included pharmacotherapy, splint therapy, and others such as nerve block, dental treatment, physiotherapy, and/or psychotherapy. Excluding the patients (52 of 221 initially enrolled patients) with unknown responses to treatment, 65.7% showed remission or a significant improvement in pain in response to treatment. Although only a small group of patients had odontogenic toothache, the rate of improvement was highest for this disorder. In conclusion, early consultation with a dentist is useful to prevent chronicity of odontogenic pain and to make a differential diagnosis in patients with orofacial pain.
en-copyright=
kn-copyright=
en-aut-name=TomoyasuYumiko
en-aut-sei=Tomoyasu
en-aut-mei=Yumiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=HiguchiHitoshi
en-aut-sei=Higuchi
en-aut-mei=Hitoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MoriMegumi
en-aut-sei=Mori
en-aut-mei=Megumi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=TakayaKumiko
en-aut-sei=Takaya
en-aut-mei=Kumiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=HondaYuka
en-aut-sei=Honda
en-aut-mei=Yuka
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=YamaneAyaka
en-aut-sei=Yamane
en-aut-mei=Ayaka
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=YabukiAkiko
en-aut-sei=Yabuki
en-aut-mei=Akiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
en-aut-name=HayashiTomoko
en-aut-sei=Hayashi
en-aut-mei=Tomoko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=
en-aut-name=Ishii-MaruhamaMinako
en-aut-sei=Ishii-Maruhama
en-aut-mei=Minako
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=
en-aut-name=JinzenjiAyako
en-aut-sei=Jinzenji
en-aut-mei=Ayako
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=10
ORCID=
en-aut-name=MaedaShigeru
en-aut-sei=Maeda
en-aut-mei=Shigeru
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=11
ORCID=
en-aut-name=KohjitaniAtsushi
en-aut-sei=Kohjitani
en-aut-mei=Atsushi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=12
ORCID=
en-aut-name=ShimadaMasahiko
en-aut-sei=Shimada
en-aut-mei=Masahiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=13
ORCID=
en-aut-name=MiyawakiTakuya
en-aut-sei=Miyawaki
en-aut-mei=Takuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=14
ORCID=
affil-num=1
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=2
en-affil=
kn-affil=Department of Dental Anesthesiology, Okayama University Hospital
affil-num=3
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=4
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=5
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=6
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=7
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=8
en-affil=
kn-affil=Department of Dental Anesthesiology, Okayama University Hospital
affil-num=9
en-affil=
kn-affil=Department of Dental Anesthesiology, Okayama University Hospital
affil-num=10
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=11
en-affil=
kn-affil=Department of Dental Anesthesiology, Okayama University Hospital
affil-num=12
en-affil=
kn-affil=Department of Dental Anesthesiology, Kagoshima University Graduate School of Medical and Dental Sciences
affil-num=13
en-affil=
kn-affil=Orofacial Pain Management, Department of Oral Restitution Graduate School, Tokyo Medical and Dental University
affil-num=14
en-affil=
kn-affil=Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
en-keyword=dental patients
kn-keyword=dental patients
en-keyword=pain clinic
kn-keyword=pain clinic
en-keyword=orofacial pain
kn-keyword=orofacial pain
en-keyword=dental anesthesiology
kn-keyword=dental anesthesiology
en-keyword=clinical observation
kn-keyword=clinical observation
END