• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.321-327
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• 2021

Sevoflurane is familiar to anesthesiologists as an inhaled anesthetic to induce and maintain anesthesia; however, it has not been widely used for sedation. Recently, the use of sevoflurane for inhalational sedation has been increasing. Moreover, in Korea, the use of sevoflurane for conscious or deep sedation in dental care for children and the disabled is increasing, primarily by dental anesthesiologists. In this article, we reviewed a sedation method using sevoflurane.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.169-175
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• 2018

Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

• Journal of Veterinary Science
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• v.21 no.1
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• pp.8.1-8.11
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• 2020

This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.11-15
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• 2015

Background: Emergency room doctors run into difficulties in treating injured pediatric patients because usually they fell into panic after trauma. In these situation, deep sedation with sevoflurane is fully recommendable method. The conventional way can interrupt common dental treatment procedure. Methods: In the present study, nasal cannula was used for sevoflurane deep sedation in 11 dental emergency treatment. Age ranged from 0 to 3 years old (average of 1.8 years). Results: Treatment duration was from 10 to 35 minutes (average of 16.7 minutes). Average duration of sedation was 25.5 minutes ranging from 15 to 45 minutes. Conclusions: It has advantages to use nasal cannula for sevoflurane deep sedation rather than conventional intubation; saves time and secures good operation field.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.1-8
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• 2018

In recent years, with continuous research efforts targeted at studying the effects of pre- and after-treatment of inhaled anesthetics, significant progress has been made regarding the common clinical use of low concentrations of inhaled sevoflurane and its effect on induced central ischemia tolerance by pre- and post-treatment. In this study, we collected, analyzed, classified, and summarized recent literature regarding the effect of sevoflurane on central ischemia tolerance and its related mechanisms. In addition, we provide a theoretical basis for the clinical application of sevoflurane to protect the central nervous system and other important organs against ischemic injury.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.125-129
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• 2012

Dental treatment under general anesthesia is considered for behavioral control of disabled patients who have severe anxiety or involuntary movement. However, in case of simple treatment, inhalation or intravenous sedation, which has earlier onset and recovery, is preferred. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less complications. In this case report, two patients with mental retardation required simple dental treatment. Deep sedation with inhaled sevoflurane were successfully employed and patients were discharged without any complications.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.283-288
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• 2016

Background: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results: We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions: Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.1
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• pp.18-26
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• 2014

Deep sedation is considered for the dental treatment of pediatric or disabled patients who have severe anxiety or involuntary movement. Deep sedation using sevoflurane inhalation in emergency dental practice, therefore, is also preferred for fast induction and recovery. This survey consists of 121 people with pediatric or disabled patients who underwent dental treatment under deep sedation using sevoflurane inhalation from January 2013 to October 2013. Patients who were scheduled for deep sedation were classified into a non-emergency sevoflurane sedation group, whereas patients who underwent emergency sedation due to trauma and patients with disabled characteristics itself were classified into an emergency sevoflurane sedation group. Of 121 patients studied, 95 patients received dental care under non-emergency sedation, 26 patients received dental care under emergency sevoflurane sedation. The two groups were analyzed according to: gender; age; primary reason for sedation; duration of sedation; treatment time; induction methods; treatment information; and departments. Non-emergency sevoflurane sedation in pediatric or disabled patients was safe and effective for controlling the behavior. Emergency sevoflurane sedation was a useful method for younger pediatric patients with traumatic injury who need simple, short time emergency treatment. Deep sedation using sevoflurane inhalation not only will reduce the use of general anesthesia gradually but also will be a useful method to emergency treatment for pediatric or disabled patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.1
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• pp.28-39
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• 2013

General anesthesia or sedation is an essential for a successful dental treatment for the disabled. The aim of this study is to assess the patients who had dental management under general anesthesia or sedation at Chungnam dental clinic for the disabled, who received dental treatment under general anesthesia, sevoflurane sedation and intravenous sedation from January, 2011 to September 2012. Of the 426 patients studied, 389 patients received dental care under general anesthesia, 20 patients received dental care under sevoflurane sedation and 17 patients received dental care under intravenous sedation. The Rate of general anesthesia was higher than that of sevoflurane sedation, intravenous sedation. Sevoflurane sedation is a useful method for short time treatment such as traumatic pediatric patients. Intravenous sedation is an option for patients who had anxiety and fear such as dentally disabled patients. Sevoflurane or intravenous sedation not only gradually reduces the use of general anesthesia but also useful methods themselves for the dentally disabled.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.2 s.7
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• pp.90-95
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• 2004

Background: Sevoflurane, a rotatively new inhalational anesthetic. has non-pungent odor and is less reluctant to pediatric patients. The purpose of this study is to examine the feasibility of sevoflurane in inhalational sedation instead of the nitrous oxide for short and simple dental treatments in pediatric patients. Patients and Methods: Fifteen healthy children, whose dental treatment was abandoned due to their little or no cooperation, were selected with their caregivers' written permission. Deep sedation was induced and maintained with oxygen and 1-5% sevoflufane via specially designed nasal mask. Blood pressure, heart rate, oxygen saturation, and electrocardiogram were monitored at 3-nin interval. A dental anesthesiologist, who was independent of dental treatments, was wholly responsible for the sedation procedure. Post-sedation complications and operator's and caregiver's acceptability of this type of inhalational sedation were also investigated. Results: The systolic and diastolic blood pressure, heart rate, and oxygen saturation was significantly depressed during the deep sedation using sevoflurane (P < 0.05). No severe post-sedation complications were found, however, bradycardia was reported in 3 patients. Almost all the operators and caregivers answered that they would adapt this sedation procedure again if possible. Conclusion: In this study, inhalational deep sedation using sevoflurane for dental treatments was found to be very useful. Furthermore, the application of sevoflurane to conscious sedation for pediatric and adult dental patients should be added.