title: The use of intravenous anesthesia and sedation techniques in oral and maxillofacial surgery.
abstract: In 1943, Olson described a method for administration of thiopental for anesthesia during oral surgical procedures (J Oral Surg 1:197, 1943). Patients were instructed not to eat for 4 hours before the scheduled surgery and to bring an escort. Premedication with atropine or morphine was not routinely used. Following venipuncture, a 2- to 3-mL test dose of thiopental (Pentothal, Abbott Laboratories, North Chicago, IL) was injected. After a pause of 15 to 20 seconds, 6 mL was injected slowly over 40 to 50 seconds. Additional medication was titrated slowly in intermittent doses to maintain an adequate level of anesthesia. The mouth was packed and kept meticulously dry to prevent coughing or laryngospasm. The patient's color and respiration were continually observed and the airway maintained. Initially, a 5% solution was used by Olson; later it was changed to 2%. Use of this concentration made it easier to titrate to "upper levels" of anesthesia because profound depth was not required. Also, adverse effects (eg, coughing, laryngospasm) occurred less frequently, and there was less venous irritation with the 2% solution. Based on his experience of 8,203 cases, Olson claimed that most patients tolerated the anesthetic well, but he recommended avoiding this technique for children younger than 12 years of age.
authors.affiliation: College of Dentistry, University of Kentucky, Lexington.
authors.forename: J B
authors.initials: JB
authors.lastname: Dembo
mesh_terms: D000766:Anesthesia, Dental / Q000266:history*; D000771:Anesthesia, Intravenous / Q000266:history*; D000772:Anesthesia, Local / Q000266:history; D014151:Anti-Anxiety Agents / Q000266:history; D001569:Benzodiazepines; D016292:Procedural Sedation / Q000266:history*; D049673:History, 20th Century; D008012:Lidocaine / Q000266:history; D010092:Oximetry / Q000266:history; D014481:United States
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D008012:Lidocaine