The Conception Vessel (CV)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Clinical Relevance: Clinical conditions such as sialorrhea (excess salivation) or incompetence of the oral sphincter from facial nerve paralysis could cause “dribbling,” i.e., the accumulation of fluid at this point. CV 24 receives innervation from bilateral facial nerve branches supplying the orbicularis oris (i.e., the buccal branch of the facial nerve, CN VII) and the mentalis muscle (via the marginal mandibular branch of CN VII). This explains its value for facial nerve paralysis or injury. Buccal branches from the facial nerve join with filaments from the buccinator branch of the mandibular nerve (CN V3) and assist with mastication. The mandibular branch of the facial nerve communicates with the mental branch of the inferior alveolar nerve (CN V3), arguing for the relevance of CV 24 in dental analgesia. In dental anesthesia, inferior alveolar nerve block is employed in order to numb the lower lip, teeth, and gingivae of the mandible. As such, neuromodulation of the same nerve by means of acupuncture and related techniques may also induce analgesia.
Self-regulation skills training for adults, including relaxation
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
The second major component of hypnotic analgesia is perceptual alteration. Patients can be taught to imagine that the affected body part is numb. Temperature metaphors are often especially useful, which is not surprising given the fact that pain and temperature sensations are part of the same sensory system – the lateral spinothalamic tract. Thus, imagining that an affected body part is cooler or warmer using an image of dipping it in ice water or heating it in the sun can often help patients transform pain signals. This is especially useful for extremely hypnotizable individuals who can, for example, relive an experience of dental anesthesia and reproduce the drug-induced sensations of numbness in their cheek, which they can then transfer to the painful part of their body. They can also simply “switch off” perception of the pain with surprising effectiveness.28,29 Some patients prefer to imagine that the pain is a substance with dimensions that can be moved or can flow out of the body as if it were a viscous liquid. Others like to imagine that they can step outside their body to, for example, visit another room in the house. Less hypnotizable individuals often do better with distraction techniques that help them focus on competing sensations in another part of the body.
Preclinical Antidepressant-Like Effects of Terpenes, Polyphenolics, and Other Non-Flavonoid Phytochemicals
Scott Mendelson in Herbal Treatment of Major Depression, 2019
Eugenol is a highly aromatic member of the allylbenzene class of chemical compounds. It is found in the essential oils of a variety of herbs and spices, most notably clove, nutmeg, cinnamon, basil, and bay leaf. It is known to have a variety of pharmacological properties, including anti-inflammatory and antioxidant effects.70 It also produces the remarkable effect of dental anesthesia.71
Locally advanced sinonasal adenoid cystic carcinomas: endoscopic endonasal surgery-centered comprehensive treatment provides benefits
Published in Acta Oto-Laryngologica, 2023
Jin Wang, Meng Zhang, Wenqi Yi, Liang Li, Liangyu Li, Chuan Pang, Lei Chen
SNACCs may spread to the PPF and ITF via direct and perineural invasion. PPF and ITF are two complex paramedial regions of the skull base that contain many critical neurovascular and osteomuscular structures. They communicate via the pterygomaxillary fissure and are connected to the orbit via the inferior orbital fissure. Although these anatomically deep sites make the surgical resections challenging, EES has an advantage in treating tumors invading PPF and ITF lesions because the anterior boundaries of these sites are comprised of the posterolateral wall of the maxillary sinus, which can be effectively accessed via endoscopic anteromedial maxillectomy while causing minimal tissue trauma [9]. Besides, it has been reported that endoscopic ipsilateral endonasal transmaxillary, contralateral endonasal transseptal transmaxillary, and CLA did not differ significantly in the exposure area [13]. However, we consider the CLA an appropriate approach for patients exhibiting maxillary and lateral skull base involvement, although it could prolong the operative duration and increase the risk of potential operative complications. We intermittently sutured the gingival incision and compressed the upper lip with a four-head band to prevent hematoma at the end of the surgery. The patients included in this study did not experience significant complications such as alveolar processes and dental anesthesia when treated via this approach.
An Extension Study Using Hypnotic Suggestion as an Adjunct to Intravenous Sedation
Published in American Journal of Clinical Hypnosis, 2018
The use of propofol, fentanyl, and midazolam are perhaps the most common medications used for outpatient dental anesthesia (Abeles, Sequeira, Swenson, Bisaccia, & Scarborough, 1999; Dyas, 2001; Leitch et al., 2004; Mackey, 2010). Adding hypnotic suggestion prior to and during the beginning phases of anesthesia administration has been shown to increase post-operative healing and decrease recovery time (Dyas, 2001; Enqvist & Fischer, 1997; Mauer, Burnett, Ouellette, Ironson, & Dandes, 1999). A randomized, controlled study by Ginandes et al. (2003), showed post-operative healing to be greatest in the control group (p < 0.001) as compared to two other nonhypnotic groups.
Lidocaine-loaded dissolving microneedle for safe local anesthesia on oral mucosa for dental procedure
Published in Expert Opinion on Drug Delivery, 2023
Hyunkyu Lee, Hye Su Min, Mingyu Jang, Geonwoo Kang, Seongdae Gong, Chisong Lee, Young Woo Song, Ui-Won Jung, Somin Lee, Hyeon Yeol Ryu, Huisuk Yang, Hyungil Jung
The previous insertion depth evaluation confirmed that the oral Li-DMNs did not physically reach or damage the nerve layer, and the in vitro local drug delivery evaluation demonstrated the efficient local drug delivery capability of oral Li-DMNs. Thereafter, to evaluate whether oral Li-DMNs only act as local agents, not systemic agents, in vivo drug delivery and pharmacokinetic analyses were performed. This is important because when undergoing dental anesthesia for dental procedures, the local anesthetic drug is desired to work in the local area, not flow throughout the body systemically, and not be delivered to areas that do not require anesthesia. Therefore, we evaluated the amount of lidocaine in blood plasma after sublingual injection, Xogel, and oral Li-DMN patches in the oral mucosal area. Each group consisted of 7 New Zealand White Rabbits and was administered a 0.5 mL sublingual injection (10 mg lidocaine), 0.2 g of Xogel (10 mg lidocaine), and oral Li-DMN 1 patch (2 mg lidocaine) (Figure 5(a)). Blood was collected before and after administration, and the plasma lidocaine concentration was evaluated by LC-MS/MS (Figure 5(b)). The pharmacokinetic parameters are summarized in Table 1. The Tmax in the sublingual injection group was 3.6 ± 0.4 min, whereas the Xogel group was 10.7 ± 3.4 min and the oral Li-DMN group was 14.3 ± 4.1 min after administration respectively. The Cmax of sublingual injection was 2827.3 ± 363.9 ng/mL, Xogel was 522.6 ± 59.1 ng/mL, and oral Li-DMN was 23.4 ± 3.4 ng/mL. Compared to injection, the Xogel and DMN took longer to reach the Cmax because the ointment needed to overcome the skin barrier to diffuse and the DMN required time to dissolve the polymer to release lidocaine. The BA% of Xogel and oral Li-DMNs were calculated by comparing the area under the curve (AUC) to the injection group and were lower 28.90% and 11.39%, respectively. This means that the amount of ointment formulation applied to the local area for a significant anesthetic effect also acts systemically and is detected in the plasma. The reason why the ointment Xogel with lower intradermal permeability than the oral Li-DMN had higher BA% is assumed to be that even though the application area was adjusted similar to the patch, it melted by body temperature and flowed into a larger area, resulting in contact with more capillaries. In contrast, the BA% of oral Li-DMNs demonstrated that approximately 90% of lidocaine loaded on the DMN acted locally. In addition, because this BA% calculation contained normalization of the dose, the BA% without dose normalization value was lowered to 2.28%, indicating that the systemically delivered amount was insignificant. Therefore, oral Li-DMNs can obtain a local anesthesia effect at a relatively lower dose, and the potential side effects due to the systemic delivery of lidocaine can be prevented.
Related Knowledge Centers
- Anesthesia
- Articaine
- Dentistry
- Mepivacaine
- Sedation
- Local Anesthetic
- Lidocaine
- Half-Life
- Bupivacaine
- Prilocaine