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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Psychogenic coma after dental surgery under general anaesthesia.

C W Yong1, W H Ng1, S H Yap2

  • 1Discipline of Oral and Maxillofacial Surgery, Ng Teng Fong General Hospital (National University Health System), Singapore.

International Journal of Oral and Maxillofacial Surgery
|July 19, 2018
PubMed
Summary

Psychogenic coma, a rare complication of general anesthesia, can cause delayed awakening. Early diagnosis and counseling for at-risk patients are crucial for effective management in oral surgery.

Keywords:
conversion disorderdental anxietygeneral anaesthesiapsychological stressunconsciousness

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Area of Science:

  • Anesthesiology
  • Psychiatry
  • Oral and Maxillofacial Surgery

Background:

  • Delayed awakening after general anesthesia is uncommon.
  • Psychogenic coma is a rare cause of prolonged unconsciousness.
  • Oral and maxillofacial surgeons may encounter this phenomenon.

Observation:

  • A case of psychogenic coma occurred after general anesthesia for dental extractions.
  • The patient experienced delayed awakening.
  • This highlights a rare but significant complication.

Findings:

  • Psychogenic coma can manifest following routine procedures like dental extractions.
  • Conversion disorder is a potential underlying condition.
  • Recognition is key for appropriate patient care.

Implications:

  • Patients with a history of conversion disorder require careful pre-operative counseling.
  • Awareness among oral and maxillofacial surgeons is essential for prompt diagnosis.
  • Early identification improves patient outcomes and management strategies.