Anesthesia & Pain Management Insider: Tramadol-dexketoprofen combo effective for 3rd-molar extraction

Dear Anesthesia & Pain Management Insider,

A combination of the opioid class drug tramadol and nonsteroidal anti-inflammatory drug (NSAID) dexketoprofen proved more effective than ibuprofen alone for managing pain after third-molar extraction. This opioid-NSAID combination is sold outside the U.S. and reportedly has a somewhat different effect than other types of similar medications. Read more in this edition's Insider Exclusive.

Also new in the Anesthesia & Pain Management Community, some clinicians are urging dentists to use a new technology that may provide more accurate dental sedation after a 5-year-old boy didn't wake up for an hour following intravenous sedation. The device, an electroencephalographic density spectral array, provides real-time information about a person's sedated state.

It's a scenario you're probably familiar with: You've given a patient local anesthesia only to hear, "I still feel that." Achieving complete anesthesia of a patient's tooth that needs treatment when everything else in the mouth seems numb is the most common difficulty clinicians face. A presenter at the Chicago Dental Society Midwinter Meeting offered tips to help your patients get fully numb.

Can kids breathe away their dental fear? Children with dental anxiety may experience improved mood and reduced pain by using a simple breathing technique. Using diaphragmatic breathing, which occurs when one consciously engages the diaphragm to take deeper breaths, could decrease visit times for children with dental anxiety.

Finally, taking a complete and accurate medical history is as easy as asking three simple questions. In the latest Dental Dose video, Tom Viola, RPh, shares the questions he asks patients and why those questions work.

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