The addition of dexmedetomidine to propofol administered by CLADS was associated with a consistent depth of anesthesia along with a significant decrease in propofol requirements, albeit with an incidence of hemodynamic depression and early postoperative sedation.

Objectives: To provide comprehensive information regarding the implications of the coronavirus disease 2019 (COVID-19), mode of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and its effects on orthodontic care during the pandemic and post-pandemic outbreak of the disease, based on currently available literature and information. Materials and Methods: A comprehensive research for studies that focused on the COVID-19 pandemic and orthodontic care up to August 18, 2020, with no language restriction. The databases included PubMed, MEDLINE, Scopus, Google Scholar, and COVID-19 Open Research Dataset (CORD-19) 2020. The research was focused on presenting symptoms, disease transmission, infection control, orthodontic care, and financial implications affecting the delivery of orthodontic treatment. The research also included reports from major health policy regulatory bodies such as World Health Organization, Centers for Disease Control and Prevention, European Centre for Disease Control and Prevention, and major international dental and orthodontic societies and associations. The peer-reviewed publications and guidelines from the health regulatory authorities were given priority. Results: The latest information on the SARS-CoV-2 virus effects and orthodontic implications were arranged sequentially. The SARS-CoV-2 virus mode of transmission and its prevention were emphasized to keep the orthodontic and dental operatory safe for continuing practice. Conclusion: The COVID-19 outbreak has changed the way orthodontics is practiced. Strict infection control, near-zero aerosol production, and minimal touch dentistry are the keys to prevent contamination of orthodontic operatory. During the pandemic, only emergency orthodontic procedures could be extended to the orthodontic patient while adhering to all the regulatory guidelines. Fortunately, to date, there is no reported case of cross-transmission of the SARS-CoV-2 virus at the dental setup.

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Background and Aims: Fentanyl can facilitate controlled intraoperative hypotension by its sympatholytic effect in patients undergoing functional endoscopic sinus surgery (FESS). We investigated the effects of different doses of pre-induction fentanyl on controlled hypotension profile during FESS. Methods: This prospective, randomised study included 120 patients randomly allocated to three groups (40 each) based on administration of pre-induction fentanyl; 2 μg/kg group, 3 μg/kg group and 4 μg/kg group. The primary objective was to assess effect on intraoperative heart rate and mean arterial pressure. Use of additional hypotensive agents, surgical field condition and surgeon satisfaction were also analysed. Results: Controlled hypotension was achieved adequately in all participants. Patients belonging to fentanyl 4 μg/kg group had significantly lower heart rate for the duration of controlled hypotension intraoperatively versus fentanyl 2 μg/kg group ( P < 0.05). Trinitroglycerin [TNG] and metoprolol were administered to 3 [7.5%] and 9 [22.5%] patients respectively in the fentanyl 3 μg/kg group, and to 3 [7.5%] and 5 [12.5%] patients respectively in the 4 μg/kg group, compared to 14 [35%] and 20 [50%] in the fentanyl 2 μg/kg group, respectively (TNG, P < 0.001). Surgical field conditions and surgeon satisfaction scores were significantly superior in fentanyl 3 μg/kg and 4 μg/kg groups than in fentanyl 2 μg/kg group. Conclusion: Pre-induction fentanyl 3 μg/kg and 4 μg/kg group showed superior controlled hypotension facilitation than 2 μg/kg fentanyl during FESS in terms of measurable haemodynamic endpoints and favourable operative conditions, surgeon's satisfaction and sparing of additional hypotensive agents.