DOI QR코드

DOI QR Code

Dexmedetomidine intravenous sedation using a patient-controlled sedation infusion pump: a case report

  • Chi, Seong In (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Kim, Hyun Jeong (Department of Dental Anesthesiology, School of Dentistry, Seoul National University) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology, School of Dentistry, Seoul National University)
  • Received : 2016.03.05
  • Accepted : 2016.03.31
  • Published : 2016.03.31

Abstract

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

Keywords

References

  1. Senel AC, Altintas NY, Senel FC, Pampu A, Tosun E, Ungor C, et al. Evaluation of sedation in oral and maxillofacial surgery in ambulatory patients: Failure and complications. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 592-6. https://doi.org/10.1016/j.oooo.2012.03.008
  2. Rodrigo C. Patient-controlled sedation. Anesth Prog 1998; 45: 117-26.
  3. Ustun Y, Gunduz M, Erdogan O, Benlidayi ME. Dexmedetomidine versus midazolam in outpatient third molar surgery. J Oral Maxillofac Surg 2006; 64: 1353-8. https://doi.org/10.1016/j.joms.2006.05.020
  4. Davies JG, Wilson KI, Clements AL. A joint approach to treating dental phobia: A re-evaluation of a collaboration between community dental services and specialist psychotherapy services ten years on. Br Dent J 2011; 211: 159-62. https://doi.org/10.1038/sj.bdj.2011.674
  5. Sbaraglia P. Sedation or general anaesthesia requirements. A literature review of dental phobia. Ont Dent 1997; 74: 19-22.
  6. Korean Society for Intravenous Anesthesia. Sedation. Edited by. Seoul Eui-hak Publishing & Printing Co. 2004.
  7. Rudkin GE, Osborne GA, Curtis NJ. Intra-operative patient-controlled sedation. Anaesthesia 1991; 46: 90-2. https://doi.org/10.1111/j.1365-2044.1991.tb09345.x
  8. Osborne GA, Rudkin GE, Curtis NJ, Vickers D, Craker AJ. Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with anaesthetistadministered midazolam and fentanyl. Anaesthesia 1991; 46: 553-6. https://doi.org/10.1111/j.1365-2044.1991.tb09654.x
  9. Oei-Lim VL, Kalkman CJ, Makkes PC, Ooms WG. Patientcontrolled versus anesthesiologist-controlled conscious sedation with propofol for dental treatment in anxious patients. Anesth Analg 1998; 86: 967-72. https://doi.org/10.1213/00000539-199805000-00010
  10. Lok IH, Chan MT, Chan DL, Cheung LP, Haines CJ, Yuen PM. A prospective randomized trial comparing patient-controlled sedation using propofol and alfentanil and physician-administered sedation using diazepam and pethidine during transvaginal ultrasound-guided oocyte retrieval. Hum Reprod 2002; 17: 2101-6. https://doi.org/10.1093/humrep/17.8.2101
  11. Rudkin GE, Osborne GA, Finn BP, Jarvis DA, Vickers D. Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with patient-controlled midazolam. Anaesthesia 1992; 47: 376-81. https://doi.org/10.1111/j.1365-2044.1992.tb02216.x
  12. Garip H, Gurkan Y, Toker K, Goker K. A comparison of midazolam and midazolam with remifentanil for patient-controlled sedation during operations on third molars. Br J Oral Maxillofac Surg 2007; 45: 212-6. https://doi.org/10.1016/j.bjoms.2006.06.002
  13. Chlan LL, Weinert CR, Skaar DJ, Tracy MF. Patientcontrolled sedation: A novel approach to sedation management for mechanically ventilated patients. Chest 2010; 138: 1045-53. https://doi.org/10.1378/chest.09-2615
  14. Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs 2000; 59: 263-8. https://doi.org/10.2165/00003495-200059020-00012
  15. Lawrence CJ, Prinzen FW, deLange S. The effect of dexmedetomidine on the balance of myocardial energy requirement and oxygen supply and demand. Anesthesia and Analgesia 1996; 82: 544-50.
  16. Chrysostomou C, Schmitt CG. Dexmedetomidine: sedation, analgesia and beyond. Expert Opin Drug Metab Toxicol. 2008; 4:619-27. https://doi.org/10.1517/17425255.4.5.619
  17. Belleville JP, Ward DS, Bloor BC, Maze M. Effects of intravenous dexmedetomidine in humans 1. Sedation, ventilation, and metabolic-rate. Anesthesiology 1992; 77: 1125-33. https://doi.org/10.1097/00000542-199212000-00013
  18. Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs. 2000; 59: 263-8. https://doi.org/10.2165/00003495-200059020-00012
  19. Fan TW, Ti LK, Islam I. Comparison of dexmedetomidine and midazolam for conscious sedation in dental surgery monitored by bispectral index. Br J Oral Maxillofac Surg 2013; 51: 428-33. https://doi.org/10.1016/j.bjoms.2012.08.013
  20. Lee S, Kim BH, Lim K, Stalker D, Wisemandle W, Shin SG, et al. Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in healthy korean subjects. J Clin Pharm Ther 2012; 37: 698-703. https://doi.org/10.1111/j.1365-2710.2012.01357.x

Cited by

  1. Smart syringe pumps for drug infusion during dental intravenous sedation vol.16, pp.3, 2016, https://doi.org/10.17245/jdapm.2016.16.3.165
  2. Anesthetic management for simultaneous drug-induced sleep endoscopy and maxillomandibular advancement in a patient with obstructive sleep apnea vol.17, pp.1, 2017, https://doi.org/10.17245/jdapm.2017.17.1.71
  3. Dexmedetomidine versus other sedatives for non-painful pediatric examinations: A systematic review and meta-analysis of randomized controlled trials vol.62, pp.None, 2016, https://doi.org/10.1016/j.jclinane.2020.109736