Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제42권3호
  • /
  • Pages.162-165
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  • 2016
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
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Oral surgery under local anesthesia with dexmedetomidine sedation in a morbidly obese patient with aortic dissection

  • Seto, Mika (Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University) ;
  • Matsuda, Michitaka (Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University) ;
  • Narihira, Kyoichi (Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University) ;
  • Kikuta, Toshihiro (Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University)
  • 투고 : 2015.11.18
  • 심사 : 2016.01.15
  • 발행 : 2016.06.30
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초록

We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

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참고문헌

  1. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/ STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010;121:e266-369. https://doi.org/10.1161/CIR.0b013e3181d4739e
  2. Hagl C, Khaladj N, Peterss S, Bonz A, Pichlmaier M, Haverich A, et al. Treatment of acute aortic dissection type A (AADA): technical considerations. Vasa 2010;39:212-8. https://doi.org/10.1024/0301-1526/a000032
  3. Cormack JR, Orme RM, Costello TG. The role of alpha2-agonists in neurosurgery. J Clin Neurosci 2005;12:375-8. https://doi.org/10.1016/j.jocn.2004.06.008
  4. Paris A, Tonner PH. Dexmedetomidine in anaesthesia. Curr Opin Anaesthesiol 2005;18:412-8. https://doi.org/10.1097/01.aco.0000174958.05383.d5
  5. Lands AM. The pharmacological activity of epinephrine and related dihydroxyphenylalkylamines. Pharmacol Rev 1949;1:279-309.
  6. Montazem A. Antibiotic prophylaxis in dentistry. Mt Sinai J Med 1998;65:388-92.
  7. Michel PL, Acar J. Native cardiac disease predisposing to infective endocarditis. Eur Heart J 1995;16 Suppl B:2-6.

피인용 문헌

  1. Perioperative intervention by oral medicine team in cardiovascular surgery patients vol.67, pp.2, 2016, https://doi.org/10.1007/s11748-018-1020-0
  2. Conscious sedation service for geriatric and special-care dentistry: A health policy brief vol.29, pp.2, 2020, https://doi.org/10.1177/2010105820903762