• 제목/요약/키워드: Dental anesthesiology

검색결과 448건 처리시간 0.026초

Nonsustained ventricular tachycardia during outpatient anesthesia: a case report

  • Kim, Keoungah;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권4호
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    • pp.363-367
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    • 2021
  • During the perioperative period, anesthesiologists frequently observe cardiac tachyarrhythmia. Ventricular tachycardia is very rare in non-cardiac surgeries. However, it can be fatal when it occurs. Therefore, anesthesiologists should be watchful so as to not to miss ventricular tachycardia and take the appropriate steps to manage it promptly. We present a case, with a review of related literature, in which a non-sustained ventricular tachycardia was observed in a patient who visited the hospital for dental treatment.

자폐증 환자의 행동조절을 위한 Midazolam Intranasal Spray 사용사례 (Use of Midazolam Intranasal Spray for Dental Treatment of Autism Patients)

  • 송영균;이숙영;김승오
    • 대한치과마취과학회지
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    • 제12권4호
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    • pp.223-227
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    • 2012
  • Autism patients in general have bad oral hygiene. It is hard for autism patients to get dental treatment as poor communication. Therefore, they may have to be treated by deep sedation or general anesthesia in numerous cases. However, this process requires induction with mask, so it is not easy to do for disobliging autism patient. Midazolam is a water-soluble benzodiazepine, has been used in pediatric dentistry or dentistry for the handicapped because of rapid onset. Midazolam can be administered through oral, rectal, intramuscular,intravenous, and intranasal (IN) routes. IN route of midazolam may be considered as effective way to allay for uncooperative autism patients before general anesthesia. In this case report, two autism patients required dental treatment. Intranasal spray of midazolam before general anesthesia was safe and effective procedure of behavioral management.

Perioperative airway management of a patient with Beckwith-Wiedemann syndrome

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권4호
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    • pp.313-316
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    • 2016
  • Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation. Preoperative assessment and preparations for difficult airway should be considered.

Anesthetic considerations for a pediatric patient with Wolf-Hirschhorn syndrome: a case report

  • Tsukamoto, Masanori;Yamanaka, Hitoshi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권3호
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    • pp.231-233
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    • 2017
  • Wolf-Hirschhorn syndrome is a rare hereditary disease that results from a 4p chromosome deletion. Patients with this syndrome are characterized by craniofacial dysgenesis, seizures, growth delay, intellectual disability, and congenital heart disease. Although several cases have been reported, very little information is available on anesthetic management for patients with Wolf-Hirschhorn syndrome. We encountered a case requiring anesthetic management for a 2-year-old girl with Wolf-Hirschhorn syndrome. The selection of an appropriately sized tracheal tube and maintaining intraoperatively stable hemodynamics might be critical problems for anesthetic management. In patients with short stature, the tracheal tube size may differ from what may be predicted based on age. The appropriate size ( internal diameter ) of tracheal tubes for children has been investigated. Congenital heart disease is frequently associated with Wolf-Hirschhorn syndrome. Depending on the degree and type of heart disease, careful monitoring of hemodynamics is important.

Impacted dental bridge in the esophagus following general anesthesia: A case report

  • Park, Jeong-Heon;Song, Jaegyok;Cho, Chaemin
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제19권2호
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    • pp.111-114
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    • 2019
  • A dental bridge impacted in the esophagus of a 43-year-old man was successfully removed using endoscopy, without any further complications. It is of utmost importance that the medical staff carefully assess the patient's dental condition, provide clear documentation, and notify the patient appropriately to prevent dental prosthesis-related complications and claims. Anesthesiologists also need to be more cautious in the perioperative period, even after extubation, because this complication may not be completely avoidable.

항경련제를 복용하고 있는 지적장애 환자의 외래전신마취 하 치과치료 후 합병증 발생 조사 연구 (Analysis of Complications of Ambulatory General Anesthesia after Discharge in Patients Who are Taking Anticonvulsant)

  • 차민주;서광석;김미선;김현정
    • 대한치과마취과학회지
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    • 제14권2호
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    • pp.95-100
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    • 2014
  • Background: About 60% of patients with epilepsy showed a variety of complications after returning home. The purpose of this study is to get further information and to help in the anesthetic management of the disable patients with epilepsy. Methods: After searching the outpatient anesthesia list of Seoul National University Dental Hospital clinic of the disabled from September 2010 to March 2012, we found total 83 patient cases who were taking antiepileptic drugs. A nurse of anethesiology department called to the patient's home after general anesthesia and got surveys with questionnaires form filled with complications at home. We enrolled total of 51 patients who agreed to participate this survey. And we also reviewed pre-anesthesia evaluation sheet, anesthesia record, and recovery and discharge record. Results: 11 of 51 (21.6%) patients had seizure convulsion at home within 1 weeks. 33.4% of patients who had at least once seizure attack per week had a seizure attack within 3 days. And 50% of once a month frequency patients had a seizure attack within 1 week. 33% of 1 - 3 seizure attacks per year patient group had a convulsion within 1 week. But there was no seizure attack within 1 week in whom had no seizure attack history during more than 1 year. Conclusions: After dental treatment, patient taking anticonvulsant have so many complications-especially seizure, more than we respected. We need more research about handle these problems.

Learning fiberoptic intubation for awake nasotracheal intubation

  • Kim, Hyuk;So, Eunsun;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권4호
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    • pp.297-305
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    • 2017
  • Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.

Use of ADMSTM during sedation for dental treatment of an intellectually disabled patient: a case report

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk;Yang, Martin;Chang, Juhea
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권3호
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    • pp.217-222
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    • 2016
  • Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

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

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권1호
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    • pp.55-59
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    • 2016
  • 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.

An anesthetic management of head and neck cancer reconstructive surgery in a patient having hemophilia A: a case report

  • Ryoo, Seung-Hwa;Kwon, Dohyun;Lee, Jong-Ho;Seo, Kwang-Suk;Kim, Hyun Jeong;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권3호
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    • pp.261-268
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    • 2021
  • Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.