scholarly journals Dexmedetomidine Infusion for Routine Dental Management of an ASA IV Patient: A Case Report

2017 ◽  
Vol 64 (2) ◽  
pp. 88-96 ◽  
Author(s):  
Andrew S. Young ◽  
Nicholas A. Russell ◽  
Joseph A. Giovannitti
Keyword(s):  
Case Report ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Functional Decline ◽  
Intravenous Sedation ◽  
Clinical Effects ◽  
Dental Management ◽  
Patients Experience ◽  
Dexmedetomidine Infusion ◽  
Caucasian Female

Anesthetic management of elderly patients requires numerous physiological considerations. With aging, degenerative changes occur in the structure and functional capacity of tissues and organs. Typically, these patients experience clinical effects with lower doses of medication. Important considerations for the geriatric populations following anesthesia include increased time to recovery and avoidance of functional decline. A case is reported in which an 83-year-old Caucasian female with a complex medical history presented for routine dental treatment under intravenous sedation via dexmedetomidine infusion.

scholarly journals Intravenous Sedation in Arnold-Chiari Malformation With Respiratory Failure

2019 ◽  
Vol 66 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Yoshiki Shionoya ◽  
Eishi Nakamura ◽  
Takahiro Goi ◽  
Kiminari Nakamura ◽  
Katsuhisa Sunada
Keyword(s):  
Respiratory Failure ◽  
Respiratory Depression ◽  
Chiari Malformation ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Cranial Nerves ◽  
Intravenous Sedation ◽  
Type Ii ◽  
Neck Extension ◽  
Arnold Chiari Malformation

Type II Arnold-Chiari malformation (ACM) is an abnormality in which the cerebellum, pons, and medulla oblongata are displaced downward into the spinal cord. Type II ACM is often complicated by respiratory depression, sleep-disordered breathing, and deglutition disorder as a result of medullary dysfunction and impairment of the lower cranial nerves. Bending and stretching of the neck is restricted, and anesthetic management is problematic in patients with the disorder. We performed dental treatment twice under intravenous sedation in a patient with intellectual disability with type II ACM complicated by hypercapnic respiratory failure. Propofol was used for the first sedation procedure. Repeated bouts of respiratory depression occurred on that occasion, so the airway was managed manually by lifting the jaw. However, aspiration pneumonitis occurred postoperatively. A combination of dexmedetomidine and midazolam was used for sedation on the second occasion, and the intervention was completed uneventfully without any respiratory depression. Our experience with this patient highlights the need for selection of an agent for intravenous sedation that does not require neck extension and has minimal effect on respiration in patients with type II ACM, who are at high risk of respiratory depression and pulmonary aspiration.

scholarly journals Anesthetic Management of a Patient With Hereditary Angioedema for Oral Surgery

2019 ◽  
Vol 66 (1) ◽  
pp. 30-32
Author(s):  
Rumiko Hosokawa ◽  
Masanori Tsukamoto ◽  
Saki Nagano ◽  
Takeshi Yokoyama
Keyword(s):  
Hereditary Angioedema ◽  
Tooth Extraction ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Anesthetic Management ◽  
Treatment Options ◽  
Third Molar ◽  
Intravenous Sedation ◽  
C1 Inhibitor ◽  
Impacted Third Molar

Hereditary angioedema (HAE) is a rare genetic disease that results from deficiency or dysfunction of C1 inhibitor (C1-INH). This disease is characterized by sudden attacks of angioedema. When edema occurs in the pharynx or larynx, it can lead to serious airway compromise, including death. Physical and/or psychological stress can trigger an attack. Dental treatment, including tooth extraction, is also a recognized trigger. We report a case of a 20-year-old male with HAE who required impacted third molar extractions. C1-INH concentrate was administered 1 hour before surgery, which was completed under deep intravenous sedation. This report describes the anesthetic management of a patient with HAE and reviews treatment options and concerns.

scholarly journals Dental Management of a Patient with Congenital Hypothyroidism: A Case Report

2016 ◽  
Vol 04 (02) ◽  
pp. 122-125
Author(s):  
Monisha Singhal ◽  
Nitin Singh ◽  
Anand Rohit ◽  
C. Chaudhary
Keyword(s):  
Case Report ◽  
Congenital Hypothyroidism ◽  
Dental Treatment ◽  
Neural System ◽  
Present Case Report ◽  
Pediatric Dentist ◽  
Dental Management ◽  
Child Patient ◽  
Oral Conditions

AbstractCongenital hypothyroidism (CHT) is one of the most common thyroid disorders. It occurs because of dysgenesis of thyroid gland which is responsible for the normal development of neural system. Child patient suffering from congenital hypothyroidism shows various medical and behavioral symptoms which makes routine dental care very challenging to the pediatric dentist. Due to increased awareness and introduction of neonatal screening, the long term hypothyroidism has become rare. The most significant oral conditions related to these patients are delayed eruption and dental caries. The present case report outlines the dental treatment of a 9yr old girl with congenital hypothyroidism.

scholarly journals Exploring Factors Influencing Complete Denture Management of Patient with Myasthenia Gravis

2020 ◽  
Vol 24 (2) ◽  
pp. 113-117
Author(s):  
Savvas Kamalakidis ◽  
Georgios Papaemmanouil ◽  
Vassiliki Anastassiadou
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Dental Treatment ◽  
Neuromuscular Disorder ◽  
Complete Denture ◽  
Treatment Protocols ◽  
Dental Management ◽  
Oral Symptoms ◽  
Natural Dentition ◽  
Neuromuscular Coordination

SummaryBackground/Aim: The purpose of this literature review and case report was to highlight the oral symptoms and the pathophysiology of Myasthenia Gravis (MG). MG is an autoimmune, antibody-mediated neuromuscular disorder. It is characterized by fluctuating fatigability and weakness affecting ocular, bulbar and (proximal) limb skeletal muscles.Case report: The case of an edentulous 72-year-old female patient with MG, and in need of removable prostheses was reported. The dental management of a complete denture wearer with MG required special attention and treatment protocols, as described in the present case report.Conclusions: Dental treatment, especially complete denture rehabilitation, of patients diagnosed with MG presents a challenge to the oral health care provider. Clinicians must be aware of the patients’ health status in order to preserve their natural dentition. Implant-supported overdentures must be the treatment of choice in cases of edentulism coupled with MG. In cases where a complete denture is the treatment option, the prosthesis should be placed in the zone of minimum conflict (neutral zone) for optimal neuromuscular coordination.

scholarly journals Anesthetic Management of a Patient With Citrullinemia Type I During Dental Treatment

2021 ◽  
Vol 68 (3) ◽  
pp. 158-162
Author(s):  
Makiko Shibuya ◽  
Rie Iwamoto ◽  
Yukifumi Kimura ◽  
Nobuhito Kamekura DDS ◽  
Toshiaki Fujisawa
Keyword(s):  
Dental Treatment ◽  
Genetic Disorder ◽  
Anesthetic Management ◽  
Third Molar ◽  
Intravenous Sedation ◽  
Type I ◽  
Oral Medications ◽  
Gag Reflex ◽  
Serum Ammonia ◽  
Citrullinemia Type I

We report a case involving intravenous sedation for third molar extractions in a 32-year-old man with citrullinemia type I (CTLN1), a genetic disorder that affects the urea cycle. The patient was diagnosed with CTLN1 after he exhibited seizures soon after birth and was intellectually disabled because of persistent hyperammonemia, although his recent serum ammonia levels were fairly well controlled. We planned to minimize his preoperative fasting, continue his routine oral medications, and monitor his serum ammonia levels at least twice. Sedation with midazolam and a propofol infusion was planned to suppress his gag reflex and reduce protein hypercatabolism due to stress. Epinephrine-containing local anesthetics, which enhance protein catabolism, were avoided, replaced by plain lidocaine for blocks and prilocaine with felypressin for infiltration anesthesia. No significant elevation in ammonia levels was observed. In patients with CTLN1, sedation can be useful for preventing hyperammonemia. Patients who develop symptomatic hyperammonemia may require urgent/emergent treatment involving other medical specialists. Therefore, preoperative endocrinology consultation, perioperative monitoring of serum ammonia levels, and preemptively coordinating for appropriate care in the event hyperammonemia occurs should all be considered.

scholarly journals Anesthetic management of a patient with Freeman-Sheldon syndrome undergoing oral surgery: A case report

2021 ◽  
Author(s):  
Aiji Sato (Boku) ◽  
Yoshiki Sento ◽  
Tatsuya Hasegawa ◽  
Kosuke Tsutsumi ◽  
Yuji Kamimura ◽  
...  
Keyword(s):  
Case Report ◽  
Local Anesthesia ◽  
Oral Surgery ◽  
Anesthetic Management ◽  
Facial Features ◽  
Intravenous Sedation ◽  
Joint Contractures ◽  
Skeletal Malformations ◽  
Hands And Feet

Freeman-Sheldon syndrome (FSS) is characterized by multiple joint contractures, characteristic facial features, such as microtia, defects of the hands and feet, such as clubfoot, and skeletal malformations. This report illustrates the case of a patient with FSS who was managed under local anesthesia with intravenous sedation for oral surgery.

scholarly journals Platelet and blood transfusion in a child with dyskeratosis congenita for dental extraction – a case report

RSBO ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. 116 ◽  
Author(s):  
Sayali Mali ◽  
P. Keerthi Kundana ◽  
Sunita Singh ◽  
Sinika Khanchandani ◽  
Milind S. Tullu ◽  
...  
Keyword(s):  
Case Report ◽  
Dental Treatment ◽  
Bone Marrow Failure ◽  
Skin Pigmentation ◽  
Blood Parameters ◽  
Dyskeratosis Congenita ◽  
Bone Marrow Failure Syndromes ◽  
White Spots ◽  
Dental Management ◽  
Overall Health Status

Introduction and Objective: Dyskeratosis congenita (DC) also known as Zinsser-Engman- Cole Syndrome is a rare inherited disorder with a prevalence of less than one per million. Zinsser et al. described an inherited variant of ectodermal dysplasia that affected skin, nails and mucous membranes in early 1900s.The syndrome eventually came to be known as DC and is classified as one of the inherited bone marrow failure syndromes (IBMFS). DC is the association of three clinical features: dystrophic nails, oral leukoplakia (white spots on the tongue and oral mucosa) and abnormal skin pigmentation. Case report and Conclusion: This case report describes a dental management of a case of DC. Fluctuating vital and blood parameters and deteriorating overall health status were major challenges delivering dental treatment. Dental extractions of this patient were done while maintaining blood parameters by blood and platelet transfusion.

scholarly journals Anesthetic management of a child with methylmalonic acidemia for lens aspiration – a case report

2020 ◽  
Vol 24 (2) ◽  
pp. 237-238
Author(s):  
Anwar Ul Huda ◽  
Mohammad Yasir
Keyword(s):  
Case Report ◽  
Anesthetic Management ◽  
Failure To Thrive ◽  
Methylmalonic Acidemia ◽  
Main Concern ◽  
Clinical Effects ◽  
Protein Catabolism ◽  
Precipitating Factors

We report a case of a child with methylmalonic acidemia who presented to our hospital for lens aspiration surgery. Methylmalonic acidemia is an inherited disorder of protein catabolism. Its clinical effects can vary from mild to severe, and include lethargy, vomiting, hypotonia, hypothermia, failure to thrive and encephalopathy. The main concern in treatment of these patients is prevention of academia by identifying precipitating factors. It is especially important to acutely manage fluids and electrolytes before, during and after surgery.

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