scholarly journals Use of the Microcuff® During General Anesthesia for Patients With Scoliosis

2020 ◽  
Vol 67 (1) ◽  
pp. 23-27
Author(s):  
Toshiyuki Kishimoto ◽  
Shintaro Hayashi ◽  
Yasunori Nakanishi ◽  
Takashi Goto ◽  
Kensuke Kosugi ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Neck Extension ◽  
Restorative Treatment ◽  
Anesthetic Considerations ◽  
Bronchial Intubation ◽  
Respiratory Conditions

Scoliosis may often be associated with a variety of cardiovascular and respiratory conditions or diseases, and depending on the severity of the spinal deformity, it may also complicate anesthetic management because of the difficulty of neck extension and tracheal deformity. Therefore, patients with scoliosis may require careful perioperative anesthetic considerations. A 14-year-old girl was scheduled to undergo extractions and restorative treatment for dental caries under general anesthesia. Her medical history was significant for intellectual disability and autism as well as previously undiagnosed scoliosis. After fixation of a 6.0 Portex® endotracheal tube (ETT), percutaneous oxygen saturation (SpO2) decreased to 93%, peak airway pressures increased, and unilateral lung ventilation was noted. Inadvertent mainstem bronchial intubation was immediately suspected, prompting removal of the Portex ETT and reintubation with a shorter 6.0 Microcuff® ETT. The dental treatment was completed successfully without further incident. Assessment of the ETTs used intraoperatively led to the determination that the distance from the glottis to the carina was considerably shorter than normal for this patient. It was speculated that the Microcuff ETT may be optimal for anesthetic management of scoliosis patients because of its shorter lengths compared with other style ETTs, which may reduce the risk of bronchial intubation in such cases.

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 Special Care Dentistry in a Patient with Prader–Willi Syndrome through the Use of Atraumatic Restorative Treatment under General Anesthesia

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Caio Vinícius Gonçalves Roman-Torres ◽  
Sérgio Takashi Kussaba ◽  
Yasmin Comoti Vita Bantim ◽  
Roberta de Barros Antunes Almeida de Oliveira
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Atraumatic Restorative Treatment ◽  
Prader Willi Syndrome ◽  
Genetic Origin ◽  
Restorative Treatment ◽  
Single Section ◽  
History Of ◽  
Grade Ii

Prader–Willi syndrome described in 1956 has a genetic origin, affecting both genders, varying in presence and intensity from individual to individual. A precocious diagnosis, before the manifestation of symptoms, has brought some improvement in the quality of life of the carriers in the last years. The objective of this case report was to describe the treatment realized in a 3-year-old boy who presented grade II obesity, difficulty of locomotion, hypotonia, and history of cardiopathy. A dental treatment under general anesthesia was defined, allowing an oral adequation in a single section, in which it was planned the extraction of the element 74 and atraumatic restorative treatment (ART) technique in the other teeth. The precocious intervention in this 3-year-old patient by the therapy realized with ART under general anesthesia was done with success, avoiding unnecessary extractions, preserving dental elements, and maintaining the oral cavity in adequate function.

scholarly journals Ventilation via Cut Nasotracheal Tube During General Anesthesia

2013 ◽  
Vol 60 (1) ◽  
pp. 11-14
Author(s):  
Yoshinao Asahi ◽  
Shiro Omichi ◽  
Seita Adachi ◽  
Hajime Kagamiuchi ◽  
Junichiro Kotani
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Invasive Technique ◽  
Mask Ventilation ◽  
Neck Flexion ◽  
Neck Extension ◽  
Dental Patients ◽  
Nasotracheal Tube ◽  
Effective Ventilation ◽  
A Prospective Study

Abstract Many patients with disabilities need recurrent dental treatment under general anesthesia because of high caries prevalence and the nature of dental treatment. We evaluated the use of a nasal device as a possible substitute for flexible laryngeal mask airway to reduce the risk of unexpected failure accompanying intubation; we succeeded in ventilating the lungs with a cut nasotracheal tube (CNT) with its tip placed in the pharynx. We hypothesized that this technique would be useful during dental treatment under general anesthesia and investigated its usefulness as part of a minimally invasive technique. A prospective study was designed using general anesthesia in 37 dental patients with disabilities such as intellectual impairment, autism, and cerebral palsy. CNT ventilation was compared with mask ventilation with the patient in 3 positions: the neck in flexion, horizontal position, and in extension. The effect of mouth gags was also recorded during CNT ventilation. The percentages of cases with effective ventilation were similar for the 2 techniques in the neck extension and horizontal positions (89.2–97.3%). However, CNT ventilation was significantly more effective than mask ventilation in the neck flexion position (94.6 vs 45.9%; P < .0001). Mouth gags slightly reduced the rate of effective ventilation in the neck flexion position. Most dental treatments involving minor oral surgeries were performed using mouth gags during CNT ventilation. CNT ventilation was shown to be superior to mask ventilation and is useful during dental treatment under general anesthesia.

scholarly journals Repeated General Anesthesia in a Patient With Noonan Syndrome

2015 ◽  
Vol 62 (2) ◽  
pp. 71-73 ◽  
Author(s):  
Yoshinao Asahi ◽  
Ryosuke Fujii ◽  
Naoko Usui ◽  
Hajime Kagamiuchi ◽  
Shiro Omichi ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Noonan Syndrome ◽  
Congenital Heart ◽  
Dental Treatment ◽  
Heart Diseases ◽  
Anesthetic Management ◽  
Nasotracheal Intubation ◽  
Suction Catheter ◽  
Congenital Heart Diseases ◽  
Autosomal Dominant Disorder

Abstract Noonan syndrome (NS) is an autosomal dominant disorder characterized by facial anomalies, short stature, chest deformity, congenital heart diseases, and other comorbidities. The challenges faced during anesthetic management of patients with NS could be due to congenital heart diseases, hemostatic disorders, and airway anomalies. Here we describe dental treatment under general anesthesia performed for a 28-year-old man with NS. He had characteristic features of NS along with mild pulmonary valve stenosis. Dental treatment under general anesthesia was performed successfully on 13 occasions with nasotracheal intubation under curve-tipped suction catheter guidance or insertion of a reinforced laryngeal mask airway. This case suggests that for patients with NS, who might present several challenges, dental anesthesiologists should consider the extent of the patient's disorders to enable them to perform dental treatment safely under general anesthesia.

scholarly journals Anesthetic Management by Laryngeal Mask Airway in a Patient With a History of Difficult Intubation Resulting in Dental Injuries

2015 ◽  
Vol 62 (1) ◽  
pp. 20-21 ◽  
Author(s):  
Yoshinao Asahi ◽  
Ryosuke Fujii ◽  
Naoko Usui ◽  
Hajime Kagamiuchi ◽  
Shiro Omichi ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Difficult Intubation ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Laryngeal Mask ◽  
Respiratory Problems ◽  
History Of ◽  
Disabled Patients ◽  
Dental Injuries

Abstract Disabled patients may face respiratory problems during general anesthesia because of head and neck anomalies. We describe a case of dental treatment under general anesthesia using a laryngeal mask airway in a disabled patient who faced difficulty in endotracheal intubation on several occasions, 5 of which resulted in dental injuries.

Comprehensive Dental Care of Pediatric Patients Treated Under General Anesthesia in a Hospital Setting in Saudia Arabia

2006 ◽  
Vol 7 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Manal Ibrahim Al-Malik ◽  
Maha Abdulla Al-Sarheed
Keyword(s):  
General Anesthesia ◽  
Dental Care ◽  
Behavior Management ◽  
Pediatric Patients ◽  
Dental Treatment ◽  
Hospital Setting ◽  
Oral Rehabilitation ◽  
Main Indication ◽  
Restorative Treatment ◽  
The Mean

Abstract The aims of this study were to determine the characteristics of patients and type of dental treatment carried out using dental general anesthesia (DGA) during two years in a following three year period. A total of 182 patients received treatment between 1999 and 2001. The mean age was 4.9 years. The main indication for DGA was behavior management problems. Complete oral rehabilitation including complex restorative treatment and extractions was provided under DGA at a single visit. Failure to return for recalls was common; 83% of patients returned for the post-operative recall but only 26% after a three year period. Most of the patients requiring further treatment accepted it in the dental chair. Only one patient received a second DGA during the three years following treatment. Citation Al-Malik MI, Al-Sarheed MA. Comprehensive Dental Care of Pediatric Patients Treated Under General Anesthesia in a Hospital Setting in Saudi Arabia. J Contemp Dent Pract 2006 February;(7)1:079-088.

Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis

2016 ◽  
Vol 17 (8) ◽  
pp. 675-678 ◽  
Author(s):  
Ravish Ahuja ◽  
Bhuvan Jyoti ◽  
Vinod Shewale ◽  
Shridhar Shetty ◽  
Santosh Kumar Subudhi
Keyword(s):  
Mental Retardation ◽  
Oral Health ◽  
General Anesthesia ◽  
Retrospective Analysis ◽  
Comparative Evaluation ◽  
Pediatric Patients ◽  
Dental Treatment ◽  
Study Groups ◽  
Age Group ◽  
Restorative Treatment

ABSTRACT Introduction Behavioral management of patients forms one of the foremost components of pediatric dental treatment. Some children readily cooperate with dental treatment, while others require general anesthesia as a part of treatment protocol for carrying out various dental procedures. Hence, we evaluated the pediatric patients with and without mental retardation, who underwent dental treatment under general anesthesia. Materials and methods The present study analyzed the record of 480 pediatric patients reporting in the department of pedodontics from 2008 to 2014. Analysis of the records of the patients who underwent dental treatment under general anesthesia was done and all the patients were divided into two study groups depending upon their mental level. For the purpose of evaluation, the patients were also grouped according to their age; 4 to 7 years, 8 to 12 years, and 13 to 18 years. Measurement of decayed, missing, and filled teeth and scores for both deciduous and permanent dentition was done before and after the commencement of the dental treatment. Chisquare test and independent t-test were used for evaluating the level of significance. Results While comparing the patients in the two groups, maximum number of patients is present in the age group of 13 to 18 years. While comparing the indices’ score between the two study groups in various age intervals, no statistically significant results were obtained. Restorative treatment and dental extractions were the most common dental treatments that were seen at a higher frequency in the intellectual disability study group. Conclusion In patients with mental retardation, a higher frequency of restorative treatment and extractions occurs as compared to healthy subjects of similar age group. Therefore, they require special attention regarding maintenance of their oral health. Clinical significance Special attention should be given for maintaining the oral health of patients with special health care needs as compared to their physically and mentally normal counterparts. How to cite this article Ahuja R, Jyoti B, Shewale V, Shetty S, Subudhi SK, Kaur M. Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis. J Contemp Dent Pract 2016;17(8):675-678.

scholarly journals Perioperative Management of a Patient With Cornelia de Lange Syndrome and Tetralogy of Fallot

2019 ◽  
Vol 66 (3) ◽  
pp. 159-161
Author(s):  
Atsushi Nakajima ◽  
Akira Ohshima ◽  
Haruhisa Fukayama ◽  
Tatsuki Kinoshita
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Tetralogy Of Fallot ◽  
Perioperative Management ◽  
Dental Treatment ◽  
Face Mask ◽  
Cornelia De Lange Syndrome ◽  
Difficult Airway Management ◽  
Restorative Treatment ◽  
Cornelia De Lange

This is a case report of a 21-year-old male patient with Cornelia de Lange syndrome (CdL) and unrepaired tetralogy of Fallot scheduled for dental treatment under general anesthesia. Anticipated dental care consisted of restorative treatment and extractions. Surgical correction of the patient's congenital cardiac abnormalities had not occurred by the time of dental treatment. As such, the developed anesthetic plan included the following goals: prevention of any anoxic episodes or spell and preparation for difficult airway management due to micrognathia secondary to CdL. To help ensure adequacy of oxygenation during induction, the normal anesthetic face mask was specially modified with a hole to permit use of the fiberoptic scope during induction and intubation. With preoperative consultation involving a cardiologist as well as the use of the modified mask, general anesthesia was safely administered without any complications.

scholarly journals Anesthetic Management of a Patient With a History of Rhabdomyolysis for Dental Treatment

2017 ◽  
Vol 64 (4) ◽  
pp. 251-252
Author(s):  
Hitomi Terasaki ◽  
Shinichi Ito
Keyword(s):  
Nitrous Oxide ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Fluid Management ◽  
Volatile Anesthetics ◽  
Electrolyte Balance ◽  
Rocuronium Bromide ◽  
History Of ◽  
Thiamylal Sodium

When general anesthesia is administered for patients considered at high risk for rhabdomyolysis, appropriate precautions are warranted. The use of suitable anesthetics, with attention to intravenous fluid management, electrolyte balance, respiration, and metabolism, should be addressed. We performed general anesthesia for dental treatment and biopsy for fibrous hyperplasia of the buccal mucosa in a patient with a history of rhabdomyolysis. We utilized thiamylal sodium, midazolam, rocuronium bromide, nitrous oxide, fentanyl, and remifentanil without using volatile anesthetics and propofol for this case. No complications of rhabdomyolysis were noted.

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